Some of the brightest people on the planet suffer from attention deficit hyperactivity disorder. A 9-year old may struggle to complete ordinary homework but get the top grades in his class on creative projects. The smartest guy in the room at a thriving corporation may seem forever unable to meet deadlines or get any work done.
ADHD affects young and old alike, but the problem almost always becomes apparent in childhood. It is marked by inability to focus, impulsivity and hyperactivity. Depending on the person, these symptoms manifest themselves in different ways.
Most Common Symptoms
It’s important to remember that everybody has a hard time focusing now and then. Loss of sleep, stress at work or emotional upsets can preoccupy someone for days. When the following symptoms persist for more than six weeks, however, it’s probably time to consult a doctor:
Inattention
- Inability to complete tasks or jumping from one activity to another
- Difficulty sustaining attention for homework, reading a book or watching a movie
- Carelessness
- Messiness and disorganization
- Forgetfulness
- Tardiness or missing appointments
- Frequently losing things
- Difficulty listening, staying on topic or following a conversation
- Overreacting to noises or minor events, such a pencil falling to the floor, that others wouldn’t notice or would ignore
- Not behaving as most others would in social situations
Hyperactivity
- Talking too much or too loudly
- Fidgeting
- Inability to stay seated or sit still
- Excessive movement at inappropriate times
- Making noises at inappropriate times
- A constant need to be physically active
- Difficulty sleeping
Impulsivity
- Interrupting or blurting out an answer before a question is fully asked
- Prematurely reacting to things
- Bothering others who are trying to concentrate or get their work done
- Lack of self-control
- Sudden, destructive behavior such as tearing up another child’s artwork
In severe, untreated cases of ADHD, there is sometimes loss of interest in friendships, work, sports or favorite hobbies. Children may be ostracized by their classmates. Parents might avoid inviting them to sleepovers and birthday parties. In adults, ADHD can affect job performance, household management and personal relationships.
Diagnosis
There is help for ADHD, but it’s difficult to diagnose. There’s nothing so simple as blood test or X-ray for it. A caregiver can only make an educated guess by observing behaviors and symptoms. The criteria for diagnosis are as follows:
- The symptoms interfere with the subject’s ability to function normally.
- The symptoms have persisted for at least six months in at least two different environmental settings. If your child seems to have it all together at home but not at school, the problem is more likely to be related to trouble at school than to ADHD.
- The symptoms are not typical for a person of that age. For example, the latest Disney movie usually holds a first grader’s attention. The average American teenager never forgets where he keeps his allowance. The average 40-year old hasn’t locked himself out of the house in years.
Only trained professionals – physicians, pediatricians, psychologists, psychiatrists or counselors – are qualified to make the diagnosis. It is based on a standardized rating scale after an evaluation is completed by an adult patient or a child’s parents and teacher. Teachers aren’t allowed to diagnose ADHD, but they may report the behaviors they’ve observed and advise you to take your child to the pediatrician or another provider. Some students qualify for special accommodations or services at school.
Treatments
There is medication for ADHD, but more and more parents are turning first to behavioral therapy. Not only has it been shown to reduce disruptive or annoying behaviors, but it teaches parents and children to work together to manage symptoms. Even siblings can attend therapy sessions, and the family bond is strengthened. Researchers see improvement in children’s behavior and concentration. They express their feelings more appropriately. Moms and dads have a chance to hone their parenting skills while getting closer to their children. Behavioral therapy is most effective if it’s begun immediately following diagnosis.
If parents do decide to medicate, their child should be observed even more closely. This calls for frequent communication with the school counselor, school nurse, teacher and doctor. Sometimes it takes several tries to get the dosage just right.
Since there’s no real scientific method to it, ADHD is easy to misdiagnose. Some kids are simply more active or learn differently. One of the easiest ways to detect a misdiagnosis is to try the medication. If it seems not to make any difference at all, the problem is not ADHD.
As with all drugs, medicines used to treat ADHD are not without risks. They are amphetamines, and even scientists are not really sure why they work.
Many adults and children do quite well on them and appreciate the increased focus, calmness and ability to get things done. Most prescriptions nowadays are timed-release pills that eliminate the need for children to visit the school nurse during the day.
Potential risk factors include the following:
- Foggy thinking
- Subdued personality
- Insomnia
- Irritability
- Stomachaches, nausea or diarrhea
- Loss of appetite
- Mood swings
- Acne in teens or adults
- Loss of libido in teens or adults
Most patients who stick to the correct dosage are safe taking the pills and have few problems. The objection to medicating has more to with a sharp increase in the number of diagnoses over the last several years. There simply hasn’t been time to study the drugs’ effects on children long-term. There is also great potential for abuse. People who don’t have ADHD or a prescription for Adderall, say, can get the drugs fairly easily. Friends give or sell their pills to classmates, especially on college campuses.
Deciding whether or not to manage ADHD with drugs is a difficult and personal decision for any patient or parent. Again, medication shouldn’t take the place of proven treatments like counseling and behavioral therapy. Small lifestyle changes also make a remarkable difference. Avoiding sugar and caffeine, eating healthy foods, getting plenty of exercise and going to bed on time are recommended for all ages.
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