How To Understand Your Attention Deficit Hyperactivity Disorder (ADHD) Diagnosis
According to Harvard Medical School, Attention Deficit/Hyperactivity Disorder (ADHD) affects as many 1 in 10 children in the United States and 4-5% of U.S adults have also received a diagnosis of ADHD – that’s over 9 million adults in the United States alone.
It also runs in families. Children whose parents have ADHD have a 40% – 60% chance of also having ADHD. Sometimes a child’s diagnosis can be the first clue that a parent may have ADHD.
If left untreated, ADHD can cause significant problems in school, in the workplace, at home and in relationships.
Here, (among many other things), we will be sharing the symptoms and diagnosis procedure, along with potential treatment options available and online tests for anyone who has, or suspects they may have ADHD.
What is ADHD?
Attention deficit hyperactivity disorder is a condition that includes symptoms such as inattentiveness, hyperactivity and impulsiveness.
It’s a medical condition that affects a person’s self-control and ability to pay attention and is defined as ‘A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development’.
Let’s look at the 3 main aspects of the condition:
- Wandering off task
- Easily distracted
- Trouble maintaining focus
- Poor time management
- Lacks persistence
- Hasty, poor thought out actions
- Requires immediate reward or gratification
- Interrupts others without thinking
- Socially intrusive
- May overreact to situations
- Children will struggle with turn-taking
- Excessive moving when not required/appropriate
- Extreme restlessness/activity
- Excessive fidgeting
- Struggle to engage in quiet or slow activities
- Excessive talking
It’s important to keep in mind that often these issues are not due to a lack of comprehension or a desire to be defiant, but due to an inability to prevent themselves from behaving this way in their daily life.
Being asked to ‘concentrate more’ or ‘try harder’ will have no positive effect on the behaviour of someone with ADHD.
Table of Contents
Symptoms of ADHD
Before looking at ADHD symptoms, it’s important to bear in mind that other mental health conditions can cause similar symptoms, such as conduct disorder, learning disorders, anxiety disorders, and depression; so receiving an accurate diagnosis from a psychiatrist or psychologist who has experience in diagnosing ADHD, is vital before starting any ADHD medication or treatment.
Symptoms of attention deficit hyperactivity disorder (ADHD) include a short attention span, constantly fidgeting and acting without thinking.
There are 3 different types of ADHD:
- Predominantly hyperactive/impulsive presentation
- Will move regularly and avoid being seated
- ‘Fidgety’ behaviour with feet and hands
- Disengages/avoids quiet activities
- Interrupt people
- Struggles to take turns
- Excessive talking
- Children – constant running/climbing
- Adults – persistent restlessness
2. Predominantly inattentive presentation
- Struggle/difficulty with organization
- Often seems disengaged/appears not to be listening
- Makes seemingly careless mistakes
- Dislike’s tasks/jobs that require sustained mental focus
- Distracted easily
- Overlooks smaller details
- Poor organizational skills
- Loses belongings
3. Combined presentation
- individuals meet the criteria for inattention and hyperactive-impulsive presentation
Symptoms of ADHD in Children
Harvard Health Publishing have released the following:
Most children with ADHD have a combination of inattention, impulsivity, and hyperactivity and would be diagnosed with ADHD-combined presentation.
Other children who struggle most with hyperactivity and impulsivity would get the diagnosis of ADHD-hyperactive/impulsive presentation.
A third group has predominantly problems with attention. While you often will hear these children described as ADD (attention deficit disorder), the correct term is ADHD-predominantly inattentive presentation. Girls tend to have inattentive symptoms more than boys.
Potential Causes of ADHD
According to GPonline.com:
“The precise causes of ADHD are unknown. Research has indicated that ADHD is ‘highly heritable’, but the responsible genes have not been identified.
Research has also demonstrated that children and young people who have recieved an ADHD diagnosis have common neurobiological problems and deficits.
ADHD affects the brain, making it difficult for children to control their behaviour. Poorly controlled ADHD can have a calamitous effect on the lives of the patient, their family and friends.
ADHD is related to the frontal lobe of the brain working more slowly, research suggests this may be because children with ADHD have a shortage of certain neurotransmitters, believed to be dopamine and noradrenaline. This deficit means the frontal lobe cannot react and respond to information appropriately.”
ADHD is commonly diagnosed in children between the ages of 6 and 12.
Due to many of the symptoms, it can be hard to diagnose young children, as often a child’s behaviour can be very active and erratic at this age regardless, even with no underlying issues, but in certain circumstances, a diagnosis will be made in pre-school aged children.
Often, for adult ADHD diagnosis several of the symptoms must have been present prior to age 12.
A central question that will be looked at when forming an ADHD diagnosis for any individual – “Are the symptoms causing significant impairment in 2 key settings of the individuals life?’
Examples of these could be:
- Job loss
- Relationship conflict/breakdown
- Financial trouble
- Impulsive spending
- Academic discipline
- Behaviours resulting in physical conflict at school
- Significant barrier to learning
- Inability to interact with family members
ADHD Diagnostic Criteria
To see if someone meets the ADHD diagnosis criteria, is a multi-staged process.
The first step to seeking treatment will be to book an appointment for the individual with a specialist.
They will then be evaluated by medical health professionals, such as a family doctor, psychologist, psychiatrist, or pediatrician.
An accurate and thorough diagnosis can be complex and include a number of stages, including a clinical review, a medical history review, and a ‘rating scale’ that can be completed by close family/teachers/colleagues.
A medical examination may also e carried out to rule out any underlying health issues that may be triggering certain behaviours.
Some of the questions asked in Child ADHD Evaluation:
- Can they complete tasks?
- Do they daydream regularly?
- Is the family always looking for things the child has lost?
- Can they concentrate on difficult, boring things?
- Are they easily distracted?
- Are they constantly on the go?
- Do they often shout things out before thinking?
- How do they cope with last-minute change in plans?
- Can they sit still in lessons or at mealtimes?
When an ADHD diagnosis is made in adulthood, there can often be a sense of relief that an explanation has been found for difficulties that have been faced for so long. There may also be resentment that the diagnosis was not made sooner.
ADHD Treatment Plan
Attention deficit hyperactivity disorder can often be treated with medicines and talking therapies.
According to the Royal College of Psychiatrists – “As with any other medication, clinicians will need to conduct a risk– benefit analysis and discuss this with the patient before recommending pharmacological treatment, incorporating the specific risks associated with stimulant use.”
Before determining the suitable treatment plan for a patient, the qualified medical professional should consider factors such as:
- Symptom severity
- Heart rate
- Blood pressure
- Sleeping pattern
ADHD treatments can also aggravate other medical conditions such as seizures and tics, so any history of these conditions should be disclosed before starting any medication.
Medication can help children and adults with ADHD.
Some studies have shown that 1 in 5 children can experience no benefit from ADHD medication, while some children who do benefit can find the side effects so disruptive that the discontinue their medication.
Medication is recommended as the first-line treatment for ADHD in adults with moderate to severe symptoms.
ADHD Drug treatments can be classified into 2 categories:
1. Stimulant Medication (e.g. methylphenidate, Adderall or dexamphetamine)
Stimulant medicines are an effective treatment and have an immediate action, meaning they can be balanced to the individual’s needs more quickly.
- Methylphenidate is often the first line treatment for ADHD in adults. It’s an (NDRI), or antidepressant medication, similar to those that are used by people with anxiety disorders.
A typical starting dose could be 5mg once or twice each day, potentially increasing to three times daily (15mg) after a week.
Substance abuse/misuse of methylphenidate is more common in stimulant drugs, than in non-stimulant medication.
2. Non-Stimulant Medication (e.g. atomoxetine, clonidine, bupropion)
Non-stimulants have a delayed onset of action, similar to that of antidepressants.
- Atomoxetine is often used when individuals are intolerant or unresponsive to stimulant treatments and requires less ‘fine-tuning’ of dose that stimulant medications require.
ADHD Medication Side effects
Side effects can sometimes be avoided by a gradual increase of dosage, but there can be some potentially serious side effects:
- Sleep Problems
- Loss of appetite
- Mood swings
- Suicidal thoughts or actions
- Heart problems
- Low self esteem
- High blood pressure
Importance of the Right Medication
Finding the right medication with your healthcare provider will have a huge impact on how the child or adult functions each day with their ADHD, in all types of social situations, making it a hugely important aspect to get right.
Informing the child’s teacher, or adults speaking with their employer, is a highly recommended step to ensure the support is in place to help those who have been diagnosed and are medicating.
5 Alternative Treatments for ADHD
If the thought of medication for you or your child is something you would like to avoid if possible, there are some alternative options that can help manage some of the symptoms associated with ADHD diagnosis and one of them might just be the best way forward for you…
- Behavioural Therapy
According to the American Academy of Pediatrics – “Behavior therapy usually is implemented by training parents in specific techniques that improve their abilities to modify and shape their child’s behavior”.
- Positive Reinforcement
- Behavioral Parent Training (BPT)
- Behavioral Classroom management
- Behavioral Peer Interventions (BPI)
- Yoga, Tai Chi and Meditation
Some smaller studies have shown that Yoga and meditation can support those with ADHD as a complementary therapy.
Reductions in hyperactivity and anxiety were all reported to improve significantly following a series of regular attendances.
- Avoiding Potential Allergens
A diet that restricts possible allergens can help behaviour in some cases. Chemical-based additives and preservatives such as BHT and BHA, found in chewing gum, potato chips, butter and cereal.
- Avoid Food Colorings and Preservatives
Sodium Benzoate found in fruit juices, carbonated drinks and salad dressings can increase hyperactive behaviour in children, while a wide range of food colorings can also contribute to associated symptoms
- The Great Outdoors
Natural, outdoor settings have proven to benefit children with ADHD, improving concentration.
Several studies have shown that green spaces and regular time outdoors is a wholly natural treatment that can help those with ADHD.
Untreated ADHD in Children, Teenagers and Adults
If you suspect yourself or your child has ADHD, it’s important that you seek professional help and support.
If you have already been diagnosed with ADHD, finding the right treatment for you will be important for any future quality of life.
Untreated ADHD can cause problems throughout life, in education, work and relationships.
Untreated ADHD during Childhood
- Struggle to control their emotions
- Social problems – turn taking / playing well / sharing
- Overreacting to situations
- Trouble making/keeping friends
- Low self-esteem/ depression
- Impulsive behavior, resulting in physical injury
Untreated ADHD as Teenager
- Likely already low attainment at school in previous years
- Inability to ‘catch up’ and improve grades
- Struggle making friends
- Negative effect on relationships
- Eating disorders more common in teenage females with untreated ADHD
- Accidents while driving
- Lead to additional dangerous activities – Alcohol / drugs / smoking
- Increased likelihood of car accidents / Gambling problems / Legal incidents
Untreated ADHD in Adults
- Employment problems
- Poorly organized
- Bad relationships with co-workers
- Higher rates of divorce among adults with untreated ADHD
- Inability to achieve deadlines
- Highly emotional / reactive
- Depression/ low self-esteem
More information and Further Reading
Whether seeking support for those in early childhood, young adults or adults, attention-deficit hyperactivity disorder presents everyone with their own unique set of challenges.
By laying out some of the facts, medication and holistic options, it is our hope that you feel slightly more confident in identifying the best way forward for you or your loved one.
Clinical Partners provide a free online test for adults, to see if they are displaying symptoms of ADHD.
A self-rating scale for adult ADHD diagnosis is also available at psychology-tools.com.
The American Academy of Pediatrics contains a wealth of in-depth knowledge.