I saw a quote on Instagram today from someone with ADHD. he said, “To be honest, I have to put things like ‘shower’ and ‘iron my shirt’ on my to-do list”. The word ‘ADHD’ brings to mind the image of a child/person who is always on the go and fairly scattered all over. But is that what ADHD really is?
Does your child whizz around the house like a perpetually-charged motor? Is he/she always in a hurry for everything? Do you find it impossible to put him/her to bed, no matter what time it is? Then it could be time to get him/her assessed for ADHD.
What is ADHD?
ADHD or Attention Deficit Hyperactivity Disorder, is a persistent pattern of hyperactivity (excessive movement, restlessness, fidgetiness, destruction of property), inattention (inability to focus) and/or impulsivity (inability to practice restraint) that is more than expected for a child at that age and level of development. It falls under the category of neurodevelopmental disorders which means its root cause lies in the neurological setup of the brain and it is usually detected in the developmental years (below 18 years).
ADHD in children
Infants with ADHD are very active in the crib, sleep little, and cry a lot. They are also less likely to restrict their activity levels in environments that are socially limiting. In school, they are quick to begin a task but don’t stay on it for more than a few minutes. They find it difficult to wait for their turn. They can be short-tempered or easily irritable. At home, it is very difficult to contain them. They can easily be moved to laughter or tears. They are also incapable of delaying gratification. Due to a lack of attention, they find it hard to memorize things. They are usually happy-go-lucky energetic children who are quite friendly. Unless there are other behavioral problems or a coexisting Oppositional Defiant Disorder (in which children defy any instructions given to them and are generally retaliatory), children with ADHD are easy to get along with.
ADHD in adults
Adults with ADHD are those people who missed their diagnosis in childhood. Have you ever come across a colleague who is forgetful and disorganised? He/She could be someone who seems restless all the time and gets distracted at the slightest stimulus. Most likely he is an adult with ADHD. The signs of adult ADHD include impulsivity and attention deficit (difficulty in organising and completing work, inability to concentrate, increased distractibility, sudden decision making without thought of consequences). The aimless restlessness of childhood ADHD manifests as purposeful restlessness in adulthood; meaning, they know what they have to do but they just can’t focus on it! These people can usually perform well only at active jobs. To be diagnosed with adult ADHD, there should be impairment in at least two domains out of work, social life, home life.
ADHD in pregnancy
A word needs to be mentioned about ADHD during pregnancy. There is no scientific evidence to suggest that ADHD surfaces in pregnancy. It might have been diagnosed in adulthood and continues during pregnancy. However, there is plenty of research that has studied the impact of ADHD medication (psychostimulants) on fetal growth. Some correlation has been found between the consumption of ADHD medication during pregnancy and some birth defects, but the number of studies with this finding is very small. The benefits of ADHD medication far outweigh the miniscule risks presented by their use during pregnancy, so if you’re thinking about getting pregnant but worried about the impact of the meds you’re taking, you can take a deep breath and a have a conversation with your doctor, it’s going to be alright!
Causes of ADHD
Now you know what ADHD looks like, but what causes ADHD? Why does it happen? If you or your child have just been diagnosed with ADHD, you’re probably looking for an answer to ‘Why did it happen?’ Let’s try and list all the possible reasons for ADHD, but know that even if you find a cause that makes sense in your case, it was not your fault!
- A strong genetic component has been found for ADHD through research. If a parent or sibling has been diagnosed with ADHD, it is likely that you might have it too.
- An interesting finding of research literature suggests that September is the peak month for births of ADHD children probably because of prenatal exposure to winter infection during the first trimester!
- Neurologically, possible brain damage in the fetal or perinatal stage associated with circulatory, toxic, metabolic, mechanical, or physical damage to the brain caused by infection, inflammation or trauma has been found to be a cause for ADHD.
- Our brain has chemicals that help in its functioning just like hormones in the rest of the body. The ADHD medication works on the neurotransmitters dopamine and norepinephrine, so it has been hypothesized that an imbalance of any of these neurotransmitters could result in ADHD symptoms.
- Children experience growth spurts in stages – 3-10 months, 2-4 years, 6-8 years, 10-12 years and 14-16 years. A maturational delay in brain development during growth spurts can lead to ADHD
- Sometimes the areas of the brain regulating inhibition are not functioning properly due to lower blood flow or metabolic rate and this can cause ADHD symptoms.
- Psychosocial stressors like emotional deprivation, stressful events, anxiety, family dysfunction can exacerbate ADHD symptoms.
- It has been theorized that the chemicals used in processed food in a modern diet can have a role to play in making children restless and fidgety.
Symptoms of ADHD
If you want to be sure whether someone you suspect has ADHD or not, here is the complete list of symptoms according to the types of ADHD:
- Often fails to give close attention to details or makes careless mistakes in schoolwork, work, or during other activities (e.g. overlooks or misses details, work is inaccurate).
- Often has difficulty sustaining attention in tasks or play activities (e.g., has difficulty remaining focused during lectures, conversations, or lengthy reading).
- Often does not seem to listen when spoken to directly (e.g., the mind seems elsewhere, even in the absence of any obvious distraction).
- Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., starts tasks but quickly loses focus and is easily sidetracked).
- Often has difficulty organizing tasks and activities (e.g., difficulty managing sequential tasks; difficulty keeping materials and belongings in order; messy, disorganized work; has poor time management; fails to meet deadlines).
- Often avoids or is reluctant to engage in tasks that require sustained mental effort (e.g. schoolwork or homework; for older adolescents and adults, preparing reports, completing forms, reviewing lengthy papers).
- Often loses things necessary for tasks or activities (e.g., school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).
- Often easily distracted by extraneous stimuli (e.g., for older adolescents and adults may include unrelated thoughts).
- Often forgetful in daily activities (e.g., doing chores, running errands; for older adolescents and adults, returning calls, paying bills, keeping appointments).
- Often fidgets with or taps hands or squirms in seat.
- Often leaves a seat in situations when remaining seated is expected (e.g., leaves his or her place in the classroom, in the office or other workplace, or in other situations that require remaining in place).
- Often runs about or climbs in situations where it is inappropriate (e.g., in adolescents or adults, may be limited to feeling restless).
- Often unable to play or engage in leisure activities quietly;
- Often “on the go” acting as if “driven by a motor” (e.g., is unable to be or uncomfortable being still for an extended time, as in restaurants, meetings; may be experienced by others as being restless or difficult to keep up with).
- Often talks excessively;
- Often blurts out answers before questions have been completed (e.g., completes people’s sentences; cannot wait for turn in conversation).
- Often has difficulty awaiting turn (e.g., while waiting in line).
- Often interrupts or intrudes on others (e.g. butts into conversations, games, or activities. may start using other people’s things without asking or receiving permission; for adolescents and adults, may intrude into or take over what others are doing).
Ways to deal with ADHD
“I’ve been diagnosed with ADHD!” or “My child has been diagnosed with ADHD!”. Now what? There is absolutely no need to panic. ADHD is a very manageable condition if you know the right tricks. With the right support and the right ways to channelize that restless energy, you can handle ADHD like a pro!
First of all, if you or your child have been diagnosed by a psychiatrist or psychologist, they will suggest medication to start with. No, that medication will not form a habit! The medicines for ADHD fall under a category called psychostimulants which help to kick-start the malfunctioning neurotransmitters in the brain and they work wonderfully! If it is your child that has been diagnosed, you can pay a visit to a developmental pediatrician or a child psychologist for a second opinion and for professional tips on how to be the best support for your child. They can suggest ways to modify your home environment and simple exercises to enhance focus. They might also suggest dietary changes that will help with attention and activity levels.
Besides professional help, here are some things you can try on your own to help with the ADHD symptoms.
- The best antidote for ADHD restlessness is physical activity! Whether a child or an adult, channelizing the bubbling physical energy into a sport or athletic pursuit is the healthiest way to dissipate it. Enroll for a sports coaching or a martial art class, or find an outdoor space that allows for a lot of running around and watch the calming effect!
- Engage in short-focus exercises to gradually increase focus and attention span. One very popular one among both adults and kids is to sort coins from a jar. Collect coins in a jar and then sort them into piles based on denomination, size, ascending or descending order. You could even try naming as many items as you can remember from particular categories like ‘red foods’, ‘ice cream flavors I’ve tried’, ‘dog breeds’, ‘car models’ etc.
- No matter what task you take up (or your child takes up), ensure that there are frequent breaks. People with ADHD cannot stay at a task for more than a few minutes at a go so it is important to take frequent breaks. However, ensure that no distraction elements from the break remain in the task area so when focusing on the task is easier.
- One of the most scientifically effective techniques to shape behavior in children with ADHD is behavior modification with reinforcement. This means that you employ a series of strategies coupled with well-timed rewards that mold the behavior in the desired way. For example, giving a reward token for staying at a task for half an hour without distraction or not losing anything from the school bag consecutively for three days. When a certain number of reward tokens have been collected, they can be redeemed for something that is pleasing to the child. When applied consistently and in a timely fashion, this technique is very effective in teaching long-lasting discipline to children. The only thing you need to remember is to not use objects like candy, chocolates or toys as rewards because they will soon lose their rewarding potential and they don’t add value to the child’s repertoire.
- Children and adults suffering from ADHD have nothing wrong with their IQ level and they need intellectual stimulation as much as anyone else. In fact, relevant intellectual stimulation helps to keep their engagement levels high and enhances their focus capacity. Jigsaw puzzles, strategy games, Spot the Difference are some examples of activities that work best for such stimulation! Try to avoid videos and apps for this purpose, no matter how beneficial they claim to be. The biggest enemy of ADHD is a flickering gadget screen!
ADHD does not mean that you or your child are disabled for life. It means that you have been granted more energy than people your age and all you need to figure out is how to tame that energy so it works in your favor and not against you. Medication helps to give you that extra-biological support to lift your spirits and you need to make it your ally. Remember, knowledge is power and once you arm yourself with the right facts about ADHD, it’s not so confusing anymore!
ADHD stands for Attention Deficit Hyperactivity Disorder. It is classified under neurodevelopmental disorders, that is to say, that it is a neurological condition that appears in the developmental years of a child.
ADHD can be caused by any sort of damage to the brain in the fetal (in the womb) or perinatal (right after birth) stage. This damage can be due to exposure to toxins or infections, blocks in circulation, injury or trauma and impaired metabolism.
There are certain common symptoms of ADHD like:
-Restlessness or fidgetiness
-Inability to focus on tasks
-Feeling disorganized all the time
-Inability to concentrate
-Losing things often
-Urge to interrupt and speaking before the other has finished
-Inability to wait for turns
If there is a persistent pattern of these symptoms, one should visit a psychologist for a complete ADHD assessment and a formal diagnosis can be made.
People who have a blood relative with ADHD are at an increased risk for ADHD. also, those whose mothers have been exposed to infections or trauma (physical or psychological) during pregnancy or have a history of substance abuse are also at greater risk.
No, it is not on the same spectrum as autism. Autism falls under Pervasive Developmental disorders, which means that autism spectrum disorders affect almost all aspects of development like social skills, learning, and behavior. ADHD falls under neurodevelopmental disorders which affects the way the brain grows and develops.
Yes, ADHD is a psychiatric condition that requires clinical attention. The treatment is straightforward and manageable with medicines and behavioral strategies.
Legally, by itself, ADHD is not considered a disability liable for benefits but along with ADHD, a lot of times learning disabilities co-exist which are applicable for benefits.
Yes, there is a strong genetic component in ADHD. Twin and family studies have found irrefutable evidence that ADHD is more prevalent among blood relatives.
ADHD presents itself in the form of restlessness, disorganization, forgetfulness, inability to focus on or complete tasks and impulsivity in the form of inability to wait for turns, interrupting while speaking and an inability to delay gratification.
ADHD can cause frustration to an individual because despite their best efforts they find themselves unable to focus or perform optimally. For children, this can lead to an unfavorable response from their teacher and this, in turn, can lead to low self-esteem or fear. ADHD by itself does not impair the learning process or social skills of a child, but due to social responses and their experiences with other people, it can cause psychological problems.
A qualified clinical psychologist, psychiatrist or developmental pediatrician can make a clinical diagnosis of ADHD.
Yes, very much. With the right pharmacological management and behavioral strategies focused on enhancing attention and fostering memory, a child with ADHD can be trained to live a normal life. There have been many successful people who have conquered ADHD to achieve success in personal and professional lives!
To help your child with ADHD you can visit a child psychologist to first educate yourself about the condition and to dispel any myths. A psychologist can also teach you behavioral strategies to increase the attention span and focus of your child. At home, you can treat the child with unconditional love and patience and recognize that he is not ‘lazy’ or ‘stupid’ but has a genuine invisible condition that is making him act this way. So you will need to gently steer his development in a way that highlights his strengths and strengthens his not-so-strong aspects. You can enhance attention by indulging in games and puzzles; you can limit screen time; you can involve him in sports activities to dissipate the extra energy and you can reward him for the patience that will reduce his impulsivity. To-do lists can also be your best friend in ensuring that your child stays on track!