symptoms of adhd

Understanding ADHD: Symptoms, Causes, and Treatment

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ADHD is an acronym for attention-deficit/hyperactivity disorder. It is a chronic underdevelopment condition characterized by persistent patterns of inattention, hyperactivity, and impulsivity that impair day-to-day functioning.

ADHD symptoms arise in early childhood, often becoming apparent around ages 3-6 as children enter school. However, ADHD frequently persists into the teen years and adulthood. It is estimated to affect around 9.4% of children and 4.4% of adults in the United States.

Main Symptoms of ADHD

The primary characteristics of ADHD include:

  • Inattention – difficulty sustaining focus on tasks, forgetfulness, disorganization, losing items, avoidance of mentally demanding work
  • Hyperactivity – excessive movement, fidgeting, restlessness, constant talking
  • Impulsivity – hasty actions without forethought, poor self-control, emotional volatility

These symptoms impede success with school, jobs, relationships, and everyday responsibilities.

Hyperactivity

ADHD Sub-types

There are three main ADHD sub-types:

Predominantly Inattentive: Exhibits inattention without significant hyperactivity. May seem absent-minded, forgetful, or constantly “in their own world”.

Predominantly Hyperactive/Impulsive: Displays hyperactivity and impulsiveness without severe inattention. Characterized by constant motion and interrupt behaviors.

Combined Type: Exhibits both inattentive and hyperactive-impulsive symptoms equally. The most common sub type, combining poor focus with restless energy.

Causes and Risk Factors

Genetic Factors

ADHD strongly runs in families, indicating a hereditary component. If one’s biological parent has ADHD, the odds of also having it range from 30-55%. The exact genes involved remain under investigation.

Neurological Factors

Imbalances in brain chemicals and impairments in the frontal cortex region governing inhibition are possible neurological contributors. Brain imaging reveals ADHD brains differ in structure, connectivity, and maturation compared to neurotical peers.

Environmental Factors

Premature birth, prenatal smoking/drinking, lead exposure, childhood head injuries, and psychosocial adversity may potentially increase ADHD risk to varying degrees. However, genetics appear to play the primary causal role.

ADHD in Children

Recognizing and Treating ADHD in Children

As a psychiatrist with over 25 years of experience treating mental health conditions in children and adolescents, one of the most common disorders I assess and manage is attention-deficit/hyperactivity disorder (ADHD). My goal is to educate parents on identifying possible ADHD, getting a proper diagnosis, and accessing evidence-based treatments to help children thrive.

Recognizing ADHD Symptoms in Children

I believe in the importance of thorough and accurate diagnosis when it comes to ADHD. In my practice, diagnosing ADHD involves a comprehensive evaluation that encompasses various aspects of an individual’s life. This evaluation is conducted through the following steps:

Clinical Assessment: One of the initial steps is to conduct a detailed clinical assessment, where I review the individual’s symptoms and medical history. This process helps me gather essential information about the individual’s behavior patterns and any underlying medical conditions that may contribute to their symptoms.

The first step is recognizing when inattentiveness, hyperactivity, and impulsivity may be indicative of ADHD rather than normal childhood behavior.

Warning signs to look out for include:

Inattention and Forgetfulness

  • Difficulty paying attention during play, conversations, or reading time
  • Forgetting chores or tasks quickly and needing frequent reminders
  • Avoidance of activities requiring focus like homework or hobbies
  • Frequently misplacing or losing needed items like toys, books, or clothing

Fidgeting and Restlessness

  • Constant fidgeting, squirming, excessive talking or unnecessary movement
  • An inability to sit still for meals or car rides compared to peers
  • Difficulty remaining seated in classrooms or at their desk for long
  • A sense of perpetual motion and restless energy

Poor Focus and Organization

  • Quickly losing interest in toys or games and becoming distracted
  • Having messy bedrooms, desks, or backpacks despite reminders
  • Difficulty finishing tasks or projects once started

Impatience and Emotional Dysregulation

  • Displays of frustration, irritability, or mood swings that seem excessive
  • Outbursts or tantrums that occur frequently and intensely
  • Interrupting conversations or difficulty awaiting their turn

Impulsiveness

  • Acting recklessly or rashly without thinking such as running into streets
  • Difficulty following instructions fully before acting
  • Saying words without considering feelings of others

If several of these behaviors persist beyond the age of 6-7, formal assessment for ADHD is advisable. While all children can occasionally be restless or distracted, consistent, impairing inattention, hyperactivity and impulsiveness may indicate ADHD.

Impact of ADHD on Childhood Development

When left unaddressed, the symptoms of ADHD can negatively impact multiple facets of children’s development, including:

Education

  • Struggling academically and earning lower grades
  • Missing more school days due to incomplete work or behavioral issues
  • Repeatedly having homework issues or failing assignments
  • Increased conflict with teachers due to classroom behaviors

Social Skills

  • Difficulty making and keeping friends due to restlessness or impulsiveness
  • Trouble learning age-appropriate social interaction norms
  • Higher risk of peer rejection or stigma due to perceived “misbehavior”

Behavior

  • Classroom disruptions affecting their own and others’ learning
  • Frequent conflicts with parents, teachers or other authority figures
  • Public tantrums, emotional meltdowns, or oppositional behaviors

Activities

  • Difficulty participating and remaining engaged in sports, clubs, lessons or hobbies requiring sustained focus
  • Giving up activities quickly when initial interest fades

Safety

  • Increased rates of physical injuries due to recklessness and thrill-seeking
  • Wandering or running away from parents or teachers
  • Doing things without regard for danger due to impulsiveness

Getting children needed support requires first recognizing these potential ADHD impacts across settings.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the criteria for diagnosing ADHD are based on persistent patterns of inattention, hyperactivity, or impulsivity that significantly impair functioning across different settings. As outlined in the DSM-5, these criteria serve as a guideline for identifying individuals who may be struggling with ADHD.

By adhering to these diagnostic criteria and conducting a thorough evaluation, I can provide an accurate diagnosis and develop a personalized treatment plan that addresses the individual’s unique needs. My goal as a psychiatrist is to support individuals with ADHD and empower them to lead fulfilling lives despite the challenges they may face.

Evidence-Based ADHD Treatment Options for Children

If thorough assessment confirms an ADHD diagnosis, evidence-based treatment recommendations include:

Behavioral Therapy

  • Cognitive behavioral therapy focused on directly improving organization, social, and emotional regulation skills
  • Building routines at home using checklists, timers, and rewards for task completion
  • Parent training for providing structured direction and responding effectively to behaviors

Classroom Accommodations

  • Allowing movement breaks, fidget devices, or alternative flexible seating
  • Reducing unnecessary distractions and noise
  • Adjusting teaching methods and assignments to enhance engagement
  • Providing written instructions, outlines, or visual guidance

Medications

  • Stimulants like methamphetamine (Ritalin) and amphetamines (Adderall) are commonly prescribed and effective for many, but should not be the only intervention used
  • Proper medication management helps improve focus and reduces hyperactivity
  • Monitoring for side effects and using the lowest effective dose is important

ADHD Parent Education

  • Parent support groups allow sharing experiences and techniques
  • Evidence-based parenting programs teach effective behavioral strategies
  • Guidance on creating structure while supporting child emotional needs
  • Training for schools on inclusive, multi-modal supports

Combining multiple modalities (medication, therapy, school support, parenting approaches) produces the best outcomes long-term for children with ADHD. No single solution succeeds alone.

As an experienced child psychiatrist, I partner closely with parents, teachers and pediatricians to develop individualized treatment plans that set children up for success academically, socially and behaviorally.

Creating Consistent Home Routines

In addition to formal interventions, establishing predictable daily routines and structure at home helps provide stability that ADHD children thrive within. Recommendations include:

Visual Schedules

  • Post visual schedules depicting daily activities, transitions, chores, etc.
  • Review daily and weekly schedules together
  • Use clocks, timers, and alarms to note schedule start/end times

Organizational Habits

  • Make regular cleanup part of routines
  • Have set places to store books, toys, clothes
  • Use checklists and calendars to track homework, activities

Praise and Rewards

  • Notice and praise positive behaviors more than criticizing
  • Use point systems, rewards, privileges for completing tasks/chores
  • Celebrate successes and effort, not just end results

Preparing Transitions

  • Give 5/10 minute warnings before activity changes
  • Explain transitions and expectations in advance
  • Play music, sing songs or use fidgets to bridge transitions

Consistency and Patience

  • Enforce rules and consequences consistently
  • Respond with empathy during emotional moments
  • Allow time for instructions to be followed
  • Model apologizing after any overreactions

With compassion, teamwork and daily practice, parents and children build the skills and self-confidence needed to manage ADHD successfully long-term.

ADHD in Adults

Adult ADHD Symptoms

In adults, ADHD may manifest as:

  • Disorganization – messy home, chronic lateness, poor time management
  • Job/school under-performance – missed deadlines, careless errors
  • Impulsiveness – overspending, substance misuse, emotional outbursts
  • Inattention – misplacing items, forgetfulness, mind wandering
  • Restlessness – boredom, excessive talking, inability to relax
  • Low motivation and task avoidance

Symptoms often moderate with age but still significantly impair functioning.

Obtaining an Adult ADHD Diagnosis

Seeking evaluation from a psychiatrist, psychologist or specialist is key. A clinical interview, symptom questionnaires, neuropsychological testing, and psycho social history aid diagnosis. Input from family helps corroborate onset before age 12.

Around 60% of childhood ADHD cases persist into adulthood. However, adult ADHD also occurs without prior childhood diagnosis.

Treatment Strategies for Adults

In my experience as Psychiatrist In Lahore (FCPS in psychiatry) the Recommended adult ADHD treatment options include:

  • Cognitive behavioral therapy (CBT) – addresses unhelpful thought/behavior patterns
  • Medications – stimulants like amphetamines (Adderall) and methylphenidate (Ritalin) are first-line
  • ADHD coaching – teaches organizational and productivity skills
  • Mindfulness training and relaxation techniques
  • Psychosocial support groups – connect with other adults living with ADHD

Consistency and combinations of approaches are most beneficial.

Living with ADHD

Educational and Learning Strategies

For students with ADHD, helpful tactics include:

  • Preferential classroom seating near the teacher, windows, or quiet areas
  • Noise-cancelling headphones to reduce distractions
  • Visual supports like colors, diagrams, outlines and schedules
  • Movement and sensory tools like exercise balls or fidget devices
  • Short frequent breaks for physical activity or relaxation techniques
  • Reduced workload and extended time allowances on assignments/assessments
  • Tutoring and executive functioning coaching

These evidence-based approaches aim to bolster focus and minimize classroom struggles.

Lifestyle Changes and Coping Skills

In daily life, recommended ADHD management skills involve:

  • Establishing structure through planners, reminders, calendars and routines
  • Removing distractions and cluttering surroundings
  • Promoting sleep hygiene and balanced nutrition
  • Incorporating physical exercise and time outdoors
  • Practicing mindfulness, meditation and breathing exercises
  • Developing strategies like talking aloud, note taking or alarms as cognitive aids
  • Pursuing passions and tapping strengths
  • Allowing sensory outlets through music, tactile tools, or nature
  • Building a circle of understanding support and accountability

Combining professional treatment with adaptive lifestyle modifications enables thriving with ADHD.

In summary, as an experienced psychiatrist, I want assure that ADHD is highly treatable. Using evidence-based multi-modal interventions combined with parenting education and lifestyle adaptations enables the majority of children with ADHD to thrive socially, emotionally and academically. My goal is to support families through this process. Please reach out if I can be of any assistance on your journey.

Key Takeaways

  • ADHD is a neurodevelopmental disorder involving inattention, hyperactivity, and impulsiveness.
  • Both children and adults are affected, with genetics playing a major causal role.
  • Multi-modal professional treatment combined with lifestyle adaptations enables managing symptoms successfully.
  • Education strategies, skills coaching, community support and daily self-care are key for living well with ADHD.
  • While not curable, ADHD is highly treatable allowing those impacted to thrive.

My thoughts about ADHD

What is ADHD?

ADHD stands for attention-deficit/hyperactivity disorder, a chronic neurodevelopmental condition characterized by ongoing inattention, hyperactive behavior, and impulsiveness. It arises in childhood and frequently persists into adulthood.

What causes ADHD?

The exact causes are not fully known, but genetics are believed to play a major role, as ADHD strongly runs in families. Imbalances in brain chemicals and impaired functioning in brain regions governing inhibition may also contribute to ADHD.

What is ADHD disease?

ADHD is classified as a neurodevelopmental psychiatric disorder, rather than a disease. It involves differences in brain structure and functioning leading to impaired executive functioning skills like focus, working memory, organization, and self-control. Both biological and environmental factors likely interact in ADHD.

What is ADHD in adults?

At least 60% of childhood ADHD continues into adulthood. Adult ADHD also includes cases without childhood diagnosis. Symptoms present as disorganization, restlessness, under-performance at work/school, emotional regulations, and poor time management. Obtaining an evaluation leads to effective treatment.

How to not procrastinate with ADHD?

Strategies to reduce procrastination with ADHD include breaking large tasks into smaller steps, setting phone alarms for reminders, using productivity apps to stay on track, minimizing distractions in your workspace, scheduling rewards after tasks are complete, and being accountable to others.

How to study when you have ADHD?

Tips for studying with ADHD include studying in quiet isolated spaces, using noise-cancelling headphones, breaking material into 15-30 minute intervals with breaks, writing summaries and outlines, utilizing study apps and tools, chewing gum for increased focus, scheduling study sessions ahead of time, and having an accountability partner or tutor.

Can educational psychologist diagnose ADHD?

Typically no, an educational psychologist cannot formally diagnose ADHD. They can identify academic struggles and suspected symptoms, but referral to a clinical psychologist, psychiatrist, pediatrician or neurologist is required for an official diagnostic evaluation and ADHD confirmation. Multidisciplinary assessments are ideal.

How can I help my child with ADHD?

Helping a child with ADHD involves classroom accommodations, being responsive but firm with discipline, establishing structure/routines, minimizing distractions, being patient, focusing on positive behaviors, allowing movement outlets, teaching organizational skills, promoting their strengths, and working collaboratively with teachers and doctors.

How to handle a child with ADHD?

Best practices for handling a child with ADHD include remaining calm, using brief clear instructions, establishing predictable schedules/rules, allowing movement breaks, reducing noise/distractions, breaking tasks into manageable steps, having them repeat directions, writing reminders, teaching coping strategies, and collaborating with the child’s teachers and treatment team.

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