October is ADHD Awareness Month. Let us take this opportunity to improve our understanding of this condition. Attention-deficit hyperactivity disorder (ADHD) is a syndrome of inattention, hyperactivity and impulsivity. In the past it used to be called ADD or Attention Deficit Disorder. One does not have to be hyperactive to have ADHD. Some have difficulty with focusing attention but are not hyperactive. It is common, affecting 5 to 12% of children and 2.5% of adults worldwide. It is more common in boys than in girls. This distinction is less remarkable in adulthood.
ADHD can seriously impair the quality of life. Children can develop academic and social difficulties, impulsive and aggressive behaviors, anxiety and depression, and possibly other psychological problems. In adults, ADHD can result in frequent job changes, marital difficulties, difficulty with schedules and money management, driving accidents, legal issues, self-esteem issues, and depression. They have difficulties with attention span, trouble completing tasks – especially those that are difficult or boring, difficulty organizing tasks, forgetfulness, losing/misplacing things, and fidgetiness. Not all symptoms are seen in every individual with ADHD.
Not every child or adult who has difficulty with attention span, hyperactivity, or impulsivity suffers from ADHD. A careful and thorough evaluation is needed to determine if the person suffers from ADHD or if there is another explanation for the symptoms. Such evaluation can be conducted by a psychiatrist, preferably a child psychiatrist if the individual is a minor, or other professionals like pediatricians and neurologists who have experience with or specialize in ADHD.
Once an accurate diagnosis is made, treatment should be pursued. Treatment can help prevent potential complications and consequences. This consists of medications and psychotherapy, especially CBT and behavioral strategies. Becoming informed and educated about the condition is critical for all involved to have a successful treatment outcome. Although most children can function in regular classroom settings, some require an Individual Educational Plan (IEP) and a special class or resource room. School counselors can assist with these. Many good self-help books are also available.
Many different kinds of medications are available for the treatment of ADHD. These include amphetamine, methylphenidate, atomoxetine, guanfacine, and clonidine. Some are stimulants and have addiction potential. These pharmacologic drugs are available as tablets, capsules, liquid formulations, and patches. There might be other medications that are not approved by FDA but may help. Information can be obtained from the treating physician. It is important to have a team comprised of the individual with symptoms, physician, teachers, nurses at school, other care givers, and any other medical professional involved, to ensure effective individualized care.
We know that ADHD can last a long time and it may get better with age in some. However, the lasting impact on the individual and caregivers can be challenging. But there is hope. Treatments are effective and can help prevent potential struggles and dysfuntion.
by Kalyani Deshpande, M.D., Board Certified Adult, and Child and Adolescent Psychiatrist
Image by Christopher Ott on Unsplash