In recent years, flippantly saying “I have ADHD” has become a common way to apologize or explain away an inability to focus on the task at hand. However, attention-deficit/hyperactivity disorder (ADHD) is more than just a buzzword spouted by overzealous multitaskers. ADHD is an actual medical diagnosis for someone with trouble maintaining attention, managing energy levels, and controlling impulses.
A 2020-2021 survey conducted by the National Survey of Children’s Health estimated that 5,768,613 children between the ages of 3 and 17 had an attention deficit disorder and over 3 million of those children’s attention deficit disorder was rated “moderate or severe.” And according to the National Institute of Mental Health, the number of children diagnosed with ADHD has steadily increased since 2003.
ADHD is commonly diagnosed in childhood; however, the symptoms can continue through adolescence and into adulthood. Untreated ADHD in childhood can not only lead to adverse effects on long-term academic performance, but it can also be harmful to a person’s individual social relationships and work performance. ADHD is particularly difficult to diagnose in adults because for symptoms to be considered ADHD, they must have started before the age of 12. That means an adult must create a timeline of the symptoms for the healthcare provider to diagnose ADHD properly.
While professing one has ADHD may have manifested into a tongue-in-cheek catchphrase, there is much more to ADHD than an inability to focus. Equally important, it should not be dismissed or discounted as merely children misbehaving, as that perpetuates stigmas and stereotypes. The condition is somewhat nuanced and can have many effects on a person’s daily activities and relationships if not correctly diagnosed and treated. To help eliminate the ambiguity surrounding ADHD and shed light on the actual struggles and hardships those plagued with ADHD face, we wanted to take the time to explore topics like the condition’s causes, symptoms, misconceptions, treatment options, and more.
Different Types of ADHD
ADHD can present itself in different ways in different people. ADHD has been defined to encompass both ongoing inattentive and hyperactive behaviors that interfere with a person’s development or functioning.
There are three main classifications for ADHD: Inattentiveness, hyperactivity, and impulsivity. A person with inattentive characteristics of ADHD exhibits an inability to or difficulty paying attention, staying on task, and focusing. Hyperactivity refers to a person having too much or excessive energy that causes fidgeting, an inability to sit still, or excessive talking. Impulsivity refers to a person with difficulty controlling impulsive behavior or acting without thinking about the consequences. While at least one presentation must be present for an ADHD diagnosis, a person can have a combined type of ADHD when two or more aspects of the criteria are met. The presentations may change over time or differ based on the person’s situation.
Causes of ADHD
Like other common neurobehavioral disorders, there is not a reported definitive cause for ADHD in either children or adults. Some research has shown that ADHD has a “strong neurobiological basis” and that heredity and genetics are the most significant contributing factors to ADHD. There is also some evidence of “anatomical differences” in the brains of children with ADHD compared to children without the condition.
While experts have not been able to determine a causal link between an ADHD diagnosis in one person rather than another, ongoing studies are attempting to determine if there are non-genetic contributing risk factors, such as brain injuries, nutrition, and social environments that may raise a person’s risk of developing ADHD. Ongoing studies also look into other potential causes, such as “difficulties during pregnancy, prenatal exposure to alcohol and tobacco, premature delivery, significantly low birth weight, excessively high body lead levels, and postnatal injury to the prefrontal regions of the brain.”
Although researchers are unsure of the exact causes of ADHD, there have been some widely cited theories that research has debunked, such as that ADHD is caused by “eating too much sugar, watching too much television, parenting, or social and environmental factors such as poverty or family chaos.” Still, we should point out that these factors may aggravate a person’s ADHD symptoms, though further research should be completed to determine any definitive connection.
Despite being unable to pinpoint the specific cause of ADHD, research has shown some notable trends and consistencies in who gets diagnosed with ADHD. For example, ADHD is more commonly diagnosed in males than females. Additionally, females are less likely to have symptoms of hyperactivity and more likely to have primarily inattentiveness.
Signs and Symptoms of ADHD
While ADHD is a cognitive disorder affecting adults and children alike, it may manifest in slightly different signs and symptoms. Moreover, many psychological and biological problems may present symptoms similar to ADHD.
Common signs of ADHD in children may include:
- Difficulty getting along with other children
- Taking unnecessary risks
- Making careless mistakes
- Having difficulty resisting temptation
- Forgetting or losing things easily
- Excessive daydreaming or inattentiveness
- Inability to sit still without squirming or fidgeting
Signs of ADHD in adults differ slightly in both how they manifest and the significant effects it may have in one or more areas of their life. Adults with ADHD often experience problems at work or in their careers because of their brain’s inability to prioritize and manage thoughts and actions.
ADHD can also affect personal relationships and cause persistent feelings of frustration and guilt. For adults with ADHD, some of the most common problems include:
- “Inconsistent performance in jobs or careers; losing or quitting jobs frequently
- History of academic or career underachievement
- Poor ability to manage day-to-day responsibilities, such as completing household chores, maintenance tasks, paying bills, or organizing things
- Relationship problems due to not completing tasks
- Forgetting important things or getting easily upset over minor things
- Chronic stress and worry due to failure to accomplish goals and meet responsibilities
- Chronic and intense feelings of frustration, guilt, or blame.”
Whether ADHD is afflicting a child or an adult, the symptoms can interfere with a person’s everyday activities and relationships. Discussing symptoms with a mental health professional is the first step toward receiving an ADHD diagnosis, enabling the person to seek the appropriate treatment to overcome it.
While many are guilty of self-diagnosing themselves with ADHD, a mental health expert would need to formally diagnose a person so that the person struggling with ADHD can learn to manage the disorder and stop symptoms from interfering with everyday activities and relationships. An ADHD diagnosis can be made by a psychiatrist, psychologist, or primary care provider. However, no single medical, physical, or genetic test can definitively diagnose a person with ADHD. Instead, it must be diagnosed based on specific signs and symptoms that are consistently experienced and their severity level.
The fact that symptoms are not always present makes it challenging for a medical professional to diagnose ADHD strictly by a physical exam. That is often because the provider can’t observe the patient engaging in behaviors consistent with ADHD if the patient is not experiencing any signs or symptoms during their appointment with the provider. Therefore, healthcare providers must follow several steps to ensure a proper diagnosis which usually includes a checklist for rating the severity of ADHD symptoms and behaviors.
Although there is no definitive test for ADHD, healthcare providers are encouraged to use the guidelines provided in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, also known as the DSM-5. Following DSM-5 criteria helps ensure that the same standards are used across communities and that people are correctly diagnosed and treated for ADHD.
While signs and symptoms of ADHD may vary between children and adults, the DSM-5 requires that those symptoms must meet the following conditions:
- The symptoms have been present in the person’s life before the age of 12 years old.
- The symptoms must present themselves in two or more settings, such as home, school or work, social occasions, or other activities.
- The symptoms interfere with and reduce the quality of the person’s social, school, or work functioning.
- Other mental disorders, such as schizophrenia, personality disorder, dissociative disorder, anxiety disorder, or mood disorder, are not causing these symptoms.
How to Determine if a Child Has ADHD
Most parents would likely report that their child occasionally has difficulty sitting still or paying attention. But for children with ADHD, those difficulties are so pervasive and persistent that they interfere with every aspect of their life. Even though these behaviors may be common in young children, a child with ADHD does not just “grow out of” these behaviors without intervention. The best-case scenario is that they learn to manage their behavior with a proper diagnosis and treatment plan. It is also important to note that other disorders, such as anxiety, depression, sleep problems, and certain types of learning disabilities, can mirror symptoms of ADHD in children or even coexist with ADHD.
Since ADHD can seriously affect a child’s life and well-being, it is vital to have a child evaluated by a pediatrician or another medical professional so ADHD can be identified and treated as early as possible. To properly identify ADHD in children, the American Academy of Pediatrics recommends that the healthcare provider ask the child’s parents, teachers, and other caregivers about the child’s behavior in various settings, such as in school, at home, or when interacting with peers. The exam can also include a physical exam to rule out vision or hearing problems that may be causing symptoms that mirror signs of ADHD in children, such as not listening or not following directions in school.
The DSM-5 guidelines also provide medical professionals with a checklist of symptoms indicative of ADHD in children. To diagnose a child aged 3 to 16 years old with ADHD, they must present with six or more symptoms associated with ADHD, and those symptoms must have been ongoing for no less than six months.
A child with ADHD shows a persistent pattern of inattention or hyperactivity that “interferes with functioning or development.” Symptoms of inattention and hyperactivity-impulsivity in children include:
- Fails to pay attention to details or makes careless mistakes in schoolwork
- Does not seem to listen when spoken to directly
- Does not follow through on instructions and fails to finish schoolwork
- Has trouble organizing tasks
- Avoids, dislikes, or is reluctant to do tasks such as schoolwork and homework because it requires mental effort over a long period
- Often loses things necessary for tasks and activities like schoolbooks and school materials
- Is often easily distracted at school
- Is often forgetful in daily activities
- Fidgeting, squirming, or frequently tapping hands or feet
- Often has trouble sitting still or staying in their seat
- Often runs about or climbs in situations where it is not appropriate
- Has difficulty taking part in leisure activities or quiet play
- Talks excessively
- Blurts out an answer before a question has been completed
- Has trouble waiting their turn
- Often interrupts or intrudes on others
How to Determine If An Adult Has ADHD
Although ADHD is primarily considered a common condition that affects children, that does not mean adults are immune to it. Many adults with ADHD do not realize they have the disorder simply because they were never diagnosed with it as children. Based on diagnostic interview data from the National Comorbidity Survey Replication (NCS-R), about 8.1% of adults ages 18 to 44 had been diagnosed with ADHD at some point in their lifetime. The data also showed that only about 4.4% of adults ages 18 to 44 years old had a current diagnosis of ADHD. According to the Children and Adults with Attention-Deficit/Hyperactivity Disorder, Inc. (CHADD), approximately 10 million adults have ADHD.
Diagnosing adults with ADHD may be slightly more challenging than diagnosing children. It may be easier to diagnose children with ADHD because parents and teachers are often available to attest to the child’s signs and symptoms, giving the healthcare provider more data to assess. However, for an adult to be diagnosed with ADHD, a healthcare provider would likely have to rely on the patient’s self-reporting to diagnose the disorder properly. A medical provider would need to conduct a comprehensive evaluation that often includes a review of past and current symptoms, a physical exam, a recounting of health history, and a comparison of predetermined checklists.
According to the DSM-5 guidelines for diagnosing an adult with ADHD, an adult or an adolescent older than 17 must show five or more persistent symptoms of inattention or hyperactivity, and those symptoms must have been present for at least six months and occur often enough and to the extent that it is “disruptive and inappropriate for the person’s developmental level.” Additionally, the adult must have begun experiencing these symptoms before they turned 12.
Although these symptoms of inattentiveness, hyperactivity, and impulsivity mirror those found in children, they manifest in adults in slightly different ways. For example, signs of ADHD may present as:
- Failing to pay close attention to details at work or with other activities
- Making careless mistakes at work or with other activities
- Having trouble holding their attention on tasks
- Does not seem to listen even when spoken to directly
- Does not follow through on instructions
- Failing to complete work assignments because they often lose focus or are easily distracted
- Having trouble organizing tasks and activities
- Avoiding finishing tasks that require sustained mental effort
- Becoming easily distracted
- Forgetful in their daily activities
- Fidgeting or constantly tapping their hands or feet
- Often feeling restless
- Often is unable to take part in or enjoy leisure activities
- Is often “on the go,” acting as if “driven by a motor”
- Talking excessively
- Interrupting others or intruding on other people’s conversations
As an adult with both personal and professional responsibilities, these symptoms can significantly interfere with one’s relationships and activities, and responsibilities in their day-to-day lives. It is imperative that adults exhibiting these symptoms receive a proper diagnosis so that their ADHD can be treated.
Treatment for ADHD is crucial as it can notably improve an individual’s quality of life, increase their academic and social success, and reduce the risk of comorbid mental health problems such as anxiety and depression.
Mental Health Treatment is One of Our Specialties at Rising Phoenix
At Rising Phoenix Wellness Services, we believe in a long-term treatment care model that can help clients identify and treat ADHD and other neurodevelopmental disorders affecting daily living. If you or a loved one believe it may be time to seek treatment for ADHD, we can help.
Through our highly tailored treatment program, we help clients learn and practice new skills to achieve their goals through evidence-based modalities. Best of all, we offer clients the option of selecting an intensive outpatient program (IOP) or an outpatient program (OP) based on their wants and needs. If needed, we also have co-occurring disorder treatment programs that simultaneously address the client’s mental health and problematic substance use.
When you’re ready for us, we’ll be prepared to help. You can contact us 24/7 for a confidential assessment and to learn more about what we can do for ADHD.