Attention-Deficit Hyperactivity Disorder (ADHD)
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What is ADHD?
Attention-deficit hyperactivity disorder (ADHD) is the name of a group of behaviors found in many children and adults. People who have ADHD have trouble paying attention in school, at home or at work. Even when they try to concentrate, they find it hard to pay attention. Children may be much more active and/or impulsive than what is usual for their age. These behaviors contribute to significant problems in relationships, learning and behavior. For this reason, children who have ADHD are sometimes seen as being “difficult” or as having behavior problems.
Most of what we hear about ADHD is how it affects children. Not as much is known about the way ADHD affects adults. Adults who have ADHD often are diagnosed when they find out their children have ADHD. For adults to be diagnosed, they must have developed symptoms prior to age 12. ADHD may run in families. Hyperactivity is more common in boys. However, other symptoms (especially inattention) are more common in girls.
Some people who have ADHD may have other conditions as well. These could include learning disabilities, anxiety, depression, oppositional defiant disorder (ODD), bipolar disorder, and Tourette syndrome.
People who have ADHD have a hard time organizing things, listening to instructions, remembering details and controlling their behavior. As a result, people who have ADHD often have problems getting along with other people at home, at school or at work.
The person with ADHD who is inattentive will have 6 or more of the following symptoms:
- Has difficulty following instructions
- Has difficulty keeping attention on work or play activities at school, work and home
- Loses things needed for activities at school, work and home
- Appears not to listen
- Doesn’t pay close attention to details
- Seems disorganized
- Has trouble with tasks that require planning ahead
- Forgets things
- Is easily distracted
The person with ADHD who is hyperactive/impulsive will have at least 6 of the following symptoms:
- Runs or climbs inappropriately
- Can’t play quietly
- Blurts out answers
- Interrupts people
- Can’t stay in seat
- Talks too much
- Is always on the go
- Has trouble waiting his or her turn
CAUSES & RISK FACTORS
What causes ADHD?
People who have ADHD do not make enough chemicals in key areas in the brain that are responsible for organizing thought. Without enough of these chemicals, the organizing centers of the brain don’t work well. This causes the symptoms in people who have ADHD. Research shows that ADHD is more common in people who have close relatives with the disorder. Recent research also links smoking and other substance abuse during pregnancy to ADHD. Exposure to environmental toxins, such as lead, can also be a factor.
DIAGNOSIS & TESTS
Talk with your child’s healthcare provider. A diagnosis of ADHD can be made only by getting information about your child’s behavior from several people who know your child. Your healthcare provider will ask you questions and may want to get information from your child’s teachers or anyone else who is familiar with your child’s behavior. Your healthcare provider may have forms or checklists that you and your child’s teacher can fill out. This will help you and your healthcare provider compare your child’s behavior with other children’s behavior.
Many people try to diagnose themselves by using a quiz or a checklist they find in a magazine or see on TV. While these lists can be helpful, it’s best to contact your healthcare provider if you think you have ADHD. Your healthcare provider may ask you questions like the following:
- Do you have problems with paying attention and being hyperactive? Have you had these problems since you were a child?
- Do you have a hard time keeping your temper or staying in a good mood?
- Do you have problems staying organized or being on time?
- Do these problems happen to you both at work and at home?
- Do family members and friends see that you have problems in these areas?
- Do you have any physical or mental health problems that might affect your behavior? (Your healthcare provider may give you a physical exam and do tests to see if you have any medical problems with symptoms that are like ADHD.)
Your healthcare provider will probably want to test your child’s vision and hearing if these tests haven’t been done recently.
It might be hard for your healthcare provider to tell if your child has ADHD. Many children who have ADHD aren’t hyperactive in the healthcare provider’s office. For this reason, your healthcare provider may want your child to see someone who specializes in helping children who have behavior problems, such as a psychologist.
What medicines are used to treat ADHD?
Some of the medicines for ADHD are called psychostimulants. Some of these drugs include methylphenidate, dextroamphetamine, and a drug that combines dextroamphetamine and amphetamine. Although these medicines have a stimulating effect in most people, they have a calming effect in people who have ADHD. These medicines improve attention and concentration, and decrease impulsive and overactive behaviors. Other medicines can also be used to treat ADHD. Talk with your healthcare provider about what treatments they recommend. Other medicines sometimes used to treat ADHD include atomoxetine, clonidine, desipramine, imipramine and bupropion.
All medicines have side effects. Psychostimulants may decrease your appetite and cause a stomach ache or a headache. The loss of appetite can cause weight loss in some people. This side effect seems to be more common in children. Some people have insomnia (trouble sleeping). Other possible side effects include fast heartbeat, chest pain or vomiting. Here are some ways to avoid side effects when taking psychostimulants:
- Use the lowest possible dose that still controls the hyperactivity. Your healthcare provider will tell you the right dose.
- Take the medicine with food if it bothers your stomach.
- Ask your healthcare provider if you can skip the medicines on the weekends. This means that you don’t take any ADHD medicines on Saturday and Sunday.
- Offer healthy snacks to children who lose weight while taking medicine for ADHD.
- It’s best to take the medicine 30 to 45 minutes before a meal. Good times to take this medicine are before breakfast and before lunch (if a second dose is needed). Lunch-time doses can be given at school for some children. If your child can’t take this medicine at school, contact your healthcare provider. Your healthcare provider might suggest a long-acting form of the medicine instead. The long-acting form of this medicine is taken once a day only, right before breakfast. If you are taking the long-acting form of this medicine, do not crush, break or chew it before swallowing it.
It’s important to take the medicine just the way your healthcare provider prescribes it. Follow your healthcare provider’s advice even if you think the medicine isn’t working. Be sure to contact your healthcare provider if you think the medicine isn’t working.
The medicines used to treat ADHD have been shown to improve a person’s ability to do specific tasks, such as pay attention or have more self-control in certain situations. The length of time a person takes medicine for ADHD depends on each person. Everyone is different. Some people only need to take medicine for 1 to 2 years, while others need treatment for many more years. In some people, ADHD may continue into adolescence and adulthood.
People who have ADHD should be checked regularly by their healthcare providers. During these checkups, the healthcare provider will want to hear what the parents have to say about a child who has ADHD. A teacher’s comments about the child are also important. If your child has ADHD, your healthcare provider may suggest that they take a break from their medicines once in a while to see if the medicine is still necessary. Talk with your healthcare provider about the best time to do this–school breaks or summer vacation might be best.
Living with attention-deficit hyperactivity disorder (ADHD)
Symptoms of ADHD often get better as children grow older and learn to adjust. Hyperactivity usually stops in the late teenage years. But about half of children who have ADHD continue to be easily distracted, have mood swings, hot tempers and are unable to complete tasks. Children who have loving, supportive parents who work together with school staff, mental health workers and their healthcare provider have the best chance of becoming well-adjusted adults.
Children who have ADHD also tend to need more structure and clearer expectations. You may need to change your home life a bit to help your child. Here are some things you can do to help:
- Make a schedule.
- Make simple house rules.
- Make sure your directions are understood.
- Reward good behavior.
- Make sure your child is supervised all the time.
- Watch your child around their friends.
- Set a homework routine.
- Focus on effort, not grades.
- Talk with your child’s teachers.
If your healthcare provider thinks you have ADHD, they may suggest counseling. Your healthcare provider may also send you for more testing and counseling to someone who specializes in treating ADHD. You can learn ways to change your work environment and keep distractions to a minimum. Organizational tools can help you learn how to focus on activities at work and at home.
FOR MORE INFORMATION
Centre for ADHD Awareness Canada
Canadian Mental Health Association