ADHD/ADD
Attention Deficit/Hyperactive Disorder 

ADHD the Basics 

ADHD is a neurodevelopmental disorder that begins in childhood and can be chronic. Studies suggest it affects 1 out every 45 people worldwide. It is characterized by a persistent pattern of inattention and/or hyperactivity and impulsivity. Of course everyone can have trouble focusing or controlling their impulses from time to time. For people with ADHD these issues are pervasive and severe enough to disrupt most core aspects of their lives (professional, social, academic, family). Severity can range from being annoying to downright debilitating. 

Emotional Effects of ADHD

ADHD can often take a toll on an individual’s self-esteem and confidence. We have worked with many people who did not receive an accurate diagnosis until later in life and thought of themselves as “stupid” or “forgetful” or “a troublemaker.” Having these messages reinforced by peers, family, teachers, and co-workers can have a large impact on self-esteem. Many adults with ADHD can readily list-off friendships and romantic relationships that were negatively impacted by impulsivity, or forgetfulness. 

Diagnosing ADHD

When it comes to diagnosing attention deficit/hyperactive disorder a comprehensive evaluation is recommended. Many psychiatric and physiological conditions can cause symptoms very similar to ADHD. Testing is needed to ensure an accurate diagnosis and accurate treatment. The evaluation can not only diagnose but also provide you with the necessary documentation for accommodations at school, for standardized tests, and at work. It can also help put people’s mind at ease. Anyone can read about something online but having a formal diagnosis can be reassuring that this is a real condition. A quality evaluation will also include recommendations for treatment and accommodations tailored to your specific difficulties and needs. This is often the most helpful part of an assessment because it provides clear steps to help you achieve your goals and manage your symptoms. 

 

Unfortunately, with all mental health issues there can be a lot of misunderstanding and stigma. ADHD is one that routinely has a lot of misunderstanding. Compared to other mental health conditions, we know a fair amount about the neurological and psychological components of ADHD. 

People with ADHD often have measurable differences with certain parts of the brain that are connected to attention, memory, reinforcement, motivation, impulse control and movement. Mostly in the frontal and temporal lobe of the cerebellum, the corpus callosum, the basal ganglia and the cerebellar vermis.

Within these brain structures researchers have found that for people with ADHD, the neurobiology or reinforcement and motivation is altered. The structures that relate to motivation, reinforcement and reward are often somewhat underdeveloped or inconstantly firing. This lack of firing may be why it is difficult for people with ADHD to stay on task and stay motivated. The normal neurological incentives are not as strong for people with ADHD. 


 

The diagnostic criteria for ADHD

are listed in two major domains, Inattention and Hyperactivity/Impulsivity. To be diagnosed with ADHD one must display at least six of the following symptoms over the past six months in either or both domains (for children these symptoms must be at an inappropriate development level): 

Inattention: 

  • Often fails to give close attention to details or makes careless mistakes 

  • Often has trouble holding attention on tasks or activities

  • Often does not listen when spoken to directly 

  • Often does not follow through on instructions and fails to finish tasks 

  • Often has trouble organizing tasks and activities

  • Often avoids or greatly dislikes, or is reluctant to do tasks that require mental effort over a long period of time 

  • Often looses things necessary for tasks, and activities (keys, wallet, books, homework, phone, etc)

  • Is easily distracted

  • Is often forgetful 

Hyperactivity and Impulsivity:

Again at least six symptoms are present for more than six months, and they are developmentally inappropriate for the individuals age or abilities. 

 

  • Often fidgets, taps hands and feet, or squirms in seat

  • Has difficulties remaining seated when necessary

  • Often runs or climbs in situations where it is not appropriate (in teens and adults this may be limited to frequently feeling restless)

  • Often unable to play or take part in leisurely activities quietly

  • Is often “on the go” or acts as if they are being “driven by a motor”

  • Often talks excessively

  • Often blurts out answers before questions is finished

  • Often has trouble waiting for their turn

  • Often interrupts or intrudes on conversations and activities of others. 

  • Additionally, all of these symptoms must have been present since childhood, and are present in two or more settings such as home, the workplace, school, in social gatherings, etc. These symptoms must significantly interfere with and reduce the quality of school, work, social activates and overall life. 

Help is available 

There are some great tools to help people with ADHD organize and structure their lives as to minimize symptoms. Additionally, working with a professional on interpersonal and communication skills can greatly help with relationships. Psychotherapy and counseling are often also helpful to unpack and process through old narratives and create new, more helpful ones. Gaining insight about yourself and your emotional world can lead to better impulse control, self-esteem, and emotion regulation.