Understanding Attention Deficit Hyperactivity Disorder (ADHD)

We all get distracted sometimes. We struggle to focus when it matters the most. We may also have difficulty keeping ourselves still in uncomfortable situations. These are all normal issues for everyone. But what if every distraction feels like an uncontrollable urge, when focusing almost seems impossible, and fidgeting and struggling to keep your mind from racing becomes a daily struggle? It impacts how you function and impedes your mental health.

This is what people with Attention Deficit Hyperactivity Disorder (ADHD) go through. This complex and often misunderstood condition affects millions worldwide. A condition where inattention and impulsivity are present, and these are not just occasional nuisances but defining characteristics. It is also worth noting that ADHD looks different in everyone. In this blog, we deeply dive into what attention deficit hyperactivity disorder is and how it impacts individuals.

What is ADHD?

ADHD is a chronic neurodevelopment disorder that affects the brain's ability to regulate attention, behaviour, impulse, and activity control. The nerve networks and neurotransmitters in people with ADHD differ from those without. Such variation in the neurological mapping results in persistent inattention, hyperactivity, and impulsivity patterns that hinder daily functioning and development.

Attention deficit hyperactivity disorder is often diagnosed in childhood and continues to persist into adulthood. It can manifest in diverse ways as you age. Often misunderstood as laziness or lack of discipline, people with ADHD struggle with low self-esteem and anxiety for the longest time before getting diagnosed. Hence, recognising that symptoms of ADHD are not merely behavioural quirks is critical to getting the right treatment.

How common is ADHD?

Over 129 million children are affected with ADHD across the world, according to 175 studies conducted by Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD). Another study by the same non-profit organisation recognises that 3.4% of adults have attention deficit conditions.

As these numbers show, the prevalence of ADHD is massive worldwide. It only continues to grow as more individuals recognise their symptoms and get diagnosed. The tricky part is that some have more pronounced signs than others. Boys get diagnosed with the condition twice as often compared to girls. This does not necessarily mean more boys have ADHD. Males often show hyperactive symptoms, while females exhibit inattentive signs, which are harder to diagnose.

Types and Symptoms of ADHD

ADHD is broadly categorised into three types based on the predominant symptoms. Find them explained as follows:

1. Inattentive

With inattentive presentation, you may face difficulties with attention and focus. Regular functions like staying on task, following detailed instructions, or organising can seem challenging. Other symptoms include being forgetful, easily distracted, and daydreaming. This type of ADHD is also referred to as attention deficit disorder in adults (ADD). However, ADD is not a formally recognised in the current diagnostic criteria.

2. Hyperactive-impulsive

In this type of ADHD, you exclusively show signs of hyperactivity and impulsivity. You may find it hard to stay seated, develop a tendency to act without thinking and exhibit excessive fidgeting. Interrupting others, overtalking, and being constantly on the go are some other signs of hyperactive-impulsive ADHD. The severity of the symptoms is often observed in younger children and decreases with age. However, impulsivity can remain an uncontrollable challenge even in adulthood.

3. Combined

The most common type of ADHD includes a combined presentation. A combination of inattentive and hyperactive-impulsive symptoms categorises it. If you have this type of ADHD, you can face difficulty in maintaining attention and controlling impulses. At least six symptoms from the other categories are noticeable in combined ADHD. It significantly impacts your social, academic, and occupational functioning.

Note: The specific symptoms differ in children and adults as their lifestyle and cognitive function are significantly distinctive.

Causes of ADHD

The exact causes of ADHD are not fully understood. However, research indicates that it is a complex disorder influenced by genetic, environmental, and neurological factors. Let us take a closer look at them:

• Genetics

Genetics plays an integral role in the development of ADHD. It tends to run in families, suggesting that genes inherited from parents may contribute to the onset of the disorder. Specific genetic variations have been associated with regulating brain chemicals. They particularly affect the dopamine system, impacting attention and behaviour regulation.

• Brain Structure

Research on ADHD, at large, has suggested differences in brain structure and function. For instance, areas of the brain responsible for controlling attention, planning, impulse, and control – such as the prefrontal cortex get affected. They may develop differently or have less activity if you have ADHD. Some neuroimaging studies have also identified differences in the size and connectivity of certain brain regions that contribute to the symptoms of ADHD.

• Environment

Our environment has an impact on the development of various health conditions. The same goes for ADHD. This is particularly true during prenatal development. Some factors leading to the risk of ADHD at this stage are exposure to toxins, premature birth, and lead. Toxins include tobacco smoke, alcohol, drugs, etc., during pregnancy, which affects foetal brain development. Premature birth, underdevelopment and low birth rate are linked to ADHD.

• Brain Injury

In some cases, brain injuries can also impact the structure and functions of the brain, causing ADHD. Injuries, particularly targeting the frontal lobe, are strongly influenced as this part of the brain regulates behaviour and attention. However, this is the least common cause compared to genetic and environmental factors.

Effects of ADHD on the Brain

When you have ADHD, your dopamine levels are low. As a result, you struggle with attention and motivation. Other parts of the brain that get affected are:

• The Prefrontal Cortex:

This part of the brain controls executive functions like planning, organising, and attention. As ADHD affects this section, you can have difficulty with such executive functions.

• The Striatum:

The striatum is in the brain's centre, influencing functions such as motivation and reward processing. When it is affected, ADHD impacts your ability to sensitise with rewards, which affects your ability to stay motivated.

• Neural Networks:

Neural networks influence how certain areas of your brain communicate. With ADHD, these networks behave differently. Thus, you may find it difficult to focus and ignore distractions.

Diagnosis and Testing in ADHD

Diagnosis of ADHD involves a comprehensive evaluation. A qualified professional, such as a psychiatrist or psychologist, will help. As it is often diagnosed in children, paediatricians can also act as the first line of contact in identifying the symptoms. There is no single test that can diagnose ADHD. Instead, such professionals would gather detailed information and contact various assessments to rule out other probable causes for the symptoms.

Some of the steps carried out for the diagnosis include:

• Clinical Interviews & Questionnaires

The first step is usually a clinical interview. During this stage, the healthcare professional asks you about inattention, hyperactivity, and impulsivity symptoms. They also would ask how these symptoms are affecting your daily life. You may also be required to fill out standardised questionnaires that help assess ADHD symptoms.

• Behavioural Assessments

Behavioural rating scales or checklists are used to get a more complete picture of ADHD. Healthcare professionals use such tools to evaluate the severity and frequency of the symptoms related to ADHD. They check the rating on difficulty focusing, restlessness, or impulsiveness.

• Medical Examination

Some symptoms of ADHD overlap with other medical conditions or certain nutrient deficiencies. Health professionals will also conduct or advise blood tests or other related medical tests to rule out such conditions with similar symptoms. For instance, they can account for thyroid disorders, sleep issues, etc.

• Assessing Development History

Typically, ADHD symptoms are present from an early age. Some realise this early, while some do it in adulthood. In both cases, doctors assess the development history. Children ask about development milestones to see if the symptoms have been consistent. In adults, a detailed review of childhood behaviour is conducted to check if ADHD has been a persistent issue.

Treatment for ADHD

Doctors prescribe treatment for ADHD based on your individual needs, as the disorder looks different for everyone. There is no definitive cure for the condition. However, the various treatment options focus on managing the symptoms and improving functioning. Treatment involves a combination of the following approaches:

• Medication

Medications help target the core symptoms of ADHD, like inattentiveness, hyperactivity, and impulsive tendencies. The most common medications prescribed for the condition are stimulants, such as methylphenidate and amphetamines. These drugs increase levels of neurotransmitters in the brain, particularly dopamine. This helps improve focus and impulse control.

Non-stimulant medications like atomoxetine and guanfacine are prescribed as alternatives when stimulants are ineffective or cause side effects. These medications are available under several brand names in India and work gradually to improve attention and other symptoms of ADHD.

• Behavioural Therapy

Behavioural therapy works wonderfully in managing ADHD symptoms, especially in children. With this approach, you can develop coping strategies for improving organisation, managing time more effectively, etc. For children, as a parent, you can consider behavioural therapy and provide consistent structure, set clear expectations, and use positive reinforcement to encourage desired outcomes.

For adults, behavioural therapy focuses on management skills, setting realistic goals, improving organisational habits, etc. Cognitive Behavioural Therapy also manages emotional challenges, such as stress, frustration, and low self-esteem.

• Lifestyle Changes

Specific lifestyle modifications can target ADHD symptoms for long-term improvement without external intervention. Some changes include establishing routines, regularly exercising, maintaining healthy sleep hygiene, a balanced diet, etc. All these habits focus on improving your well-being and improving your neurological health to counter the overbearing symptoms of ADHD.

Accommodations at work and school can also play a role in managing ADHD symptoms. As parents, you can support your child with ADHD through modified home assignments to support learning, extra time on tests, and thoughtful seating arrangements to minimise distractions. Similarly, as an adult, you can try incorporating workplace accommodations like flexible schedules, regular breaks, and other strategies to improve focus.

• Counselling & Family Support

ADHD can impact your relationships. This is why family therapy or counselling is helpful. When communicated well enough, families can learn strategies to support their loved ones and improve communication. Training programs and more information are available from the healthcare professional to help through this process.

Prevention of ADHD

Since there is no definitive cause of ADHD, prevention of this condition is not well-established. Often, genetic factors and brain structure play a key role. However, to reduce the risk, in case of other probable causes, here are some prevention approaches:

• Prenatal or Early Childhood Care

As a parent, you can avoid ADHD caused by premature delivery and other neurological complications at the foetal stage by avoiding unhealthy habits. These include smoking, alcohol, and drug use during pregnancy. Accessing proper healthcare, including supplements and routine checkups, is also helpful in mitigating risks.

• Healthy Environment

While not necessarily applicable in all cases, your environment does have an impact on the development of ADHD. Children who grow up in a stable and supportive environment have less likelihood of developing ADHD-related symptoms. Besides, emotional, and environmental exposure to toxins like lead should also be reduced to protect against alteration in brain chemicals.

• Nutrition and Diet

A balanced diet rich in omega-3 fatty acids, multivitamins, and other essential nutrients is often recommended to support brain health. Diet can act as a supportive measure rather than a preventive measure to reduce the progression of ADHD symptoms.

• Early Intervention

When you notice signs of inattentiveness, impulsive behaviour, and hyperactivity in your children or yourself, it is crucial to act quickly. The sooner you get it checked, the better it is to control the symptoms of ADHD. This approach is, again, not a preventive measure but a way to curb the intensity of the condition by getting it under control on time.

Managing ADHD with The Right Approach

Living with ADHD can seem challenging. However, understanding the condition is the first step toward managing it effectively. With a combination of medical treatment, therapy, lifestyle adjustments, and support, you can lead a fulfilling life despite this disorder. You can explore multiple avenues to seek help with the growing prevalence of this condition. All you need to do is take the step to get the right help at the right time.

So, do not hesitate to reach out for help. For adequate financial support in covering the costs, explore ManipalCigna Health Insurance Plans with different coverage options to suit your needs. Protect your mental and physical well-being today!

FAQs

Can a person with ADHD lead a normal life?

Yes, a person with ADHD can lead a normal and successful life. The key is to get the required help. The right treatment and strategies like medication, therapy, lifestyle changes, and support from family or professionals help manage the symptoms effectively. Many people with the condition thrive in their careers and relationships once they understand and work with the condition.

Is ADHD a disability?

Although recognised as a learning disability in children, no law or act defines ADHD as a disability. It does impair your ability to function in daily life, but the impact of the disorder varies from person to person and is often manageable.

Are there any advantages to having ADHD?

Yes, most people with ADHD have been observed to have certain strengths, such as creativity, problem-solving skills, and the ability to think outside of the box. They might also exhibit spontaneity and a rush of energy at times. Leveraging these traits in positive ways while working through the ADHD challenges helps make the condition manageable and more result-oriented rather than dreadful.