Attention-Deficit / Hyperactivity Disorder (ADHD)
What is ADHD?
ADHD (attention-deficit/hyperactivity disorder) is a common disorder that affects some people’s ability to pay attention, control impulsive behaviors, and regulate themselves. Collectively, these skills can be referred to as “executive functioning.”
Inattention vs. Hyperactivity
Inattention:
- Difficulty staying focused on activities.
- Forgetful of doing everyday tasks (i.e. homework)
- Misses small details, making careless mistakes
- Avoids mentally challenging tasks.
- Loses things.
- Seems to not listen when spoken to.
Hyperactivity/Impulsivity:
- Fidgeting, being unable to sit still.
- Inability to focus on tasks.
- Excessive talking.
- Interrupting conversations.
- Being unable to wait their turn.
Biological basis of ADHD
ADHD is a genetic, brain-based syndrome that has to do with regulation of a specific set of brain functions & related behaviors, such as attention, concentration, memory, motivation, effort, impulsivity, hyperactivity, and organization.
Scientists have found differences in the structure and chemistry of the
ADHD brain, which makes the challenges faced by those with ADHD make sense.
Can adults have ADHD? Does it look different than kids with ADHD?
While ADHD symptoms begin in childhood (Before the age of 12), they often persist into adulthood and can even be lifelong.
ADHD in childhood
Hyperactivity and impulsivity is usually present by 4 years old and increases until age 8 when hyperactivity declines.
ADHD in adolescent years
Hyperactive symptoms may be barely noticeable to observers, but the adolescent may describe feeling restless or unable to relax. Impulsive symptoms may persist and can be lifelong. In adolescents, look out for substance use, risky sexual behavior, and driving under the influence.
ADHD in adulthood
Many adults with ADHD are unaware that they have it. These adults may have difficulty with everyday tasks, find it hard to focus and prioritize, which can lead to missed deadlines or forgotten plans. They may have impulses that could be anything from impatience waiting in lines/traffic to mood swings/outbursts.
Treatment options for ADHD
The preferred treatment is a combination of medication and cognitive-behavioral therapy (CBT) targeting executive dysfunction.
Medication
Stimulants (amphetamines or methylphenidates) and nonstimulants (atomoxetine or antidepressants) are options.
There are longer-acting medications that have a slower onset but last all day, and shorter acting medications that kick in faster but last a shorter period.
Long acting and short acting medications can be used on their own, or combined depending on what your provider recommends.
CBT-EF
Targets executive dysfunction. It focuses on prioritizing tasks, organization, and planning rather than the typical CBT that targets thought patterns associated with anxiety and depression.
Typically, this can be achieved in around 12-15 sessions. Patients are given at home assignments to complete in between sessions to help with adapting to behavioral changes in their everyday life.