An Introduction to ADHD

This week (Sept 12-18, 2010) is ADHD Awareness Week. While ADHD is a well known diagnosis among kids, do you REALLY know ADHD?

The stereotypical patient with ADHD is an 8-year-old boy who can’t sit still, sometimes literally jumping off walls. His clothes may look like Pig Pen from Peanuts, but his actions are more like Dennis the Menace. But would you be surprised to know that the quiet girl in the back row of Mrs. Martin’s 4th grade classroom, who is staring out the window instead of listening to the teacher, has this same diagnosis? Or the high school freshman, who is struggling to maintain a B average by spending 4, 5, or 6 hours on homework after school? What about the church youth director, who has so much passion and energy for his students, but can’t remember to return your phone call? ADHD has many faces.

So what does it really mean to have ADHD? To start to answer that question, let’s first dissect the name. ADHD stands for Attention-Deficit/Hyperactivity Disorder. Since 1994, ADD (Attention Deficit Disorder) is now known as ADHD-Inattentive Type. There are also Hyperactive and Combined Types. So people with this disorder can have problems with attention (task completion, organization, memory, daydreaming), hyperactivity (fidgeting, excessive talking, loud, constantly in motion) or both. It can be diagnosed at any age, but is most commonly discovered during elementary school. Some people seem to “outgrow” ADHD as their brains mature, but many of these people may have simply found a better environmental fit for themselves, where their ADHD “blends in.” Many adults continue to struggle and it is becoming more common for them to continue or seek treatment.

What causes ADHD? The most honest answer to this one is, “We don’t know.” Scientists believe ADHD is a disorder of the brain’s frontal cortex, which handles “executive functions” such as attention, short-term memory, and organization. Think of it as your brain’s executive secretary. The brain chemicals (known as neurotransmitters) in this part of the brain are out of balance; there are too few of them. As a result, the frontal cortex is understimulated. The brain then responds by trying to create stimulation, either by reaching out into the world (outside distractions, hyperactivity) or into the mind (daydreaming). That is why the most common form of medication used to treat ADHD are stimulants. They help to simulate these neurotransmitters in order to bring them into the proper balance.

What can be done to help a person with ADHD? While there is no “cure,” research has consistently shown that the best treatment for ADHD is a combination of behavior modification and medication. A qualified therapist can help you with behavior modification, which involves a system of rewards for positive behavior and consequences for negative behavior. Punishment alone will not help your ADHD child to behave. They need to be taught what to do and rewarded for doing well. Remember, they are trying very hard to accomplish something that will seem second nature to most of us. Medication can often be managed by a pediatrician, but an evaluation by a specialist such as a psychiatrist or neurologist is usually a good idea, as there are many disorders, such as anxiety, depression, even seizure disorders, that can present similarly to ADHD.

There are times in each of our lives that we all look a little ADHD. For example, the first few weeks of a new school or job leave us all feeling disoriented, scatter-brained, and disorganized. By week two, most of us are starting to get this under control. If symptoms persist, it may be wise to consider an evaluation. Because this is a brain disorder, ADHD cannot be turned off and on. If you see symptoms in one environment but not others, consider that there may be a stressor in that environment bringing on this behavior. In that case, it is more likely that you are dealing with an anxiety or learning disorder. This is why a good evaluation is so important, rather than just asking your doctor for a prescription. In some cases, behavior modification alone may be enough to help alleviate symptoms, making medication less necessary.

It is my hope that this article has helped you to have a better understanding of this common diagnosis. If it has raised more questions than it has answered, perhaps a call to Heritage Counseling Center or another qualified professional can be of assistance.

Written by Rachael DeWitt, LCSW.