Attention-deficit hyperactivity disorder (ADHD) affects many people all over the United States. It’s so common that 8.4% of children have the disorder. Many people believe attention problems stop after childhood, but many adults can struggle with it as well. Around 2.5% of adults have the disorder as well. ADHD can make it difficult to work, play, and interact with others in the way other people can. If it’s not treated, it can get in the way of a child’s growth and an adult’s ability to pursue their life goals. But what is ADHD, and how is it different from ADD? Can you grow out of ADHD symptoms? Learn more about ADHD and how it can be treated.
What Are ADD and ADHD?
Attention problems are among the most common mental health issues in the United States that affect children and adults. People with attention disorders may find it difficult to concentrate, sit still, or complete tasks. Children with ADHD begin life in a world that’s not designed for them, requiring calmness, focus, and attention. Children are often challenged by these tasks as they develop, but children with ADHD may struggle even more. However, treatment learning ways to cope with attention problems can help.
Attention deficit disorder (ADD) was the term used to describe disorders that cause attention problems. But today, attention-deficit hyperactivity disorder (ADHD) is the official medical term. In some cases, ADD may be used to describe an attention disorder that does not cause significant hyperactivity symptoms. It may seem inaccurate to use ADHD to describe someone who does not appear to have a problem with hyperactivity, but if you receive an official diagnosis from the Diagnostic and Statistical Manual of Mental Disorders (DSM), you will be diagnosed with ADHD. However, there are multiple types of ADHD, and learning the type that you or your child has can help you better understand the disorder.
What Are the Three Types of ADHD?
ADHD is separated into three major symptoms: inattention, impulsivity, and hyperactivity. There are three types of ADHD that depend on which of these three symptoms you experience primarily. However, it’s important to note that mental health issues are often complicated, so your ADHD may defy specific categories. You may experience more than one of the three main symptoms and have a mix of the types of ADHD. In that case, you would not be dominant in any one type, and you’d fall in the combination ADHD category. Still, understanding each type may help you understand your own ADHD or your child’s disorder. Here’s a breakdown of each of the three major symptoms:
Focus and attention are difficult to maintain, and you may be easily distracted. This can also cause you to have poor organizational skills, and you may struggle with timed tasks. You may also feel that you make many careless mistakes when doing a task because of a lack of attention to detail. You may also have difficulty following through with instructions. You may even avoid activities that require sustained mental effort, knowing it will be uncomfortable for you. Inattention may cause you to lose things often, especially things that are necessary to complete tasks, like your glasses or a pen. You may also find yourself to be forgetful, missing assignments, or failing to complete tasks because you forgot about them.
This is one of the most common symptoms of ADHD, and even the other types of ADHD symptoms can cause you to be inattentive. If you are dominant in these symptoms, your doctor may describe your ADHD as a “predominantly inattentive subtype.” If you experience a mix of symptoms, you may have the combination ADHD type.
People who are predominant in this type might feel they are better described as having ADD and not ADHD. But an accurate diagnosis would be ADHD with the predominantly hyperactive subtype.
Hyperactivity conjures up images of a child running around, unable to be calmed. But hyperactivity can also describe other actions that are a result of the inability to control compulsive actions. Hyperactivity can cause you to squirm, fidget, and have difficulty sitting still. *You may also feel restless and unable to relax in certain situations. Children with ADHD may often get in trouble when they are asked to engage in quiet activities or asked not to touch certain objects.
Fidgeting with objects, even when they aren’t necessary for a given task, is common. Hyperactive ADHD may cause you to be extremely talkative. You also may often interrupt people and have trouble waiting your turn in a conversation. You may also feel the need to blurt out answers or comments quickly, which can mean talking at inappropriate times.
It may be difficult to sit down for a long time. You may feel the need to stand up, walk around, or leave an area when you’re expected to remain seated. Children may run and climb when it’s inappropriate. However, adults may feel a general restlessness rather than the need to run and climb.
If you experience hyperactivity symptoms but don’t have trouble remembering things or organizing tasks, you may have ADHD with the hyperactivity-impulsivity subtype.
There are several criteria in diagnosing ADHD and its subtypes that must be met in order for you to have an official diagnosis. If you meet the full criteria for one of the subtypes and not the other, you will be in a predominant subtype group. However, if you meet the criteria for both the hyperactivity and inattention subtypes, you may have the combination subtype. Combination ADHD is fairly common. Most people with ADHD experience a mix of symptoms that include symptoms from both categories. In many ways, hyperactivity and inattention can work together to get in the way of your life and your ability to complete tasks in school or in your career.
Impulsivity may make it difficult to sit still when you’re sitting down to complete a project. Simultaneously, inattention can make it difficult to focus on the project. Hyperactivity is often more pronounced in children, while inattention is associated with adults. However, children and adults may experience both symptom categories in different ways.
How Is ADHD Diagnosed?
ADHD is diagnosed using the DSM. Most doctors and therapists use the fifth edition. According to the DSM, several factors are examined when diagnosing ADHD, including the signs and symptoms that were previously mentioned.
To be diagnosed with either of the two subtypes as a child up to 16 years old, you have to have six of the symptoms for that subtype or more. If six or more of both subtypes apply to you, you may have the combination subtype. At age 17 or older, just five of the symptoms have to apply to you. Symptoms also have to be inappropriate for your developmental level.
Several other symptoms apply to ADHD in general, including all subtypes. These other factors include the following:
- You have to have experienced several symptoms before age 12. ADHD is thought to begin in early development. If symptoms begin after age 12, there may be another cause.
- Symptoms occur in more than one setting, like at home and at school. You may also experience symptoms at work, with friends, with relatives, or in other activities.
- Since ADHD is a disorder, symptoms must interfere with your life, interfering with your social life, work or school performance, or other aspects of your life.
- The symptoms must not be better explained by another mental health issue like a mood disorder or an anxiety disorder.
If you were never diagnosed with ADHD as a child, it doesn’t mean you can’t experience ADHD as an adult. Adults can be diagnosed with ADHD, but they still have to have experienced symptoms before age 12, even if they weren’t diagnosed until later.
Do I Have ADHD?
Many mental health disorders are underdiagnosed because of stigma and other barriers to treatment. However, there are some concerns about overdiagnosis when it comes to ADHD. A mental health issue may be overdiagnosed if diagnostic criteria changes, if diagnosing practices aren’t high quality, or if there’s a lack of information when it comes to diagnostic challenges.
However, ADHD is especially common as a self-diagnosis, partly because the symptoms may seem very relatable to many people. Becoming distracted is common, and sometimes it prevents you from getting your work done. In fact, you may feel like you meet the symptoms criteria for ADHD, experiencing five of the symptoms in one or both of the ADHD subtypes. However, many people may believe they have ADHD when they read through the symptoms, forgetting about the other diagnostic criteria.
You have to have experienced ADHD symptoms before the age of 12. If you’re starting to experience these symptoms for the first time as an adult, there may be a better explanation. For instance, common issues that affect adults may contribute to a lack of focus and distractibility. Depression, anxiety, and insomnia can all make it difficult to focus on tasks as an adult. There may be physical diseases that can affect the brain in a way that causes cognitive problems and a loss of focus.
Another factor that is often overlooked is the diagnostic criteria that apply to all mental health disorders: symptoms have to significantly impair functioning. You may be prone to some ADHD symptoms, but if you are generally able to cope with them without being impaired in your life, you don’t have ADHD. Still, if you’ve recently started to struggle with symptoms that are getting in the way of your normal life, speaking to a doctor or therapist may uncover the source of the problem.
How Can I Get an Accurate Diagnosis?
The best way to get an accurate diagnosis is to work with professionals. Doctors and therapists can help investigate symptoms and possible causes. But it’s important to note that doctors and mental health professionals rely on what you report and some routine tests as a starting point in finding a diagnosis. It’s important to report your symptoms completely and accurately. It’s easy to assume that professionals will be able to uncover something wrong with some quick tests, but they may only order certain tests if you report certain symptoms.
It’s often good to start speaking to your doctor and going through some routine tests. ADHD can’t be diagnosed with blood tests, but tests can rule out some other causes like vitamin deficiency and other common problems. A physical examination can also help. After going through a physical assessment, a psychological assessment can also be helpful.
It’s also important to realize that mental health is complicated; there is no one-size-fits-all treatment plan. When you get a diagnosis and begin treatment, you should continue to work with your treatment professionals. Let them know if your symptoms are improving or if you’re experiencing side effects. There are often many treatment options, even for ADHD, and treatment is often a trial and error process.
How Does ADHD Affect Children and Adults?
ADHD is often associated with children, but it can last into adulthood, and adults can sometimes be diagnosed with ADHD. However, ADHD may affect children and adults differently. Because of that, some assume that ADHD only affects children. However, ADHD symptoms can change as you get older.
One of the biggest differences between adult and child ADHD involves hyperactivity. Adults and children may express and experience hyperactivity and impulsivity differently. Children tend to squirm in their seats and get up when they shouldn’t. They may also feel the need to run around and climb when they shouldn’t. When children play, they may not be able to do so quietly.
Adults may feel similar hyperactive impulses that they express differently. They may feel more internal restlessness. Sitting still for long periods may be uncomfortable, and they may feel compelled to get up, pace, or walk away. It may be difficult to sit through long meetings, meals, or even leisure activities like movies. Adults may be prone to feeling impatient. They may avoid activities and situations where patience is required. In conversations, adults with ADHD may finish other people’s sentences, interrupt, and talk excessively. Adults may take jobs that change often and are highly active. They may also be prone to reckless behavior, including fast driving or substance misuse.
Can You Outgrow ADHD?
Because the symptoms of ADHD change over time, some may assume you can outgrow the disorder. In fact, it was once common to think that ADHD was a disorder that only affected children, and adults would eventually stop struggling with ADHD symptoms. However, today we believe ADHD is a disorder that starts in childhood and lasts into adulthood. Still, some children experience fewer ADHD problems over time to the point that it no longer impairs their lives. This may be because they learn to cope with problems that would cause impairments in adult life. Children with mild or moderate ADHD may be able to adapt to the disorder over time.
Still, the majority of people with ADHD continue to struggle with it into adulthood. Since ADHD symptoms can appear in adults in a way that it doesn’t in children, growing up with ADHD may mean coping with changing symptoms. With treatment, it’s possible to learn effective coping strategies that allow you to live a life that is not impaired by ADHD symptoms.
What Causes ADHD?
It’s unclear whether ADHD is a genetic disorder or a disorder that’s developed through environmental factors. It may be caused by a combination of biological, environmental, and developmental factors. Still, it’s clear that it starts at a young age and it may persist into adulthood. ADHD seems to run in families, so it’s likely that there is a significant genetic component to the disorder. Researchers have studied twins and the children of adoption to investigate heritability. Twins are often helpful in identifying genetic disorders. Since identical twins share the same DNA, they should have a high probability of sharing the same genetic diseases and disorders. If a disorder often occurs in one twin and not the other, it may not have a significant heritability.
Adopted children can help show the difference between genetic factors and environmental factors. A child whose biological parent has a genetic disease may pass it on to the adopted child despite being raised in a separate environment. ADHD has shown to have a significant heritability, but genetics don’t make up 100% of your likelihood to develop the disorder. It’s unclear what environmental factors contribute to ADHD, but there are some possibilities.
Some potential environmental factors that can contribute to ADHD include:
- Exposure to toxins like lead
- Exposure to drugs in the womb
- Smoking during pregnancy
- Premature birth
There may be some unknown factors that contribute to ADHD, and there is still a lot to learn about this disorder.
How Does ADHD Affect the Brain?
In the brain, ADHD is thought to be caused by differences in brain anatomy and function. One of these functions may have to do with low levels of a chemical called dopamine. Dopamine is a neurotransmitter that’s responsible for things like reward, pleasure, and focus. Certain things release high amounts of dopamine, like eating your favorite meal. However, small amounts of dopamine are released all the time while you’re doing a task. This dopamine helps keep you motivated to complete tasks. People with ADHD are thought to have lower levels of this ambient dopamine. When they’re trying to complete tasks, their brain is seeking a better source of dopamine release. Small distractions may become irresistible to someone with ADHD.
How Is ADHD Treated?
ADHD is a chronic condition that can impair your ability to perform at school or work. But it can be treated with the right plan for your needs. ADHD can be treated with both medications and psychotherapy. Treatment for children may be different from treatment for adults. For instance, children under six years old shouldn’t be treated with medications until other options are attempted. Parent training can help parents learn how to help young children with ADHD cope with symptoms and address behaviors that impair their ability to learn and grow. Children over six may use medications, but they can also go through behavioral therapies, and parent training may be an effective first-line treatment approach.
Behavioral therapies refer to a broad range of talk therapy programs that are designed to help people address behavioral problems. For instance, children that can’t sit still or feel restless may learn coping skills to help them in classroom settings. Since ADHD is common among children, teachers may also go through training to help children with ADHD thrive in the classroom.
ADHD is also treated with stimulant medications like amphetamine and methylphenidate. Common stimulant prescriptions include Adderall and Ritalin. Stimulants are thought to increase the amount of dopamine in your brain, which can help people with ADHD avoid symptoms that are caused by low dopamine levels. The FDA has also approved a non-stimulant medication called atomoxetine in treating ADHD. Atomoxetine is sold under the brand name Strattera. It works by increasing norepinephrine levels in the brain, which seems to decrease impulsivity and distractibility in people with ADHD.
Medications like Ritalin and Adderall are often first-line treatments for ADHD in older children and adults. However, a combination of medications and therapy may be the most effective and comprehensive approach to treating the disorder. There is no magic bullet medication for treating ADHD or any mental health disorder. When you take medication for the first time, it’s important to make a note of your symptoms and the side effects you experience. You may need to work with your doctor to find the right medication and dose for your needs.