Frequently Asked Questions About Attention Deficit Hyperactivity Disorder (ADHD)
When you, your child, or someone close to you is diagnosed with ADHD there are bound to be certain aspects of the disorder that seem confusing to you and/or that you’d like to have more clearly defined. The following questions are some of the most frequently asked:
Q. What are the symptoms of ADHD?
A. There are three major symptoms associated with ADHD: inattention or distractibility, hyperactivity, and impulsivity. Everyone acts these ways occasionally, so it’s important to compare the person's behavior to those of others in his or her age group. ADHD may be considered as a diagnosis if a person has the following signs for more than six months:
Inattention or Distractibility
A person who is inattentive has a hard time keeping their mind focused on one thing and may become bored with a task after only a few minutes. They may also have difficulty following conversations.
Hyperactivity
A person who is hyperactive always seems to be in motion; sitting still through a meeting or class can be a near impossible task. They may talk incessantly and/or fidget constantly. They may feel intensely restless. The hyperactivity component is not always present in adults, in which case, a diagnosis of Attention Deficit Disorder (ADD) may be more appropriate.
Impulsivity
A person who is overly impulsive seems unable to curb their immediate reactions or think before they act. As a result, they may blurt out answers to questions, make inappropriate comments, or bolt into a situation, for example, darting across the street or barging into a room, without regard for safety or appropriateness. Their impulsivity may make it hard for them to wait for things they want or to take their turns in conversations and other activities.
Q. How is ADHD diagnosed?
A. ADHD is diagnosed through an assessment interview process in which a person’s history and observable behaviors in their usual settings (at home, school or work) are noted. Ideally, the therapist making the diagnosis includes input from key people in the person’s daily environment, which could include family members, co-workers, and/or teachers. It is always helpful to determine what precipitated the request for evaluation (for example, symptoms of inattentiveness or impulsivity that lead to problems in school or work performance), what approaches to correct problems have already been tried (for instance, behaviorial techniques like positive reinforcement), and how effective those approaches have been.
Q. Is ADHD inherited?
A. Research shows that ADHD tends to run in families, so there are likely to be genetic influences. A person who has ADHD usually has at least one close biological relative who also has the disorder. And at least one-third of all fathers who had ADHD in their youth have children with ADHD. Even more convincing evidence of a possible genetic link is that when one twin of an identical twin pair has ADHD, the other twin is likely to have the disorder too.
Q. What is the long-term prognosis?
A. ADHD can persist from childhood through adolescence, and recent follow-up studies that from 10 to 60% of childhood-onset cases will continue, in varying degrees, into adulthood. ADHD that lasts into adulthood is often referred to as ADHD-RT (Residual Type).
Q. Is ADHD on the increase? If so, why?
A. No one knows for sure whether the prevalence of ADHD per se has risen, but it’s very clear that the number of people identified with the disorder who obtain treatment has risen over the past decade. Some of this increased identification and increased treatment-seeking is due in part to greater media interest, heightened consumer awareness, and the availability of effective treatments. A similar pattern is now being observed in other countries.
Q. Can ADHD be seen in brain scans of those with the disorder?
A. Neuroimaging research has shown that the brains of individuals with ADHD differ fairly consistently from those of children without the disorder in that several brain regions and structures (pre-frontal cortex, striatum, basal ganglia, and cerebellum) tend to be smaller. Overall brain size is generally 5% smaller in affected individuals than those without ADHD. While this average difference is observed consistently, it is too small to be useful in making the diagnosis of ADHD in a particular individual. In addition, there appears to be a link between a person's ability to pay continued attention and measures that reflect brain activity. In people with ADHD, the brain areas that control attention appear to be less active, suggesting that a lower level of activity in some parts of the brain may be related to difficulties sustaining attention.
Q. Aren't there nutritional treatments for ADHD?
A. Many people have already exhausted nutritional approaches, such as eliminating sugar from the diet, before they seek medical attention. At this time, there are no well-established nutritional interventions that have been consistently demonstrated to be effective in diminishing the symptoms of ADHD.
Q. What medications are currently being used to treat ADHD?
A. At this time, Psychostimulant medications, including methylphenidate (Ritalin®) and amphetamines (Dexedrine®, Dextrostat®, and Adderall®), are by far the most widely researched and commonly prescribed treatments for ADHD. Antidepressant medications may also be used as a second line of treatments for those who show poor response to stimulants, who have unacceptable side effects, or who have comorbid conditions (such as tics, anxiety, or mood disorders).
Q. In addition to medications, how else is ADHD treated?
A. While a closely monitored medication treatment can be extremely beneficial to most people with ADHD, expert’s findings indicate that medication alone may not necessarily be the best strategy and that treatment plans that combine medication with therapy are the most effective. Therapeutic counseling can offer help in modifying behaviors, improving social skills, and/or addressing self-esteem, depression or other emotional issues.
Q. What are behavioral treatments?
A. There are various forms of behavioral interventions used for people with ADHD, including psychotherapy, cognitive-behavioral therapy, social skills training, and support groups. Click here to learn more about how therapy works.
Q. Why are stimulants used when the problem is hyperactivity?
A. While the answer to this question is not yet well established, one theory suggests that ADHD is related to difficulties in inhibiting responses to internal and external stimuli. Research suggests that the areas of the brain thought to be involved in planning, foresight, weighing of alternative responses, and inhibiting actions when alternative solutions might be considered, are under-aroused in persons with ADHD and that stimulant medication works on these same areas of the brain, increasing neural activity to more normal levels.
Q. What are the risks of using a stimulant medication?
A. Stimulant medications, when used with careful medical and therapeutic supervision, are usually considered quite safe. Although they can be addictive if they are abused, when taken as prescribed for ADHD, these medications have neither been shown to be addictive nor to lead to substance abuse problems. They seldom make people "high" or jittery, nor do they sedate them. When adverse drug reactions do occur, they are usually related to dosage and are always reversible. Effects associated with moderate doses are decreased appetite and insomnia; these effects usually occur early in treatment and in most cases decrease with time.
Q. What is the relationship between ADHD and other disorders, such as learning disabilities, anxiety disorders, bipolar disorder, or depression?
A. Comorbidity (the presence of co-existing or additional conditions) occurs in most people clinically treated for ADHD. ADHD can co-occur with learning disabilities (15-25%), language disorders (30-35%), conduct disorder (15-20%), oppositional defiant disorder (up to 40%), mood disorders (15-20%), and anxiety disorders (20-25%). Impairments in memory, cognitive processing, sequencing, motor skills, social skills, modulation of emotional response, and response to discipline are common. Sleep disorders are also more prevalent.
Although aggressive research still continues, great progress has been made in recent years to understand ADHD, how it can affect lives and how to best treat the symptoms. In addition to learning more about ADHD in the below-listed links, you may also consider talking with a therapist in your area. There are therapists who are especially trained and experienced at addressing ADHD-related issues and helping individuals and their families who are directly affected by the condition.
Q. What are the symptoms of ADHD?
A. There are three major symptoms associated with ADHD: inattention or distractibility, hyperactivity, and impulsivity. Everyone acts these ways occasionally, so it’s important to compare the person's behavior to those of others in his or her age group. ADHD may be considered as a diagnosis if a person has the following signs for more than six months:
Inattention or Distractibility
A person who is inattentive has a hard time keeping their mind focused on one thing and may become bored with a task after only a few minutes. They may also have difficulty following conversations.
Hyperactivity
A person who is hyperactive always seems to be in motion; sitting still through a meeting or class can be a near impossible task. They may talk incessantly and/or fidget constantly. They may feel intensely restless. The hyperactivity component is not always present in adults, in which case, a diagnosis of Attention Deficit Disorder (ADD) may be more appropriate.
Impulsivity
A person who is overly impulsive seems unable to curb their immediate reactions or think before they act. As a result, they may blurt out answers to questions, make inappropriate comments, or bolt into a situation, for example, darting across the street or barging into a room, without regard for safety or appropriateness. Their impulsivity may make it hard for them to wait for things they want or to take their turns in conversations and other activities.
Q. How is ADHD diagnosed?
A. ADHD is diagnosed through an assessment interview process in which a person’s history and observable behaviors in their usual settings (at home, school or work) are noted. Ideally, the therapist making the diagnosis includes input from key people in the person’s daily environment, which could include family members, co-workers, and/or teachers. It is always helpful to determine what precipitated the request for evaluation (for example, symptoms of inattentiveness or impulsivity that lead to problems in school or work performance), what approaches to correct problems have already been tried (for instance, behaviorial techniques like positive reinforcement), and how effective those approaches have been.
Q. Is ADHD inherited?
A. Research shows that ADHD tends to run in families, so there are likely to be genetic influences. A person who has ADHD usually has at least one close biological relative who also has the disorder. And at least one-third of all fathers who had ADHD in their youth have children with ADHD. Even more convincing evidence of a possible genetic link is that when one twin of an identical twin pair has ADHD, the other twin is likely to have the disorder too.
Q. What is the long-term prognosis?
A. ADHD can persist from childhood through adolescence, and recent follow-up studies that from 10 to 60% of childhood-onset cases will continue, in varying degrees, into adulthood. ADHD that lasts into adulthood is often referred to as ADHD-RT (Residual Type).
Q. Is ADHD on the increase? If so, why?
A. No one knows for sure whether the prevalence of ADHD per se has risen, but it’s very clear that the number of people identified with the disorder who obtain treatment has risen over the past decade. Some of this increased identification and increased treatment-seeking is due in part to greater media interest, heightened consumer awareness, and the availability of effective treatments. A similar pattern is now being observed in other countries.
Q. Can ADHD be seen in brain scans of those with the disorder?
A. Neuroimaging research has shown that the brains of individuals with ADHD differ fairly consistently from those of children without the disorder in that several brain regions and structures (pre-frontal cortex, striatum, basal ganglia, and cerebellum) tend to be smaller. Overall brain size is generally 5% smaller in affected individuals than those without ADHD. While this average difference is observed consistently, it is too small to be useful in making the diagnosis of ADHD in a particular individual. In addition, there appears to be a link between a person's ability to pay continued attention and measures that reflect brain activity. In people with ADHD, the brain areas that control attention appear to be less active, suggesting that a lower level of activity in some parts of the brain may be related to difficulties sustaining attention.
Q. Aren't there nutritional treatments for ADHD?
A. Many people have already exhausted nutritional approaches, such as eliminating sugar from the diet, before they seek medical attention. At this time, there are no well-established nutritional interventions that have been consistently demonstrated to be effective in diminishing the symptoms of ADHD.
Q. What medications are currently being used to treat ADHD?
A. At this time, Psychostimulant medications, including methylphenidate (Ritalin®) and amphetamines (Dexedrine®, Dextrostat®, and Adderall®), are by far the most widely researched and commonly prescribed treatments for ADHD. Antidepressant medications may also be used as a second line of treatments for those who show poor response to stimulants, who have unacceptable side effects, or who have comorbid conditions (such as tics, anxiety, or mood disorders).
Q. In addition to medications, how else is ADHD treated?
A. While a closely monitored medication treatment can be extremely beneficial to most people with ADHD, expert’s findings indicate that medication alone may not necessarily be the best strategy and that treatment plans that combine medication with therapy are the most effective. Therapeutic counseling can offer help in modifying behaviors, improving social skills, and/or addressing self-esteem, depression or other emotional issues.
Q. What are behavioral treatments?
A. There are various forms of behavioral interventions used for people with ADHD, including psychotherapy, cognitive-behavioral therapy, social skills training, and support groups. Click here to learn more about how therapy works.
Q. Why are stimulants used when the problem is hyperactivity?
A. While the answer to this question is not yet well established, one theory suggests that ADHD is related to difficulties in inhibiting responses to internal and external stimuli. Research suggests that the areas of the brain thought to be involved in planning, foresight, weighing of alternative responses, and inhibiting actions when alternative solutions might be considered, are under-aroused in persons with ADHD and that stimulant medication works on these same areas of the brain, increasing neural activity to more normal levels.
Q. What are the risks of using a stimulant medication?
A. Stimulant medications, when used with careful medical and therapeutic supervision, are usually considered quite safe. Although they can be addictive if they are abused, when taken as prescribed for ADHD, these medications have neither been shown to be addictive nor to lead to substance abuse problems. They seldom make people "high" or jittery, nor do they sedate them. When adverse drug reactions do occur, they are usually related to dosage and are always reversible. Effects associated with moderate doses are decreased appetite and insomnia; these effects usually occur early in treatment and in most cases decrease with time.
Q. What is the relationship between ADHD and other disorders, such as learning disabilities, anxiety disorders, bipolar disorder, or depression?
A. Comorbidity (the presence of co-existing or additional conditions) occurs in most people clinically treated for ADHD. ADHD can co-occur with learning disabilities (15-25%), language disorders (30-35%), conduct disorder (15-20%), oppositional defiant disorder (up to 40%), mood disorders (15-20%), and anxiety disorders (20-25%). Impairments in memory, cognitive processing, sequencing, motor skills, social skills, modulation of emotional response, and response to discipline are common. Sleep disorders are also more prevalent.
Although aggressive research still continues, great progress has been made in recent years to understand ADHD, how it can affect lives and how to best treat the symptoms. In addition to learning more about ADHD in the below-listed links, you may also consider talking with a therapist in your area. There are therapists who are especially trained and experienced at addressing ADHD-related issues and helping individuals and their families who are directly affected by the condition.
![Photo: [content-profile-user_profile-profile_first_name] [content-profile-user_profile-profile_last_name]](http://www.4therapy.com/sites/default/files/imagecache/profile_thumb/profile/TH129.jpg)
