What is ADHD?
Attention Deficit Hyperactivity Disorder (ADHD) is derived of three main types of symptoms: inattention, hyperactivity, and impulsivity in various different environments. Many people with ADHD display varying degrees of each of the symptoms. Some symptoms are usually more prevalent than others which helps to determine the type. In children, ADHD is typically diagnosed between the ages of 5 and 7. Many adults with ADHD grew up with the disorder, though it may have not been diagnosed. It will not impair a person in only one location. It would affect them pretty much anywhere but may be more manageable in certain environments.
To date, there are no truly definitive statements proving the cause of ADHD. The evidence currently available shows that a variety of biological factors may predispose children to significant symptoms relating to attention and higher energy levels and impulsive behaviors. Recent evidence specifically suggests that brain functioning in the areas responsible for modulating and inhibiting behavior may be affected by hereditary factors in individuals that develop the disorder. In the well controlled studies on the causes, no significant links have been found between the disorder and dietary factors such as sugar, caffeine, or artificial coloring. In other words, while dietary factors may have some impact on behavior or symptoms (for any child), there is no direct relationship between dietary factors and ADHD. Likewise, the evidence does not support the theory that parenting practices or anxiety are important causal factors in the development of the disorder. However, they can impact the severity of the symptoms and behaviors, as they do with any child.
Another common myth, is that children will outgrow the disorder. It was widely believed, for a long time, that children would outgrow their symptoms and behavioral difficulties by adolescence or early adulthood. However, now that data on long term outcomes has been accumulated, it shows that 70-80% of children with ADHD continue to exhibit significant deficits in attention and impulsivity relative to their same age peers during adolescence. About 50% continue to exhibit deficits into adulthood. I am one of those.
Some people question whether ADHD is a valid thing or if people with it are just “different” from the norm. Some of this doubt stems from the fact that most people, especially children, display the symptoms of ADHD at some point in their lives. For example, there are plenty of energetic children out there. Why is one considered energetic and the other considered hyper? What’s the difference? How come when I forget something silly, we call it forgetful but when my son does it, he’s ADHD?
The key difference between a person with ADHD and any “normal” person is simply persistence. People with the disorder have a persistent pattern of inattention, hyperactivity, or impulsivity, or any combination of the three that occurs in academic, occupational, and social settings. Let’s break that down a little bit to make it more clear. The environment doesn’t matter. People with ADHD can’t control themselves in a social setting but then not in an academic setting. They don’t behave at school and only “act up” at home or work. One of the key distinguishing factors of ADHD is that the symptoms are prevalent in multiple settings.
Inattentive ADHD: This type used to be called ADD as people have a hard time focusing and paying attention. We may lose our focus mid-sentence or be easily distracted. These are often called “butterfly” moments. This may also include failing to complete tasks, making careless mistakes, inability to stay organized, and difficulty keeping track of things.
Hyperactive-impulsive ADHD: These folks can pay attention but seem to always be on the go, we can’t sit still. This is often seen as tapping of the fingers, shaking a foot or leg, bouncing up and down, climbing on things, etc. Problems with hyperactivity usually present as excessive fidgeting or squirminess, inappropriate running and/or climbing, talking excessively, or constantly being on the go. Impulsivity may include frequently interrupting others, lack of patience, blurting out answers, or constant failure to wait their turn.
Combined ADHD: As the name implies, this type of ADHD includes all of the above. There are attention issues as well as hyperactivity and impulsivity. This is the most common type.
Frequent careless mistakes
Many butterfly moments (Easily distracted)
Difficulty with focus and staying on task
Blurting out answers
Trouble finishing tasks before moving on to others
Trouble sustaining attention to conversations
Trouble taking turns
Squirming when sitting
Difficulty in quiet situations
While many people may display some of these symptoms from time to time, people with ADHD experience more of these symptoms and they usually tend to be much more persistent, severe, and intense. The difference between an energetic child and a Hyperactive child is that the hyperactivity causes persistent problems. This may be in a school setting where a teacher is trying to get the class to come to order and the child with ADHD simply can’t calm down and sit still. Or it may be in the doctor’s office when trying to get a blood pressure reading and the child can’t stop fidgeting. It could be at home when the family is trying to eat dinner and the child is climbing all over the table and chairs. While it’s normal for some children to have trouble completing homework or chores, the child with ADHD needs constant supervision, monitoring, and redirection to complete any given task. The big difference between the “norm” and ADHD is that these symptoms cause significant impairment in daily functioning while the behaviors that occur only occasionally tend to reflect normal childhood behavior. Children with ADHD don’t fit in the same box as other children.
One of the most perplexing aspects of ADHD is that the symptoms tend to vary considerably at different times and in different settings. For example, my son may have very good days at school where he stays on task and completes all of his work but maybe 60 – 80% of the time, he’s inattentive and hyper. This is misconstrued as lazy or defiant to his teachers because they know he can do it. He “just chooses not to” most of the time. He “lacks motivation” or simply “doesn’t care”. Erratic performance at home and/or at school is highly common among those with ADHD. Just because he has one good day doesn’t mean every day can be just as good. I think of it this way, just because I got a “hole in one” on the putt-putt course that one time doesn’t mean I can do it every time. Can you? Performance fluctuates for everybody, even with ADHD.
Many children with ADHD tend to display several other problems. They may display low levels of frustration tolerance, temper tantrums/fits, social problems, lack of confidence, irrational fears, academic underachievement, bossiness, and low self esteem. None of these are considered ADHD symptoms and while some children with it may experience some of these difficulties, not all do. These difficulties can occur for a variety of different reasons. There is a rather long list of medical conditions and other disorders that tend to mimic ADHD symptoms as well. It is very important to know the difference as this can help prevent a misdiagnosis which can lead to ineffective treatment that may exacerbate an underlying condition.
ADHD Diagnosis & Treatment
There is no specific test to diagnose ADHD. Making the diagnosis should include a medical evaluation first to rule out any other possible causes of the symptoms. Next, there should be information gathering for medical professionals to evaluate known medical issues, personal and family medical and academic history, and academic records. This will be followed by specific questionnaires for family members, school personnel, and anybody else who is frequently involved in the child’s life, such as babysitters, coaches, and friends of the family. ADHD rating scales will help the medical professionals collect and evaluate the information for an accurate diagnosis. For a true ADHD diagnosis, multiple symptoms will be present for more than six consecutive months and will be consistent in at least two different environments, such as home and school.
While medical treatment can help with some symptoms, there is no “cure all” pill that fixes ADHD. It is not a curable disorder. As far as treating the core symptoms of inattention, hyperactivity, or impulsivity, numerous studies have shown that stimulant medication has shown significant benefits in around 80% of children with ADHD. Evidence suggests that the stimulants correct a biochemical condition in the brain that interferes with attention and impulse control. That being said, stimulant medications also come with a wide variety of negative side effects which I will list for any products I’ve tried and reviewed. It is absolutely vital that a correct diagnosis be determined, by medical professionals, before any medical treatment is started. Hindsight doesn’t undo any damage that may be done by giving meds that make an underlying condition worse.
While medications tend to help with symptoms, and may make the child with ADHD undistinguishable from other children their age, they do not treat all symptoms of the disorder. Behavior Therapy has also proven highly effective when done correctly and is often done in addition to medications. Behavior Therapy should be designed and implemented by parents with the help of a mental health professional or behavior therapist. The basic premise of behavior therapy is that every specific behavior will increase or decrease based on the consequences of that behavior. As easy as that sounds, it is extremely difficult to implement and follow an individualized behavior treatment plan effectively due to the difficulty people naturally have in being entirely consistent. Finding appropriate rewards and punishments also proves quite challenging for so many specific behaviors.
With appropriate medical and behavioral treatment, the core symptoms of the disorder can be managed effectively. However, other interventions are often necessary to address other difficulties the child may be having. These may included specialized educational assistance, social therapy, or emotional therapy to name a few. For ADHD to be treated and managed effectively, all problems that the child has must be addressed to either help reduce or eliminate the symptoms. But with a combination of treatment, constructive discipline, coping strategies, and creative parenting… people with it can be highly successful. In fact, I read somewhere that about 7% of adults with ADHD became some of the most influential people. A few of these include:
- Actor – Christopher Knight
- Actor – Jim Carrey
- Actor – Robin Williams
- Actor – Will Smith
- Actress – Paris Hilton
- Artist – Pablo Picasso
- Athlete – Michael Jordan
- Aviation Entrepreneur – David Neeleman
- Baseball Star – Pete Rose
- Business Mogul – Richard Branson
- Comedian / TV Host – Howie Mandel
- Entrepreneur – Bill Gates
- Founder of Disneyland – Walt Disney
- Founder of Kinko’s – Paul Orfalea
- Inventor – Benjamin Franklin
- Inventor – Thomas Edison
- Music Composer – Mozart
- NFL Quarterback – Terry Bradshaw
- Olympian – Bruce Jenner
- Olympian (Most decorated of all time) – Michael Phelps
- Physicist – Albert Einstein
- Political Consultant – James Carville
- President of the United States – John F. Kennedy
- Professional Dancer (Dancing With the Stars) – Karina Smirnoff
- Singer/Actor/Producer – Justin Timberlake
- Sing – Solange Knowles
- Star Chef – Jamie Oliver
- TV Host (Extreme Makover) – Ty Pennington
In conclusion, ADHD is a neurological disorder with an undetermined cause at this point. There are multiple symptoms but the primary three are a combination of inattentiveness, hyperactivity, and impulsivity that significantly impair a child’s daily functioning for more than six months in multiple settings. The two primary forms of treatment are stimulant medications and behavior therapy, though other interventions are often necessary. Academic difficulties are almost always prevalent in children with ADHD. Dietary factors, parenting practices, and anxiety have no direct link to the disorder. There are many conditions which mimic the same symptoms, as well as many myths surrounding the disorder. There are also many people with it that grow up to be highly effective people in society.
I hope this clears things up!
8 thoughts on “ADHD – What is it Exactly?”
That sums up my childhood about right. When I was a kid they didn’t have a thing called ADHD. We were just discipline problems. I got plenty but in truth I wasn’t trying to be a problem, I just couldn’t help my behaviours. Well flash forward to me now being near 50. It has been a hard road but I was able to earn a college degree and have had a successful career. I had a son that had ADHD as well. He was placed in special ed. I am not sure if that served him well or not. He was always lumped with kids that had a diminished cognitive capacity. He didn’t but felt like he did. Nice work you are doing. Nice to connect on WA.
Yeah, I went down that path myself. Grew up ADHD with no diagnosis. My own mom still calls me a discipline problem and doesn’t really think about the impact that ADHD had on me as a kid. My son is not in special ed but currently has a Section 504 plan. We are working on getting him on an IEP. The problem is, both are only as good as the people that implement them. If the school doesn’t try to help, there’s really no use. My son will be passed to 5th grade this year with a report card full of D’s and F’s. He’s completely lost in math and considers himself a failure despite my efforts to try and convince him otherwise. The 504 plan keeps him out of special ed. So that’s a good thing as special ed isn’t really necessary for him. It’s tough. We’ve come along way from when I grew up and when you grew up, but we still have a long way to go. If I can help with that, I’m happy to do so. Thanks for the feedback!
A very detailed article on ADHD, I think my wife has it because she is always talking. lol It appears if you have it you are in good company with the list of celebrities and famous people you mention. I always enjoy being different than the norm anyway. I’m always looking for alternative medicines and I would definitely stay away from stimulants due to the adverse side effects. Great job on bringing this to your readers attention. I learned a lot from your article. Keep up the great work.
Thanks, Bob! Yes, stimulants can be very bad news. In fact, psychiatrists prefer non-stimulants due to the negative side effects. I will be going into that at a later date. Thanks for the feedback!
Judging from the list of famous people with ADHD it seems with names like Einstein, Picasso, and Mozart that ADHD can be a blessing in disguise.
I’m not sure that medications are really appropriate for ADHD, especially since most of these medications are nothing more than amphetamines which are quite addictive.
Yes, ADHD can absolutely be a blessing in disguise. At least it is for me. However, many people go through so many obstacles and so much turmoil in school due to this disorder, that it kills their confidence which, in turn, kills their creativity. True ADHD is hard. It’s hard to live with, it’s hard to be understood, it’s hard to function.
I don’t look at it as a matter of what’s appropriate for ADHD, I look at it as what’s most appropriate for your child? What’s most appropriate for the affected person? The two primary treatments for ADHD are medications and behavior therapy, that’s a fact. The effectiveness of each is debatable. There are many medications that can be used to treat ADHD symptoms, many of which are not stimulants or amphetamines. Strattera, for example, is a highly effective medication that doesn’t fall under the stimulants and does not come with the quite addictive side effect. There are many different methods for treating ADHD, which I will go into in later posts. This page simply lists the facts.
Thanks for the feedback!
Wow, that is such a detailed discussion of ADHD. You have covered a lot of angles. I appreciate that as a sufferer yourself, you are speaking with a fair amount of experience.
I note with interest the list of influential people who it seems have ADHD. Was that diagnosed for sure for each of them or could it be that they are simply introverts trying to survive in an extroverted world? There are many introverts that are deemed social incapable but that is based on the premise that the extrovert model is the best one to focus on.
Have you investigated the perceived link between introversion and ADHD?
The list includes many confirmed, diagnosed cases of ADHD and many unconfirmed that have said they have it. They are not simply introverts trying to survive in an extroverted world. I would not classify the people on this list as socially incapable, nor would I say the same for anybody with ADHD alone. My son suffers from ADHD and is a highly extroverted person with many friends. I am blessed with ADHD and am somewhat introverted, but can function just fine socially when I want to. ADHD is not characterized by social incapability or introverted at all. Yes, I have investigated the perceived link, the fact is, there is no scientific link between introversion and ADHD. Bear in mind that introversion is simply a personality type, not a medical disorder as ADHD is. Likewise, ADHD is not a personality type. The only real correlation is that both are highly misunderstood, misrepresented, and misdiagnosed for many years. Another potential link between the two, from personal experience, is that introverts are often exhausted by being around other people and need to retreat on their own to regain energy. Similarly, people with ADHD are exhausted by trying to conform to society and dealing with trying to control themselves in a world that doesn’t understand and so they’ll often retreat to regain energy before facing the world again. Thanks for your feedback!