ADHD is a neurodevelopmental condition that affects people of all ages. It is characterized by recurrent patterns of hyperactivity, impulsivity, and inattentiveness that can have a serious negative effect on social, vocational, and academic functioning.
You might also describe it as a behavioral issue that makes it difficult to focus on ordinary tasks and requests.
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Getting organized, maintaining focus, creating practical goals, and thinking things through before acting are common difficulties for people with ADHD. They could be restless, obnoxious, and unable to adjust to shifting circumstances.
What is ADHD??
ADHD is one of the most prevalent and extensively researched neurodevelopmental disorders in children. Nerves are referred to as “neuro”. People with ADHD have different brains, nerve networks, and neurotransmitters, according to scientists.
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Executive dysfunction, or the inability to control one’s own emotions, ideas, and behaviors, is a long-term (chronic) brain disorder caused by ADHD. People with ADHD have difficulty:
- Control what they do.
- Become still.
- Seize the moment.
- Control too much activity.
- Control your feelings.
- Organize yourself.
- Obey the rules.
The illness is typically diagnosed in children during their early years, and it frequently persists into maturity. But there are effective treatments out there. If ADHD is not addressed, it may result in serious, life-long consequences.
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How common is ADHD?
According to a 2016 report from the Centers for Disease Control and Prevention (CDC), around 6.1 million children in the United States (9.4 percent) between the ages of 2 and 17 are thought to have been diagnosed with attention deficit hyperactivity disorder (ADHD or ADD).
The data include 388,000 (2.4%) young children between the ages of 2 and 5, 2.4 million (9.6%) school-age children between the ages of 6 and 11, and 3.3 million (13.6%) teenagers between the ages of 12 and 17.
The same study discovered that males (12.9 percent) and girls (5.6 percent) had different odds of ever receiving an ADHD diagnosis.
But according to research, there are more girls affected by ADHD than is commonly and conventionally believed. Due to the differences in how girls’ symptoms present compared to boys’, ADHD may go undiagnosed in girls, which may be indicative of a systemic bias in the diagnostic process.
The DSM-53 lists ADHD as one of the most widespread neurodevelopmental disorders of childhood. Although statistics vary, it is believed that roughly 5% of children globally suffer from ADHD.
Additionally, According to a 2020 study, there are 2.8 percent of adults globally who have adult ADHD.
Estimates of the prevalence of adult ADHD in the US vary. According to a 2019 study, the prevalence of adult ADHD is 0.96 percent, double the 0.43 percent figure from a decade earlier.
According to earlier research, the prevalence of adult ADHD in the United States ranges from 2.5 to 4.4 percent7, with men more likely to be diagnosed than women (5.4 to 3.2 percent).
Types of ADHD
The three primary kinds of attention-deficit/hyperactivity disorder (ADHD) are as follows:
- Inattentive type
- Hyperactive-impulsive type
- Combination type
Each form of ADHD is connected to one or more traits. Inattention and hyperactive-impulsive conduct are symptoms of ADHD.
These actions frequently take the following forms:
- Inattention includes being easily distracted, having trouble focusing, and having trouble planning.
- Hyperactivity is characterized by an inability to stop talking or fidgeting and difficulty focusing.
- Impulsivity includes disrupting and taking chances.
Since everyone is unique, it’s typical for two people to react differently to the same symptoms. For instance, these actions differ frequently between boys and girls. Girls may be subtly inattentive while boys may be perceived as being more energetic.
Which form of ADHD you have will be determined by the symptoms you encounter.
If you have this form of ADHD, you might notice more inattentional symptoms than impulsive and hyperactive ones. You might occasionally have trouble with hyperactivity or impulse control. However, these aren’t what inattentive ADHD is primarily known for.
People that frequently display inattentive conduct include:
- Miss details and get sidetracked easily
- Become bored easily
- Struggle to concentrate on one task
- Struggle to organize their thoughts and learn new material
- Misplace pencils, papers, or other necessary items
- Don’t seem to listen
- Move slowly and
- Seem to be daydreaming
- Process information more slowly and inaccurately than others
- Struggle to follow instructions
ADHD of the inattentive kind is diagnosed in more women than in men.
Hyperactivity and impulsivity are symptoms of this specific form of ADHD. Even if they are less visible than the other symptoms, this person can exhibit signs of inattention.
Individuals that are impulsive or hyperactive frequently:
- Move around or get agitated
- Have difficulties sitting still,
- Talk constantly,
- Touch and play with objects—even when it’s unnecessary
- Have trouble undertaking peaceful activities, act out of turn, and fail to consider the implications of their actions. They are constantly “on the go” and impatient.
Children with ADHD who are impulsive and hyperactive may cause issues at school. They might hinder their own and other students’ ability to study. Boys are diagnosed with the hyperactive-impulsive type more often than girls.
If you are a mixture type, your symptoms don’t just relate to inattention or hyperactive-impulsive conduct. Instead, a hybrid of the signs and symptoms from both groups is shown.
The majority of people, whether they have ADHD or not, exhibit some degree of inattentive or impulsive conduct. But among those with ADHD, it’s worse. The more frequently it happens, the more it affects your ability to perform at home, at school, at work, and in social settings.
The National Institute of Mental Health Trusted Source states that combo-type ADHD affects the majority of youngsters. Compared to girls, boys are more likely to exhibit this type. Hyperactivity is the most prevalent symptom in preschoolers.
Causes of ADHD
Like other prevalent medical and mental conditions (such as schizophrenia, and asthma), ADHD is influenced by several genes, non-inherited variables, and their interactions. ADHD has multiple causes, and being exposed to a risk factor does not guarantee the development of the illness. This implies that a risk factor will only be seen in a certain percentage of cases and will also be present in healthy individuals.
Additionally, risk factors that affect ADHD’s course and consequences may not always be the same as those that contribute to the disorder’s origins.
The fact that genetic and environmental factors can interact to produce indirect risk effects adds another layer of complexity. Gene-environment interactions, such as those caused by environmental pollutants or psychosocial hardship, can cause changes in susceptibility to environmental dangers. The likelihood of being exposed to specific environmental dangers can also be influenced by inherited variables (gene-environment correlation; see later). This means that the impacts of hereditary and environmental risk factors cannot be completely separated.
Strong evidence of a hereditary component to ADHD has been found in a variety of study methods. According to family studies, relatives of affected probands have greater rates of ADHD (a two- to eight-fold increased risk) than those of unaffected controls. Studies on twins have found that monozygotic twin pairs have much higher concordance rates for ADHD than dizygotic twin pairs.
Adoption studies have also discovered higher rates of ADHD in the biological parents of ADHD adoptees when compared to both the adoptive parents of the probands and the parents of controls without ADHD (e.g., Sprich et al). The estimated mean heritability is 79%. The fact that heritability is not 100% indicates that non-inherited factors may possibly be involved.
Along with other neurodevelopmental and psychiatric issues, including ASDs, developmental coordination issues, reading ability issues, IQ issues, conduct issues, and mood issues, ADHD also appears to have a hereditary vulnerability. These findings imply that the same familial and hereditary hazards may appear as several clinical presentations.
Environmental risk factors
There are many more explanations for ADHD than inherited traits. It can be difficult to determine which of the environmental risk factors for ADHD are causal, despite the fact that there are many of them. This is due to the fact that many observed associations could result from unmeasured confounders, such as inherited factors, or from reverse causation, such as peer rejection, family adversity, low socioeconomic status, or head injury
Interestingly, despite an increase in identification, studies on time trends have not found an increase in the prevalence of ADHD in the general population. There is currently no conclusive evidence that certain nations have lower incidence of ADHD, according to cross-national studies.
These results are in contrast to information on childhood behavioral issues, which has shown that rates have increased over the past 50 years and vary geographically. These findings imply that many environmental risks, each with a minor impact, are more likely to exist for ADHD, with the cumulative load of these risks being constant across time and across nations.
Genetic influences may change some of these risk factors (gene-environment interaction). Through tissue-specific epigenetic pathways, environmental dangers can also change how genes operate. Animal studies, for instance, have shown how poor early parenting affects stress responses via such systems and that these biological alterations can be passed down to succeeding generations.
Low birth weight and prematurity
The majority of research, including meta-analyses of children born prematurely and/or with low birth weight, finds evidence of a link between ADHD symptoms and/or attentional issues (relative risk of ADHD in preterm children, according to one study) Extreme preterm and very low birth weight tend to carry the highest risk in terms of inattention symptoms and the ADHD inattentive subtype.
Additionally, preliminary research points to the probable significance of intrauterine growth restriction (small for gestational age). However, it is unknown if low birth weight, preterm, and other related pre/perinatal hazards are risk factors for ADHD or if they are causes of the disorder. The findings at least imply that there should be greater attention paid to the possibility of ADHD in very premature/low birth weight children.
Toxins and diet
Organic pollutants (such pesticides, polychlorinated biphenyls (PCBs), and lead) are two examples of environmental exposures that seem to be relevant to the ADHD phenotype. They might harm the neurological and cognitive systems that are linked to ADHD.
Assessments of prenatal and postnatal (childhood) urinary organophosphate metabolites and umbilical cord plasma levels of pesticides have been used to investigate associations between organophosphate pesticide exposure and ADHD cross-sectionally and prospectively (e.g. Eskenazi et al., Marks et al., Rauh et al.,).
PCBs are a sizable class of hazardous synthetic organic chemicals that were formerly produced in enormous quantities. Working memory, reaction inhibition, and cognitive flexibility have all been reported to be impaired in research on both humans and animals that looked at the impact of PCB exposure on neurobehavioral outcomes related to ADHD.
A recent prospective study also discovered a favorable dose-response link between low-level prenatal PCB exposure and middle childhood ADHD-like behavior. Studies of lead exposure in both humans and animals have revealed similar deficits in executive processes and attention, with cognitive flexibility, vigilance, and alertness being most consistently impacted.
Although causality cannot be inferred from the evidence to far, there is accumulating evidence from numerous research that lead may be related to ADHD even at low levels. Similar to this, further research is necessary before drawing clear conclusions concerning the significance of pesticides and PCBs as causes of ADHD.
There are various steps involved in determining whether a child has ADHD. There is no single test for diagnosing ADHD, and a lot of other issues, including anxiety, depression, sleep issues, and some forms of learning difficulties, might have symptoms that are comparable.
To rule out other conditions with symptoms similar to ADHD, one phase of the approach entails undergoing a medical examination, which includes hearing and vision testing. When a child is diagnosed with ADHD, parents, teachers, and occasionally the child themselves provide a history of the child and complete a checklist to rate their ADHD symptoms.
In most cases, ADHD is best treated with a combination of behavior therapy and medication. For preschool-aged children (4-5 years of age) with ADHD, behavior therapy, particularly training for parents, is recommended as the first line of treatment before medication is tried.
What works best can depend on the child and family. Good treatment plans will include close monitoring, follow-ups, and making changes, if needed, along the way.
ADHD is a complex neurodevelopmental disorder that affects millions of individuals worldwide. By understanding its symptoms, causes, and impact, we can develop effective strategies for managing ADHD and supporting those affected by it.
Through a combination of behavioral interventions, medication, coping strategies, and a supportive environment, individuals with ADHD can thrive and lead fulfilling lives, contributing their unique strengths to society. Increased awareness, research, and empathy are essential in improving the lives of individuals with ADHD and promoting a more inclusive society for all.