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Attention Deficit Hyperactivity Disorder (ADHD)
Here at New Braunfels Psychiatry, we specialize in the treatment of Adult ADHD. Attention Deficit Hyperactivity Disorder, or ADHD is a developmental disorder that is first noticed in early childhood and impacts people throughout their lives. ADHD has been prominently studied since the 1970s, and the majority of treatment options and research focus on childhood symptoms of the disorder. While ADHD almost always presents between the ages of six and twelve years old, many people with ADHD continue to have symptoms throughout adulthood. In the United States alone, over 6 million people have been diagnosed with the disorder, and numbers grow every year.
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ADHD is characterized by a lack of focus, hyperactivity, forgetfulness, and difficulty concentrating on certain tasks. The symptoms can be varied, and expressed slightly differently from person to person.
Every person exhibits some of the symptoms of ADHD at some point in their life. We can all identify with having a lack of focus, or the struggle to sit still or pay attention in certain situations. ADHD is diagnosed when these symptoms are severe, to the point that they result in behavioral problems or impact the ability to function.
Signs and Symptoms of ADHD
Symptoms of ADHD are more common and easily identified in children than adults. Parents and teachers are responsible for monitoring and correcting behavior, and are more likely to realize when a child is exhibiting the disorder. In recent years, many parents, teachers and physicians are more aware of ADHD and how it presents in children, but it is only since the 1970s that ADHD has really been studied, diagnosed and treated. As a result, there are many adults who have struggled with the symptoms of ADHD throughout their lives and remain undiagnosed, or only realize they exhibit the disorder in adulthood. Those diagnosed with ADHD will show some or all of the following symptoms.
Symptoms of Inattentiveness:
- Presenting with a short attention span
- Being easily distracted from the task at hand
- Prone to being disorganized and forgetful, and may often misplace things
- Tend to move from task to task without completing the first
- Have trouble listening, following instructions, or carrying out prolonged and complex tasks
Symptoms of Hyperactivity
- Have trouble sitting still and are likely to fidget. This may be particularly apparent in quiet or formal surroundings where there is pressure to be silent and pay attention
- Unable to complete or focus on tasks
- Fast or excessive talking
- Impulsive or needlessly risky behavior
- May interrupt others speaking or have trouble waiting their turn in line
It is believed that ADHD cannot be diagnosed in adults without first having been present during childhood years. Children tend to exhibit pronounced symptoms of ADHD and while these symptoms may lessen over time, some people continue to struggle with ADHD into adulthood. Adults with ADHD may experience any of the following symptoms.
- Carelessness with tasks; lack of attention to detail and prone to careless mistakes
- Starting many new tasks or projects without first completing those in progress
- May be poorly organized, prone to forgetting tasks and events
- May have a tendency to misplace things or lose even important items
- Struggle with speaking out of turn, interrupting, and “blurting” out statements in conversation
- Struggling with mood swings, irritability, and a quick temper
- May exhibit extreme impatience, even over everyday tasks
- May engage in risky activities such as dangerous driving
- Some adults turn to substance abuse in an attempt to cope with the symptoms of their ADHD
People with ADHD may exhibit some or all of the signs above, but research has identified three broad groups within those suffering from ADHD.
The Three Types of ADHD
There are three broad types of ADHD that have been identified, with each type exhibiting slightly different characteristics of the same disorder:
- ADHD – Predominantly Inattentive Type: Those diagnosed tend to exhibit symptoms of forgetfulness, disorganization, lack of concentration, daydreaming and being prone to distraction
- ADHD – Predominantly Hyperactive or Impulsive Type: Sufferers exhibit hyperactivity, impatience, immature behaviour, an inability to sit still, and may be prone to destructive behaviours
- ADHD – Combined Type: Patients tend to show symptoms of both of the above
Impact of ADHD
ADHD symptoms can have a severe and long lasting impact on a person’s life, particularly if they are not aware they suffer from the condition. It may be difficult for those with the disorder to behave and perform as expected personally and in public life. People suffering from ADHD may exhibit any of the following impacts as a result of the disorder.
- Children with ADHD may struggle to perform well in school. Children may find it difficult to behave and absorb information in a typical classroom environment
- Adults with ADHD may suffer from unemployment or chronic underemployment
- Adults with ADHD may face trouble with the law and have difficulty maintaining personal finances
- Personal life and relationships may be impacted due to inattention and trouble with anger
- Those with the disorder may have low self-esteem and a poor self-image. They may turn to substance abuse in an attempt to cope with these feelings
- Children and adults may face feelings of shame, or feeling stigmatized
- People diagnosed with ADHD are at increased risk of suicide, particularly since adults with ADHD tend to present with a dual mental health diagnosis
ADHD in Childhood vs. Adulthood
ADHD is most commonly diagnosed and recognized in childhood. Early intervention can help people with ADHD recognize their symptoms and develop good coping strategies early in life. Early diagnosis also gives loved ones the opportunity to understand and support children in their disorder, rather than having symptoms interpreted as intentional defiance. Parents can ensure their children have access to the treatment, medication, and learning opportunities they need to cope with their symptoms and learn to manage them. As they grow up, many children diagnosed with ADHD will eventually “grow out” of the disorder, and no longer exhibit symptoms.
Many others struggle with ADHD into adulthood. Where ADHD persists in this way, it is often present alongside other mental health issues, such as substance abuse, anxiety, and depression. If someone is not diagnosed in childhood, it can be more difficult to identify the presence of ADHD. It is believed that ADHD symptoms do not develop in adulthood, and a diagnosis for the disorder will not be made unless symptoms were also present between the ages of six and 12 years old. Reaching an adult diagnosis for ADHD is often based on information provided by parents, siblings and teachers about symptoms that may have been missed in adolescence.
Both children and adults benefit from a treatment regime that combines medication, therapy, and appropriate self-care and lifestyle choices.
Causes of ADHD
ADHD is one of the most studied and most understood mental health issues impacting young adults, but the real cause of the disorder is still unknown in most people diagnosed. It is commonly believed by experts that ADHD develops with some combination of genetic, environmental, and social factors – but there is no single predictor for the development of the disorder. Some rare cases have been known to develop after a patient has suffered from injury, illness, or other damage to the brain.
Scientists have identified a link between a number of different genetic markers and ADHD. These markers may be linked to how effective stimulant medication will be for managing symptoms. It has been theorized that in the past, the development of the characteristics of ADHD may have been to our evolutionary benefit. The disorder makes individuals perfect for dealing with highly stressful and rapidly changing environments, traits which served our ancestors well, but may make modern life difficult. Children of parents with ADHD are more likely to develop the disorder, which suggests a strong genetic component as well.
Environment has also shown to be a factor in many cases as well. Fetal exposure to alcohol and tobacco, and premature birth have been linked to ADHD. People who have suffered severe abuse, neglect, social deprivation, or other childhood traumas also exhibit ADHD at higher rates. Children who have suffered a brain injury or infections (such as measles or rubella) may be more likely to develop ADHD as well.
There is no single test that one can take to determine whether they have ADHD. Diagnosis involves a careful examination and ruling-out of disorders by a professional who is familiar with the condition. Anyone who feels they are exhibiting symptoms of ADHD can speak to a doctor to explore if they are impacted by the disorder. A physician may opt to perform some physical tests to be sure there are no underlying issues causing the symptoms. However, the process of diagnosis relies heavily on gathering a patient history, reviewing symptoms, ruling out other issues, and using some available tests, scales, and interview questions to determine if ADHD is present.
Children will be diagnosed with ADHD if they exhibit the majority of the typical symptoms, and investigation is usually triggered if the child exhibits behaviors that are inappropriate for their age. Even if someone was not diagnosed with ADHD in childhood, it is possible to retroactively recognize that the symptoms were present at an earlier age. May adults who are diagnosed at a later age feel a sense of relief and revelation, finally seeing a link between many of their lifelong struggles.
Psychological Counselling for ADHD
Effective treatment for ADHD usually involves a combination of psychological counselling, medication, education, and training for symptom management. Each of these activities is undertaken to help patients to minimize and manage their symptoms, but do not cure the disorder.
For adults, psychological counselling can help to:
- Improve time management and organizational skills; develop systems to keep these skills in place
- Reduce the tendency toward impulsive and reckless behavior
- Develop problem-solving skills that can help to serve in personal and professional life
- Cope with low self-esteem related to ADHD symptoms, and related past failures (in school, work or personal life)
- Help with anger management and stabilizing mood
- Improve relationships and assist in developing a robust support system
For individual counselling, Cognitive Behavioral Therapy is a very successful form of therapy for ADHD patients because it helps to develop concrete thinking patterns that sufferers can rely on when symptoms overwhelm them.
ADHD can cause strain in personal relationships and families, and many people find that couples or family counselling can help to strengthen relationships and cope with ADHD. Communication and problem-solving skills are central to this process, and patients can benefit endlessly from the full support of a loved one. Together, loved ones can learn to manage and minimize the symptoms of ADHD, learn constructive ways to deal with frustration, and learn how to best support one another.
ADHD is commonly treated using stimulant medications, which are believed to boost and balance the level of neurotransmitters in the brain. Vyvanse, Ritalin, and Adderall are all commonly used to treat the symptoms of ADHD. These medications can help to improve attention span, increase self-control, improve social behavior and help with fine motor control. Some stimulant medications are fast acting, and taken as needed, while others are slow acting and can take weeks to build up in a patient’s system. To find a successful treatment regimen for ADHD, some patience and experimentation may be required.
Some people do not respond well to stimulant medication, and may need to avoid them because of side effects of medical history. Luckily, there are many other medications that can be tried for patients in this situation. Antidepressants can be effective in the treatment of ADHD, particularly if someone is facing a dual-diagnosis. Atomoxetine (Strattera) is a norepinephrine reuptake inhibitor and has been shown to help with core symptoms of ADHD, and also helps to regulate mood. It may take up to three weeks to begin to show effectiveness, but has been very helpful to children and adults with ADHD.
There are a number of alternative treatments available for ADHD, including dietary regimens and nutritional supplements. These have not shown to have any impact on the treatment. Anyone considering treatment with these remedies should speak to their doctor before using them, to avoid any negative side effects.
Self-Care and ADHD
Adults who exhibit symptoms of ADHD must practice self-care to ensure they minimize symptoms of the disorder. Sticking to a treatment plan, and taking medication according to instructions is an excellent place to start. It is also recommended that adults with ADHD ensure they maintain their physical health, getting enough sleep, proper nutrition, and plenty of exercise. There are also many organizational tools that adults find helpful in managing symptoms.
The symptoms of ADHD can be confusing and very distressing to experience. They may cause problems in family life, in personal relationships, with finances, and with employment. As a result, many sufferers turn to drugs and alcohol in an attempt to self-medicate, and alleviate their own pain. In people with ADHD, these substances can worsen symptoms over time, and it is recommended that they be avoided.
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Learn more About ADHD
You can learn more about ADHD by visiting: http://www.apa.org/topics/adhd/
Parents of children with ADHD can find help and resources here: http://www.apa.org/topics/parenting/index.aspx
To learn more about Ritalin and the history of Ritalin use for treating ADHD, you can find out more at: http://www.apa.org/topics/adhd/ritalin-debate.aspx
Adults suffering from ADHD can find excellent support and resources at this address: http://www.chadd.org/
For those diagnosed with ADHD and anxiety, find more information here: http://www.adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/adult-adhd
To learn more about Vyvanse and its’ use in treating ADHD, you can go to: http://www.vyvanse.com/
New Braunfels Psychiatry Treats Adult ADHD in the Central Texas region covering New Braunfels, Canyon Lake, Seguin, San Antonio, San Marcos, Stone Oak, and surrounding areas.