Attention Deficit Hyperactivity Disorder (ADHD): Symptoms, Effects, Risk, and Treatment

Attention-deficit hyperactivity disorder (ADHD) involves persistent patterns of inattention, hyperactivity, and impulsivity that interfere with daily functioning and development. It affects both children and adults, with symptoms often persisting into adulthood. 

ADHD manifests through a variety of symptoms, including difficulty maintaining attention, managing energy levels, and controlling impulses. Individuals exhibit inattention by daydreaming, becoming easily distracted, or making careless mistakes. Hyperactivity presents as an inability to sit still, excessive talking, or impulsive actions without considering consequences. These symptoms fluctuate in intensity and change over time, affecting life’s personal, academic, and professional aspects.

The risks associated with ADHD are physical, emotional, and social. Children and adults with ADHD get accidents due to impulsive behavior or inattention. They also experience difficulties in personal relationships or social situations due to hyperactivity and impulsivity. The condition can also lead to low self-esteem, anxiety, depression, and other mental health problems.

ADHD effects are stress and negative impact on academic or job performance, personal relationships, and daily functioning. Children may struggle with learning and behavioral issues in school, leading to poor grades and social isolation. Adults may face challenges in the workplace due to their symptoms.

Diagnosing ADHD involves a comprehensive evaluation by a healthcare professional, including medical history and physical exam, symptom assessment using standardized criteria, and ruling out other conditions with similar symptoms.

Treatment for ADHD requires a multimodal approach, including medications, behavioral therapy, cognitive-behavioral therapy, social skills training, educational support, lifestyle modifications, and other therapies. While ADHD can present significant challenges, proper treatment and management can significantly improve the quality of life and reduce associated risks.

What is ADHD?

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by persistent patterns of inattention, hyperactivity, and impulsivity that interfere with functioning and development, as defined by Dr Rana Elmaghraby’s review “What is ADHD?” in the American Psychiatry Association (2022).

In 2018, the percentage of people with an ADHD diagnosis was 20 per 10,000  in women and 74.3 per 10,000 (95%CI 72.3-76.2) in men. For boys, the proportion was 255 per 10,000 (95% CI 247-263), while for girls, it was 67.7 per 10,000 (95% CI 63.5-71.9), according to McKechnie DGJ’s 2023 report on Pubmed Central Journal.

ADD is an outdated term that is used to refer to the inattentive type of ADHD, which is characterized by symptoms like distractibility, forgetfulness, and difficulty focusing, but without hyperactivity. ADHD is the current medical term that encompasses three subtypes: predominantly inattentive (formerly called ADD), predominantly hyperactive-impulsive, and combined type. 

All three ADHD subtypes involve problems with attention, but the hyperactive-impulsive and combined types also feature symptoms of hyperactivity like restlessness and impulsivity that the inattentive type does not. Mental health professionals no longer diagnose ADD separately but rather diagnose one of the three ADHD types based on the patient’s specific symptoms.

What are the symptoms of ADHD?

The symptoms of ADHD are hyperactivity, impulsivity, and difficulty focusing. ADHD is characterized by a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development, according to an NHS article on “Attention deficit hyperactivity disorder (ADHD).”

These symptoms vary in severity, frequency, and impact and often manifest differently in children and adults, 

Hyperactivity

Hyperactivity involves excessive movement and activity that is not appropriate for the setting. Adults with hyperactivity experience extreme restlessness and may talk excessively. Although hyperactivity decreases with age, adults still feel restless and have difficulty engaging in sedentary activities.

Impulsivity

Impulsivity is characterized by hasty actions that occur immediately without forethought and have a high potential for harm. Examples include interrupting others, making important decisions without considering long-term consequences, and being unable to delay gratification. Impulsive behaviors lead to social and academic challenges in children, unstable relationships, and poor job performance in adults.

Difficulty Focusing (Inattention)

Difficulty focusing, or inattention, involves problems sustaining attention, staying organized, and following through on tasks. Individuals with inattention overlook details, make careless mistakes, have trouble staying focused during lectures or conversations, and struggle with task organization. 

This leads to academic underperformance in children and difficulties in professional settings for adults. Inattention can also result in forgetfulness in daily activities and a tendency to be easily distracted by external stimuli.

What are the common symptoms of ADHD seen in toddlers and kids?

The common symptoms of ADHD in toddlers and children include difficulty sustaining attention, hyperactivity, impulsive behavior, being constantly on the move, talking excessively, having trouble sitting still for meals or stories, and experiencing frequent, intense tantrums that seem to come out of nowhere, according to Akinbami LJ, Liu X’ & Pastor PN’s 2011 review “Attention deficit hyperactivity disorder among children aged 5-17 years in the United States” PubMed Journal.

They often struggle to focus on activities for over a few minutes, become easily frustrated, and are prone to aggressive outbursts. As children age, symptoms can manifest as ignoring details, having trouble organizing tasks, fidgeting, interrupting others, and appearing not to listen when spoken to directly.

While many young children display some of these behaviors occasionally, children with ADHD exhibit them more frequently, intensely, and in multiple settings, significantly impacting their daily functioning and relationships.

What are the types of ADHD?

The types of ADHD include predominantly inattentive, predominantly hyperactive-impulsive, and combined hyperactive-impulsive and inattentive types, according to the Attention Deficit Disorder Association article titled “Types Of ADHD In Adults: Understanding The Differences,.”

The most important types of ADHD are given below.

Predominantly Inattentive Type

This type is characterized by significant difficulties in maintaining attention, following through on tasks, and organizing activities. Due to a lack of focus, individuals often appear forgetful, easily distracted, and struggle with completing assignments.

Predominantly Hyperactive-Impulsive Type

Individuals with this type primarily exhibit hyperactive and impulsive behaviors. They fidget, have trouble remaining seated, talk excessively, and interrupt others. This type is less common than the others and is often more noticeable in children.

Combined Hyperactive-Impulsive and Inattentive Type

Combined Hyperactive-Impulsive and Inattentive type is the most prevalent form of ADHD, where individuals display symptoms from both the inattentive and hyperactive-impulsive categories. This combination leads to significant challenges in various settings, including home and school, as symptoms interfere with daily functioning.

Understanding these types is crucial for diagnosis and treatment, as symptoms vary widely among individuals and impact their daily lives and interactions.

What are the causes of ADHD?

The causes of Attention Deficit Hyperactivity Disorder (ADHD) are a combination of genetic, neurobiological, and environmental factors, according to the Cleveland Clinic article titled “Attention-Deficit/Hyperactivity Disorder (ADHD).”

The most important causes of ADHD are given below.

• Genetics: ADHD tends to run in families, indicating a vital genetic component. Children with a parent or sibling diagnosed with ADHD have a significantly higher chance of developing the disorder themselves, with estimates suggesting a 50% likelihood if a parent has ADHD. According to an NIH study titled “Genetics of attention deficit hyperactivity disorder” by Stephen V. Faraone (June 2019).
• Brain Function and Structure: Individuals with ADHD may exhibit differences in brain structure and function. For instance, certain areas of the brain responsible for attention and impulse control are smaller or less active in those with ADHD. Neurotransmitter imbalances, particularly involving dopamine, are also implicated in the condition.
• Prenatal and Perinatal Factors: Exposure to harmful substances during pregnancy, such as alcohol and nicotine, as well as complications like low birth weight and premature birth, increases the risk of developing ADHD. Additionally, significant head injuries, especially to the frontal lobe, may contribute to the onset of ADHD symptoms.
• Environmental Toxins: Exposure to environmental toxins, such as lead, is linked to developmental issues and plays a role in the emergence of ADHD symptoms. These toxins interfere with brain development and functioning.
• Other Risk Factors: Conditions such as epilepsy or brain damage can also elevate the risk of ADHD. Stressful environments and unstable family dynamics, while not direct causes, exacerbate symptoms in predisposed individuals.

The harmful effects of untreated ADHD affect various aspects of life. Individuals struggle with self-control, decision-making, and muscle control, leading to difficulties in academic performance, relationships, and overall quality of life.

What is the process for diagnosing ADHD?

The process for diagnosing ADHD typically begins with an initial screening evaluation, which involves an interview to assess whether ADHD symptoms are contributing to various challenges in an individual’s life, such as social, emotional, or academic difficulties, according to the Centers for Disease Control article “Diagnosing ADHD” May 2024. This initial screening is crucial, as it helps determine if the symptoms align with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria.

If the initial assessment suggests the possibility of ADHD, a comprehensive evaluation is conducted. This includes in-depth interviews with the individual and others familiar with their behavior, such as parents or teachers of children, to gather a thorough history of the symptoms and their impact on daily functioning.

The comprehensive evaluation process involves a detailed bio-psycho-social assessment, which covers various aspects of the individual’s life, including prenatal and early development history, medical and family history, and current functioning. This assessment aims to identify specific ADHD symptoms, their onset, duration, and the contexts in which they occur.

Are there tests for diagnosing ADHD in teenagers?

Yes, there are tests for diagnosing ADHD in teenagers. The diagnosis involves a comprehensive evaluation that includes behavior assessments, interviews with the teenager and their parents, and other medical evaluations, as reviewed in The American Academy of Pediatrics post, “Tools for the Diagnosis of ADHD in Children and Adolescents: A Systematic Review. “(2024).

These tests aim to assess the presence and severity of ADHD symptoms, rule out other possible underlying conditions, and gather information about the teenager’s overall functioning.

The tests for diagnosing ADHD in teenagers are listed below.

• Behavior Assessments: These are essential for diagnosing ADHD in teenagers. They involve observing the teen’s behavior in various settings (school, home, social situations) and using behavior rating scales, such as the Conners rating scale and the Vanderbilt assessment scale, to evaluate symptoms and functional impairments. The Behavior Assessment System for Children (BASC) offers a comprehensive assessment of behavior and emotions.
• Interviews: Structured interviews with the teen, parents, and teachers are conducted to gather detailed information about the teen’s behavior across different environments. Parent and teacher questionnaires provide additional insights.
• Direct Observation: This method involves observing the teen in classrooms and homes to identify ADHD-related behaviors.
• Symptom Checklists: Tools such as the Child Behavior Checklist (CBCL) and the Child Attention Profile (CAP) identify behavioral problems and specifically focus on attention-related issues.
• Clinical Assessment: A thorough evaluation by a psychologist or psychiatrist may include cognitive testing to rule out learning disabilities or other conditions.
• Physical Examination: This is conducted to exclude other medical conditions that could mimic ADHD symptoms.
• Standardized Tests: While there is no single definitive test for ADHD, standardized assessments are used to quantify symptoms and their impact on daily functioning

These methods collectively help clinicians determine whether a teen meets the criteria for ADHD, as outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

What are the treatments for ADHD?

The treatments for ADHD include medication and natural remedies, each serving distinct roles in managing symptoms, according to Ahn, J., Ahn, H. S., & Cheong, J. H’s (2016) review “Natural Product-Derived Treatments for Attention-Deficit/Hyperactivity Disorder” in the Neural Plasticity Journal.

ADHD medication

ADHD medications are the drugs used to treat the symptoms of Attention Deficit Hyperactivity Disorder (ADHD). These medications help reduce hyperactivity, impulsiveness, and inattention in individuals with ADHD. They are considered safe and effective when used as prescribed by a doctor.

There are different types of ADHD medications available, including stimulants and non-stimulants. Stimulant medications work by increasing neurotransmitters like dopamine and norepinephrine levels in the brain, which helps improve concentration and focus. Due to their effectiveness, they are usually the first line of treatment for ADHD.

Natural remedies for ADHD

Natural remedies for ADHD are alternative treatments that help to manage the symptoms of ADHD. While they may not be as well-studied or supported by scientific evidence as medication, some individuals with ADHD find them helpful in managing their symptoms.

Some natural remedies for ADHD include dietary changes, herbal supplements, and behavioral therapy. Nutritional changes involve eliminating certain additives or processed foods from the diet and increasing the intake of omega-3 fatty acids and whole grains.

While medications play a crucial role in managing ADHD, integrating natural remedies and behavioral therapies can enhance treatment outcomes and support individuals in navigating daily challenges associated with the disorder.

What are the complications of ADHD?

The complications of ADHD are low self-esteem, depression, oppositional behavior, school failure, and engaging in risk-taking activities, as suggested by The American Academy of Pediatrics post, “Tools for the Diagnosis of ADHD in Children and Adolescents: A Systematic Review. “(2024).

These issues persist into adulthood, where individuals may struggle with poor self-worth, increased sensitivity to criticism, and higher levels of self-criticism. ADHD impacts academic and professional achievements, interpersonal relationships, and daily functioning. 

Adults with ADHD face challenges in prioritizing tasks, staying organized, and maintaining focus, which can derail careers, ambitions, and relationships. Additionally, individuals with ADHD are at a higher risk for accidents, especially when driving, due to difficulties in maintaining attention. The chronic nature of these challenges leads to ongoing problems in various aspects of life if not properly addressed and treated.

What are the differences in the treatment of ADHD between adults and children?

The treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) varies between children and adults due to differences in symptom presentation, comorbidities, and treatment approaches. A combination of medication and behavioral interventions is the primary treatment approach in both populations, according to McKechnie DGJ’s 20023 review in The British Journal of Psychiatry. 

Stimulant medications, such as amphetamines and methylphenidate, are commonly prescribed for both children and adults, with non-stimulant options available for those who do not respond well to stimulants. 

However, the administration of these treatments differs. Children, parents, and teachers often act as primary change agents, implementing behavior modification strategies, while adults may rely on spouses, therapists, or self-management techniques.

Furthermore, the symptoms of ADHD can manifest differently across age groups. Children typically exhibit more overt hyperactivity and impulsivity, while adults may experience restlessness, frequent job changes, and difficulty maintaining relationships. 

Diagnosis in adults also requires a more comprehensive evaluation, often involving multiple observers like spouses and coworkers to confirm symptoms and rule out other conditions. Moreover, new stimulant formulations and personalized treatment plans are increasingly tailored to meet each patient’s needs, whether pediatric or adult.

What are the differences between ADD and ADHD symptoms in adults and children?

The differences between ADD and ADHD symptoms in adults and children are primarily related to the presence or absence of hyperactivity and impulsivity. ADD, now referred to as inattentive ADHD, is characterized by difficulties with focus, organization, and completing tasks without the hyperactive-impulsive symptoms seen in other ADHD types. In contrast, ADHD can present as predominantly hyperactive-impulsive or combined type, which includes both inattentive and hyperactive-impulsive symptoms. 

For children, ADHD symptoms may manifest as constant fidgeting, interrupting others, or difficulty sitting still, while adults might experience restlessness, impulsive decision-making, or trouble with time management. 

According to a 2016 study by the National Institute of Health, the combined type of ADHD is more common in adults, with 62% of adult ADHD cases being the combined type, 31% inattentive type, and 7% hyperactive-impulsive type. However, a meta-analysis of 12 studies on children and adolescents found that the inattentive type was slightly more prevalent (2.95%) compared to hyperactive-impulsive (2.77%) and combined (2.44%) types. 

The symptoms must be present for at least 6 months, begin before age 12, occur in multiple settings, and significantly impact daily functioning to meet diagnostic criteria for ADHD.

What strategies are used to prevent ADD?

Preventing Attention Deficit Disorder (ADD) involves a combination of lifestyle adjustments, dietary considerations, and behavioral strategies, according to Kamimura-Nishimura, K. I., Brinkman, W. B., & Froehlich, T. E. (2019) “Strategies for improving ADHD medication adherence in the Current Psychiatry Journal.” One practical approach is ensuring a balanced protein-rich diet, which can help stabilize blood sugar levels and improve concentration. 

Peanut butter, yogurt, milk, cheese, and eggs are recommended for a protein-rich breakfast. Additionally, maintaining a regular sleep schedule and incorporating physical activity into daily routines can significantly reduce symptoms of inattention and hyperactivity. Regular exercise helps manage stress, improve mood, and enhance overall cognitive function.

Behavioral strategies also play a crucial role in managing and preventing ADD. Creating a structured environment with consistent routines can help individuals, especially children, manage their symptoms more effectively. 

Positive reinforcement for good behavior and clear consequences for negative behavior can foster better self-control and focus. In educational settings, reducing distractions and using tools like color-coded lists and visual aids can help students stay organized and attentive. 

Moreover, for adults, setting aside daily time for organization, using lists, and minimizing external commotion can enhance productivity and reduce the impact of ADD symptoms in the workplace.

Can lifestyle changes help manage Attention Deficit Hyperactivity Disorder (ADHD)?

Yes, lifestyle changes can help manage Attention Deficit Hyperactivity Disorder, as reviewed by Párraga JL & Fernández-Jaén A’s 2019 report on Attention-deficit/hyperactivity disorder and lifestyle habits in children and adolescents in PubMed Journal. Exercise promotes brain growth, improves brain efficiency, and strengthens learning abilities. Dietary changes also play a role in managing ADHD symptoms. Nutrients such as omega-3 fatty acids, zinc, iron, and Vitamin D are crucial for brain health and signaling. 

Adequate sleep is essential for managing ADHD symptoms. Sleep problems are common in individuals with ADHD and can exacerbate symptoms. Managing stress is another critical aspect of lifestyle changes for ADHD. High levels of stress worsen ADHD symptoms. Techniques such as mindfulness meditation, relaxation exercises, and structured daily routines can help reduce stress and improve overall well-being.

Are inattentive ADHD symptoms common in girls?

Yes, inattentive ADHD symptoms are common in girls, according to Professor Stephen Hinshaw in Childmind Institute Journal 2023. Girls are more likely to exhibit inattentive ADHD symptoms compared to boys. These symptoms include difficulty focusing, being easily distracted, forgetfulness, and daydreaming. Unlike boys, who often display more hyperactive and impulsive behaviors, girls with ADHD appear shy, withdrawn, or “spacey,” leading to underdiagnosis and misinterpretation of their symptoms.

What is the diagnostic code for ADHD inattentive type?

The diagnostic code for ADHD inattentive type is F90.0 in the ICD-10 classification system. This code refers explicitly to “Attention-deficit hyperactivity disorder, predominantly inattentive type.” 

It falls under the broader category of F90, which encompasses all attention-deficit hyperactivity disorders. This diagnosis is characterized by symptoms such as difficulty sustaining attention and forgetfulness without the prominent hyperactive-impulsive features seen in other ADHD subtypes. 

What is the most compelling childhood ADHD treatment?

The most effective treatment for childhood ADHD typically combines medication and behavioral therapy, according to Ahn, J., Ahn, H. S., & Cheong, J. H’s (2016) review “Natural Product-Derived Treatments for Attention-Deficit/Hyperactivity Disorder” in the Neural Plasticity Journal.

Medications, particularly stimulants, are widely used and reduce symptoms in 70-80% of children. However, for younger children (under 6 years), behavior therapy is recommended as the first line of treatment due to the potential side effects of medications and the lack of long-term studies on their impact on this age group.