What Is ADHD?
Attention-deficit/hyperactivity disorder (previously known as attention deficit disorder or ADD) is a neurobehavioral disorder characterized by core symptoms of inattentiveness, distractibility, hyperactivity, and impulsivity. ADHD is thought to be the most common childhood mental health disorder, with estimates of its prevalence in children ranging from 5 to 11 percent. ADHD in adulthood is thought to be less common, with approximately 2 to 5 percent of adults diagnosed.
ADHD symptoms can interfere with work, school, household tasks, and relationships, and managing the disorder can be a challenge for both children and adults. Fortunately, there are treatments that have been shown to be effective, and anyone affected by ADHD can learn coping skills to work around struggles and harness their talents—as many successful individuals with ADHD have already done.
What does ADHD look like?
Some children and adults with ADHD find it difficult to concentrate on tasks at school or work and may daydream frequently. Children with ADHD may become disruptive, defiant, or have trouble getting along with parents, peers, or teachers. Children who struggle with hyperactivity and impulsivity, in particular, often have behavioral challenges that can be difficult for adults to manage.
Adults, on the other hand, may be more likely to report feeling restless or fidgety; if they struggle with impulsivity, they may make rash decisions that adversely affect their life. For both children and adults, executive functioning (planning, emotional regulation, and decision-making) is often affected as well. Many children and adults display either hyperactive or inattentive symptoms of ADHD, but it’s also possible for both sets of symptoms to exist together, in what is typically called combined type ADHD.
What causes ADHD?
Like many other mental health disorders, the causes of ADHD remain under investigation. Genes are theorized to play a key role, as are environmental influences such as exposure to toxins in the womb and early traumatic experiences. Since ADHD is a behavioral disorder, expectations of appropriate behavior, particularly in children, likely influence diagnoses in some cases.
How is ADHD treated?
Medication and behavioral treatments are both widely used to treat ADHD. While medication is often the first-line treatment, patients who receive behavioral treatments—typically therapy, parent training, or neurofeedback—often ultimately need less medication or are able to stop using it entirely. At the same time, several influential studies have concluded that the two treatment approaches may work best in tandem.
What is the best treatment for ADHD?
The best treatment plan for ADHD is unique to the individual, and typically includes a mix of medication, therapy, and/or lifestyle changes. Effective treatment should address both the underlying symptoms—like impulsivity or distractibility—as well as the resulting behavioral and social challenges (such as difficulties making friends, managing time, and poor self-esteem).
The most commonly used ADHD medications are stimulants such as Ritalin and Adderall. Non-stimulants like Strattera or certain classes of antidepressants can be used for those who don’t respond to stimulants or cannot tolerate them.
Whatever medication is used, it’s important to receive the correct dosage, since ADHD medications, and stimulants in particular, can worsen other conditions that may co-occur with ADHD, including bipolar disorder, obsessive-compulsive disorder, and anxiety.
Behavioral therapy is thought to be the most effective non-medical approach for children with ADHD. It typically trains parents to respond consistently to their child’s negative behaviors and help them set and meet goals, while teaching the child coping techniques and social skills. A common refrain in the ADHD community, “pills don’t teach skills,” highlights the fact that while medication may control symptoms of hyperactivity or inattention, it cannot necessarily help a child learn how to behave appropriately or break negative habits. Behavior therapy aims to fill that gap.
For adults and older children with ADHD, cognitive behavioral therapy is most often used. CBT therapists can help adults develop stronger emotional regulation, overcome bad habits, and confront negative patterns of thinking and poor self-esteem that may be impeding their success
Is ADHD genetic?
Significant evidence suggests that ADHD has both genetic and environmental underpinnings. Twin studies, for instance, have found that identical twins are significantly more likely than fraternal twins to both be diagnosed with ADHD or display ADHD-like behaviors. There is no single gene that is considered “responsible” for ADHD; rather, like many psychiatric conditions, it is thought to be linked to many genetic variants, only some of which have been uncovered.
Is ADHD a disease of modernity?
Some experts argue that what we call ADHD is actually a “disease of civilization”—that is, a disorder that arises because of a mismatch between humans’ evolutionary roots and our modern environment. High energy levels, for instance, may have been adaptive for a hunter-gatherer but are problematic in a modern classroom. Some prominent child development experts have noted that the recent rise in ADHD diagnoses has coincided with an increased focus (particularly in American schools) on rigorous standardized testing and reduced playtime—suggesting that at least some children diagnosed with ADHD have been placed in environments that worsen the evolutionary mismatch.
How can I best help my child manage his ADHD?
All children benefit from love, structure, and consistency; children with ADHD need all three in droves. Since ADHD symptoms and their resulting academic and social challenges can be damaging to a child’s self-esteem, parents should take steps to find a treatment that works, help the child identify his strengths, and advocate for his needs as he learns to navigate the world on his own. Parents should also help the child set up routines, identify academic strategies that address her specific needs, and learn the social skills necessary in order to form lasting friendships.
Parenting a Child with ADHD
Children with ADHD are often bright, spontaneous, and caring. But parenting them is not without its challenges. Behavioral problems—from forgetting to do chores to outright defiance—can be frustrating for parents to navigate, as can low self-esteem, difficulty making friends, and the emotional ups and downs that are characteristic of ADHD.
In order to help their children navigate a world that isn’t always friendly to those with developmental delays or mental health challenges, parents should advocate strongly for their children’s needs—particularly in the classroom—encourage them to pursue their passions, and make sure their child feels loved, supported, and secure. Talking openly about ADHD, and seeking treatment if necessary, can also give the child the tools he needs to become his own self-advocate as he grows up.