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Attention deficit hyperactivity disorder disease

Attention Deficit Hyperactivity Disorder (ADHD) is characterized by a persistent pattern of inattention andor hyperactivity and impulsivity that interferes with functioning or development.


Summary

Attention Deficit Hyperactivity Disorder (ADHD) is characterized by a persistent pattern of inattention and/or hyperactivity and impulsivity that interferes with functioning or development. 

People with ADHD have a persistent pattern of the following types of symptoms:

  • Inattention means that a person may have difficulty staying on task, staying focused, and staying organized, and these problems are not due to challenges or a lack of understanding.
  • Hyperactivity means that a person may appear to be constantly moving, including in inappropriate situations, filling up, clicking, or talking excessively. In adults, hyperactivity can mean fidgeting or talking a lot.
  • Impulsivity means that a person may act without thinking or have difficulty controlling themselves. Impulsivity can also include the desire for immediate rewards or the inability to delay gratification. An impulsive person may interrupt others or make important decisions without thinking about the long-term consequences.

Signs and symptoms

Some people with ADHD primarily experience symptoms of inattention. Others mostly have symptoms of hyperactivity and impulsiveness.

Many people suffer from inattentiveness, unfocused motor activity, and impulsivity, but for people with ADHD, these behaviors:

  • more severe
  • often occur
  • Interfere with or diminish the quality of their way of working socially, at school, or at work

inattention

People who often show symptoms of inattention:

  • Ignoring or missing details and making seemingly reckless mistakes in schoolwork, work, or other activities
  • They have trouble maintaining their attention during play or tasks, such as prolonged conversations, lectures, or reading
  • You find it difficult to follow instructions, complete school assignments, chores, or work assignments, or you may start tasks but lose focus and become easily distracted
  • They have difficulty organizing tasks and activities, completing tasks in order, keeping materials and possessions in order, managing time, and meeting deadlines
  • Avoiding tasks that require constant mental effort, such as homework, teens, and seniors, preparing reports, filling out forms, or reviewing lengthy research papers
  • Check items needed for tasks or activities, such as school supplies, pencils, books, tools, purses, keys, papers, glasses, and cell phones.
  • You can be easily distracted by irrelevant thoughts or stimuli
  • Being forgotten in daily activities, such as chores, errands, phone calls, and keeping appointments

Hyperactivity and impulsivity

People with symptoms of hyperactivity and impulsivity can often:

  • restlessness and cramping while sitting
  • Leaving their seat in situations where they are expected to remain seated, such as in a classroom or office
  • Run, jog, or climb at inappropriate times, or teens and adults often feel anxious
  • Being unable to play or pursue hobbies quietly
  • Always be moving or moving, or act like you're driven by a motor
  • talk excessively
  • Answer questions before they're completely asked, finish other people's sentences, or speak without waiting for a turn in a conversation
  • They find it difficult to wait for a turn
  • Interrupting or disturbing others, for example in conversations, games, or activities

Primary care providers sometimes diagnose and treat ADHD. They can also refer people to a mental health professional, such as a psychiatrist or clinical psychologist, who can perform a full assessment and make an ADHD diagnosis.

For a person to be diagnosed with ADHD, the symptoms of inattentiveness and/or hyperactivity and impulsivity must be chronic or long-lasting, impair the person's functioning, and result in normal growth failure for their age. Stress, trouble sleeping, anxiety, depression, and other physical conditions or illnesses can cause ADHD-like symptoms. Therefore, a thorough evaluation is needed to determine the cause of the symptoms.

Most children with ADHD are diagnosed during the elementary school years. For a teenager or adult to be diagnosed with ADHD, symptoms must be present before the age of 12.

ADHD symptoms can appear as young as 3 to 6 years old and can persist into adolescence and adulthood. ADHD symptoms can be mistaken for emotional or disciplinary problems, or completely lost in mostly inattentive children, delaying diagnosis. Adults with undiagnosed ADHD may have a history of poor school performance, problems at work, or difficult or failed relationships.

ADHD symptoms can change over time as you age. In young children with ADHD, hyperactivity and impulsiveness are the most common symptoms. When a child reaches primary school, symptoms of inattention may become more noticeable and cause the child to have academic difficulties. By adolescence, hyperactivity appears to lessen and symptoms may include feeling restless or restless, but inattention and impulsivity may persist. Many teens with ADHD also experience antisocial behaviors and relationships. Inattention, restlessness, and impulsiveness tend to persist into adulthood.

risk factors

Researchers don't know exactly what causes ADHD, although several studies suggest that genes play an important role. Like many other disorders, ADHD is likely caused by a combination of factors. In addition to genetics, researchers are investigating potential environmental factors that may increase ADHD risk and investigating how brain injury, nutrition, and social environments may play a role in ADHD.

ADHD is more common in men than in women, and women with ADHD are more likely to have symptoms of inattention in the first place.

Treatment and Treatments

Although there is no cure for ADHD, currently available treatments can reduce symptoms and improve functioning. Treatments include medication, psychotherapy, education, training, or a combination of treatments.

medication

For many people, ADHD medications reduce hyperactivity and impulsivity and improve their ability to concentrate, work and learn. Sometimes you have to try several different drugs or doses before you find the right one for a particular person. Anyone taking medication should be closely monitored by the prescribing physician.

steroids. The most common type of medication used to treat ADHD is called a "stimulant." Although it may seem unusual to treat ADHD with a drug that is a stimulant, it works by increasing brain chemicals such as dopamine and norepinephrine, which play a vital role in thinking and paying attention.

Under medical supervision, stimulant drugs are considered safe. However, like all medications, it can have side effects, especially when abused or taken more than the prescribed dose and requires the person's health care provider to monitor their reaction to the medication.

Not stimulated. Few other ADHD medications aren't stimulants. These medications take longer to work than stimulants, but they can also improve focus, attention, and impulsivity in someone with ADHD. Doctors may prescribe non-stimulant medication: when a person has bothersome side effects from stimulants, when a stimulant is not effective, or with a stimulant to increase effectiveness.

Although not approved by the United States Food and Drug Administration (FDA) specifically to treat ADHD, some antidepressants are used alone or in combination with stimulants to treat ADHD. Antidepressants can help with all symptoms of ADHD and may be prescribed if a patient experiences bothersome side effects from stimulants.

Antidepressants may be helpful in combination with stimulants if the patient also has another condition, such as an anxiety disorder, depression, or another mood disorder. Non-stimulant medications for ADHD and antidepressants can also have side effects.

Doctors and patients can work together to find the best drug, the best dose, or the best combination of drugs. Learn the basics about stimulants and other mental health medications on the NIMH Mental Health Medications web page and check the FDA website for the latest drug approvals, warnings, and patient information guides.

Psychotherapy and psychosocial interventions

Several specific psychosocial interventions have been shown to help people with ADHD and their families manage symptoms and improve daily functioning.

For school-aged children, frustration, blame, and anger can build up within the family before the child is diagnosed. Parents and children may need professional help to deal with negative emotions. Mental health professionals can educate parents about ADHD and its effects on the family. They will also help the child and his parents to develop new skills, attitudes, and ways of communicating with each other.

All types of treatment for children and teens with ADHD require parents to play an active role. Psychotherapy that involves only one-on-one therapy sessions with the child (without parental involvement) is not effective in managing ADHD symptoms and behavior. This type of therapy is likely to be most effective for treating symptoms of anxiety or depression that can occur with ADHD.

This may include practical help, such as helping to organize tasks or complete school work, or get through emotionally difficult events.

Behavioral therapy also teaches how to:

  • Observe their behavior
  • Praise or reward yourself for acting in a desired way, such as controlling anger or thinking before you act

Parents, teachers, and family members can also provide feedback on specific behaviors and help establish clear rules and structured lists of tasks and routines to help the person control their behavior. Therapists can also teach children social skills, such as how to take turns, share toys, ask for help or react.

Cognitive-behavioral therapy helps a person learn to recognize and accept their thoughts and feelings to improve their focus. The therapist also encourages the person with ADHD to adapt to the life changes that come with treatment, such as thinking before you act or resisting the urge to take unnecessary risks.

Family and marital therapy can help family members and spouses find productive ways to deal with disruptive behaviors, encourage behavioral changes, and improve interactions with the person with ADHD.

Behavioral Management Training for Parents teaches parents the skills needed to encourage and reward positive behaviors in their children. Parents learn to use the reward and consequence system to modify the child's behavior, to give immediate and positive feedback to behaviors they wish to encourage and to ignore or redirect behaviors they wish to discourage.

Specific classroom behavior management interventions and/or school accommodations for children and adolescents are effective in managing symptoms and improving performance in school and with peers. Interventions may include behavior management plans or the teaching of organizational or academic skills. Accommodations may include preferential seating in class, reduced class workload, or extended exam and exam times. The school may provide facilities through what is called a 504 plan or, for children who are eligible for special education services, an Individual Education Plan (IEP).

To learn more about the Individuals with Disabilities Education Act (IDEA), visit the U.S. Department of Education's IDEA website.

Stress management techniques can benefit parents of children with ADHD by increasing their ability to manage frustration so they can respond calmly to their child's behavior.

Support groups can help parents and families connect with others who have similar issues and concerns. Groups often meet regularly to share their frustrations and successes, to share information about recommended specialists and strategies, and to talk with experts.

The National ADHD Resource Center, a program for children and adults with Attention Deficit/Hyperactivity Disorder (CHADD®) supported by the Centers for Disease Control and Prevention (CDC), has information and many resources.

For more information on psychotherapy, see the Psychotherapy webpage on the NIMH website.

Tips to help kids and adults with ADHD stay organized

for kids:

Parents and teachers can help kids with ADHD stay organized and follow directions with tools like:

  • Maintain routine and schedule. Maintain the same routine every day, from the time you wake up until the time you go to bed. Set times for homework, outdoor play, and indoor activities. Keep the schedule on the refrigerator or on the bulletin board. Note changes to the schedule as far in advance as possible.
  • Organize everyday things. Make a place for everything (like clothes, backpacks, toys) and keep everything in its place.
  • Use homework and notebook organization tools. Use organizers for school materials and supplies. Stress to your child the importance of writing homework and bringing home the necessary books.
  • To be clear and consistent. Children with ADHD need firm rules that they can understand and follow.
  • Congratulations or rewards for following the rules. Find good behavior and praise it.

For adults:

A professional counselor or therapist can help an adult with ADHD learn to organize their life using tools such as:

  • Maintain a routine.
  • Make lists of different tasks and activities.
  • Use the calendar to schedule events.
  • Use reminder notes.
  • Provide a special place for keys, bills, and papers.
  • Break down large tasks into smaller, manageable steps so that completing each part of the task feels a sense of accomplishment.

Join a study

Clinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions. The purpose of clinical trials is to find out if a new test or treatment works and is safe. Although individuals can benefit from participating in a clinical trial, participants should be aware that the main purpose of the clinical trial is to gain new scientific knowledge so that others can be better helped in the future.

Researchers at NIMH and across the country are conducting several studies with patients and healthy volunteers. We now have new and better treatment options thanks to clinical trials discovered years ago. Be part of tomorrow's medical breakthroughs. Talk to your healthcare provider about clinical trials, their benefits and risks, and whether any of them might be right for you.

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