Useful Notes / Attention Deficit Hyperactivity Disorder

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most misunderstood mental conditions. Most works portray it as being either overly hyperactive or easily distracted, but there are far more traits than just those two.

ADHD has three different types that are recognized by the DSM-V: Primarily Hyperactive and Impulsive, Primarily Inattentive, and Combined Type. It is one of the more common and treatable psychiatric conditions, diagnosed in approximately 5-8% of adults and 10-12% of children.

Hyperactive and Impulsive Type ADHD

When people think of or picture ADHD, they probably think of or picture a child running around in a quiet classroom. In that thought or mental image, that child would likely have this type of ADHD, which is characterized by a person having more of the "hyperactive" traits. Due to how pronounced these traits are, this type is typically diagnosed during childhood and is more commonly diagnosed in men. Additionally, most of the hyperactivity traits do become less pronounced in adulthood, though they don't quite "disappear" as many people believe. The traits for this type include:

• Fidgeting and Squirming when seated
• Getting out of their seat frequently to move around
• Running or climbing in inappropriate situations (manifests as restlessness in adults and teens)
• Having difficulty doing quiet activities
• Appearing to constantly be "on the go"
• Talking excessively
• Having difficulty waiting for their turn
• Speaking at inappropriate times
• Frequently interrupting/intruding on others' conversations
• Difficulty understanding social cues
• Speaking/acting without thinking, also known as impulsivity

Inattentive Type ADHD

Formerly known as "Attention Deficit Disorder (without Hyperactivity)," and not defined in the literature until the 1987 publication of the DSM-III-R, this type is perceived as the "Attention Deficit... Ooh, Shiny!" type. However, there are many other traits that define this type of ADHD, all of which are characterized by leaning more toward the "attention deficit" side. This type isn't immediately apparent early on in life, but the traits do tend to become more pronounced during adulthood, resulting in this type typically being diagnosed later in life. Additionally, this type happens to be more prevalent in women. The traits for this type include:

• Frequently being disorganized
• Lacking focus
• Experiencing boredom during routine activities, leading to
• Experiencing pain when bored
• Having difficulty paying attention to details
• Easily being distracted by minor things that are ignored by others
• Frequently daydreaming
• Having trouble staying on topic while talking
• Being forgetful about daily activities (such as when an appointment is or what they need to bring to work/school)
• Having difficulty reading people's moods
• Getting so lost in their thoughts that they don't hear what others are saying

Combined Type ADHD

This type has both the "attention deficit" and "hyperactivity" be equally prevalent. In order to be diagnosed with this kind of ADHD, the person must have at least six symptoms of Inattentive Type ADHD and six symptoms of Hyperactive and Impulsive Type ADHD.

Diagnosis and Treatment

Depending on what kind of ADHD is being presented and how severe the symptoms are, ADHD can be diagnosed as young as 3 years old. For most children, it is typically diagnosed around the age of 12. While ADHD is frequently believed to be overdiagnosed, there is research to suggest that it is actually underdiagnosed, particularly in women. This is primarily due to the way that ADHD presents itself in men and women: men tend to have Hyperactive and Impulsive Type ADHD (which is typically disruptive and pronounced to others), while women tend to have Inattentive type ADHD (which isn't as disruptive and pronounced to others). Regardless of presenting symptoms, a recognized trait of ADHD that has not yet made it into diagnostic criteria is emotional dysregulation, a trait of exaggerated or minimized emotions (essentially, the ADHD person's emotional "dimmer switch" is disabled, their emotions are usually either on at full power or entirely calm) that can cause conflict, especially as an adult where full-strength emotional outbursts are socially inappropriate. Modulating a powerful emotional reaction into something more socially acceptable causes a great deal of stress, and can lead to anxiety disorders.

There are multiple mental conditions that tend to occur alongside ADHD. These include Autism, learning disabilities, Tourette's Syndrome, Oppositional Defiance Disorder, Mood disorders (most commonly Anxiety, Bipolar Disorder, and Depression), and sleep disorders. Additionally, many people with ADHD suffer from substance abuse, which is theorized to be a way that they "self-medicate" the symptoms.

While there is no real cure for ADHD, there are medications that can alleviate some of the symptoms (the most common are methylphenidate (trade names include Ritalin and Concerta) and amphetamines (trade names include Adderall and Elvanse/Vyvanse)), and some people with ADHD also take behavioral therapy. Some people with ADHD can decide to not have any treatment for their condition.

Misconceptions

• ADHD goes away once the child grows up: ADHD does not usually go away once the person reaches adulthood. Part of the reason many think it goes away during adulthood is because the symptoms become less pronounced during adulthood (especially for Hyperactive and Impulsive Type ADHD) which may partially be due to people learning coping mechanisms and to mask their symptoms as they age.
• People with ADHD aren't trying hard enough/should try to focus: While many people tell this to those with ADHD, the truth is that people with ADHD aren't lazy or unmotivated, they literally cannot pay attention no matter how hard they try. In short, telling a person with ADHD to "try to focus" is like telling someone with asthma to "just breathe". Additionally, "trying to focus" too hard can cause the unreliable prefrontal cortex to shut down entirely, resulting in a person who literally cannot focus on anything because their already-limited ability to do so has just checked out completely.
• People with ADHD can't ever focus: On the other hand, while an inability to focus is one of the main traits of ADHD (it's in the name, after all), people with ADHD also tend to experience a phenomenon called hyperfocus (also known as hyperfixation), which is an uncontrollable intense focus on one particular subject for an extended period of time (think of it as an obsession cranked up to eleven) - in fact, ADHD might be more accurately called "Attention Regulation Hyperactivity Disorder". For instance, someone with ADHD might have trouble writing a paper that would take about an hour at most, but could spend hours upon hours writing an incredibly long Star Trek fanfiction without getting bored. Put more flippantly, it's like playing Dungeons & Dragons with your brain as the Dungeon Master rolling the D20.
• Everyone with ADHD is hyperactive/easily distracted: While hyperactivity and being easily distracted are the classic traits of ADHD, they aren't the only traits of ADHD. It is entirely possible for someone with ADHD to not be blatantly hyperactive or inattentive, and even those who are must have more than just those two traits to have ADHD.
• Only boys can have ADHD: While boys are twice as likely to get diagnosed with ADHD than girls, girls can still have ADHD. In fact, girls are considered by many psychologists to be underdiagnosed with ADHD due to it frequently presenting as the less-obvious Inattentive Type ADHD.
• ADHD is a learning disability: While ADHD symptoms can get in the way of learning, it isn't in and of itself a learning disability. This belief likely stems from the fact that ADHD can cause kids to have difficulty completing their schoolwork and/or fail classes that they don't find interesting, which can lead the parents to the conclusion that ADHD is causing their child to not understand the school work.
• ADHD is caused by [X]: ADHD is a neurological disorder, and studies have shown that the brain of someone with ADHD is wired differently than a neurotypical person the same age as them, so any "causes" for ADHD happen before the child is born (such as being born premature or having a genetic predisposition). Despite this, many people blame ADHD on poor parenting, too much sugar, artificial colors/flavors, computers, video games, or watching too many fast-paced shows like SpongeBob SquarePants - while all of these can worsen ADHD symptoms, they do not cause ADHD.

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