Attention Deficit/Hyperactivity Disorder (ADHD)

Adhd is the most frequently diagnosed behavioral disorder of childhood and affects 3 - 5% of school aged children worldwide.

Attention-Deficit/Hyperactivity Disorder (ADHD) is a chronic condition characterized by inattention and hyper-activeness that can last well into adulthood. Adults with ADHD often have difficulties maintaining long term relationships, perform poorly in school or at work and tend to have low self-esteem.

In most people, symptoms of ADHD start before the age of seven.

A diagnosis of ADHD can be difficult for parents and children. However, treatment can help, and the majority of children with ADHD grow up to be successful adults.

Symptoms

The symptoms of ADHD can be divided in three sub-categories: innatention, hyperactivity and impulsivity.

Innatention

• Frequently makes careless errors in the classroom , work, or other activities.

• Difficulty listening when spoken directly

• Experiences problems with completing chores, schoolwork, or duties.

• Regularly has difficulty with organization and planning.

• Often forgets important items necessary for work or school (e.g., notebook, pencil).

• Becomes easily sidetracked by external distractions

Hyperactivity

• Regular fidgeting with hands or feet.

• Talking excessively.

• Difficulty engaging in regular activities appropriately.

• Constantly feeling the urge to move or be "on the go"

Impulsivity

• Frequently answers questions before they have been completed.

• Difficulty awaiting turn.

• Often interrupts conversations.

So what causes ADHD?

While there is a lot that isn’t known about ADHD, researchers have identified important factors that could play a role:

Changes in the brain - Recent studies have revealed less activity in the areas of the brain that control activity and attention than in normal children.

Heredity - Attention deficit disorder can run in families. Studies have shown that about one child with ADHD out of three has a relative with the same condition.

Exposure to drugs - Pregnant women who smoke are at a higher risk of having a child with ADHD. Similarly, women who abuse recreational drugs or prescribed medications are also more likely to have children with this condition. Scientists have hypothesized that alcohol and drugs impair brain activity by restricting blood flow to the nerve cells that produce neurotransmitters such as dopamine or serotonin.

Exposure to environmental toxins - Children that live in older buildings are at risk of chronic lead exposure, which can result in highly disruptive behaviors and attention problems.

New Medications

Medications and counseling is often the preferred choice of treatment and can be divided into two groups: stimulants and non-stimulants.

Stimulants

Examples of stimulants include: Adderall, Dexedrine, Concerta and Ritalin. These are available in fast-release (about 4 hours) and long-release acting (6 to 12 hours) forms.

Many parents prefer the slow-release option for their children because of its longer lasting effects. However, it might take up to three hours to kick in.

Stimulants help manage impulsive behavior and strengthen attention span by increasing the release of neurotransmitters such as epinephrine and norepinephrine, that transmit signals between nerve cells.

Even so, the effects of these medications fade away rapidly. Furthermore, the proper dosage differs from person to person and from child to child, therefore it will take a little extra time at first to get the right dosage.

Common side-effects can include nervousness, irritability (as the medication wears off), problems sleeping and weight loss. Some children develop 'tics' or unusual gestures (exaggerated grimace), but these tend to go away when the dosage is reduced.

Non-stimulants

Atomoxetine (Strattera) is the most popular non-stimulant to treat ADHD. It is usually used when stimulant medications are no longer effective or cause side effects.

Aside from reducing ADHD symptoms, atomoxetine has shown to also reduce anxiety.

Common side effects can include nausea, sedation and weight loss. Atomoxetine has also been linked to liver problems in some children. Call your doctor immediately if you notice yellowing of the skin (jaundice) or dark-colored urine.

Natural Treatment

Some research has shown that alternative medicine treatments can help to reduce ADHD symptoms. These include:

• Yoga. There's increasing support yoga might help relieve symptoms of ADHD. Yoga instructors who teach children with ADHD noted an improvement in their behavior over time, and have said that the practice can help improves the ability to concentrate and relax.

• Vitamin supplements. Vitamins are definitely important for health and well being, but there is still no real evidence that vitamin therapy can control symptoms of ADHD. High doses of vitamins that exceed the recommended dietary allowance can be dangerous. Always consult with a physician if you think you have a vitamin deficiency.

• Special diets. Most diets for ADHD involve eating organic foods, and avoiding high mercury fish as much as possible. Other diets encourage eliminating high calorie junk food (such as pizzas, sodas) and replacing it with healthier alternatives like whole grains, fruit and lean meat. Recent studies have shown that some children improve with these diet changes. However, most current scientific research is still yet to find a direct link between diet and ADHD.

• Herbal supplements. Several people have experienced positive results from taking herbal supplements like hypericum, ginkgo biloba and ginseng, and some research has shown that they may help with ADHD. Other supplements that may be useful: N-acetyl-cysteine, Phosphatidylserine, Alpha lipoic acid, and Coenzyme Q-10. All of these nutrients have been clinically proven to enhance brain performance.

• DHA Suplements/fatty acids. These fats such as DHA, an omega-3 fatty acid, are necessary for the mind to perform properly. The jury is still out there on whether these supplements may improve ADHD symptoms.

ADHD counseling and therapy

In many cases children and adults with ADHD have other conditions such as anxiety and depression. The most effectivce outcomes generally take place when a group approach is used, with parents, counselors or doctors working with each other.

Counseling types:

• Cognitive/Behavioral therapy. Children/adults with ADHD learn to talk about living with this condition learn newer approaches to cope better with their symptoms.

• Family therapy. This type of therapy can help parents better deal with the stress of raising a child with ADHD, as well as gain new awareness about this condition.

• Social skills training. Many children with ADHD lack socially appropriate social skills. This training can help children improve social behaviors.

• Parenting skills training. Like family therapy, this can help parents learn more about this condition, and identify more effective ways to guide their child's behavior.

Online Citations

DSM-IV: Diagnostic and Statistical Manual of Mental Disorders. DSM-IV

ADHD: Comprehensive overview covers symptoms, causes, treatment and coping with this brain disorder. The Mayo-Clinic.

ADHD and Creativity: Reviews some of the treatment options for schizophrenia. Health Central.

Citations

Jensen, P.S., and Kenny, D.T. (2004). The effects of yoga on the attention and behavior of boys with attention deficit hyperactivity disorder (ADHD). Journal of Attention Disorders. 7(4): 205-16.

Jensen PS, Garcia JA, Glied S (September 2005). "Cost-effectiveness of ADHD treatments: findings from the multimodal treatment study of children with ADHD". The American Journal of Psychiatry 162 (9): 1628–36. doi:10.1176/appi.ajp.162.9.1628. PMID 16135621. http://ajp.psychiatryonline.org/article.aspx?articleid=177754

Article created: May 6, 2012

Updated: June 2, 2011

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