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What is ADHD? Common—and Surprising—Symptoms

Do you frequently start and abandon projects?  Does your ability to concentrate flip-flop between The Laser Beam and The Disco Ball?  Sometimes ADHD is obvious, but sometimes it can fly under the radar.  The Savvy Psychologist explains the common, and not so common, signs of this disorder. Plus, learn about medication-free tips to manage ADHD in kids and adults. 

By
Ellen Hendriksen, PhD,
April 11, 2014
Episode #014

Page 1 of 2

Attention deficit hyperactivity disorder (ADHD), once thought to be the fault of lousy parents or a conspiracy propagated by drug companies, is a brain-based disorder, and quite the disorderly disorder it can be..

The part of the brain affected is called the prefrontal cortex, which lies directly behind the forehead.  It is responsible for “executive functioning,” which includes attention, planning, problem solving, decision-making, and reasoning.  Trouble with executive functioning translates into two groups of symptoms:

Group #1: Inattention.  Symptoms like disorganization, messiness, forgetfulness, and losing things drive parents of inattentive kids and partners of inattentive adults up the wall.  Other signs include not paying attention to details, distractibility, spacing out, daydreaming, not following through, and trouble focusing on tedious tasks.  Also difficult for an individual with inattention is prioritizing what’s happening around them. For example, for a kid with ADHD, the TV in the background and the garbage truck outside seem just as important as the homework in front of them. Individuals with these symptoms are said to have ADHD Predominately Inattentive Type, which is the most common type among girls.

Group #2: Hyperactivity and impulsivity.  Picture the arms-and-legs tornado of the Looney Toons Tasmanian Devil, leaving a trail of destruction in his wake.  Hyperactive kids seem to have a motor—they are often in constant motion, touch everything, and have a hard time waiting their turn.  They also have a motormouth—talking a blue streak, blurting out answers, and interrupting.  Hyperactive adults often feel restless, have a hard time sitting at a desk or in a meeting, and may find themselves making impulsive purchases, repeatedly starting and abandoning projects, being chronically late, or having trouble controlling anger.  Individuals with these symptoms have ADHD of the Predominately Hyperactive-Impulsive Type.

Then there are the kids and adults who have both sets of symptoms. This is called ADHD Combined Type and is the most common variation.

See also: What Is ADD?

 

An interesting symptom that doesn’t get much…um…attention is hyperfocus.  Despite its name, ADHD may not be a “deficit” of attention at all, but rather an inability to regulate attention.  On a spectrum of attention, let’s call one end The Disco Ball, where attention is scattered and boring tasks are quickly abandoned.  We’ll call the other end The Laser Beam.  When a task is interesting or stimulating, focus becomes intense, sustained, and shifting to another task is difficult.  You can think of hyperfocus as Attention Surplus Disorder, as it were.  Folks with ADHD move from The Disco Ball to The Laser Beam without much in between.

How Common Is ADHD?

ADHD affects up to 7% of kids, which translates to at least one or two kids in every classroom.  It also affects around 4% of adults.  Why the lower percentage of adults?  Some kids with a specific genetic variation of ADHD will grow out of it, but the majority won’t.  Overall, about 60% of kids with ADHD grow up to be adults with ADHD.

Why Is ADHD Often Misdiagnosed?

ADHD often goes unrecognized but is also frequently overdiagnosed.  Overdiagnosis can occur because most people, especially kids, are inattentive, hyperactive, or impulsive sometimes, or they may have a sleep disorder that causes similar symptoms.  But it’s important to remember that for kids and adults with true ADHD, the symptoms are persistent across many aspects of life and have negative academic, work, or social consequences.

The most important thing to remember is that ADHD is not equivalent to stupidity or laziness. 

As for under-diagnosis, women and girls with ADHD often fall through the cracks because they may show more subtle signs of the disorder like messiness, forgetfulness, or motivation difficulties, or they simply don’t cause enough trouble to trigger a second look.  Also, gifted students who are able to compensate for their difficulties often go under the radar, but without treatment they are missing out on achieving their full potential. 

Also, up to 45% of kids and 81% of adults with ADHD have another overlapping disorder like a learning disability, depression, or anxiety.  This can complicate getting an accurate diagnosis.  In addition, medications for one problem may interfere with ADHD medications or vice versa.  For example, Ritalin can make OCD, an anxiety disorder, worse.

What Are the Treatments of ADHD?

Adults who have grown up with ADHD, but without a diagnosis, have often been labeled as stupid or lazy, and their self-esteem and relationships may have suffered as a result.  The most important thing to remember is that ADHD is not equivalent to stupidity or laziness.  For both adults and kids, an important step is finding a good therapist or other supporter who knows about the disorder and can help with issues of worth or competence.

A common and effective treatment is stimulant medication, such as Ritalin or Concerta, or non-stimulants like Strattera.  Talk to your doctor about medications for more information, benefits, and side effects.

Behavioral strategies abound as well.  A neuropsychologist can assess an individual’s strengths and weaknesses and give recommendations for action.  A good cognitive-behavioral therapist can work on building skills and strategies.  In the meantime, here are some medication-free tips for ADHD, for both kids and adults....

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