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Understanding ADHD

ADHD stands for attention-deficit hyperactivity disorder. It is a neurodevelopmental disorder found commonly in children where they have difficulties in focusing on their attention on a single object or task or situation and also have hyperactive behaviours like inability to sit or constant fidgeting or talking too much along with impulsive behaviours like hitting someone if angry. In adults, it is called an Adult attention deficit hyperactivity disorder.

The DSM-V diagnostic criteria for ADHD are (A, B, C, D and E is present) :

  1. Either 1 or 2 is present or both are present:

  1. Inattention where an individual might find it difficult to listen to someone, concentrate on details, inability to do homework or schoolwork which requires increased mental effort, lose focus and loss of belongings. (Any of 6 or more symptoms should be present for at least 6 months for children of age group between 16-17 years of age.)

  2. Hyperactivity and impulsivity where a child might be constantly fidgeting, unable to sit for longer periods f time, lack of patience, hitting others, always interrupting others, unable to finish a thought. (Any of 6 or more symptoms should be present for at least 6 months for children of age group between 16-17 years of age.)

                  B.  Before age 7, sone hyperactive or attention deficit behaviour must be present.

                  C.  Work impairment in two or more settings must be present.

                  D.   Evidence of impairment must be present in social and occupational settings.

                  E.    The symptoms occur independently without any other mental disorder.

 

RISK FACTORS

As per studies, most of the cases of ADHD do not have a specified cause of occurrence. Causes are an interaction of genetics and social settings.

  1. Genetic influence: As per this, the disorder might be caused as it may have been present in someone in the family. 

  2. Neurochemical changes: Children with ADHD show increased levels of neurotransmitters dopamine and norepinephrine which explains the reason behind the impulsivity found in children. 

  3. Environmental factors: Maternal smoking or alcohol use, presence of increased stress during pregnancy can lead to it. Apart from that, poor parenting habits like uncaring communications or excessive control over life and family conflicts within family members can increase the risk of developing ADHD. Having ties with deviant peers who promote aggressive behaviours and can increase impulsivity. 

 

SYMPTOMS IN KIDS

  1. Inability to focus or sit or stand at place (fidgeting).

  2. Not being able to realize the needs of others and fulfilling and addressing one’s needs.

  3. Difficulty in handling emotions like anger and showing it at inappropriate times.

  4. Not being able to participate in calm activities.

  5. Inability to complete or start tasks.

  6. Lack of planning makes them more prone in committing mistakes. This does not mean that they are low on intelligence.4

  7. They are not able to remember things.

  8. They may have trouble in maintaining personal hygiene as well and also in managing time.

SYMPTOMS IN ADULTS

  1. Poor organisational skills.

  2. Difficult to pay attention or concentrate.

  3. Restlessness, mood swings and lack of patience.

  4. Inability to complete tasks.

  5. Having difficulties to perform day to day activities like driving or grooming oneself which puts their life at risk.

  6. Lack of coping mechanisms to deal with stressful situations. It is difficult for them to remain calm.

 

It should be noted that ADHD has often being viewed through a gendered lens, and stereotypes have long led to the assumption that only boys have ADHD. However, girls and women are just as likely to have ADHD, though they are more likely to be impated by the attention-deficit part of the disorder rather than the the hyperactivity part. Symptoms from girls usually differ, and may include low self-esteem, anxiety, and underachievement. 
It is thus important to understand that while ADHD is not gender-based, it's manifestation can be different in boy and girls, with girls running a risk of underdiagnosis due to the symptoms of ADHD being stereotypically associated with boys.

 

TREATMENT AND PREVENTION

The sooner it is diagnosed, the better it can be dealt with. It is better to consult a mental health professional if parents think that their child has ADHD. To begin with, parent can ask themselves questions like the following before consulting a psychologist:

  1. Is the child inattentive and impulsive in social settings?

  2. Does he have trouble controlling his impulses?

  3. Is the child unable to complete his homework?

  4. Is the child not able to sit and eat properly and always moving?

  5. Is it difficult for the child to modify his behaviour even after punishments and scolding him for the same things over and over again?

If the answer to most of these questions is yes, then the parents should definitely consult a mental health professional for treatment. The treatment for ADHD involves both the use of medicines and therapies. The most common drug for ADHD is methylphenidate which is found in medicines like Ritalin. The drug helps to reduce the hyperactive and impulsive behaviors of the children by reducing the secretion of neurotransmitters like dopamine in the body. But the drug has its own set of side effects like headaches, increased weight and worse, insomnia. Due to this, therapeutic procedures are used more.

Therapy concerning ADHD not only focuses on training and modifying the behaviour of children but also that of parents. Parents are educated about the problem and adopt ways like use of token economy or ignoring minor inappropriate behaviours like whining or providing rewards when they show appropriate behaviors to help the child learn control. For children, they are advised to undertake occupational therapy where they are made to involve and indulge in exercises which reduces their hyperactivity and all also enrolled in intervention programs which target specifically on the development of problem-solving behaviours, enhanced academic competence and increased interpersonal activities.

With proper and timely intervention, children with ADHD are able to achieve stability in their symptoms. If not treated, the symptoms may pertain and can even get accompanied by other disorders like anxiety or depression in adulthood.

To diagnose it at an early stage, it is important for parents to observe the behaviours of their children properly. Most of the disorders can be prevented from taking severe forms only with early interventions. If people are unsure to reach out to a mental health professional, they can always start by talking to a near and dear one. 

 

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Delhi, India

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