Attention-deficit/hyperactivity disorder (ADHD)

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common behavioral and learning disorders in children. It affects adults too. At Atrium Health Floyd and Harbin Clinic, our behavioral health specialists provide treatment to help children and adults manage ADHD.

What is ADHD?

ADHD is a disorder that affects brain development. It’s most often diagnosed in children, but the condition often continues into adulthood. ADHD was formerly known as attention-deficit disorder or ADD.

People with ADHD may have a harder time controlling their focus or attention. They may focus on tasks too little or too much (hyperfocus). Others may have trouble sitting still or controlling their behavior.

Causes of ADHD

Experts don't know exactly what causes ADHD. Research suggests it may be a genetic condition, meaning a gene change may affect how the person's brain develops.

Most people with ADHD have low levels of a brain chemical called dopamine. This chemical is a type of neurotransmitter that plays a key role in attention, emotional regulation, memory, motivation and mood.

ADHD types

Health care providers classify the type of ADHD based on a person's symptoms. There are three main types of ADHD:

• Inattentive ADHD: The person struggles to be organized, stay on task and focus. They have few, if any, hyperactivity symptoms.
• Hyperactive-impulsive ADHD: The person struggles to remain still or quiet. They may fidget and talk a lot. They may also make impulsive decisions without thinking about the consequences.
• Combined ADHD: The person has signs of both inattentive ADHD and hyperactive-impulsive ADHD.

ADHD symptoms

ADHD affects people differently depending on the type of ADHD they have.

A person with inattentive ADHD may:

• Be easily distracted
• Have a short attention span
• Have poor organizational or study skills
• Lose or forget things
• Make careless mistakes
• Seem distracted or like they’re daydreaming
• Struggle to listen to others or focus

A person with hyperactive-impulsive ADHD may:

• Be overly talkative
• Fidget or struggle to stay still or seated
• Find it hard to stay on task and finish a project
• Interrupt others
• Lose or forget things
• Struggle to wait their turn

ADHD diagnosis

Health care providers diagnose ADHD based on symptoms. When making a diagnosis, they use guidelines from the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM). Providers look for a consistent pattern of symptoms over time.

The DSM's diagnostic criteria for ADHD depend on a person’s age:

• Children up to age 16 must have six or more symptoms of any type of ADHD.
• People age 17 and older must have five or more symptoms of any type of ADHD.

ADHD risk factors

Certain factors may increase a person's chances of developing ADHD. These risk factors include:

• Exposure to lead or environmental toxins while in the womb or during early childhood
• Having a parent or sibling with ADHD
• Parent's substance use, including alcohol or tobacco, during pregnancy
• Preterm birth or low birth weight
• Previous head injury

Although males are almost twice as likely as females to receive an ADHD diagnosis, assigned sex at birth isn’t considered a risk factor. This is because males tend to have more noticeable ADHD symptoms, like hyperactivity and impulsivity, that lead to earlier diagnosis. Females may be inattentive or daydream, but these signs are easier to overlook.

ADHD prevention

Often, there is no way to prevent ADHD. Avoiding substances like alcohol and environmental toxins during pregnancy may lower your child’s risk of developing ADHD. Recognizing the symptoms and getting appropriate treatment as soon as possible can improve quality of life for people with ADHD.

ADHD treatments

Stimulant medications (also called psychostimulants) are the most common ADHD treatment. Despite their name, stimulants tend to have a calming effect on people with ADHD.

Medications often work best when combined with other therapies, such as:

• Neurofeedback: This noninvasive therapy retrains your brain waves to help improve focus and concentration.
• Psychotherapy: Also called talk therapy, psychotherapy can teach you strategies to improve organization, focus and emotional regulation. Cognitive behavioral therapy (CBT) is a common ADHD therapy.