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October is ADHD Awareness Month Understanding ADHD

ADHD is a highly genetic, brain-based syndrome that has to do with the regulation of a particular set of brain functions and related behaviors.

These brain operations are collectively referred to as “executive functioning skills” and include important functions such as attention, concentration, memory, motivation and effort, learning from mistakes, impulsivity, hyperactivity, organization, and social skills.  There are various
contributing factors that play a role in these challenges including chemical and structural differences in the brain, as well as genetics.

Is it ADD or ADHD?
To better explain, let’s briefly discuss the language used for describing diagnoses in general. Diagnostic terminology for psychiatric and behavioral disorders comes from the Diagnostic and Statistical Manual (DSM), the manual used by doctors to identify, describe, and code various conditions.

The most recent revision, DSM-5, breaks Attention Deficit/Hyperactivity Disorder into three subtypes to more accurately reflect the most common forms of the condition:

Combined Presentation: symptoms of both criteria inattention and hyperactivity-impul-sivity were present for the past 6 months;

Predominantly Inattentive Presentation: predominant symptoms of inattention, but not hyperactivity-impulsivity, were present for the past six months; and

Predominantly Hyperactive-Impulsive Presentation: predominant symptoms of hyperactivity-impulsivity but not inattention were present for the past six months.

Who has ADHD?
According to epidemiological data, approximately 5% of adults have ADHD.
That represents over 11,000,000 people in the US.  It occurs in both men and women and, in the majority of cases, persists throughout the lifespan.

ADHD usually persists throughout a person’s lifetime. It is NOT limited to children.
Since ADHD is a neuro-behavioral condition, there is no cure and the majority do not outgrow it.  Approximately two-thirds or more of children with ADHD continue to have symptoms and challenges in adulthood that require treatment.

ADHD occurs in both men and women.
While initially research was focused on studying hyperactive, school-aged boys, we now know that women also have ADHD.  Boys and men are more likely to be referred for ADHD testing and treatment, receive accommodations, and participate in research studies, which makes it hard to identify the ratio of men to women with ADHD.  Some researchers have suggested that ADHD is more prevalent in men, but we are learning that this is likely not the case. ADHD in women are consistently under-diagnosed under-treated compared to men, especially those who do not demonstrate hyperactivity and behavior problems.

Not every case of ADHD is the same.
There are different subtypes of ADHD (inattentive, hyperactive, and combined type), and every person has a unique brain profile. As with anything else, no two people with ADHD are exactly the same and everyone experiences ADHD in their own way.

What Is The Definition Of ADHD?
The diagnosis of ADHD is outlined by the American Psychological Association in the DSM-5 as a lifelong, persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development across time and settings. The diagnosis requires the following criteria:

Inattention:
Six or more symptoms of inattention for children up to age 16, or five or more for adolescents 17 and older and adults; symptoms of inattention have been present for at least 6 months, and they are inappropriate for developmental level:
• Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities.
• Often has trouble holding attention on tasks or play activities.
• Often does not seem to listen when spoken to directly.
• Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked).
• Often has trouble organizing tasks and activities.
• Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework).
• Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).
• Is often easily distracted
• Is often forgetful in daily activities.

Hyperactivity and Impulsivity
Six or more symptoms of hyperactivity-impulsivity for children up to age 16, or five or more for adolescents 17 and older and adults; symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for the person’s developmental level:
• Often fidgets with or taps hands or feet, or squirms in seat.
• Often leaves seat in situations when remaining seated is expected.
• Often runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless).
• Often unable to play or take part in leisure activities quietly.
• Is often “on the go” acting as if “driven by a motor”.
• Often talks excessively.
• Often blurts out an answer before a question has been completed.
• Often has trouble waiting his/her turn.
• Often interrupts or intrudes on others (e.g., butts into conversations or games).

In addition, the following conditions must be met:
• Several inattentive or hyperactive-impulsive symptoms were present before age 12 years.
• Several symptoms are present in two or more settings, (e.g., at home, school or work; with friends or relatives; in other activities).
• There is clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning.
• The symptoms are not better explained by another mental disorder (e.g. Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a Personality Disorder).