Houston Lifestyles & Homes November 2009
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HEALTH & WELL BEING
FAMILY HEALTH, IN FORT BEND COUNTY>>
Malady Misunderstood
De-mystifying Attention Deficit/Hyperactivity Disorder
Recently, many different terms have been used to classify and diagnose children, adolescents and adults who suffer from Attention Deficit/ Hyperactivity Disorder (ADHD) or Attention Deficit Disorder (ADD). Most people don ’t know that there is really no difference in the two terms. Imagine a new illness showing up in two polar opposite locations. Dr. “A” calls it ADD.  Dr. “B” calls it ADHD. The National Center for Health and Wellness asserts that ADD and ADHD are technically the same disease. Regardless what name it goes by, ADHD is still a very misunderstood mental illness and common questions abound:
Are there different types of ADHD?
In short, yes, of course. Just like there are different types of cancers, there are different manifestations of this disease.
•Combined ADHD (the most common, according to WebMD) involves all of the symptoms.
•Inattentive ADHD (previously known simply as ADD) is marked by impaired attention and concentration.
•Hyperactive-impulse ADHD is marked by hyperactivity without inattentiveness.
What are the symptoms of ADHD?
Symptoms of ADHD are generally grouped into three categories: inattention, hyperactivity and impulsivity. Of course, all children exhibit some of these behaviors, but children who have ADHD exhibit these behaviors frequently, and they interfere with the child ’s ability to function normally.
A person with ADHD might exhibit some of the following symptoms that display inattention:
•Easily distracted
•Doesn’t follow directions
•Doesn’t appear to listen
•Very forgetful
•Very disorganized
•Can’t sit still
•Loses things
•Daydreams
A person with ADHD might exhibit some of the following symptoms that display hyperactivity:
•Squirms, fidgets, bounces when seated
•Can’t stay seated
•Can’t play quietly
•Always moving, such as running or climbing on things; as an adult—may seem restless
•Talks excessively
Hyperactivity may vary with age and developmental stage. Toddlers and preschoolers with ADHD tend to be constantly moving, jumping on furniture and having difficulty participating in sedentary group activities, such as listening to a story. School-age children display similar behavior but with less frequency. Adolescents and adults may commonly feel restless and have difficulty engaging in quiet activities.
A person with ADHD might exhibit some of the following symptoms that display impulsiveness:
•Has difficulty waiting for a turn
•Blurts out answers or comments inappropriately
•Interrupts
•Chronically late and forgetful
•Anxious
•Low self-esteem
•Difficulty controlling anger
•Substance abuse or addition
•Chronically bored
•Difficulty concentrating
•Mood swings
•Depression
•Relationship problems
Impulsivity may lead to accidents such as knocking over objects or banging into people. Children may engage in potentially dangerous activities without considering consequences —for instance, climbing too high.
What causes ADHD?
Though researchers continue to study the brain for clues, the exact cause of ADHD remains unknown. Several factors, however, are known to contribute to the condition:
•Heredity—ADHD tends to run in families.
•Chemical imbalance—an imbalance of neurotransmitters (brain chemicals) may be a factor.
•Brain changes—areas of the brain that control attention are less active in those with ADHD.
•Head injury—reports of children with head injuries, particularly those
associated with concussion, indicate behavioral problems that mimic ADHD.
Other factors may include poor nutrition, infections, substance abuse (including drug and/or alcohol abuse during pregnancy), exposure to toxins (lead or PCBs) or other brain injury. Though a proper diet is essential for normal development, too much sugar does not cause ADHD, nor does watching too much TV, a poor home life, poor schools or food allergies. ➝
How is ADHD diagnosed and treated? 
To begin with, your doctor will conduct a complete physical examination and get a complete medical history, and although there are no specific lab tests for ADHD, other various tests, such as X-rays or blood tests, will be used to determine any physical disorders that may contribute to the symptoms. Since certain other mental illnesses, such as depression and anxiety disorders, have similar symptoms, a complete psychiatric evaluation should also be conducted. If no physical disorder is found, someone specially trained to diagnose and treat ADHD will be recommended. The diagnosis will then be based solely on the symptoms and behavior. Input can be requested from parents, teachers and others who are familiar with the patient ’s symptoms. Most research concludes that this is not an adult onset disorder. The symptoms must be verifiable as present in childhood.
Treatment options abound depending on your approach, but patients should realize upfront that ADHD has no cure. Treatment often includes a combination of medication and psychological therapy. A variety of pharmaceutical companies market drugs targeted at controlling the symptoms of ADHD. Psychosocial therapies can include any or a combination of the following:
•Special education—children with ADHD often benefit most from a highly structured environment and strict adherence to routine.
•Behavior modification—including strategies for supporting appropriate behaviors and reducing problem behaviors.
•Counseling—assists in equipping the patient with tools to handle their emotions and improve self-esteem.
•Social skills training—teaches the patient how to better behave with others, addressing such issues as taking turns and sharing.
•Support groups—this approach can help with acceptance and support through difficult times, providing a forum for educating parents and teachers.
How common is ADHD?
According to the Washington Post, 9 percent of children suffer from ADHD, but only 32 percent are receiving treatment. Several studies in recent years estimate 30 percent to 70 percent of those children continue to exhibit behaviors and symptoms into their adult years.
What is adult ADHD?
Adult ADHD is a neurological brain disorder that presents itself as a recurring pattern of inattention and hyperactivity/impulsivity more frequent and severe than in individuals at the same level of mental development. Some teens outgrow ADHD as they age and mature, but approximately 60 percent continue to exhibit symptoms late into adulthood.
According to LDOnline.com, most adults with ADHD are unaware that they have this disorder—they often just feel that it’s impossible to get organized, stick to a job or keep an appointment. The everyday tasks of getting up, getting dressed and ready for the day ’s work, getting to work on time and being productive on the job can be major challenges for the ADHD adult. A person ’s inability to accomplish these seemingly ordinary tasks can greatly impair their academic development or negatively affect their professional career.
How is adult ADHD diagnosed and treated?
The diagnostic and treatment principles used for adult ADHD are identical to those for diagnosing ADHD in children, but it is important to establish whether the adult ADHD symptoms were present in childhood, even if they were not previously recognized.
How does one move forward with ADHD?
A correct diagnosis of ADHD can bring a sense of relief. Most individuals who suffer from ADHD acquire many negative perceptions of themselves that lead to low esteem. Once diagnosed, the person can begin to understand the problems they face and deal with them intelligently. Above all, ADHD patients and those who love and support them should learn as much as they can about their disorder. As the patient begins to experience small successes in their newfound ability to bring order to the chaos of their lives, they can begin to appreciate the more positive characteristics of ADHD —enthusiasm, energy and authenticity.
By Cheryl Alexander
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