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Attention deficit hyperactivity disorder (ADHD) is a mental health disorder that can cause above-normal levels of hyperactive and impulsive behaviors. People with ADHD may also have trouble focusing their attention on a single task or sitting still for long periods of time.
Attention-deficit/hyperactivity disorder (ADHD) is a chronic condition that affects millions of children and often continues into adulthood. ADHD includes a combination of persistent problems, such as difficulty sustaining attention, hyperactivity and impulsive behavior.
Children with ADHD may also struggle with low self-esteem, troubled relationships and poor performance in school. Symptoms sometimes lessen with age. However, some people never completely outgrow their ADHD symptoms. But they can learn strategies to be successful.
While treatment won’t cure ADHD, it can help a great deal with symptoms. Treatment typically involves medications and behavioral interventions. Early diagnosis and treatment can make a big difference in outcome.
Types of ADHD
To make ADHD diagnoses more consistent, the APA has grouped the condition into three categories, or types. These types are predominantly inattentive, predominantly hyperactivity-impulsive, and a combination of both.
Predominantly inattentive
As the name suggests, people with this type of ADHD have extreme difficulty focusing, finishing tasks, and following instructions.
Experts also think that many children with the inattentive type of ADHD may not receive a proper diagnosis because they don’t tend to disrupt the classroom. This type is most common among girls with ADHD.
Predominantly hyperactive-impulsive type
People with this type of ADHD show primarily hyperactive and impulsive behavior. This can include fidgeting, interrupting people while they’re talking, and not being able to wait their turn.
Although inattention is less of a concern with this type of ADHD, people with predominantly hyperactive-impulsive ADHD may still find it difficult to focus on tasks.
Combined hyperactive-impulsive and inattentive type
This is the most common type of ADHD. People with this combined type of ADHD display both inattentive and hyperactive symptoms. These include an inability to pay attention, a tendency toward impulsiveness, and above-normal levels of activity and energy.
The type of ADHD you or your child has will determine how it’s treated. The type you have can change over time, so your treatment may change, too.
Symptoms
The primary features of ADHD include inattention and hyperactive-impulsive behavior. ADHD symptoms start before age 12, and in some children, they’re noticeable as early as 3 years of age. ADHD symptoms can be mild, moderate or severe, and they may continue into adulthood.
ADHD occurs more often in males than in females, and behaviors can be different in boys and girls. For example, boys may be more hyperactive and girls may tend to be quietly inattentive.
There are three subtypes of ADHD:
- Predominantly inattentive. The majority of symptoms fall under inattention.
- Predominantly hyperactive/impulsive. The majority of symptoms are hyperactive and impulsive.
- Combined. This is a mix of inattentive symptoms and hyperactive/impulsive symptoms.
Inattention
A child who shows a pattern of inattention may often:
- Fail to pay close attention to details or make careless mistakes in schoolwork
- Have trouble staying focused in tasks or play
- Appear not to listen, even when spoken to directly
- Have difficulty following through on instructions and fail to finish schoolwork or chores
- Have trouble organizing tasks and activities
- Avoid or dislike tasks that require focused mental effort, such as homework
- Lose items needed for tasks or activities, for example, toys, school assignments, pencils
- Be easily distracted
- Forget to do some daily activities, such as forgetting to do chores
Hyperactivity and impulsivity
A child who shows a pattern of hyperactive and impulsive symptoms may often:
- Fidget with or tap his or her hands or feet, or squirm in the seat
- Have difficulty staying seated in the classroom or in other situations
- Be on the go, in constant motion
- Run around or climb in situations when it’s not appropriate
- Have trouble playing or doing an activity quietly
- Talk too much
- Blurt out answers, interrupting the questioner
- Have difficulty waiting for his or her turn
- Interrupt or intrude on others’ conversations, games or activities
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Typical developmental behavior vs. ADHD
Most healthy children are inattentive, hyperactive or impulsive at one time or another. It’s typical for preschoolers to have short attention spans and be unable to stick with one activity for long. Even in older children and teenagers, attention span often depends on the level of interest.
The same is true of hyperactivity. Young children are naturally energetic — they often are still full of energy long after they’ve worn their parents out. In addition, some children just naturally have a higher activity level than others do. Children should never be classified as having ADHD just because they’re different from their friends or siblings.
Children who have problems in school but get along well at home or with friends are likely struggling with something other than ADHD. The same is true of children who are hyperactive or inattentive at home, but whose schoolwork and friendships remain unaffected.
When to see a doctor
If you’re concerned that your child shows signs of ADHD, see your pediatrician or family doctor. Your doctor may refer you to a specialist, such as a developmental-behavioral pediatrician, psychologist, psychiatrist or pediatric neurologist, but it’s important to have a medical evaluation first to check for other possible causes of your child’s difficulties.
r pediatrician or family doctor. Your doctor may refer you to a specialist, such as a developmental-behavioral pediatrician, psychologist, psychiatrist or pediatric neurologist, but it’s important to have a medical evaluation first to check for other possible causes of your child’s difficulties.
Causes
While the exact cause of ADHD is not clear, research efforts continue. Factors that may be involved in the development of ADHD include genetics, the environment or problems with the central nervous system at key moments in development.
Despite how common ADHD is, doctors and researchers still aren’t sure what causes the condition. It’s believed to have neurological origins. Genetics may also play a role.
Research suggests that a reduction in dopamine is a factor in ADHD. Dopamine is a chemical in the brain that helps move signals from one nerve to another. It plays a role in triggering emotional responses and movements.
Other research suggests a structural difference in the brain. Findings indicate that people with ADHD have less gray matter volume. Gray matter includes the brain areas that help with:
- speech
- self-control
- decision-making
- muscle control
Researchers are still studying potential causes of ADHD, such as smoking during pregnancy.
Despite how common ADHD is, doctors and researchers still aren’t sure what causes the condition. It’s believed to have neurological origins. Genetics may also play a role.
Research suggests that a reduction in dopamine is a factor in ADHD. Dopamine is a chemical in the brain that helps move signals from one nerve to another. It plays a role in triggering emotional responses and movements.
Other research suggests a structural difference in the brain. Findings indicate that people with ADHD have less gray matter volume. Gray matter includes the brain areas that help with:
- speech
- self-control
- decision-making
- muscle control
Researchers are still studying potential causes of ADHD, such as smoking during pregnancy.
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ADHD testing and diagnosis
There’s no single test that can tell if you or your child has ADHD. A recent study highlighted the benefits of a new test to diagnose adult ADHD, but many clinicians believe an ADHD diagnosis can’t be made based on one test.
To make a diagnosis, your doctor will assess any symptoms you or your child has had over the previous six months.
Your doctor will likely gather information from teachers or family members and may use checklists and rating scales to review symptoms. They’ll also do a physical exam to check for other health problems.
If you suspect that you or your child has ADHD, talk to your doctor about getting an evaluation. For your child, you can also talk to their school counselor. Schools regularly assess children for problems that may be affecting their educational performance.
For the assessment, provide your doctor or counselor with notes and observations about you or your child’s behavior.
If they suspect ADHD, they may refer you or your child to an ADHD specialist. Depending on the diagnosis, they may also suggest making an appointment with a psychiatrist or neurologist.
Risk factors
Risk factors for ADHD may include:
- Blood relatives, such as a parent or sibling, with ADHD or another mental health disorder
- Exposure to environmental toxins — such as lead, found mainly in paint and pipes in older buildings
- Maternal drug use, alcohol use or smoking during pregnancy
- Premature birth
Although sugar is a popular suspect in causing hyperactivity, there’s no reliable proof of this. Many issues in childhood can lead to difficulty sustaining attention, but that’s not the same as ADHD.
Complications
ADHD can make life difficult for children. Children with ADHD:
- Often struggle in the classroom, which can lead to academic failure and judgment by other children and adults
- Tend to have more accidents and injuries of all kinds than do children who don’t have ADHD
- Tend to have poor self-esteem
- Are more likely to have trouble interacting with and being accepted by peers and adults
- Are at increased risk of alcohol and drug abuse and other delinquent behavior
Coexisting conditions
ADHD doesn’t cause other psychological or developmental problems. However, children with ADHD are more likely than others to also have conditions such as:
- Oppositional defiant disorder (ODD), generally defined as a pattern of negative, defiant and hostile behavior toward authority figures
- Conduct disorder, marked by antisocial behavior such as stealing, fighting, destroying property, and harming people or animals
- Disruptive mood dysregulation disorder, characterized by irritability and problems tolerating frustration
- Learning disabilities, including problems with reading, writing, understanding and communicating
- Substance use disorders, including drugs, alcohol and smoking
- Anxiety disorders, which may cause overwhelming worry and nervousness, and include obsessive compulsive disorder (OCD)
- Mood disorders, including depression and bipolar disorder, which includes depression as well as manic behavior
- Autism spectrum disorder, a condition related to brain development that impacts how a person perceives and socializes with others
- Tic disorder or Tourette syndrome, disorders that involve repetitive movements or unwanted sounds (tics) that can’t be easily controlled
Prevention
To help reduce your child’s risk of ADHD:
- During pregnancy, avoid anything that could harm fetal development. For example, don’t drink alcohol, use recreational drugs or smoke cigarettes.
- Protect your child from exposure to pollutants and toxins, including cigarette smoke and lead paint.
- Limit screen time. Although still unproved, it may be prudent for children to avoid excessive exposure to TV and video games in the first five years of life.
ADHD treatment
Treatment for ADHD typically includes behavioral therapies, medication, or both.
Types of therapy include psychotherapy, or talk therapy. With talk therapy, you or your child will discuss how ADHD affects your life and ways to help you manage it.
Another therapy type is behavioral therapy. This therapy can help you or your child with learning how to monitor and manage your behavior.
Medication can also be very helpful when you’re living with ADHD. ADHD medications are designed to affect brain chemicals in a way that enables you to better control your impulses and actions.
ADHD medication
The two main types of medications used to treat ADHD are stimulants and nonstimulants.
Central nervous system (CNS) stimulants are the most commonly prescribed ADHD medications. These drugs work by increasing the amounts of the brain chemicals dopamine and norepinephrine.
Examples of these drugs include methylphenidate (Ritalin) and amphetamine-based stimulants (Adderall).
If stimulants don’t work well for you or your child, or if they cause troublesome side effects, your doctor may suggest a nonstimulant medication. Certain nonstimulant medications work by increasing levels of norepinephrine in the brain.
These medications include atomoxetine (Strattera) and some antidepressants such as bupropion (Wellbutrin).
Natural remedies for ADHD
In addition to — or instead of — medication, several remedies have been suggested to help improve ADHD symptoms.
For starters, following a healthy lifestyle may help you or your child manage ADHD symptoms. The Centers for Disease Control and Prevention (CDC)recommends the following:
- eat a healthy, balanced diet
- get at least 60 minutes of physical activity per day
- get plenty of sleep
- limit daily screen time from phones, computers, and TV
Studies have also shown that yoga, tai chi, and spending time outdoors can help calm overactive minds and may ease ADHD symptoms.
Mindfulness meditation is another option. Research in adults and teens has shown meditation to have positive effects on attention and thought processes, as well as on anxiety and depression.
Avoiding certain allergens and food additives are also potential ways to help reduce ADHD symptoms.
Is ADHD a disability?
While ADHD is a neurodevelopmental disorder, it’s not considered a learning disability. However, ADHD symptoms can make it harder for you to learn. Also, it’s possible for ADHD to occur in some individuals who also have learning disabilities.
To help relieve any impact on learning for children, teachers can map out individual guidelines for a student with ADHD. This may include allowing extra time for assignments and tests or developing a personal reward system.
Although it’s not technically a disability, ADHD can have lifelong effects.
ADHD and depression
If you or your child has ADHD, you’re more likely to have depression as well. In fact, the rate of major depression in children with ADHD is more than five times higherTrusted Source than in children without ADHD. Up to 31 percent of adults with ADHD have been found to also have depression.
This may feel like an unfair double whammy, but know that treatments are available for both conditions. The treatments often overlap. Talk therapy can help treat both conditions. Also, certain antidepressants, such as bupropion, can sometimes help ease ADHD symptoms.
Of course, having ADHD doesn’t guarantee that you’ll have depression, but it’s important to know it’s a possibility.
Tips for coping with ADHD
If you or your child has ADHD, a consistent schedule with structure and regular expectations may be helpful. For adults, using lists, keeping a calendar, and setting reminders are good ways to help you get and stay organized. For children, it can be helpful to focus on writing down homework assignments and keeping everyday items, such as toys and backpacks, in assigned spots.
Learning more about the disorder in general can also help you learn how to manage it. Organizations like Children and Adults with Attention Deficit Disorder or the Attention Deficit Disorder Association provide tips for management as well as the latest research.
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