Attention Deficit Hyperactivity Disorder, or ADHD, is a medical condition that affects a person’s ability to focus, stay still, or control impulses. Kids with ADHD tend to be in constant motion, choosing to run instead of walk, interrupt people in conversation, are easily distracted and have trouble listening. Adults with ADHD have difficulty remembering instructions, talk excessively, and may be diagnosed with secondary medical conditions, like depression or anxiety.
While there is no official, specific test that defines whether or not a person has ADHD, children and adults concerned about the possibility can seek the advice of a medical or mental health professional. Diagnosis for both children and adults involves numerous steps and may take some time to complete.
If you are concerned your child possibly has ADHD, you and your child, along with his or her teachers and other caretakers, will be asked to gather together some information regarding your child’s behavior. Your doctor will run over a set of questions asking about certain symptoms and how long these symptoms have been present. If your child has shown six or more specific symptoms consistent with inattention or hyperactivity over the course of six months or longer, your child may get an ADHD diagnosis.
Adults may present similar symptoms to children with ADHD, including feeling the need to fidget during extended periods of sitting or listening (like in church, during a class lecture, or in a business meeting), or may be unable to sit through a movie or a meal. However, adult ADHD can look much different: adults with this disorder may draw conclusions faster than most, choose careers where office work isn’t required, monopolize conversations or talk too fast, and may be impulsive, impatient and easily frustrated. Adults with ADHD may not be able to keep attention for long periods of time and appear “glazed over” in conversation. They may experience problems with memory, lose important items frequently, can’t keep track of projects and things to do, and may be disorganized and reckless.
Although many of these symptoms are reported by adults with ADHD, no two people share exact symptoms of the disorder, and the severity of symptoms vary from person to person. Many adults with ADHD report that the inattention part of the disorder is what is often more outwardly displayed than hyperactivity, which is felt internally but not often exposed.
How is ADHD treated?
There are a number of approaches when it comes to treating ADHD. The best treatment for ADHD is what works for you, and it may take some experimenting before you find exactly what works.
The key to success is follow-through – regardless of the treatment type. If your child is being treated, include him or her in the treatment approach. When your child feels empowered and included, he or she will be more likely to adhere to the treatment plan. If you or your adult family member is being treated for ADHD, keep the lines of communication open with your clinician and family.
Types of treatment for ADHD
The most typical treatment approaches for ADHD are medication, behavioral therapy (including cognitive behavioral therapy, or CBT), and meditation therapy. There are merits to each of these approaches, and mental health professionals may even suggest a combination of the three in order to have the best plan of treatment at your disposal.
Medication and ADHD. Riley, 7, was “literally bouncing off the walls,” says her mother, Rayna. “I guess I’m not like a lot of moms… I felt like I was pushing for the ADHD diagnosis because everyone else was like, ‘Oh, she’s just being a kid!’
“But she wasn’t just a happy kid who loved play time. I was seriously concerned. This was a kid who would have tried to swing from a chandelier if I let her. It was beyond misbehaving.”
After collecting information from teachers, who agreed that Riley had difficulty focusing in class and who constantly needed to be relocated from desk to desk because other children would complain of her noise level and persistent moving, Ryan sought the advice of their family physician, who sent Riley to be seen by a neuropsychologist.
Riley was diagnosed with ADHD, and Rayna was not surprised at all when she was prescribed medication.
“When a couple of my friends found out we were going the medicine route right away, we were totally judged,” she shares. “We got everything from the ‘Don’t you think she’ll just outgrow it?’ to ‘Are you okay with your kid depending on pills instead of teaching her ways to control herself?’
“I just think that until you’re in a situation, you really don’t know what you’d do. But I can truthfully say that medication was not the easy way out that some people think it is. For Riley, it was so helpful. It gave her sharper focus and has helped tremendously - socially, personally, and academically.”
There are several medications on the market that are available for children with ADHD. Many of these medications have been in existence for decades, and some children react better to one formulation than another. Typically, your doctor will choose to start your child on a low dose stimulant, like Adderall or Dexedrine, which are amphetamines, or Ritalin, which is a methylphenidate. Both stimulants assist with hyperactivity and a child’s ability to sit still, focus, and ingest information.
It might sound strange, that a stimulant can actually calm a brain, but what the drugs actually stimulate is the brain’s ability to focus. This then reduces a child’s impulsivity and inhibits his or her hyperactive behavior.
And for parents who are hesitant on giving their child medicine? Experts understand the concern. But research has shown that when medication is used properly, it is safe, effective and harmless, with a success rate of 80%.
Adults with ADHD may be prescribed medication as well. Medication for adult ADHD include amphetamines (known by brand names like Dexedrine, ProCentra, or Vyvanse), methylphenidates (like Concerta, Cotempla, Ritalin and Daytrana), or mixed salts of a single-entity amphetamine (like Mydayis).
Low doses are often prescribed by physicians to start, and you are responsible for reporting your response to the dose. If your symptoms don’t improve, your doctor may opt to increase your dosage or try you on something else altogether.
Owen, a 40-year-old soccer coach, takes a long-acting medication once a day to help his symptoms. “Best thing I ever did,” he admits. “It’s not a magic pill – I’m still who I am.
“I’m still the guy the kids love because I’m running all over the place like they are,” he says with a laugh. “But it’s a huge improvement. I feel calmer. When I’m not on medication, I’m like a runaway lawn mower. On it, I feel like a normal, contributing member of society!”
But stimulants aren’t for everyone. If stimulants aren’t right for you, your physician may prescribe atomoxetine (known by the brand name Strattera), which raises chemicals in the brain that assists in controlling behavior. Non-stimulants may take a few weeks before they start working.
Other options include antidepressants, low blood pressure drugs like clonidine or guanfacine (which are known to manage hyperactivity and impulsivity), or even supplements.
All medications come with a risk of side effects, which you should discuss with your doctor. If you have a history of drug or alcohol abuse, glaucoma or heart disease, stimulants may not be an option for you. Consult with your physician if you are on any other medications, or if you already suffer from some of the listed side effects.
Therapy and ADHD. Little evidence is available on the efficacy of cognitive behavioral therapy (CBT) on children, but there are behavioral interventions that can help children with ADHD manage their symptoms. These treatments are designed not to get rid of the symptoms, but rather to assist children in learning how to control them. With successful treatment, kids with ADHD will be able to become more organized, reduce destructive or violent behavior, or experience overall better functionality at home and in school. As a companion to medication, behavioral therapy is reported to be highly successful in the treatment of kids with ADHD – especially because the skills learned can be used through to adolescence and adulthood.
Parent training (which include Parent Child Therapy or PCIT, Parent Management Training or PMT, or Positive Parent Program or PPT) involves working with the child and parents, together. Parents are taught a different way to interact with the child, encouraging better behavior and discouraging negative behavior. Parent training focuses on the interaction between parent and child; successful training reduces tantrums and outbursts in the child, because kids learn how to respond to what becomes positive and predictable parent behavior. Using praise, positive reinforcement and consistent consequences, kids learn how to listen to instructions and as a result, have fewer tantrums and arguments.
Skills-based interventions are also another are of behavioral therapy for kids with ADHD. This type of therapy teaches kids to be able to complete their schoolwork or other responsibilities by utilizing their strengths.
Experts report that executive functioning – the skills we depend on to finish tasks or duties – is weaker in kids with ADHD. Skills-based interventions help bring out a child’s abilities and helps him or her learn how to be better organized, how to plan, how to make decisions and how to move from one task to the next without a meltdown or tantrum. These interventions also help a child control his or her emotions. Tools used in skills-based interventions include rewards charts, planners, checklists and time limits for larger projects.
Adults with ADHD may benefit from cognitive behavioral therapy (CBT), which is designed to change irrational thoughts that lead to negative behaviors. Adults with ADHD may have distorted thoughts that lead to anxiety or other emotional disorders, and CBT improves the production of new thoughts and habits.
During a CBT session, your therapist will help you identify situations where you may be disorganized, inattentive, or hyperactive. You may report an inability to manage tasks or follow through with plans. You may have unhealthy coping strategies and negative expectations of yourself.
Jack, a 32-year-old dog groomer, began CBT on the advice of his general practitioner. “It basically shed light on how I function on a day to day basis, which honestly was not great,” he admits. “It was a lot of stuff I already knew, but didn’t know I knew, like ‘I have to do this perfectly or I’m not doing it at all,’ or ‘If this isn’t perfect, I suck.
“I’m looking at things with a different perspective now. And on top of that, I’m learning how to plan and cut things into a smaller bite-size pieces so I’m not freaking out when I have this big thing ahead of me.”
Meditation and ADHD. At first blush, meditation – the art and skill of mindfulness, attention and awareness – seems an impossibility for anyone with ADHD, a disorder characterized by the patient’s inability to be attentive. But this kind of attention training, one that increases one’s ability to be self-aware and controlled, may be exactly what a person with ADHD needs.
There are numerous ways to practice meditation. Even for children who don’t have ADHD, mindfulness has been proven to improve focus, mental wellbeing, and even social skills. There are many resources available through mental health professionals, but one mindful exercise that a child or adult can easily practice is the following:
Sit on a chair comfortably, your feet shoulder-width apart and planted firmly on the ground
Feel your feet on the ground, from your toes to your heels
Feel the backs of your thighs on your seat
Feel your back against the chair
Relax your arms and your shoulders, and then your neck
Breathe in for four seconds and pay attention to your stomach pulling in as you breathe
Breathe out for four seconds, noticing how your stomach relaxes
Repeat for five minutes
Yoga is another way to practice meditation, and is a form of mental and physical exercise that is beneficial for anyone, regardless of age or physical condition. Studies have shown that yoga specifically improves ADHD symptoms, increase levels of dopamine, a feel-good hormone. Attention and focus have improved in kids who practice yoga for 20 minutes twice a week for eight weeks.
If you or your child have ADHD and you’d like guidance on treatment, visit www.hopetherapyandwellness.com to book an appointment today. Contact us today for a free 15-minute consultation!