ADHD

What is ADHD?

ADHD (Attention Deficit hyperactivity Disorder) is a neurological condition which affects an individual’s behaviours including impairments to: concentration, memory recall, hyperactivity, attention and Impulsivity.

There are 3 types of ADHD;

Inattentive
Hyperactive
Combined

ADHD affects both males and females, although currently the ratio of males to females is around 3:1 but in recent times, diagnosis of females has risen due to more awareness of the condition. Decades ago, ADHD was seen as a condition that affected only young boys and that children would grow out of when they reach adolescence. Research has taken place over recent years, to show the preconceived perception of a childhood condition is no longer the case and it is now known that ADHD is a condition that occurs throughout childhood and adulthood.

The main methods of treatment for the condition are: medication, therapy, behavioural management and CBT. Although this is a condition that cannot be cured, a combination of medication and therapy can help an individual to manage the condition.

Assessments are carried out by psychiatrists/psychologists specialising in ADHD, giving a diagnosis of the type of ADHD that the individual has. A treatment plan is then created depending on the individual, their medical history and their type of ADHD. Medication comes in the types of stimulants and non-stimulants and are prescribed based on the type of ADHD and the potential side effects that may occur. There are none -prescription medications that research has shown may help individuals with ADHD.

The ADHD brain is different to that of a non-ADHD brain, as the neurotransmitters that allow the brain to send signals are not accepted by the receptors in the brain (think of a claw machine trying to pick up toys, but the claw doesn’t open). Therefore, struggling to naturally absorb attempts of dopamine uptake. As the brain does not take in the correct amount of dopamine, a person with ADHD thus then “dopamine seeks” trying to flood the brain with the dopamine that it is missing. Dopamine fuel’s executive function and is typically associated with feelings of happiness and excitement. Therefore, the impairment of dopamine absorption in an ADHD individual can have affects on:

The working memory
Impulsivity
Hyperactivity
Focus
Stress
Low mood

Types of ADHD

ADHD can display differently in each individual. Individuals may be inattentive, hyperactive or a combination of both. Although the condition contains “deficient in hyperactivity” this is not always the case for every individual and some traits will fall outside of what people have perceived as the “typical ADHD traits” being:

• Inability to concentrate on a task – an individual may become physically restless during a task, getting up, starting something else or may start to daydream
• Hyperactivity – individuals may struggle to sit still whether that be: at a desk, school, work or watching a film. They may find they tap the desk, swing legs, sit on the feet or trace shapes (this is called stimming).
• Impulsivity – individuals may be seen to not think things through before making a decision, they may like to do things off plan or spur of the moment. They may become impulsive with money, alcohol, food, drugs see co-occurring conditions tab) and decision making. This can lead to issues with the law and addiction.

Quite the opposite of the stereotypical traits can occur in individuals, with very little awareness of other traits currently failing to exist. Below is a list of some of the lesser-known ADHD traits, that may help people to identify some traits that they may have always exhibited but never been made aware that these in fact are traits of ADHD:

Justice sensitivity
This is when an individual may feel a strong sense of injustice in a situation and may take it upon themselves (no matter how big or tough the situation is) to resolve the matter and to right the wrong.

Task paralysis
When it comes to hyperactivity, an individual may struggle to get started with task paralysis. They may leave things until the very last minute (procrastination) and may struggle to organise tasks they need to carry out.

Hyperfocus
Individuals may find that they have bouts of hyperactivity, being able to hyperfocus on a certain task, then meaning that they are unable to stop until that task is complete. That could mean they spend hours fixating on learning new skills, buying items required, failing to eat or to go to the toilet, missing appointments or essential daily tasks until the task is done. They may then fail to have any interest in that subject whatsoever after the task is done due to burn out. Hyper fixation is not a trait that can be turned on or off, so it is usually seen as being quite an inconvenient trait.

How to spot ADHD

Shaking/ tapping legs, tracing shapes with fingers, tapping fingers, rocking back and forth, humming and making noises (stimming)
Constant needs to have noise – talking to self, singing, having the radio, being on the phone to someone when alone
Speaking loudly and fast
Getting very excited and passionate about things (can be interpreted as talking aggressively)
Once an idea is in your head, you can’t get it out until you get/achieve it
Pacing whilst on the phone
Sits with legs pulled up, crossed legs on chair, need for pressure on legs
Extra joint mobility (hypermobility) can flip elbows round, very flexible
Constantly reeling off a list of things you have done or need to do
Oversharing information (if someone asks you divulged too much information then instantly regret it after)
Are awake late at night doing random things (decoration/ making bread/ searching new hyper focus)
Have had a whole list or hobbies and interests that you now have no interest in whatsoever
Have had numerous jobs as you get bored, are sure you are ongoing to get fired so leave
Have money issues due to money management or spend impulsively
Get overwhelmed if too much is going on around you (if people talk whilst you are trying to talk/think)
Being around people mentally drains you
Struggle emotionally – gets upset/cry at the smallest of things or snap and get angry really quickly
Constantly needing a distraction – wondering around at work, half finishing jobs, eating snacks due to boredom
Cutting people off in a conversation
Forgetting what you are saying part way through a sentence
No filter/ just saying things to provoke a reaction
Get irritated by the littlest of things – sounds of a person breathing or eating

Co-occurring conditions

https://www.adhdfoundation.org.uk/wp-content/uploads/2022/05/What-conditions-can-co-occur-with-ADHD-Colin-Foley.pdf

ADHD is thought to have an ever-evolving list of medical conditions that run alongside it. Research has found that due to the amount of stress on the nervous system due the ADHD, that this leads to other medial issue occurring.

However, the 2 most common conditions that tend to occur with ADHD are anxiety and depression. This is why a large number of individuals undiagnosed with the condition, as they are misdiagnosed with anxiety and/or depression.

These co-occurring conditions can include:

Hypermobility (flexible joint/joints dislocating/ double jointed)
Thyroid issues
Acid reflux
Digestive issues

Other learning difficulties that can occur have been listed as:

Tourette’s/tics
Dyslexia – issues with reading, writing and spelling
Dyspraxia – poor hand eye co-ordination, leading to falling, tripping, balance issues and grip
Dyscalculia – struggles with dealing with numbers and mathematical issues
Sleep issues – falling asleep or staying asleep
Sensory issues including : touch (clothing, seating, bedding) smells (strong smells or struggle to smell) textures and taste (food) light (bright lights) sounds (overwhelmed by too much noise or need for noise in order to function)

Co-morbidities

A comorbidity is when an individual has both a mental health condition along with a substance/addiction issue. Individuals with ADHD not only tend to have other medical conditions that occur alongside it but also have substance and addiction problems that are caused due to ADHD issues. Such as problems with drugs (both prescription and non-prescription) and alcohol dependency.

Some traits noted in the traits section includes Oppositional Defiance Disorder (ODD) and justice sensitivity. This along with authoritarian issues and lack of natural dopamine absorption can be that one of the greater-known impacts of an individual having ADHD can be that they can end up leading to a life of entangled with crime, that over time leads to prison sentences. The amount of individuals with ADHD in prisons is still uncertain but has been thought at times to be up to around 60%, as those with ADHD are 2 to 3 times more likely to get into trouble with the law. With individuals seeking dopamine meaning they may have a tendency to: turn to drugs, consume excessive alcohol and break the law. The effects of oppositional defiance can lead to issues with the police and authority. In the book “how not to murder your ADHD child” the author explains how when she worked in prisons, the impact that an ADHD diagnosis, along with treatment and medication can help to turn around the lives of ADHD criminals.

Autism

One other condition that is thought to be strongly related with ADHD is Autism and is that’s that around 50%-70% of individuals with one condition display traits for the other. Both conditions are often misdiagnosed as one another, as there are some traits that overlap with both conditions but it can often be the case that in fact an individual has both. The traits of Autism can mean that an individual goes undiagnosed with ADHD, as some Autistic traits are not seen on the ADHD spectrum and therefore an individual may be instantly dismissed for ADHD. These can include:

Need for routine
Struggling with change
Organisation
Social Anxiety

But overlapping traits of both conditions can include:

Perfectionism

Rejection sensitivity disorder

Meltdowns

Emotional dysregulation

ADHD is often means that individuals are stereotyped as being disorganised. Whereas an individual with both conditions (known as being AuDHD) display the traits of ADHD, potentially being hyperactive and impulsive but then have the need for routine, struggle with change, struggle socially not just with RSD but also with eye contact and general conversations. Along with some individuals having the inattentive form of ADHD this can make it incredibly hard to diagnose an individual with ADHD. As the more prominent ADHD traits are not always displayed in a person with both conditions.

ADHD in girls and women

Commonly affects about 8% of children. 50% co-occurrence rate with other conditions.

Attention deficit hyperactivity disorder (ADHD) has long been thought of as a condition affecting males. But more women and girls are being diagnosed as our understanding of it deepens. This is due, in part, to learning that ADHD in girls can look different than it does in boys. Originally the assessments were designed based on male characteristics ( by men)

For instance, girls are more likely to have inattentive ADHD, in which daydreaming and shyness are common. Conversely, it is more typical for boys to have hyperactive-impulsive ADHD or combined type ADHD.

If left undiagnosed, ADHD in girls can result in disadvantages such as a lack of accommodation in the classroom, low self-esteem, and self-blame. It can even affect mental health well into adulthood. Being aware of the different symptoms of ADHD in girls can help you know when it might be time to see a doctor for an evaluation.

Current thinking is it is more likely for a woman with ADHD to commit suicide than a man with adhd.

Symptoms of ADHD in Girls

ADHD symptoms in girls are often thought of as personality /traits/characteristics rather than ADHD, which is why they are often overlooked or explained away. But what exactly does ADHD look like in girls vs. boys? The following signs may help tell that a girl has ADHD include:

Appears withdrawn
Cries easily
Daydreaming and in a world of her own
Difficulty maintaining focus; easily distracted
Disorganized and messy (in both appearance and physical space)
Doesn’t appear to be trying
Doesn’t seem motivated
Forgetful
Highly sensitive to noise, fabrics, and emotions
Hyper-talkative (always has lots to say, but is not good at listening)
Hyperreactivity (exaggerated emotional responses)
Looks to be making “careless” mistakes
Might often slam her doors shut
Often late (poor time management)
Problems completing tasks
Seems shy
Seems to get easily upset
Shifting focus from one activity to another
Takes time to process information and directions; seems like she doesn’t hear you
Verbally impulsive; blurts out and interrupts others

ADHD characteristics can manifest differently in each child. You may have one child who has been diagnosed with ADHD, but never considered that the other might also have it because their issues seem so different.

ADHD characteristics may change somewhat as a girl ages. ADHD in teenage girls can have a significant impact on emotional and social well-being. Teen girls may struggle with social rejection, difficulty staying focused in school, poor impulse control, shyness, anxiety, and poor self-esteem.

Girls may internalize their symptoms, mistakenly believing that their struggles are due to character flaws or personality traits rather than as signs of neurodivergence.

They can mask themselves.

For many girls with ADHD, paying attention to the task at hand is their biggest challenge. They can get distracted by external events or drift off into a world of their own. For example, a bird outside a classroom window may take attention away from something more important in their environment, like a teacher announcing the date of an upcoming exam.

To compensate, a girl with ADHD may hyperfocus on something she likes or is good at. She will put forth so much effort and concentration toward that one thing that parents or teachers may dismiss the possibility of ADHD.

Sometimes, this hyperfocus is a coping strategy to keep herself entertained when something is boring. Other times, she may not feel she has any control over it. While it can be advantageous at times, it can also be disruptive when it interferes with a girl’s ability to focus on other things.

Always in Motion

Some girls with ADHD display more of the classic signs of hyperactivity. If a girl is hyperactive, she might be described as a “tomboy” because she likes physical activity and doesn’t seem to enjoy the same things as other girls her age.

ADHD in girls might also show up in less obvious ways that still involve always being in motion. Examples include doodling constantly or always moving around in her chair.

Other behaviours that are related to hyperactivity, such as aggression, talkativeness, and emotionality, are sometimes misattributed to personality characteristics rather than ADHD.4

Lack of Impulse Control

A girl with ADHD may have impulsivity and be hyper-talkative. She may be verbally impulsive, interrupt others, talk excessively, or change topics repeatedly during conversations. She might even blurt out words without thinking about their impact on others.

Girls with ADHD can also be overly sensitive. Some are described as overemotional and easily excitable.

Simply knowing she has ADHD can relieve a young girl of a huge burden of guilt and shame. It can also free her from the damaging labels of being “spacey,” “unmotivated,” “stupid,” or “lazy.”

A girl with ADHD is none of those things. She simply has ADHD. And strategies can be put in place to make her life a little easier and her future brighter. The first step to making this happen is recognizing the different ADHD symptoms in girls, and now you know what to look for.

In addition to behavioural therapies, medications for ADHD can be very helpful in reducing impulsiveness and hyperactivity and increasing focus and attention. Let’s gain an understanding of the types of prescription medications people with ADHD can use to feel better and improve their symptoms.

Stimulants

Stimulant medications are the most commonly prescribed medications for ADHD and have been found to be very effective in alleviating ADHD symptoms. Stimulants increase the level of the neurotransmitters dopamine and norepinephrine in the brain. This improves inattention, impulsivity, and hyperactivity in people with ADHD.1

While stimulants are the classic medication of choice for ADHD and are approved by Food and Drug Administration (FDA) for treatment in children, many people either cannot tolerate stimulant therapy or don’t respond to it. Also, some people respond to one kind of stimulant and not another.2

Some common side effects of stimulants include: