Definition

Attention-Deficit/Hyperactivity Disorder (ADHD), also known as attention deficit hyperactivity disorder, is a developmental disorder characterized by difficulties in concentrating, hyperactivity, and/or persistent impulsivity. Symptoms of ADHD can interfere with daily activities and relationships, impacting performance at school, work, and home life.

ADHD usually begins in childhood, around ages 3 to 7, and can continue into adolescence and adulthood. Boys are more likely to have ADHD than girls. Children with ADHD may also have problems with low self-confidence, and poor performance at school. Symptoms sometimes decrease with age. However, in some cases, the symptoms are not completely resolved. People with ADHD may also have additional problems, such as sleep disorders and anxiety.

Causes

The exact causes of ADHD are still not fully understood, although a combination of factors is thought to play a role, such as:

Genetic factors

ADHD tends to run in families and in many cases, it is thought that genes inherited from parents are an important factor in the emergence of this disorder. Research shows that the parents and siblings of someone with ADHD are likely to have ADHD. However, the inheritance process of ADHD tends to be complex and is not thought to be related to the fault of a single gene.

Brain function and structure

Research has examined some possible differences between the brains of people with ADHD and normal people, although the results are still unclear. For example, research with brain scans shows that certain brain areas may be smaller in people with ADHD, while other areas may be larger. Other research suggests that people with ADHD may have an imbalance in the levels of neurotransmitters (chemical compounds for communication between brain cells) in the brain, or may not function properly.

Risk factor

Several factors can increase a person's risk of suffering from ADHD, including:

• Have a family history of ADHD or other mental health disorders
• Exposure to environmental toxins, such as lead, is found primarily in paint and pipes in older buildings
• Malnutrition
• Infection
• Smoking habit
• Alcohol consumption and drug abuse during pregnancy
• The child was born prematurely (before the 37th week of pregnancy) or with low birth weight
• Have a history of epilepsy
• Brain injury or brain abnormalities, either during pregnancy or after birth. Damage to the front part of the brain, called the frontal lobe, can cause problems controlling impulses and emotions.

Symptoms

Symptoms of ADHD usually begin before the age of 12 years, and in some cases, they begin to appear as early as the age of 3 years. ADHD symptoms can be mild, moderate or severe, and can continue into adulthood.

There are three types of ADHD symptoms, namely predominantly reduced attention, predominantly hyperactive/impulsive behavior, and a combination of both. The following are the symptoms that can appear from each type of symptom.

Symptoms of decreased attention

• Can't pay close attention to details or makes careless mistakes in schoolwork
• Having difficulty staying focused on tasks or play
• Doesn't seem to listen, even when spoken to directly
• Having difficulty following instructions and failing to complete school assignments or homework
• Has problems organizing tasks and activities
• Avoids or dislikes tasks that require effort to focus, such as homework
• Losing items needed to do assignments or activities, for example glasses, books, school assignments, pencils
• Easily distracted
• Forgetting to do some daily activities

Symptoms of hyperactive and impulsive behavior

• Appears restless by frequently moving his arms or legs, or squirming in his chair
• Having difficulty remaining seated in class or in other situations
• Always actively moving
• Running or climbing in inappropriate situations
• Having difficulty playing or doing activities quietly
• Too much talking
• Interrupting questions, and always willing to answer before being asked
• Having difficulty waiting your turn
• Interrupting or interrupting other people's conversations, games, or activities

There are also ADHD sufferers who experience a combination of the two types of symptom groups above. Additionally, ADHD symptoms may change with age. In adults the symptoms can include:

• Often late or forgetting something
• Worry
• Lack of confidence
• Trouble at work
• Difficulty controlling anger
• Impulsive behavior
• Abuse or addiction to illegal substances/drugs
• Difficulty staying organized
• Habit of procrastination
• Easily frustrated
• Often bored
• Difficulty concentrating while reading
• Mood swings
• Depression
• Problems in relationships

Diagnosis

In diagnosing ADHD, the doctor may carry out several examinations, starting with anamnesis or an in-depth interview with the patient, physical examination, and supporting examinations if necessary.

The doctor can interview family members, the child's teacher, or others who know the child well, such as the child's caregiver or babysitter. This step is taken to collect the information needed to diagnose the disease, such as medical problems or symptoms experienced, personal and family health history, and school records, as well as looking for possible risk factors.

The doctor can also perform a physical examination and neurological (nerve) assessment, including examination of vision, hearing, and verbal and motor skills, to help rule out the possibility of another disease underlying the symptoms. The ADHD Rating Scale questionnaire can also help collect and evaluate information about a child's symptoms.

Management

Treatment for ADHD usually includes behavioral therapy, medication, or both. Types of therapy include psychotherapy or talk therapy. With talk therapy, you or your child will discuss how ADHD is affecting your life and ways to help you manage it. Another type of therapy is behavioral therapy. This therapy can help you or your child learn how to monitor and manage your behavior.

Medication can also be very helpful when you have ADHD. ADHD medications are designed to affect chemicals in the brain, allowing you to control your impulses and actions better. The two main types of drugs used to treat ADHD are stimulants and non-stimulants.

Central nervous system (CNS) stimulants are the most commonly prescribed ADHD medications. This drug works by increasing the amount of a chemical compound in the brain, dopamine. If stimulants don't work well or cause bothersome side effects for you or your child, your doctor may recommend non-stimulant medications. Certain non-stimulant drugs work by increasing levels of the compound norepinephrine in the brain.

In addition to medication, several methods have been suggested to help improve ADHD symptoms, such as:

• Eat balanced, nutritious food
• Get at least 60 minutes of physical activity per day
• Enough sleep
• Limit daily screen time from your phone, computer, and TV
• Complementary therapies such as yoga, tai chi, meditation, and spending time outdoors may also help relieve symptoms

Complications

ADHD can create difficulties in a child's life and can cause:

• Children often struggle in class, which can lead to academic failure and bullying by other children and adults
• Tend to have more accidents and injuries than children who do not have ADHD
• Tends to have low self-confidence
• More likely to have difficulty interacting with and being accepted by peers and adults
• Have an increased risk of alcohol and drug abuse and other delinquent behavior

Prevention

There is no specific way to prevent the onset of ADHD. Some things that can help reduce the risk of ADHD in your child include:

• Avoid things that can harm the fetus during pregnancy, such as alcohol, drugs, or smoking.
• Protect your child from exposure to pollutants and toxins, including cigarette smoke and lead paint.
• Limit the time staring at gadget layers. Although it remains unproven, it may be better for children to avoid excessive exposure to TV and video games in the first five years of life.

When to see a doctor?

If you are worried that your child is showing symptoms of ADHD, consult a doctor for a medical evaluation first to check for other possible causes of your child's symptoms.