Attention-deficit/hyperactivity disorder (ADHD) is a mental disorder that causes above-normal levels of hyperactive and disruptive behaviors. People with ADHD tend to have difficulty concentrating, sitting still, paying attention, staying organized, following instructions, remembering details, and/or controlling impulses. One of the unfortunate complications for people with untreated ADHD is that they often have trouble getting along with their peers, family members at home, and coworkers.
For children, ADHD is perhaps most associated with problems at school. Children with ADHD often have difficulty succeeding in a controlled classroom setting. Assignments become difficult obstacles, instead of productive learning experiences. Perhaps because of this—although it affects people of all ages—ADHD is more commonly diagnosed in children than in adults.
According to a Centers for Disease Control and Prevention survey in 2007, ADHD affects about 9.5 percent of American children ages 4 to 17 (approximately 5.4 million overall), making ADHD one of the most common childhood disorders in the United States. The survey also found that boys are more than twice as likely to be diagnosed as girls (CDC, 2011).
Unfortunately, ADHD can be difficult to diagnose, and many children who suffer from the condition are labeled simply as troublemakers, problem children, or, even worse, stupid or lazy. ADHD is, however, a real and serious condition, not a means of explaining away behavioral problems. Luckily, with an early diagnosis and proper treatment, children with ADHD can be just as successful as children who do not have the condition.
Though you may hear ADD and ADHD used interchangeably, there are differences between the two conditions.
ADD and Its Symptoms
ADD, which stands for attention deficit disorder, is an older term used to diagnose individuals who are inattentive and often distracted. The American Psychological Association (APA) first coined the term ADD in 1980 to describe individuals who had trouble paying attention, were often forgetful, and had difficulty with organization at home, school, or work.
Children with ADD have trouble focusing in school or appear to daydream, and can be easily distracted by small noises that most people tune out. They may also forget or lose things. These children often jump from task to task without completing them, which can lead to poor grades. Some have trouble “turning off” their brains at night and struggle to fall asleep.
Adults can also have ADD, though the symptoms are often more mild. Adults with ADD may have trouble with organization and maintaining conversations, and will lose focus if the task at hand is something they do not enjoy. Adults with ADD are also more likely to be unemployed or to jump from job to job than adults without the disorder.
ADHD and Its Symptoms
ADHD is a neural behavioral disorder in which an individual is unable to concentrate on everyday tasks. Individuals with ADHD, like those with ADD, have trouble with focusing and organization. They may have difficulty following a conversation, and, in some cases, they are impulsive or have a higher than normal energy level (hyperactivity). However, not everyone with ADHD has the same symptoms—in fact, how ADHD presents in any one individual depends on many biological and environmental factors.
Three Types of ADHD
An individual with inattentive ADHD has trouble focusing and completing tasks and is easily distracted. This individual may stare into space or seem to be “missing” from a conversation. With this type of ADHD, the person is often forgetful and disorganized and may make mistakes with the details of a task. For example, a child with inattentive ADHD may complete a math homework assignment, but forget to show his or her work, or make mistakes in the details of the calculations. An adult may not follow or recall points covered in a business meeting.
Individuals with this type of ADHD are usually not hyperactive, but are quiet and seem “spacey.” However, individuals with inattentive ADHD are not really inattentive at all—rather, they are paying attention to everything at once (the hum of the air conditioner, the tapping of pencils, the ticking of the clock, the teacher speaking). This overload of stimuli makes focusing on one task difficult and leads to the assumption they aren’t paying attention. This type of ADHD is often overlooked in the classroom or the workplace because individuals with inattentive ADHD do not draw attention to themselves.
With this type of ADHD, the individual has a higher than normal energy level and great difficulty remaining seated, even for short periods. The person may fidget, tap their hands or feet, or get up and walk around. In severe cases, the individual has to be in constant motion, even when it is not appropriate. In some individuals, hyperactivity is expressed by nonstop talking.
Impulsivity is also present in people with this type of ADHD. The person may interrupt conversations or have trouble waiting in line or taking turns. Impulsivity also means that the individual may act before thinking—for example, a child may suddenly jump from a high place on the playground or hit someone who has made them angry. This makes these individuals more prone to injury and can have an effect on their social relationships.
Combined Hyperactive/Impulsive and Inattentive Type
Individuals with the combined form of ADHD have characteristics of both the inattentive and hyperactive/impulsive types. According to the CDC, this is the most common type of ADHD.
Adults with ADHD have typically had the disorder since childhood, but it may not have been diagnosed until later in life. An evaluation usually occurs at the prompting of a peer, family member, or coworker who has observed problems at work or in relationships. Adults can be diagnosed with any of the three subtypes of ADHD discussed above. However, due to the relative maturity of adults, as well as physical differences between adults and children, adult ADHD symptoms can be somewhat different from those experienced by children. For example, adults with hyperactive/impulsive ADHD are unlikely to run and jump around.
ADD and ADHD Severity
The symptoms of ADD and ADHD can range from mild to severe, depending on a person’s neurobiology and environment. Some experience mild inattentiveness or hyperactivity when they perform a task they do not enjoy, but have the ability to focus on tasks they like. Others may experience more severe symptoms, which can have a negative impact in school, at work, and in social situations.
Symptoms seem to be more severe in unstructured group situations (e.g. on the playground) than in more structured situations where rewards are given (e.g. in the classroom). Other conditions, such as depression, anxiety, or a learning disability may worsen the symptoms of ADD or ADHD . Some patients report that symptom severity diminishes with age. For example, an adult with ADHD who was hyperactive as a child may find that he or she is now able to remain seated or curb some impulsivity.
The good news is that by determining your type of attention deficit disorder and its severity, you are one step closer to finding the right treatment to help you cope. Be sure to discuss all your symptoms with your doctor to ensure an accurate diagnosis.