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ADHD: Recognizing Symptoms, Diagnosis, and More

Understanding ADHD

Attention deficit hyperactivity disorder (ADHD) is a chronic condition. It mainly affects children, but can also affect adults. It can have an impact on emotions, behaviors, and ability to learn new things.

ADHD is divided into three different types:

  • inattentive type
  • hyperactive-impulsive type
  • combination type

Symptoms will determine which type of ADHD you have. To be diagnosed with ADHD, symptoms must have an impact on your day-to-day life.

Symptoms can change over time, so the type of ADHD you have may change, too. ADHD can be a lifelong challenge. But medication and other treatments can help improve your quality of life.

Three types of symptoms

Symptoms

Each type of ADHD is tied to one or more characteristics. ADHD is characterized by inattention and hyperactive-impulsive behavior.

These behaviors often present in the following ways:

  • inattention: getting distracted, having poor concentration and organizational skills
  • impulsivity: interrupting, taking risks
  • hyperactivity: never seeming to slow down, talking and fidgeting, difficulties staying on task

Everyone is different, so it isn’t uncommon for two people to experience the same symptoms in different ways. For example, these behaviors are often different in boys and girls. Boys may be seen as more hyperactive, and girls may be quietly inattentive.

Predominantly inattentive ADHD

 Type 1

If you have this type of ADHD, you may experience more symptoms of inattention than those of impulsivity and hyperactivity. You may struggle with impulse control or hyperactivity at times. But these aren’t the main characteristics of inattentive ADHD.

People who experience inattentive behavior often:

  • miss details and are distracted easily
  • get bored quickly
  • have trouble focusing on a single task
  • have difficulty organizing thoughts and learning new information
  • lose pencils, papers, or other items needed to complete a task
  • don’t seem to listen
  • move slowly and appear as if they’re daydreaming
  • process information more slowly and less accurately than others
  • have trouble following directions

More girls are diagnosed with inattentive type ADHD than boys.

Predominantly hyperactive-impulsive ADHD

Type 2

This type of ADHD is characterized by symptoms of impulsivity and hyperactivity. People with this type can display signs of inattention, but it’s not as marked as the other symptoms.

People who are impulsive or hyperactive often:

  • squirm, fidget, or feel restless
  • have difficulty sitting still
  • talk constantly
  • touch and play with objects, even when inappropriate to the task at hand
  • have trouble engaging in quiet activities
  • are constantly “on the go”
  • are impatient
  • act out of turn and don’t think about consequences of actions
  • blurt out answers and inappropriate comments

Children with hyperactive-impulsive type ADHD can be a disruption in the classroom. They can make learning more difficult for themselves and other students.

Combination ADHD

Type 3

If you have the combination type, it means that your symptoms don’t fit inattention or hyperactive-impulsive behavior.

Most people, with or without ADHD, experience some degree of inattentive or impulsive behavior. But it’s more severe in people with ADHD. The behavior occurs more often and interferes with how you function at home, school, work, and in social situations.

The National Institute of Mental Health explains that most children have combination type ADHD. The most common symptom in preschool-aged children is hyperactivity.

Diagnosing ADHD

Diagnosis

There isn’t a simple test that can diagnose ADHD. Children usually display symptoms before the age of 7. But ADHD shares symptoms with other disorders. Your doctor may first try to rule out conditions like depression, anxiety, and certain sleep issues before making a diagnosis.

The American Psychiatric Association's Diagnostic and Statistical Manual (DSM-5) is used across the United States to diagnose children and adults with ADHD. It includes a detailed diagnostic evaluation of behavior.

A person must show at least six of the nine major symptoms for a specific type of ADHD. To be diagnosed with combination ADHD, you must show at least six symptoms of inattention and hyperactive-impulsive behavior. The behaviors must be present and disruptive to everyday life for at least six months.

Besides showing the pattern of inattention, hyperactivity-impulsivity, or both, the DSM-5 states that to be diagnosed, a person’s symptoms must be displayed before 12 years of age. And they must be present in more than just one setting, like at both school and home. Symptoms must also interfere with everyday life. And they can’t be explained by another mental disorder.

An initial diagnosis may reveal one type of ADHD. But symptoms can change over time. This is important information for adults, who may need to be reevaluated.

To be diagnosed

  1. You must experience at least six symptoms of either inattentive of hyperactive-impulsive ADHD to be diagnosed with either type.
  2. You must experience at least six symptoms of both inattentive and hyperactive-impulsive ADHD to be diagnosed with combination type.
  3. These behaviors must be displayed before 12 years of age.
  4. These behaviors must disrupt your everyday life for six months or longer.
  5. These behaviors must occur in more than one setting.

Treatment options for ADHD

Treatment

After you’ve been diagnosed, there are a number of treatment options available. The primary goal of treatment is to manage ADHD symptoms and to promote positive behaviors.

Therapy

Your doctor may recommend behavioral therapy first before starting any medications. Therapy can help people with ADHD replace inappropriate behaviors with new behaviors. Or help them find ways to express feelings.

Parents can also receive behavior management training. This can help them manage their child’s behavior. And help them learn new skills for coping with the disorder.

Children under age 6 usually start with behavior therapy and no medications. Children ages 6 and up may benefit most from a combination of behavior therapy and medications.

Medication

There are two types of ADHD medications.

Stimulants are the most commonly prescribed medications. They are fast-acting and between 70 to 80 percent of children have fewer symptoms while on these medications.

Nonstimulants don’t work as quickly to relieve ADHD symptoms. But these medications can last up to 24 hours.

Adults with ADHD often benefit from the same combination of therapies as older children.

Outlook

Outlook

Most children diagnosed with the disorder no longer have significant symptoms by the time they are in their mid-20s. But ADHD is a lifelong condition for many people.

You may be able to manage your condition with medication or behavioral therapy. But treatment isn’t a one-size-fits-all approach. It’s important to work with your doctor if you think your treatment plan isn’t helping you.

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