Akeem Marsh, MD, is a board-certified child, adolescent, and adult psychiatrist who has dedicated his career to working with medically underserved communities.
Attention-deficit/hyperactivity disorder (ADHD) is a common neurobehavioral condition that is usually first diagnosed during childhood. More than six million children between the ages of two and 17 have been diagnosed with ADHD. It is characterized by patterns of inattention, hyperactivity, and impulsivity that make it difficult for people to pay attention and control their behaviors.
ADHD is a lifelong condition. While symptoms do change with time, they can still interfere with an adult's functioning. Relationships, health, work, and finances are just a few areas that may be impacted. There are treatment options, including medications and therapies, as well as coping strategies that can help you to live well with ADHD.
The exact causes of ADHD are not known but experts believe there are a number of factors at play. Genetics are thought to play a significant role in causing ADHD, but environmental factors also contribute and often interact with genetic predispositions. Factors that can increase the risk of ADHD include certain illnesses such as meningitis, exposure to toxins such as lead, and poor nutrition or substance use during pregnancy.
There is no simple lab test or questionnaire that can determine if a person has ADHD. Mental health professionals conduct an evaluation and can use a variety of tools including IQ tests, interviews, measures of attention, rating scales, and other assessments to evaluate symptoms and determine if they meet the criteria for diagnosis.
ADHD is classified as a mental illness, but can also be described as a neurodevelopmental disorder. It is important to recognize that mental illness is a broad term that refers to any type of condition that impacts a person's thoughts, moods, or behaviors. Because the three primary symptoms of ADHD—inattention, impulsivity, and hyperactivity—all impact these areas, ADHD is considered a form of mental illness.
There is a strong genetic component to ADHD. Estimates suggest that the genetic heritability of the condition is over 70%. However, having a genetic predisposition does not necessarily mean that you will develop ADHD. Research has found that there are several genes that play a role and it is the interaction of these genes along with environmental influences that may cause the disorder.
ADHD may be considered a disability according to the guidelines established by the Americans with Disabilities Act (ADA) if you have impairments that limit one or more major life activities (such as work or school). There must be a record of this impairment or others must be able to perceive these challenges. This means some people who have ADHD may request accommodations at work or school.
ADHD has gone through several name changes over the years and one of these former names was attention deficit disorder (ADD). While the term no longer represents an official diagnosis, it is still sometimes used to describe the inattentive presentation of the condition without hyperactivity. People with this presentation of the condition have trouble staying on task.
Neurobehavioral disorders are a group of conditions that involve behavioral issues that accompany brain-related conditions or injuries. ADHD is one of the most common neurobehavioral disorders to affect children. Other examples include autism spectrum disorder and traumatic brain injury.
Behavior therapy utilizes techniques such as conditioning and reinforcement to teach desired behaviors and eliminate unwanted ones. For children with ADHD, this approach can often help improve behavior and self-control. Techniques used in behavior therapy include praising or rewarding good behavior and allowing people to experience the logical consequences of negative behaviors.
Impulsive behaviors are those that are poorly planned, risky, premature, and sometimes inappropriate for the situation. Such behaviors can seem unpredictable and, because they are not well-conceived, can lead to poor outcomes. Impulsivity is a symptom of ADHD that is often caused by an inability to focus and control behaviors.
This presentation of ADHD is characterized by difficulties with attention and focus. Symptoms include having trouble focusing, not paying attention to details, difficulty organizing tasks, being easily distracted, not following instructions, forgetting to do routine things, avoiding activities that require sustained focus, frequently losing things, and not listening to what others are saying.
This presentation of ADHD is marked by hyperactive and impulsive behaviors without the symptoms of inattention. Symptoms often include moving constantly, squirming, fidgeting, and talking excessively. People with this presentation struggle to stay seated, move on to new tasks without finishing previous ones, interrupt others, and blurt out things without thinking.
In this presentation of ADHD, people exhibit symptoms of both inattention and hyperactivity/impulsivity. Symptoms include trouble focusing on tasks, fidgeting, talking excessively, and saying things without thinking. Children and adults may be diagnosed with a combined presentation if they experience six or more symptoms of inattention and six or more symptoms of hyperactivity and impulsivity.
Centers for Disease Control and Prevention (CDC). National prevalence of ADHD and treatment: information on children and adolescents, 2016. Reviewed September 9, 2020.
Zasler ND, Martelli MF, Jacobs HE. Neurobehavioral disorders. Handb Clin Neurol. 2013;110:377-88. doi: 10.1016/B978-0-444-52901-5.00032-0
Cleveland Clinic. Attention deficit hyperactivity disorder (ADHD). Inattentive type in adults. Updated September 25, 2019.
Magnus W, Nazir S, Anilkumar AC, et al. Attention deficit hyperactivity disorder. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Updated June 29, 2020.
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