Symptoms of Attention-Deficit Hyperactivity Disorder (ADHD)

Attention-deficit hyperactivity disorder (ADHD) is a behavioral condition usually diagnosed during childhood. It is characterized by symptoms including inattention, hyperactivity, and impulsivity. Understanding the symptoms of ADHD can help parents distinguish between what might be considered "normal" rambunctiousness and inattention and the genuine inability to sit still and focus. It can also help adults recognize whether they may have symptoms of undiagnosed ADHD.

This article discusses the common symptoms of ADHD and some less common ones people might experience. It also explores potential complications and when you should seek help from a professional.

Signs & Symptoms

The "Diagnostic and Statistical Manual of Mental Disorders (DSM)" is the official diagnostic guide for mental health issues used in the United States. It identifies nine symptoms of inattention and nine symptoms of hyperactivity and impulsivity.

Symptoms of Inattention

Children and adults who are inattentive have difficulty staying focused and attending to tasks that they perceive as mundane. Because of this, they may procrastinate doing work that requires a great deal of mental energy. People who experience symptoms of inattention may:

• Be easily distracted by irrelevant sights and sounds
• Shift from one activity to another and get bored easily
• Appear forgetful and even spacey or confused
• Make careless mistakes
• Struggle to stay on task and pay attention
• Have difficulty following instructions, finishing projects, and staying on task
• Have trouble organizing tasks
• Lose belongings frequently
  

Symptoms of Hyperactivity and Impulsivity

Hyperactivity is the symptom most people think of when they hear the term "ADHD." Children and adults who are hyperactive have excessively high activity levels, which may present as physical and/or verbal overactivity. Symptoms of hyperactivity and impulsivity include:

• Being constantly in motion as if driven by a motor
  
• Restlessness, including excessive squirming or fidgeting
• Talking excessively, interrupting others, monopolizing conversations
• Loud and disruptive behaviors
• Difficulty sitting still or remaining seated
  

Other ADHD Symptoms

In addition to the official symptoms, there are additional ADHD symptoms that many children and adults experience. While these are not taken into account during the diagnostic process, they frequently affect the quality of people's lives. For example, people with ADHD are often accused of not trying or not appearing to care, which can be hurtful. They may also experience:

• Slow progress: Tasks, homework, a project at work, or a household chore seem to take people with ADHD longer than other people.
• Hyper-focus: While they have a low tolerance for boredom, they may hyper-focus on tasks that interest them, to the detriment of essential activities like sleep and social interaction.
• Underachievement: They may underachieve in areas of life where they have a lot of potential and talent, such as academics, their profession, athletics, or managing finances.
• Forgetfulness: People with ADHD may forget things ranging from important people's birthdays, taking out the trash, or handing in homework (even when it has been completed).
• Financial problems: Even if they earn an above-average wage, impulsive spending and forgetting to pay bills can cause problems.
• Sleep problems: Getting to sleep, staying asleep, and waking up on time can all be difficult. They may also consume a lot of caffeine.
• Low self-esteem: People with ADHD do not trust themselves to do what they say they will. They worry about things they might have forgotten to do or done poorly because of inattention or impulsivity. Because of this, they often have low self-esteem after years of not meeting their own and other people's expectations.

When people with ADHD realize that these behaviors are connected with ADHD, they can experience a sense of relief. A diagnosis helps explain why they are the way they are and why they feel different from others.

Complications & Comorbidities

As many as two-thirds of children with ADHD have one or more comorbidities, or co-occurring conditions. The most common of these are behavioral problems, anxiety, depression, and learning and language disabilities.

Adults with ADHD show an even higher incidence of comorbid disorders. These adults may also experience depression, bipolar disorder, substance use disorders, anxiety disorders, or eating disorders.

ADHD can also affect different populations in different ways. For example, symptoms may present differently in adulthood than during childhood. It is also notable that symptoms often differ somewhat in girls and women. Because of this, misdiagnosis and underdiagnosis are common in these groups.

ADHD Symptoms in Adults

ADHD symptoms typically change in adulthood. Hyperactivity becomes less visible to the observer. An adult can sit relatively still, even while feeling an internal restlessness.

Inattentive symptoms of ADHD usually remain consistent. However, adults typically have more control over their environment than children do. Adults can design a life that works with their ADHD symptoms.

For example, many people with hyperactive ADHD are careful to choose a career that does not involve sitting at a desk for long. They might work at a hospital in a job that involves lots of walking or become a salesperson who uses their car as a traveling office. This freedom is not available to a child in school, so childhood ADHD symptoms tend to appear worse than adult symptoms.

In children, ADHD symptoms typically cause problems in school, such as low grades or getting into trouble for disruptive behavior.

The fifth edition of the DSM states that ADHD can be diagnosed if an adult meets the following criteria:

1. The symptoms of ADHD have been present since childhood. You may not have been diagnosed as a child, but there must be evidence that you had problems with attention and self-control before you were 12 years old.
2. The symptoms are present in more than one setting. You currently experience significant problems with inattentive and/or hyperactivity-impulsive symptoms in two or more important settings, for example, at home and school, or home and work.
3. The symptoms affect performance. Your symptoms reduce the quality of your social, academic, and/or job performance.
4. There are five or more symptoms present. The DSM identifies 18 symptoms of ADHD. Nine are related to inattention, and nine are linked to hyperactivity. After 17 years of age, if you have five of the symptoms listed, a diagnosis can be made.
5. Other causes have been ruled out. Sometimes, ADHD-like symptoms are caused by another condition, like bipolar disorder or a sleep disorder. Before accurately diagnosing ADHD, the doctor or clinician needs to rule out all other possible causes that could account for the ADHD-like symptoms.

ADHD Symptoms in Girls and Women

Girls are more likely to have inattentive ADHD, which often can go unnoticed and undiagnosed. A hyperactive child is much easier to detect than a quiet, day-dreamy one.

If a girl has hyperactivity-impulsivity, she might be considered a "tomboy" because she is more physically active than other girls her age. She might also be very talkative and impulsively interrupt others who are speaking. Because of this, it can be challenging for her to make friends.

One of the benefits of girls being formally diagnosed with ADHD is that the diagnosis lifts the shame and guilt they might have about their symptoms. It also frees them from the labels they have been given.

Girls with ADHD are also more likely to have an eating disorder than girls who don't have ADHD.

ADHD can also look different throughout the lifespan. The hormone changes associated with puberty, pregnancy, menopause, and menstruation can increase the severity of ADHD symptoms.

In the past, women living with ADHD were often misdiagnosed with anxiety or depression. Thanks to increased knowledge and research about ADHD symptoms, more women are being diagnosed correctly.

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Frequently Asked Questions

When should you see a doctor about symptoms of ADHD?

If you or your child are experiencing symptoms of ADHD, it is important to seek help. Symptoms vary from person to person, and there are different types of ADHD, so it's essential to keep that in mind when considering whether you or a loved one might have ADHD.

ADHD symptoms can:

• Change with age
• Change depending on the situation or environment a person is in
• Differ depending on the gender of the individual
• Range in severity, from mild to severe
• Increase in severity during times of stress

A healthcare provider can help make a diagnosis, refer you to a specialist, and get started with a treatment plan. If your child is diagnosed with ADHD, they may need accommodations at school to help them succeed. Contact your child's teacher to start this process.

Is there a test for ADHD?

There is no single test that can diagnose ADHD and similar behavioral or learning disorders, and even trained physicians can have a hard time making the correct diagnosis. ADHD is diagnosed by looking at a person's behavior history, interviewing family members, conducting a physical exam, and utilizing psychological tests. It's crucial to get an accurate diagnosis to understand the specific type of ADHD you have.

What are the positive aspects of having ADHD?

While symptoms of ADHD can interfere with different areas of life, getting an appropriate diagnosis and treatment can help you or your child manage the condition. While ADHD is often thought of as a liability, there can be some positive aspects to having ADHD, especially when it is treated appropriately.

For example, having lots of energy can help you get a lot done and achieve your goals. You may also experience a great deal of creativity and curiosity about the world. And because you know what it's like to cope with challenges, you are probably an empathetic and trustworthy friend. Treating your condition's disruptive and distressing symptoms can help you make the most of your abilities and live life to the fullest.