Attention deficit hyperactivity disorder (ADHD) is a behavioral disorder related to the brain that is characterized by impulsive behaviors, hyperactivity, and inattention. Exactly what causes ADHD is unknown, but it is the most common behavioral disorder of childhood, with about eleven percent of all children being diagnosed. It can also persist into adulthood.
ADHD is treated with behavioral therapies and with medication. Stimulants are used to treat ADHD, although they are controversial because of dangerous potential side effects, including heart attack and sudden death. There are also medications that have been implicated in contributing to behavioral disorders when women use them during pregnancy, including over the counter painkillers like Tylenol.
What Is ADHD?
ADHD is a trick type of disorder. Some people believe it is over-diagnosed and that some children are simply more active and less able to control behaviors than others. Some experts think that the diagnoses are necessary to get treatment for children who struggle socially, emotionally, and academically because of the symptoms of ADHD.
The three characteristic features of ADHD are inattention, hyperactivity, and impulsivity. To be diagnosed, though, these characteristics must be more severe than what is typical for a child and interfere with his life or functioning in some way. For instance if a child has such a hard time paying attention that she does poorly in school and often gets in trouble, she may be diagnosed with ADHD.
Current statistics show that eleven percent of children in the U.S. have been diagnosed with ADHD. Boys are more often diagnosed than girls. The incidence for boys is as high as 13 percent, while for girls it is closer to six percent. Diagnoses for ADHD have risen consistently every year. In 2003, just 7.8 percent of children had been diagnosed. Approximately six percent of children are taking prescription medications for ADHD.
Symptoms of ADHD
The symptoms and signs of ADHD fall under the three categories of inattention, hyperactivity, and impulsivity. A child may display symptoms of all three, just inattention or just impulsivity and hyperactivity. Inattention may manifest as being unable to pay attention or focus in school, difficulty following directions, failing to follow through on homework, chores, and other activities, avoiding tasks that require concentration and focus, being easily distracted, and difficulty being organized.
Hyperactivity and impulsivity are characterized by talking nonstop, fidgeting and squirming, being unable to sit still for long, difficulty waiting turns, running and moving most of the time, blurting out answers or cutting people off, interrupting games and activities, or having trouble engaging in quiet play or quiet activities.
Consequences of ADHD
Children with ADHD are at risk for a number of problems, which can extend into adolescence and adulthood. The risk increases for those children who never receive treatment for ADHD. Children with ADHD are more likely to have social difficulties, problems with peers, and difficulty forming relationships. They are more likely to be physically injured, to engage in substance abuse, to get into vehicle accidents, and to engage in crimes. Living with ADHD a child is more likely to have low self-esteem, to do poorly in school, to miss days of school and to drop out of school. They are more likely to be disruptive and to get in trouble at school
ADHD in Adulthood
Children are not the only ones affected by ADHD. Adults may be diagnosed with the condition, but even those diagnosed in childhood may continue to struggle with ADHD well into adulthood. It is not as easy to diagnose ADHD in adulthood and someone living with it may not even realize he has it. An adult with ADHD may find daily activities challenging, things like being on time for work or staying organized.
Some common signs of ADHD in adults include difficulty focusing on tasks, being easily distracted, being disorganized, having poor time management, getting frustrated easily, mood swings, an inability to multitask, having a temper, being unable to cope well with stress, restlessness, and being bad at planning things.
Consequences for adults with ADHD can be serious, as they are for children. Adults with ADHD are more likely than peers to be fired from a job and are more likely to jump around from one job to the next. They have more difficult relationships with bosses and coworkers. They have a harder time forming personal and romantic relationships and are more likely to abuse drugs or alcohol.
Exactly what causes ADHD is not known. There may be a combination of factors that lead to some issue with development in the part of the brain related to focus, decision making, and impulsivity. What is well known is that males are at a greater risk for having ADHD and that other risk factors include a family history, drug, cigarette, or alcohol use by the mother during pregnancy, experiencing a brain injury, being exposed to environmental toxins in the womb or in infancy, and being born with a low birth weight.
Combination Treatment for ADHD
The most effective treatment for ADHD is a combination of therapy and medication. Medications for ADHD are stimulants. Stimulants increase the production of certain neurotransmitters, chemical messengers in the brain, and this has the effect of increasing focus, and reducing hyperactivity and impulsivity. There are many different stimulants used to treat ADHD, mostly amphetamines and methylphenidates, and children may need to try one or more before finding a drug that works with minimal side effects.
The best results are seen when ADHD medication is combined with therapy. Behavioral therapy is most often used to treat ADHD. A trained therapist will teach a child or adult to better monitor his own behaviors and to learn how to recognize and change those behaviors. With time and practice and the use of therapist-taught strategies, a child or adult can eventually get better at focusing and thinking before acting or speaking.
Dangers of ADHD Medications
Stimulants used to treat ADHD are helpful for many children and even adults. They can make the difference between being unable to function or interact normally with other people, and being calm, focused, and related well with peers. The vast majority of drugs used to treat ADHD are stimulants belonging to one of two classes: amphetamines and methylphenidates. Examples of the former are Adderall and Vyvanse. Ritalin, Concerta, and Focalin are methylphenidates.
Stimulants increase and balance out the neurotransmitters norepinephrine and dopamine. These chemicals play important roles in thinking and attention, so although a stimulant seems like the opposite of what someone with ADHD needs, it does help people be more focused and thoughtful and less impulsive.
Stimulants also stimulate the central nervous system, which means they raise blood pressure and heart rate. They can also induce anxiety. People with existing health conditions related to these should not use stimulants. Possible side effects of stimulants are difficulty sleeping, a decreased appetite and weight loss, repetitive movements, stomach pain, headaches, anxiety, and personality changes.
It is rare, but these stimulants can cause sudden, heart-related deaths in children using them. It is most likely that the incidents that occurred were in children who had heart conditions or defects that had been undetected at the time of death. The FDA has not put a black box warning on stimulants like Adderall because it has declared that the risk is low and that the benefits strongly outweigh it.
Acetaminophen and ADHD
Stimulants used to treat ADHD can cause some minor and some very serious problems. There may also be medications that contribute to ADHD. Recent information about acetaminophen, the main ingredient in Tylenol, has shown that this over the counter painkiller used in pregnancy could cause later behavioral problems in the child.
Researchers looked at thousands of mothers and children. Half of the mothers had used acetaminophen during pregnancy. The researchers found that for those that used the over the counter medication, their children had a greater chance of having behavioral problems, like ADHD, by the age of seven. The study has not proven that this drug causes ADHD, but it does provide a connection that needs to be further explored.
Abuse of ADHD Stimulants
Stimulant medications used to treat ADHD are often abused by teens and adults. This misuse of stimulants is dangerous because it can lead to a greater risk of side effects, interactions with other substances, accidental overdoses, and even dependence. Surveys have found that this abuse is on the rise and that college students are especially vulnerable to abusing stimulants.
There are a few common reasons to abuse stimulants. Students may abuse them to increase focus and wakefulness for the purpose of studying. The pressure to do well in school may lead even the best students to abuse these drugs. Other adults may use stimulants to stay awake for partying, driving, or getting through a night work shift. Some people may even abuse stimulants to try to lose weight.
Consequences of abusing ADHD medications include insomnia, weight loss and malnutrition, hostility, irritability, paranoia, personality changes, high blood pressure, and even sudden heart attack or stroke. Long-term use can worsen and increase the risk for any of these side effects and can lead to dependence and addiction.
ADHD is a difficult behavioral disorder that affects both children and adults. The consequences of living with ADHD can be serious, but with treatment these can be mitigated. The best approach for treatment is a combination of therapy and drugs, but care should be taken with the medications. They can cause serious side effects and even death.