Attention deficit hyperactivity disorder (ADHD)

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What is ADHD?
Attention deficit hyperactivity disorder (ADHD) is a developmental disorder that begins in early childhood. ADHD used to be called attention deficit disorder (ADD).
ADHD is often misunderstood. It can cause problems:

concentrating
becoming distracted
being hyperactive (sometimes)
being impulsive

This may cause people with ADHD to have problems with their:

schooling
friendships
work
family life

Around 1 in every 20 Australians has ADHD. While ADHD is more common in boys — it’s under diagnosed in girls and adults.
More than 3 in 4 children diagnosed with ADHD still have symptoms as an adult.
What are the symptoms of ADHD?
ADHD can present in 3 ways:
Inattentive symptoms — a person is easily distractible but isn’t hyperactive or impulsive.
Hyperactive-impulsive symptoms — a person has symptoms of impulsivity and hyperactivity.
Combined symptoms — a person has a mixture of symptoms including hyperactivity, inattention and impulsivity.
Inattentive symptoms
People with inattentive ADHD may have these symptoms:

a tendency to start but not finish tasks
putting off tasks that need sustained effort
being easily distracted or daydreaming
having trouble remembering things
having difficulty organising tasks, activities, belongings or time
losing things
not following instructions
not paying attention to detail and making careless mistakes
struggling to focus and concentrate on tasks they find boring or tedious

Hyperactive-impulsive symptoms
People with hyperactive-impulsive ADHD may have these symptoms:

fidgeting and squirming more than others
talking non-stop and interrupting conversations
blurting out answers before the question has been finished
reacting quickly to situations without thinking about the consequences
badgering their parent, partner or friends when they want something
finding boredom intolerable
looking for stimulation
participating in risk taking or dangerous behaviour
choosing a smaller reward now rather than a larger reward later

Combined symptoms
Some people have symptoms of both inattentive and hyperactive-impulsive ADHD.
What causes ADHD?
People with ADHD have differences in their brain anatomy and function. The exact causes of ADHD aren’t known. Genetic studies show that ADHD is an inherited disorder.
Research has shown that ADHD symptoms are related to the biology of your brain.
The following environmental factors may contribute towards the development of ADHD:

maternal smoking during pregnancy
maternal drinking during pregnancy
premature birth
low birth weight

Other environmental factors that can cause changes in your brain’s development and function include the following.

Toxins: chemicals like lead can affect brain development.
Home environment: if there is a lot of conflict in the home.
Early childhood trauma: children who experience trauma in early childhood are more likely to show features consistent with ADHD. Most children with ADHD have not had early childhood trauma.

When should I see my doctor?
It’s normal for people to get restless and distracted from time to time. But when you have ADHD, your symptoms are persistent and interfere with your work or school and friendships.
If you are concerned that you may have ADHD, the first step is to see a doctor. They will most likely refer you to a psychologist.
A psychologist can only make a diagnosis after a detailed assessment of your behaviour.
There are many behavioural disorders that can cause symptoms of ADHD, especially in young children. It’s important to have a proper assessment.
Other reasons for people being inattentive, impulsive or hyperactive are:

health or emotional problems
learning difficulties
lack of sleep
brain injury

How is ADHD diagnosed?
There are clear criteria used to diagnose ADHD.
The symptoms of ADHD need to:

have lasted for more than 6 months
been present before the age of 12 years
not match your developmental age
have caused serious impairment at school, at home and socially

In children, the diagnosis is usually made by a:

paediatrician (a doctor who specialises in children)
child psychiatrist or psychologist

Your doctor can give you a referral to see these specialists.
To diagnose ADHD in adulthood, it needs to be established that your symptoms began in childhood.
How is ADHD treated?
There are many different treatment options for ADHD, depending on the needs of each person.
Treatment may involve different health professionals, including your:

doctor
psychologist
psychiatrist
paediatrician (child specialist)
family therapist

Medicine for ADHD
If your ADHD is having a big effect on your life, you might consider taking medicine.
Stimulant medicines can lower hyperactivity and impulsivity. They may help you to focus and learn.
Stimulant medicines have been thoroughly researched for many years. They have been shown to:

be safe
improve concentration
improve impulse control
improve hyperactivity

The doses used to treat ADHD are not addictive and don’t cause withdrawal symptoms.
However, they can cause side effects like loss of appetite and difficulty falling asleep. For people who have side effects from these medicines, non-stimulant medicines are also available.
Psychological treatments
Cognitive behavioural therapy may help you develop strategies and skills for learning and controlling your behaviour.
Couples or family counselling may be useful for those people having relationship difficulties.
Nutrition and supplements
Taking fish oil supplements to raise levels of omega-3 may improve some symptoms of ADHD in some people.
The evidence suggests that fish oil is only of benefit in people that don’t have enough to start with.
Always check with your doctor or pharmacist before taking supplements to make sure they are right for you.
Good nutrition is also important.
ADHD across the life course
Caring for a child with ADHD
If the person with ADHD is a child, their parents and school teachers need to be involved in their treatment.
The first step is often to use positive parenting strategies. It can help to stick to a routine and help your child build their social skills.
Talk to the school to plan an environment where your child can learn.
If you are caring for a child with ADHD, below are some tips that can help.

Have a routine.
Try to keep any instructions clear and brief.
Reward achievements and positive behaviour — this will help their self-esteem.
Try to have one-on-one time with your child doing something they enjoy.

ADHD in teenagers
Many teenagers aren’t diagnosed in childhood. As they become older, they find it more difficult to cope with change.
In the teenage years, ADHD may show up as:

often running late
being disorganised
worrying a lot
feeling bad about yourself
interrupting conversations
daydreaming
forgetting instructions
saying things you shouldn’t say
procrastination
multi-tasking when you should remain focussed on one thing

Having some of these symptoms doesn’t mean you have ADHD. Everyone has some of these symptoms some of the time.
We now know more about ADHD. Your school will be able to get information, resources and expertise to support you.
It’s important to get help and support. When ADHD is not identified or treated, it may lead to self-medication. This may be with alcohol or illicit drugs, which can lead to addiction.
ADHD in adulthood
Some adults with ADHD:

successfully learn to manage their lives
just get through knowing they could achieve more
struggle as they don’t get the help they need to reach their potential

Adults with ADHD may have:

depression or anxiety
problems with family
problems at work

Complications of ADHD
It’s important that people with ADHD are diagnosed, treated and supported. This can help avoid problems in their lives.
Only 1 in 3 people has ADHD as their only diagnosis. Most people with ADHD often have other conditions such as:

anxiety and depression
learning difficulties
autism

Obstructive sleep apnoea (a blocking of the airway during sleep) happens more often in people with ADHD. Poor sleep during the night can make it hard to concentrate the next day.
To best support a person with ADHD, it’s important to: