Attention-Deficit/Hyperactive Disorder, also known as ADHD or ADD, is the most commonly diagnosed psychiatric condition in children.  Somewhere around half of the children diagnosed with ADHD have symptoms that will persist into adulthood.  ADHD can be categorized as (1) hyperactive-impulsive, (2) inattentive, (3) or a combination of both.  But unless you have medical training to guide you, it can be hard to determine the difference between behavior that is “normal” and behavior that is indicative of ADHD.  It may be helpful to take a look at some of the common complaints that people with ADHD have.

Q:  What are some of the complaints from children with ADHD ?

Children with ADHD may have difficulty sitting still and may be disruptive in the classroom.  They tend to have difficulty listening to teachers and following instructions.  They require significantly more attention and monitoring in order to complete assignments.  They may frequently stare out of the window, have their mind drift off, or become distracted by the slightest sound.  ADHD can also affect children socially by making it harder for them to make friends.  This can impact their self-confidence at an early age.  Girls with inattention can go undiagnosed because they may work hard, be less disruptive, and get fair grades in school.

Q:  What do you notice from teenagers and young adults with ADHD ?

Young adults with ADHD have some of the same challenges that children have, but young adults will be better at coping with distractions.  If they are hyperactive, they will probably learn to participate in sports or other physical activities as an outlet.  They can still be disruptive by finding it difficult to remain still, by clicking pens constantly, or by regularly walking in and out of the classroom.  Young adults with ADHD will have to spend relatively more time studying in order to complete the same material as their peers.  They will tend to score higher on homework than on tests.  Young adults may notice a drop in their academic performance.  If it didn’t affect grades in high school, it often catches up to young adults in college when it may not be possible to study even more and when mid-terms/finals have a significant impact on grades.

Q:  Do these issues continue into adulthood ?

These issues can continue into adulthood, but by that time people usually become quite accustomed to living and coping with their condition.  Ever watch a movie and not remember what it was about after just seeing it?  Ever read the same page of a book 3 or 4 times and yet it never really sinks in?  Do you have lots of projects started around the house that keep piling up but never seem to get finished?  Do you have a mountain of post-it notes or to-do lists stacking up such that even looking at it makes you nervous?  None of these are formal symptoms of ADHD, but I can tell you that my adult ADHD clients have them! Dealing with ADHD your whole life can usher in a series of other feelings.  You might feel that you are not as smart as others, or that you are not worthwhile.  You can convince yourself, through diminishing self-confidence, that you are not good enough or do not deserve to continue towards lifelong goals you have thus far worked towards.  You might give up on your profession even after finally earning a degree or a certification.  In my experience, prolonged ADHD symptoms can also lead to the development of other mental health issues such as anxiety and depression.

Q:  Is it ever too late to get treatment for ADHD ?

It's never too late to receive treatment.  With treatment, some of our adult clients find that they are able to accomplish things that they have put off for years, such as going back to school or re-entering the workplace.  Regardless of age, why allow yourself or your children to go through life at a reduced potential?  These disadvantages can affect your academic performance, your career, your family, and the course of your life.  If you feel that you or your child might have ADHD, I recommend seeking an evaluation from a psychiatrist, a doctor who is medically trained to diagnose and treat this and other co-existing mental health conditions.

- - - - - - - - - -

Write-up on ADHD by Dr. Cat Dang, as seen in the June 2010 issue of Coast Magazine in the "Ask the Doctor" section.

ADHD - Am I getting the right treatment?

Attention-Deficit/Hyperactive Disorder, or ADHD, is the most commonly diagnosed psychiatric disorder in children, and symptoms often persist into adulthood.  It can greatly impair concentration and performance in the classroom or the workplace.  Many health professionals can provide treatment for ADHD, but how do you know that you (or your child) are getting the right treatment or have explored all of your options?  To get to the bottom of this, I recommend that you consider the following four questions:

Q:  Do I Really Have ADHD ?

It is easy enough to spot some of the classic symptoms of ADHD: there can be symptoms of hyperactivity or impulsivity, symptoms of inattentiveness, or elements of both.  In order to properly diagnose ADHD, it is important to consider other conditions that can present themselves like ADHD such as sleep deprivation, substance abuse, learning disabilities, certain health conditions, and other psychiatric disorders.

As a psychiatrist, I have taken over the care of individuals diagnosed with ADHD who actually had completely different psychiatric disorders or health conditions that were causing ADHD-like symptoms.  The individuals in these cases were usually taking medications that did little to help their true conditions, and in some cases made their conditions worse.  I recommend asking the doctors who performed your evaluation to explain how they excluded other conditions to reach your diagnosis.

Q:  Do I ONLY Have ADHD ?

After taking medication for treatment of ADHD, do you notice having irritability, sadness, nervousness, hallucinations, and/or tics?  If so, you may be experiencing side effects to the medication.  Or, there are undiagnosed coexisting psychiatric conditions that are triggered by or are exacerbated by your current medication.

Most people diagnosed with ADHD have at least one other coexisting psychiatric disorder such as anxiety, depression, bipolar, obsessive compulsive disorder, or oppositional defiant disorder.  The presence of coexisting conditions, or susceptibility to them, can be obvious or quite subtle.  It is imperative to uncover coexisting conditions to increase the likelihood of choosing effective medication(s) and to reduce complications.  Besides, do you really want these conditions to go untreated?

To increase your chances of being properly diagnosed for ADHD and any coexisting conditions, I encourage you to consult with a psychiatrist.  A psychiatrist is a doctor who has had years of medical training and clinical experience specifically devoted to diagnosing and treating psychiatric disorders.

Q:  Am I Taking the Right Medication ?

Psychiatric medications usually have side effects.  It is my goal when selecting from all of the available medications to find one, or a combination, that maximizes treatment benefits while minimizing side effects.  To achieve this, I believe it is important to consider the patient?s medical history, family medical history, weight, sleep pattern, lifestyle, drug use, drug interactions, sensitivity to medications, and other factors.  I often will request feedback from other sources such as family, school, and other health professionals.

People are unique and can have different reactions to medication.  For example, it is critical for people with cardiac abnormalities to avoid stimulant medication unless cleared and monitored by a cardiologist.  To do otherwise is to risk developing cardiac complications.  When prescribing medication, I believe it is always safest to start with a low dosage and to go up slowly over time, while monitoring the patient's reaction, to determine the effective dosage.

Before consenting to a medication, you should request that your doctor explain to you the side effects of the medication being prescribed, why such medication was selected, and why other medications were not chosen.

Q:  What Options Do I Have Besides Medication ?

There are other treatment options besides medication.  A healthy diet with vitamin supplementation is a good start.  In addition, studies have shown that Omega-3 fatty acids can reduce symptoms of ADHD.  And, based on my experience, regular exercise or participation in a sport can provide an outlet for hyperactive symptoms.

Communication with teachers and counselors increases awareness of the challenges being faced at school.  Most public schools perform testing when requested, and based on the results, determine if special accommodations are needed.  A psychiatric evaluation can lend credibility to discussions with schools regarding accommodations.  There are also private schools that cater specifically to children with special needs.

Therapy is a viable treatment option.  It helps the individual develop coping skills to better understand and deal with his/her challenges more effectively.  Other modalities of treatment such as neurofeedback are being studied for their efficacy in treating ADHD.

After exploring these questions and your options, I hope you walk away even more confident in your current treatment, or discover new possibilities that help you to lead a happier and healthier life.