ADHD is often misunderstood by both the public and by professionals. Below are some common questions and misconceptions about the disorder.
What is ADHD?
According to the DSM-V, Attention-Deficit Hyperactivity Disorder (ADHD) is a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development. Symptoms can include difficulty sustaining focus or mental effort, distractibility, fidgeting, impulsivity/self-control problems, and difficulty inhibiting one's emotions or behaviors. While difficulty focusing or behavioral problems can occur for many reasons, there are a few ways to distinguish ADHD from everyday inattention or from other disorders that cause similar problems.
Most experts agree that ADHD is due to deficits in executive functioning. Basically, executive functions (EFs) coordinate most of our everyday mental and behavioral activities. EFs include planning, organization, decision-making, time-management, self-inhibition, emotion regulation, multitasking, and working memory (sometimes called short-term memory). Individuals with ADHD can be accurately identified by an underlying pattern of executive functioning problems. Many signs of ADHD relate to problems with the ability of our brain to:
Stop - Interrupting, fidgeting, preventing distraction, trouble calming down after an upset, excessive talking or blurting out
Switch - Hyperfocus, difficulty with multitasking, trouble changing tasks, adjusting to changes in routine, going on tangents
Start - Difficulty initiating tasks, not following through on plans/intentions, unable to keep organized, getting interested enough to pay attention
While not an exhaustive list, these are common signs that may suggest ADHD. While everyone will experience these from time to time, if you or someone you know has a pattern of these types of problems, it may be helpful to get an evaluation for ADHD.
What is the difference between ADD and ADHD?
The short answer is nothing. ADD and ADHD are both names that have been used to describe the same disorder in different diagnostic manuals. ADD has been used in the past, and ADHD has been the formal name used since about 1994. The "H" in the name does not always mean the person has hyperactivity or problems with self-inhibition. The DSM-V describes ADHD as one phenomenon that has three common presentations:
ADHD - Predominantly Inattentive Presentation
ADHD - Predominantly Hyperactive/Impulsive Presentation
ADHD - Combined Presentation
Aren't these just symptoms that everybody deals with?
A common belief is that ADHD is simply "kids being kids" or lazy people using a fancy diagnosis as an excuse. The reality is that ADHD is a very real neuropsychological disorder that severely impacts the lives of millions of children, teens, and adults. ADHD has been identified (by several names) and studied by health professionals for nearly 300 years! Today, it is estimated to affect about 5% of children and 2.5% of adults. It is a misconception that ADHD is over diagnosed. In fact, experts believe that many with ADHD (especially adults and females) currently go undiagnosed and untreated. The problems caused by untreated ADHD include poor academic and job performance, increased accidents, other mental illness, substance abuse, job loss, low self-esteem, failed social relationships, and many more. It is important to have an accurate assessment to ensure treatment is informed and properly targeted.
Is medication for ADHD really necessary? Is it safe?
While not everyone with ADHD will use medication, nearly 80 years of research has shown that stimulant medication is the most effective treatment for most people. There are also several non-stimulant medications that can be effective alternatives. All of these medications have been shown to be safe and effective for children, teens, and adults for both short and long-term use. All medications can have risks or side effects, and it is important to talk with your physician about these concerns. However, many public perceptions of these medications are very distorted.
There is a great deal of stigma and outright propaganda out there about stimulant medications. Much of it is completely out of line with the massive body of research literature we have about them. The medications do not change one's personality. Some people may experience heightened anxiety or anger, which would be considered an unacceptable side effect, and can often be corrected by adjusting the dosage or type of medication. The medications have been shown to be safe, and even beneficial, for people to use long-term. Given the impairments caused by ADHD, it is important to weigh the risks and benefits of not treating it as well.
While stimulants have some risk of abuse and are listed as controlled substances, they are usually quite safe when used as prescribed. In fact, the vast majority of stimulant abuse comes from non-ADHD individuals. While these medications work by increasing the activity of dopamine in the frontal lobe, this is not the same brain area as the "pleasure center" of the brain that makes a person feel "high" when abusing drugs. Swallowing a pill of a relatively small dose is much different from snorting, smoking, or injecting a drug recreationally, which is also used in a much larger quantity than prescribed. Finally, while some stimulants contain derivatives of the chemical amphetamine, this is not the same substance as methamphetamine. While they sound similar, the two chemicals have very different properties and affect the brain differently.
Does ADHD only affect school and work?
Usually, many parents or students become concerned about ADHD when it affects schoolwork. The same goes for adults and their job. However, ADHD actually affects many aspects of daily life. In fact, people with strong academic skills or high intelligence may not have any school or work problems at all (or at least none that are obvious). ADHD can make it hard to find or keep friendships, it can be a big strain on romantic relationships, and it can cause stress in the family of a person with ADHD. Many people with ADHD struggle with low self-esteem, feeling stupid or lazy, or fear of stigma associated with the disorder. Understanding the facts about ADHD is very important to help manage these problems and help fight against the misconceptions that are out there.