Experts suggest that attention deficit hyperactivity disorder (ADHD) affects an estimated 8 percent of school-aged children, and about two-thirds of children diagnosed with ADHD continue to show signs of the disorder into adulthood.

1. ATTENTION DEFICIT HYPERACTIVITY DISORDER
Overview
Expertssuggestthatattentiondeficithyperactivitydisorder(ADHD) affectsanestimated8percentof
school-agedchildren,andabouttwo-thirdsof childrendiagnosedwithADHDcontinue toshow signsof
the disorderintoadulthood.
ADHD interfereswithyourabilitytoregulate motoractivity(hyperactivity),control keybehaviors
(impulsivity) andfocusontasks(inattention).Whenthe hyperactivityisnotpresent,the conditionis
sometimescalledattentiondeficitdisorder(ADD),althoughthe more accurate termisADHD-inattentive
type.
By currentestimates,more thantwotimesasmany boysas girlsare affectedbyADHD,but the ratio
appearsto become more evenbyadulthood.
Overall,womenandgirlsmay exhibitfewerof the typical symptomsassociatedwithADHDinboys.For
example,girlswithADHDare more likelytobe reservedthanhyperactive.Theytendtobe lessdefiant
and more compliantthanboysand menwiththe condition.Like boysandmenwith ADHD,however,
womenwiththe conditionmayhave difficultycompletingtasksandremainingorganized.Insteadof
beingtestedforADHD,they’re oftendismissedasflightyorspacey.
Thus,because girlsare lesslikelytodisruptclass—the kindof behaviorthatoftenbringsboyswiththe
conditiontomedical professionals’attention—girlsare lesslikelytogetdiagnosedwithADHD.
Consequently,manygirlsandwomendonotgetthe helptheyneed.Often,girls’self-esteemsuffersas
theyencounteracademicproblemsinschool.Theymayhave difficultywithinterpersonal relationships
as well associal challenges.
These secondarydifficultiesmayresultindepression,anxietydisorders,problemssleeping,self-harmful
(cutting) behaviorsand/orabuse of alcohol orothersubstances.Furthermore,girlswithADHDare at
greaterriskfor earlypregnancy,promiscuityandsexuallytransmitteddiseases.A recentstudyfollowing
girlsfor10 yearsshowedsignificantlyhigherriskforsuicide attemptsandself-injurycomparedtoa
comparisongroup.
Once diagnosed,manywomenrecall painful ordifficultchildhoodexperiencesinschool thatwere likely
to have beenlinkedtoADHDbutattributedat the time toother causes,suchas lazinessorlackof
ability.Thismisattributioncanitself leadtosignificantdamage toself-esteemandself-confidence,
resultingindemoralization.
Causes of ADHD
Althoughnoone knowsforsure what causesADHD,the conditiondoesruninfamilies,suggestinga
stronggeneticcomponent.Children whohave aparentwithADHDare at an increasedriskforADHD
themselves.Andtwinandadoptionstudiesconfirmahighdegree of geneticconnectionwiththis
condition.Foridentical twins,there isastrongchance the other twinhasit.Again,this“family

2. resemblance”appearsstronglyrelatedtogenesratherthansocial factors.Many researchersaroundthe
worldare nowinvestigatingvariousgenesthatmaycontribute tothe developmentof ADHDinfamilies.
It isunlikelyasingle geneisresponsible,but undoubtedlymanygenes,operatinginteractivelywithone
anotherand withenvironmentalrisks.
A smallerpercentage of casesof ADHDare due to environmental ornongeneticbiological riskfactors,
includingpremature birth,lowbirthweight;prenatal use of alcohol,tobaccoand/orcocaine;and
exposure tolead,whichcanalterbraindevelopmentinthe fetus.Infectionsandcomplicationsduring
pregnancycan alsoincrease the chancesthat a babywill eventuallydevelopADHDinchildhood.
Additionally,some postnatal problems,suchaschroniclow levelsof lead,recurrentearinfectionsor
severe headtrauma,can resultinADHD.
For years,ADHD wasthoughtto be a disruptive behaviordisorderthatmostexpertsintuitivelybelieved
involvedsome brainabnormality.Withthe developmentof more sophisticatedbrainscanning
techniques,itisnowknownthatpeople withADHDdohave anatomical differencesintheirbrains,as
well asdifferencesinthe biochemical balance thatcontrolseverythingfrommoodtoimpulses.
Brain imagingstudiesshow differencesinADHDbrainsinseveral areas:
 differencesindopamine receptorsinspecificareasof the brain
 differencesintotal brainvolume andbrainvolume of specificareasof the brain
 differencesinthe brainnetworks thatare usedtosolve specifictasks
 differencesinthe rate of maturationof frontal/prefrontal areasof the brain
ChildrenwithADHDshowa patternof delayedmaturationof certainregionsof the braincomparedto
theirpeerswithoutthe disorder.These regionsof delayeddevelopmentare involvedwithcontrolling
motor behavior,impulsecontrol andattentionlevels.The conclusionisthatslowerbraindevelopmentis
a characteristicof ADHD brainsand may explainthe delayindevelopmentof emotion/impulse control
and organizational skills.
Anotherbiological componentof ADHDhas to do withlevelsof certainneurotransmittersinthe brain.
AdultswithADHDwhohave neverreceivedanymedicationhave loweramountsof receptorsforthe
neurotransmitterdopamineinkeysubcortical regionslinkedtomotivationandrewardthandoadults
withoutthe disorder.Infact,stimulantmedicationsusedinthe treatmentof ADHDhelpbalance levels
of dopamine,improvingsymptomsof inattention,hyperactivityandimpulsivity.
ADHD isnot causedby manyenvironmental triggerscommonlybelievedtobe associatedwiththe
disorder,suchas toomuch TV,foodallergies,eatingtoomuchsugar,problematichome life,poor
teachingor schoolsorpermissive parenting.Still,itis essential torealize thatthe home environment
and the school settingare extremelyimportantinmanagingADHD—andthatineffective parentingand
educational settingscanexacerbate the symptomsandleadtoadditionalimpairments.
Diagnosis

3. Attentiondeficithyperactivitydisorder(ADHD) isthe mostprevalentchronicneurobiologicaldisorderin
children.Once thoughttoaffectonlychildren,itisnow recognizedasa disorderthatmostoften
continuesintoadulthoodandpresentsuniqueissuesforgirlsand women.
Commonsymptomsof ADHD can include:
 failingtogive close attentiontodetailsormakingcarelessmistakes
 difficultysustainingattentiontotasks
 appearingnotto listenwhenspokentodirectly
 failingtofollowinstructionscarefullyand completely
 losingorforgettingimportantthings
 feelingrestlessorfidgeting
 talkingexcessivelyorblurtingoutanswersbefore hearingthe whole question
ADHD isa seriousdiagnosisthatcan have a tremendousnegative impactonyourlife,workandfamily.It
may require long-termtreatmentwithcounselingandmedication,soit’simportantthata healthcare
professionalcarefullyevaluateall symptomstorule outotherconditionsthatcouldcause similar
symptomsorbehaviors.
For instance,stresscancause symptomssimilartothose seeninADHD,suchas forgetfulnessorfeeling
overwhelmedanddisorganized.However,reactionstostressare usuallytemporary,subsidewhenthe
stressful eventspass,andare not presentina chronicfashionsince childhood. Symptomscausedby
ADHD are persistent,chronicandunchangingsince childhoodorearlyadolescence.
The diagnosisitself,however,mustbe approachedverycarefullyandshouldn’tbe done duringatime -
limitedoffice visitwithapediatricianorothermedical doctor.Impropertreatmentfrommisdiagnosisor
failure toobtaintreatmentbecause of amissedADHDdiagnosiscanbothhave significant,long-term
consequences.
To reach an ADHD diagnosisinchildren,healthcare professionalsuse diagnosticcriteria publishedby
the AmericanPsychiatricAssociation(APA) inthe DiagnosticandStatistical Manual of Mental Disorders,
4th edition(DSM-IV-TR)andconsiderinformationfromothersources.Forexample,interviewswiththe
patient,the patient’sfamilyand, inthe case of children,informationprovidedbycaregiversand
teacherswhosee the childregularlycanprovide apicture of the patient’sbehaviorandlearningstyles.
Diagnosingandtreatingadultsischallenging.The diagnosticcriteria,withtheiremphasisonschool
behaviorandperformance,are designedtomake the diagnosisinchildren,notadults.Hyperactivity,for
instance,tendstodiminishbyadulthood,althoughothersymptoms,suchasinattention,mayappear
worse because of mountingadultresponsibilities.
The followinginformal checklistfurtherdescribesbehaviorsinadultsthatmaybe the resultof ADHD.An
individualhavingchronicproblemssince childhoodwithmanyof these symptomsmayrequire further
evaluation:

4.  I am constantlytryingto get organized,butcanneverseemtogetor staythere.
 I oftenfeel thatItalktoo much or impulsivelyblurtthingsout.
 I oftenfeel overwhelmed.
 I make impulsivepurchasesanddecisions.
 I frequentlymisplace personalitems.
 I start one thingbut neverfinishitbecause Iamdistractedbysomethingelse.
 I am frequentlylate.
 I am a procrastinator.
 I oftenmake carelesserrorsandoversightsduringthe day.
 I oftenpaybillslate andhave difficultymanagingmymoney.
There are three primarysubtypesof ADHD:predominantlyhyperactive-impulsive,predominantly
inattentiveandcombinedhyperactive-impulsive andinattentive.The DSM-IV liststhese othersignsof
ADHD, manyof whichapplytochildreninthe classroom:
Inattention
Those whoare inattentivefinditdifficulttokeeptheirmindsonanyone thingandmay getboredwitha
task afteronlya fewminutes.Theymay,however,giveeffortless,automaticattentiontoactivitiesand
thingsthat are highlyengaging,likevideogames.Buttheymayhave difficultywithdeliberatefocus,
consciousattentiononorganizingandcompletingtasks,responsestorepetitive materialsormasteryof
challenginginformation.
Hyperactivity-impulsivity
 Hyperactivity:Those whoare hyperactivealwaysseemtobe inmotionandhave trouble sitting
still.Theysquirmintheirseatsorroam aroundthe room. Or theymightwiggle theirfeet,touch
everythingornoisilytaptheirpencils.Theymaybe fidgetyortryto do several thingsatonce,
bouncingaroundfromone activityto the next.Theyreportaninternal sense of restlessnessand
the needto continuallymovearound.
 Impulsivity:Those whoare overlyimpulsiveseemunable tocurbor weightheirimmediate
reactions,thoughtsandbehaviorsbefore acting.Asaresult,they mayblurtout inappropriate
commentsor physicallyattemptsomethingwithoutthinkingitthrough.Thiscouldapplyto
takingtestsinschool as well asparticipatinginpotentiallydangerousbehaviors.Their
impulsivityalsomakesithardforthemto wait for thingstheywant.Thisleadstopoor
frustrationtolerance andtemperoutbursts.
Noteveryone whoisoverlyhyperactive,inattentive orimpulsive hasanattentiondisorder.Nordoes
everyone withADHDexhibitall behaviorsassociatedwiththe disorder. It’simportanttorealize that
duringcertainstagesof development,itmaybe normal forchildrentobe inattentive,hyperactiveor
impulsive,andthatthese behaviorsatthese stagesdon’tfitanADHD profile.

5. For example,preschoolerstypicallyhave lotsof energyandruneverywhere theygo,butthatdoesn’t
meantheyare hyperactive.Andmanyteenagersgothroughaphase whentheyare messy,disorganized
and rejectauthority.Thisphase doesn’tnecessarilypersistasalifelongproblemwithattention,
organizationand/orimpulsecontrol.
Because everyone exhibitssome of these behaviorsattimes,the DSM-IV containsveryspecific
guidelinesfordeterminingwhenthe behaviorsindicate ADHD.Specificsymptomsmustappearearlyin
life,beforeage seven,andcontinueforatleastsix months.Inchildren,theymustbe muchmore
frequentorsevere thaninothersthe same age.Above all,the behaviorsmustcreate areal handicapin
at leasttwoareas of a person’slife,suchasschool,home,workor social settings.However,it’s
importantto knowthatthe inattentive type of ADHDmaynot be diagnoseduntil age nine or10, the age
whensymptomsof inattentionbecome noticeable andproblematicbecause school demandshave
increased.
So if yourbehavioror yourchild’sdoesn’timpairwork,friendshipsorotherrelationships,youprobably
won’tbe diagnosedwithADHD.Norwoulda childwhoseemsoverlyactiveatschool butwhofunctions
well elsewhere.
Healthcare professionalsalsoconsiderthe followingquestions duringanassessmentforADHD:
Are these behaviorsexcessive,long-termandpervasive?Thatis,dotheyoccur more ofteninyouor
your childthaninothersthe same age?
Are theya continuousproblemratherthana response toa temporarysituation?
Do the behaviorsoccurin several settingsoronlyinone specificplace?
The healthcare professional piecestogetheraprofile of behaviors,basedonall available information,
and thenconsiders:
 WhichADHD-like behaviorpatternslistedinthe DSM-IV are apparent?
 How oftenandinwhat situations?
 How longhave theybeengoingon?
 How oldwasthe child/adultwhenthe problem(s) started?
 Are the behaviorsseriouslyinterferingwithschool,friendships,activitiesorhome life?
 Are there any otherrelatedproblems?
 Is there a parentwithADHD symptoms?
The answersto these questionshelpidentifywhetherthe hyperactivity,impulsivityandinattentionare
significantandlong-standing.If so,adiagnosisof ADHD maybe made.
Otherconditionsmayoccur withADHD,makingitmore difficulttoarrive at a cleardiagnosis.Women
and girlswithADHD,for example,are more prone todepressionthanmenandboyswithADHD.A
seriousbuttreatable mental disorder,depressioncandisruptall areasof yourlife,includingmood,
sleep,appetite,relationships,andthe abilitytothinkclearly.If youthinkyou’re sufferingfrom

6. depression,it’scritical thatyougeta diagnosisandpropertreatment.Leftuntreated,depressioncanbe
life-threatening,giventhe riskof suicide thataccompaniesthe disorder.
Anxietyisanothercommonconditionseeninthose withADHD.Some childrenwithADHD,forexample,
feel tremendousworry,tensionoruneasiness,evenwhenthere’snothingtofear.Because the feelings
are scarier,strongerand more frequentthannormal fears,theycanaffectthe child’sthinkingand
behavior.
ChildrenwithADHDare alsomore likelytohave achievementproblemsthanchildrenwithoutthe
disorder,evenif theydon’thave afull-blownlearningdisability.ADHDisnotin itself alearningdisability
but learningdisabilitiescommonlyoccurwithADHD.But because itcan interfere withconcentrationand
attention,itcanmake it doublyhardfor a childto do well inschool,creatinglifelongfrustrations.
A verysmall numberof people withADHDhave arare disordercalledTourette syndrome.People with
Tourette syndrome have ticsandotherinvoluntarymovementslikeeye blinksorfacial twitchesthey
can’t control.Some maygrimace,shrug,sniff orbark out words.Fortunately,these behaviorscanbe
controlledwithmedication.
The effectsof ADHD extendfarbeyondthe classroom, oftenwreakinghavoconeverythingfrom
educational budgetstosiblingrelationships.In2005, the CDC reportedthatthe educational costof
ADHD was about$36 billionto$52 billionannually.ChildrenwithADHDuse more mental health
services,have more frequentemergencydepartmentvisitsandhave higherratesof pedestrian,bicycle
and drivingaccidentsthanchildrenwithoutADHD.All of which placesextreme stressontheirparents.
It doesn’tmatterif the childwithADHDis male or female;parentingeitherisequallystressful.Overall,
mothersof childrenwithADHDreportsignificantlyhigherlevelsof parentingstressthanmothersof
childrenwithotherchronicdisorders,andthey’remore likelytobecome depressed.
Parentsof childrenwithADHDare alsomore likelytoexperience increasedabsenteeismanddecline in
productivityinthe workforce thanparentsof childrenwithoutthe disorder. The annual costtothe
economyintermsof lack of productivity,unemploymentandrelatedissueslinkedtoADHDis
measurable inmanybillionsof dollars.Of course,ADHDalsoplacestremendousstrainonrelationships
and placesmarriagesathigherriskfor divorce.Learninghow tomanage childrenwithADHDeffectively
and consistentlyisamajor componentof mosttreatmentplans.
Some researchlooksatthe conceptof executive function(EF).Thisinvolvesthe abilitytoorganize,
sequence atask,shiftfromtask to task,prioritize,planandanticipate,andholdinformationinyour
memoryas youconsidermultiple factorswhenmakingadecision.Some researchersconsiderexecutive
dysfunctioninherenttoADHD,while othersconsiderita separate categoryas definedby
neuropsychological testresults.ChildrenandadultswithADHDplusEF deficitsshow more academicand
life impairmentsthatthose withADHDwithoutEFdysfunction.ADHDmedication,althoughhelpful for
ADHD symptoms,hasmuchlessbeneficial effectonEFsymptoms.Skills-basedtherapiesare more useful
inthese cases.

7. Getting a Diagnosis
Several typesof healthcare professionalsare qualifiedtodiagnose andtreatADHD.
For children:
 Childpsychiatristsare physicianswhospecialize in diagnosingandtreatingchildhoodmental
and behavioral disorders.A psychiatristcanprovide therapyandprescribe anynecessary
medications.
 Childpsychologistsare alsoqualifiedtodiagnose andtreatADHD.Theycan provide therapyfor
the childand helpthe familydevelopwaystodeal withthe disorder.Butpsychologistsare not
medical doctorsandmust relyonphysiciansformedical examsandprescriptions.
 Neurologists,physicianswhoworkwithdisordersof the brainandnervoussystem, canalso
diagnose ADHDand prescribe medicines.Theywill likelybe involvedwithanybrainimaging
tests.But unlike psychiatristsandpsychologists,neurologistsusuallydonotprovide therapyfor
the emotional/organizational aspectsof the disorder.
 Familyphysicians receivetrainingtoprovide continuingandcomprehensive medical care,health
maintenance andpreventiveservicestopatientsof all ages.WhenitcomestoADHD, theycan
diagnose the condition,prescribemedicationsand,insome cases,provide counseling.
 Pediatriciansare physicianswhohave specializedtrainingintreatingchildren’sillnesses.Like
familypractitioners,pediatriciansmayormay nothave specialtytraininginorexperience with
ADHD. Because ADHDis mostprevalentinchildren,itislikelythata pediatricianwill have
experience inthe ADHDscreeningprocessandcanhelprule out(or identify) medical conditions
similartobehaviororlearningpatternsof ADHD.Pediatricianscanalsoprovide referralstolocal
ADHD specialists.
 Developmentalandbehavioral pediatriciansspecialize inbehavioranddevelopmentinchildren.
Servingasa liaisonwithprimarycare physiciansandothermedical specialists,developmental
and behavioral pediatriciansserveaskeymembersof amultidisciplinaryteam.Theyprovide
comprehensive developmental,medical andbehavioral assessments;educationforparentsand
professionalsregardingvariousmedical/developmental diagnoses;andmedical managementof
ADHD and otherneurobehavioral disorders.
For adults:
 Psychologists,psychiatrists,neurologistsandprimarycare physiciansmayalsodiagnose and
treat ADHD inadults.Butnot all healthcare professionalsare trainedandskilledinidentifying
or treatingADHD inadults.
 Withineachspecialty,individual healthcare professionalsandmental healthprofessionalsdiffer
intheirknowledge of andexperience withADHD.Sowhenselectingahealthcare professional,
it’simportantto findsomeone withspecifictrainingandexperienceindiagnosingandtreating
the disorderanddistinguishingcoexistingpsychiatricdisorders.

8. Treatment
An effective treatmentplanwill helpyoucope withADHD,whetheryouoryour childisthe one withthe
diagnosis.Foradults,the treatmentplanmayinclude medicationalongwithpractical andemotional
support.For childrenandadolescents,itmayinclude providinganappropriate classroomsettingand
accommodations,aswell asmedicationandhelpingparentsunderstandandmanage the child’s
behavior.
TreatmentforADHD may involve medication,behavioral/psychological counseling,
educational/workplace interventionsora combination.
Three medicationsinthe classof medicationsknownaspsychostimulants,orstimulants,seemtobe the
mosteffective intreatingADHDinbothchildrenand adults.These are:
 Methylphenidate (e.g.,Ritalin,Concerta,Metadate,Methylin,Daytrana).Methylphenidate is
available inbrandname andgenerictablets,capsulesandliquid.Daytranaisa methylphenidate
transdermal patchapprovedfortreatingADHDin childrenagedsix to12.
 Dexmethylphenidate(Focalin,FocalinXR)
 Dextroamphetamine-amphetaminemix (Adderall,Adderall XR).
 Dextroamphetamine(Dexedrine,Dextrostat,Concentra).
 Lisdexamfetamine (Vyvanse)
Stimulantmedications,whenusedwithmedical supervision,are usuallyconsideredsafe.Stimulants
seldommake childrenwithADHD“high”whentakenasprescribed.Becausethese medicationsare
stimulants,there isnosedatingeffect.However,restlessnessandfidgetinessmaydecline leavingthe
personfeeling“calmer.”Ultimately,the stimulantshelpchildrencontrol theirhyperactivity,inattention
and otherADHD-relatedbehaviors.
Stimulantdrugsare available inbothshort-,medium- andlong-actingforms.The short-actingformslast
for aboutfourhours,medium-actingformsforabout6 hoursand long-actingformslast8 to 14 hours.
Stimulantsdocarry the riskof abuse andaddiction.However,abuse anddependence withADHD
stimulantmedicationare more likelywithshort-actingforms.Toreduce chancesof substance abuse,
make sure you or yourchildisgettingthe rightdose of stimulantmedicationatthe neededtimeof the
day.Do not put yourchildor adolescentincharge of hisor her ownmedication.Keepmedicationlocked
ina childproof containerathome.If a school time dose isneeded,don’tsendsuppliesof medicationto
school withyourchild;instead,delivermedicationtothe school nurse orhealthoffice yourself.
Althoughsuddendeathshave occurredinchildrenonstimulantmedications,arecent extensive review
of suddendeathinchildrenandadolescentsonstimulantmedicationconcludedthatstimulant
medicationposesnoincreasedriskforsuddendeath,cardiacarrestor stroke comparedtochildrenand
adolescentsnotonthese medication.Always reviewmedicationpackaginginformation,andtalktoyour
healthcare professional aboutthispotential risk.Heartscreeningquestionstoassessanyriskshouldbe
askedbefore startinganyADHDmedication.

9. Additionally,stimulantmedicationshave beenassociatedwithaslightlyreducedgrowthrate insome
children,althoughthe extentof thisappearstobe a half inchon average.
Otherpotential side effects,suchasweightloss,problemssleepingandtics,shouldbe carefullyweighed
againstthe benefitsbefore prescribingthe medications.Preexistingticsmayor may notworsenwith
stimulantmedication.Mostside effectscanoftenbe handledbyreducingthe dosage.
Atomoxetine
(Strattera).The firstnon-stimulantmedicationapprovedtotreatADHD, Stratterais classifiedasa
selectivenorepinephrine reuptake inhibitor.Itworksbyblockingnorepinephrine inthe brain,thus
leadingtogreateramountsinthe synapse whenthe medicationisused.Overall,Stratterahasbeen
shownto leadtosignificantimprovementsinindividualswithADHD,butthe benefitmaybe less
substantial thanstimulants.
Stratterahas beenlinkedtorare side effectsthatinclude liverproblemsaswell asthe increasedriskof
suicide,accordingtothe FDA.Call your healthcare professionalrightawayif youor yourchild
experiencesyellowingof the skinoreyes(jaundice),unexplainedflu-like symptomsordark-colored
urine,orif youor your childhasthoughtsof suicide ora suddenchange inmoodor behavior,especially
at the beginningof treatmentoraftera change in dose.
Stratterais notclassifiedasa controlledsubstancelikethe otherADHDmedications(i.e.,the
stimulants),althoughitisaprescriptiondrug.Unlike stimulants,refillscanbe providedonprescriptions.
Side effectsinclude:decreasedappetite,upsetstomach,nauseaorvomiting,andfatigue.Inaddition,
some of the mostcommonside effectsinadultsare problemssleeping,drymouth,dizziness,problems
urinating(more soinmales) andsexual side effects.
Otheradditional medicationsare sometimesusedtotreatthe conditionif stimulantsdon’twork
completelyorif the ADHDoccurs withanotherdisorder.These medicationsare notapprovedforthe
treatmentof ADHD,yet manyhave beenshowneffectiveinatleastsome studies.
For example,clonidine(Catapres)andguanfacine (Tenex),medicationsnormallyusedtotreat
hypertension,maybe helpful inpeople withADHDwhohave ticsand/orinsomniaasa resultof ADHD
medicationsorwhoexperience aggressionaspart of theircondition.Clonidine canbe administered
eitherbypill orskinpatch andhas differentsideeffectsthanstimulants,includingrash(fromthe patch),
constipation,nervousnessandsedation.
OthermedicationsnotFDA-approvedforADHDbutthat may be prescribedincludethe antidepressants
nortriptyline(Pamelor,Aventyl)andbupropion(Wellbutrin).
Antidepressantsmaytemporarilyincrease riskof suicidalthoughtsandbehaviorinpeople uptoage 24,
accordingto the FDA.Short-termstudiesinchildrenandadolescentswithmajordepressivedisorderand
otherpsychiatricdisordersshowedanincreasedriskof suicidal thoughtsinthose taking

10. antidepressants,duringthe initial weeksof treatment.Althoughthiseffectisrare,anyone considering
the use of an antidepressantinachildor adolescentmustbalance thisriskwiththe needforthe drug.
Also,healthcare professionalsshouldobserve theirpatientscloselyforanyincreasedriskof suicide or
unusual changesinbehavior.Familiesandcaregiversshouldalsocloselywatchpatients.
Medicationwon’tcure ADHD; itwill justcontrol the symptomswhileyou’re takingthe medication.For
instance,stimulantshave onlyimmediate benefits,soonce a dose wearsoff that day,the symptoms
return.
Also,althoughthe medicationsmayhelpyoupaybetterattentiontoandcomplete yourwork,theycan’t
increase yourknowledgeorimprove your(oryourchild’s) academicskills.Asthe expressiongoes,“Pills
don’tteach skills.”The medicationsalone can’tmake youfeel betteraboutyourselforcope with
problems.These issuesrequire otherkindsof treatmentandsupport.
Psychosocial Treatment
AlthoughADHDprimarilyaffectsaperson’sbehaviorandcognition,the disorderhasbroademotional
repercussions.Scoldingisthe onlyattentionsome peoplewithADHDevergetwhile growingup.They
may have fewpositiveexperiencestobuildtheirsense of worthandcompetence.Facingthe daily
frustrationsthatcan come withhavingADHD can make people fearthattheyare strange,abnormal,lazy
or stupid.
Oftenthe cycle of frustration,blame andangerhasgone on so longit becomesincorporatedintoone’s
self-concept.Insuchcases,mental healthprofessionalscanhelpadolescentsandadultswithADHD
developnewskills,attitudesandwaysof relatingtootherpeople.Oftensuccessful treatmentwill helpa
personseparate the disorder(ADHD) anditssymptoms/impairmentsfromthe individual andtheir
innate strengthsandpotential.
In groupcounseling,peoplelearnthattheyare notalone;otherpeople withADHDhave similar
experiences,andthere are people whowanttohelp.Supportfromgrouptherapycan be complimented
withindividual therapytoaddressspecificlife issues.Veryoften,ADHDsymptomsandinconsistent
performance adverselyaffectspersonalrelationships.Familyandmarital therapywithaprofessional
aware of ADHD can be helpful inchangingthe communicationpattern.
Several typesof therapyare available,withdifferenttherapistspreferring differentapproaches.
Knowingsomethingaboutthe varioustypesof interventionsmakesiteasiertochoose atherapist.
PsychotherapyworkstohelppeoplewithADHDlike andacceptthemselvesdespite theirdisorder.In
psychotherapy,patientstalkwiththe therapistaboutupsettingthoughtsandfeelings,exploreself-
defeatingpatternsof behaviorandlearnalternative waystohandle theiremotions.Astheytalk,the
therapisttriestohelpthemunderstandhow theycanchange.However,people dealingwithADHD

11. usuallywanttogain control of theirsymptomaticbehaviorsmore directly.The followinginterventions
can provide thatkindof help.
Behaviortherapy,usedwithchildrenandadolescents,involvesprovidingparentswitheducationabout
ADHD, teachingthemtouse regularand consistentrewardsandpunishmentswiththeirchildrenand
coordinatingeffortswithteachersatschool.Indeed,forchildrenandadolescents,behaviortherapyand
medicationare the onlytwoevidence-basedinterventionsthatconsistentlyleadtoimprovementin
symptomsandimpairments.
Cognitive-behavioral therapyhelpsyouworkonimmediate issues.Ratherthanhelpingyouunderstand
your feelingsandactions,itsupportsyoudirectlyinchangingyourthoughtsandbehavior.The support
mightbe practical assistance,likelearningtothinkthroughtasksandorganize workor changinga
repetitivenegative thoughtpattern.Cognitivetherapieshave notbeenfoundtobe veryhelpful for
childrenandadolescents,butforadults,resultsare promising.
Social skillstraininghelpschildrenandadultslearnnew behaviors,specificallysocial behaviors.
Impulsive behaviorcanbe intrusive andabrasive ininteractions.Insocial skillstraining,the therapist
discussesandmodelsappropriatebehaviorsandhelpsthe patientpractice the new behavior.Itis
essential thatclearlimitsare setinthe social skillsgroups;otherwise,childrenmaymodel maladaptive
behaviorsfromone another.
Supportgroupsconnectpeople whohave commonconcerns.ManyadultswithADHD andparentsof
childrenwithADHDfindituseful tojoinalocal or national supportgroup.Manygroupsdeal withissues
of children’sdisorders,andevenADHDspecifically.
Ineffective orunprovenalternative treatments
The followingtreatmentshave NOTbeenscientificallyshowntobe effective intreatingpeople with
ADHD:
 restricteddiets(althoughrecentstudiesfromthe UnitedKingdomdoshow small effectsof
certainfoodadditivesonhyperactive behavior)
 allergytreatments
 medicinestocorrectproblemsinthe innerear
 megavitamins
 chiropracticadjustmentandbone realignment
 treatmentforyeastinfection
 eye training
 special coloredglasses
 herbal supplements
 essential fattyacids
 yoga andmeditation

12. Neurofeedback,alsoknownasbiofeedback,isapromisingintervention,notcompletelysupportedby
definitivestudiesbutwithsome recentinvestigationsyieldingsupportforimprovementsinattention
and behavior.
Be cautiousaboutpursuingcomplementaryandalternative treatmentsthatare notsupportedby
scientificresearchand/orthe U.S.Foodand Drug Administration.Althoughsingle positive studiesoften
receive mediaattention,itisimportantthatsuchfindingsbe replicated.Until sound,scientifictesting
showsa treatmenttobe effective,familiesriskspendingtime,moneyandhope onfadsandfalse
promises.
Managing Your Life as an Adult with ADHD
Here are some practical stepsyoucan take to manage yourlife withADHDfromADHD expertKathleen
Nadeau,PhD.
Give yourself abreak.Highexpectationsare deeplyingrainedinmanywomen.Identifyyourstrengths
and performthose tasks.Identifyyourweaknessandeitherfindacompensatoryskillorasksomeone
else toperformthese tasks.Psychotherapycanhelpcapitalizeon strengthswhile limitingthe
impairmentsinareasof weakness.
Educate your partnerabout ADHD andhow itaffectsyou.Your partnermay be angry or resentful about
a less-than-organizedlifestyle.If yourpartnerunderstandsthisasa disorder,he orshe may be more
understandingandaccommodating.Reassignhouseholdresponsibilitiesbasedonskill strength.
Strategize howtomake yourlife at home andworkmore accommodating.
Try to create an “ADHD-friendly”environmentinyourhome andwork.If you can approach yourADHD
withacceptance andgood humor,tensionswilldecreaseandyou’ll save more energyforthe positive
side of things.
Simplifyyourlife.Lookforwaystoreduce commitmentssoyou’re notalwayspressedfortime.Learn
howto betterprioritize taskstoavoidovercommitment.
Choose supportive friends.Manywomendescribefriendsorneighborswhosehousesare immaculate,
whose childrenare alwaysclean,neatandwell-behavedandwhomake themfeel terribleby
comparison.Tryto avoidsituationsthatleadyouto impossible expectationsandnegative comparisons.
Builda supportgroupfor yourself.Forexample,askafriendwhounderstandsyourconditiontokeep
youcompanywhile completingataskthat is alwaysdifficultforyou.
Buildindailybreaks.Thisisessentialwhenyouhave ADHD,especiallyif you’re raisingchildren.Make
themroutine sothat youdon’thave to keepplanningandjuggling.Forexample,arrange fora regular
babysitterseveral timesaweek.
Eliminate anddelegate.Lookat thingsthatyou require of yourself athome oron the job.Can you
eliminatesome of these things?Canyouhire someone todosome of them?

13. Get helpforpremenstrual ormenopausalsymptoms.Theymaybe severe inwomenwithADHD.
Managing the destabilizing effectsof yourhormonal fluctuationsisacritical part of managingyour
ADHD.
Make listsandencourage otherfamilymemberstolistandrecordactivities,responsibilitiesandevents.
Try to create a central familycalendarwithall activitiesforeveryonetocheck.Online calendarsmay
facilitate this.Avoidscatteringinformationonmultiple piecesof paperthatcan get lost.
Create filingsystemsororganizational systemsthatworkforyou.Colorcodingfoldersisafast visual
wayto identifywhat’sinthem.Setupautopayforbills,providedyouhave moneyandwon’toverdraw
accounts.Don’t letyourself be overwhelmedathome orat the office bymountainsof paperwork:sort,
file ordiscard.
Prevention
Accordingto currentmedical research,there isnoknownwayto preventmostADHD.There are some
pre and post-natal riskfactorsthat can be addressed:avoidalcohol andtobaccowhenpregnant,avoida
premature birthif possible andavoidleadexposure tothe child.
Facts to Know
1. It isestimatedthat attentiondeficithyperactivitydisorder(ADHD),alsoknownasattention
deficitdisorder(ADD) whenpresentwithouthyperactivity,affects8percentof U.S. school-aged
children,accordingtothe CentersforDisease Control.
2. Follow-upstudiesof children withADHDfindthatthe vastmajoritywill continuetosuffer
impairmentsthroughadolescence,and60 percentthroughadulthood.Manygirlsandwomen
sufferthe effectsof ADHDanddo not getthe helptheyneed.
3. Once diagnosed,manywomenrecall painful or difficultchildhoodexperiencesinschool that
were likelycausedbyADHD,butat the time were attributedtolazinessorlackof ability.Low
self-esteemisthe outcome of chroniccriticismandiscommonamongwomenwithADHD.
4. ADHD, once calledhyperkinesisorminimal braindysfunction,isthe mostcommonpsychiatric
conditionamongchildren.More thantwotimesasmany boysas girlsare affectedinchildhood;
however,inadultsit’salmostequal proportions.
5. ADHD can be mild,moderate orsevere.AnADHD diagnosisismore difficulttoidentifyin
womenandgirlsbecause theytendtobe lesshyperactive,lessdefiantandmore compliantthan
boys(thoughthisisnot alwaysthe case).The absence of disruptive behaviorcandelay
identification.
6. ADHD has a verystrong geneticcomponent.Childrenwhohave aparentwithADHDor another
moodor behavioral disorderare at an increasedrisk.Still,aswithotherconditionswithastrong
geneticliability,the qualityof life andthe provisionof strongparentingand qualityschooling
can greatlyinfluence anylong-termoutcomes.
7. Like all chronicmedical conditions,there are nocuresfor ADHD.Treatmentfor ADHD may
involve medication,behavioral/psychological counseling,educational interventionsora
combination.

14. 8. Medicationcanhelpto control the core symptoms:hyperactivity,impulsivityandinattention.
But more often,there are otheraspectsof the problemthatmedicationwon’talleviate.Even
thoughADHD primarilyaffectsaperson’sbehaviorandcognition,havingthe disorderhasbroad
emotional repercussions.
9. Currently,ADHDisa diagnosismade inpeople whodemonstrate chronicandpersistent
symptomsacrossa numberof settings.Althoughpeople identifywithsome of these symptoms
at differenttimesintheirlives,ADHDisa disorderstartinginchildhoodthatusuallypersistsinto
adulthood.Childhoodonset(orearlyadolescence,inthe case of the inattentive type)isthe
cornerstone of the diagnosis.There isnosuchdisorderas“adult-onsetADHD,”althoughsome
adultswiththisconditionmaynothave beendiagnosedaschildren.
Key Q&A
1. I have trouble focusingontasksandoftenfeel overwhelmedduringtimesof extremestress.
DoesthismeanI have attentiondeficithyperactivitydisorder(ADHD)?Notnecessarily.Stress
can cause symptomssimilartoADHD,such as forgetfulnessorfeelingoverwhelmedand
disorganized.Reactionstostressare usuallytemporaryandsubsidewhenstresssubsides.These
symptomsshouldnotbe confusedwithADHDsymptomsorbehaviors, whichare longlasting
and persistent.
2. Are bad parentingskillstoblame forADHD?No.ADHDisa complex neurobiological disorderthat
affectslearningandbehavior.ToomuchTV,poorhome life,poorschoolsorteachers,food
allergiesorexcesssugardonotcause ADHD.International researchdemonstratesthe presence
of ADHD inchildrenregardlessof culture andparenting.Still,how afamilyrespondstotheir
child’sADHDmay go a longway inshapingthe child’sultimateoutcome.Biologyisnotdestiny.
3. DoesADHD onlyaffectchildren?IthinkIrecognize some symptomsinmyself.No.Until recent
years,adultswere notthoughtto have ADHD,so many adultswithongoingsymptomshave
neverbeendiagnosed.There hasbeenarecentincreasedawarenessof adultADHD,however.
Abouthalf of childrenwithADHDcontinue tohave impairmentsthroughadulthood.The recent
awarenessof adultADHDmeansthat manypeople canfinallybe correctlydiagnosedand
treated.
4. What causesADHD?Scientistsare notsure whatcausesADHD, althoughgeneticand
neurobiological factorsare clearlyinvolved.Healthcare professionalsstressthatbecause there
isno knowncause,itis far more importantfora womanand her familytomove forwardwith
treatmentandidentifywaystomanage herlifestyleinareasaffectedbyADHDthanto search
for a cause.
5. Can stimulantmedicationsbe abused?Althoughstimulantmedicationsare recognizedasa safe
and effective treatmentforADHDwhentakenas prescribed,these medications,like many
others,nonethelessdohave the potential forabuse.Stimulantmedicationhasbeenmisusedby
people withoutADHD.Theytake these medicationstoincrease alertnessandfocusbutalsoto
gaina “high.”Substance abuse anddependence doesnotdevelopinpeoplewhotake their
medicationsasprescribed.Youshoulddiscussthe risksandbenefitsof stimulantmedication
withyourhealthcare professional.If youhave ahistoryof substance or alcohol abuse,this

15. shouldbe discussedwithyourphysiciantochoose the rightcourse of treatmentand
medication.
6. My relationshipwithmyhusbandhassufferedbecauseof myADHD.Is there anythingIcan
do?Yes.Because adultwomenoftensufferformanyyearswithouthelpfortheirADHD,their
personal relationshipscanbecome strained. Healthcare professionalsusuallyrecommend
counselingforwomenandtheirfamilies,alongwithmedicationtreatments.A therapistcan
assistyouand your familyinfindingbetterwaystodeal withyourADHDand reduce the
frustrationof the non-ADHDspouse/familymember.
7. Is ADHD a learningdisorder?No.ADHDisa specificpsychiatricdisorderthatcan occur witha
coexistinglearningdisorder.Learningdisordersdonot,ingeneral,improvewithmedication.
IntelligenceandADHDare separate entities.PeoplewithADHDcanhave a broadrange of IQs.
Regardlessof IQ,mostADHD individualsfeel frustratedatnotlivinguptotheirpotential
because of the impairments.
For more informationvisitusourwebsite:http://www.healthinfi.com