ADHD: Symptoms, treatment, and how therapy can help

Attention-deficit/hyperactivity disorder (ADHD) affects 9.8% of children between the ages of 3 and 17 and almost 16 million adults in the United States. But what is ADHD? This neurological condition is commonly diagnosed in childhood and may affect your ability to form and maintain meaningful personal and professional relationships.

Each person with ADHD is unique, and the condition can look different from person to person. We’re taking a deeper look at this disorder, including what it is, its types, causes, and ways you can treat and manage ADHD for yourself or a loved one.

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Understanding ADHD: what is it and how does it affect people?

ADHD is a neurodevelopmental disorder that’s, on average, diagnosed at age six, though more severe cases are often diagnosed when children are several years younger. With that said, there’s also a percentage of people who aren’t diagnosed until adulthood.

A general pattern of inattention, hyperactivity, and impulsivity defines ADHD. Each of the three attributes of ADHD plays out uniquely in different people. Some of the most common symptoms include:

• Excessive talking

• Extreme restlessness

• Excessive fidgeting

• Difficulty staying organized and paying attention

Whether ADHD is diagnosed early or late in life, various treatment options exist to manage symptoms best.

Symptoms and signs of ADHD

The signs and symptoms of ADHD are more complex than daydreaming, restlessness, and careless mistakes. The symptoms and signs of ADHD require observation over a period of time to identify other disorders that may cause similar symptoms.

ADHD in children

ADHD is typically diagnosed in childhood, though some people aren’t diagnosed until adulthood. Joseph Melendez, a licensed clinical social worker with Grow Therapy, says, “With kids, the symptoms are at their rawest forms. They haven’t learned to mask or cope. Instead, you’ll see the symptoms in their full potential.”

Children with ADHD tend to fare better socially than adults with ADHD. Melendez explains, “Kids have friends and are more accepting of those quirky behaviors . . . Children tend to be more resilient and forgive some of the quirks that someone with ADHD may have . . .”

There are specific criteria for an ADHD diagnosis, broken down into two categories, inattention and hyperactivity/impulsivity. Children under 16 must show six or more symptoms of either inattention or hyperactivity/impulsivity, with symptoms present for at least six months. Additionally, the symptoms must be inappropriate for the child’s developmental age. Inattentive symptoms include:

• Careless mistakes in schoolwork, activities, or work and often lacks close attention to detail

• Difficulty paying attention during play activities or tasks

• Poor listening when spoken to

• Failure to follow through on instructions, including finishing schoolwork, work tasks, or chores

• Difficulty with time management, including organizing activities and tasks

• Showing reluctance, avoiding, or disliking tasks and activities that require mental concentration over a long period of time

• Frequently losing or misplacing needed items

• Easy distraction

• Forgetfulness

Symptoms of hyperactivity and impulsivity include frequent:

• Interruption of activities, such as conversations and games, of others

• Squirms, taps, and movement

• Movement when staying seated

• Blurting of answers before questions are completed

• Difficulty waiting their turn

• Excessive talking

• Excess of activity

• Difficulty participating in quiet activities

• Running and climbing when inappropriate

ADHD in adults

Adult ADHD symptoms are the same as children. However, in those 17 and older, only five or more of the inattentive or hyperactive/impulsivity symptoms are required for a diagnosis.

Adult presentation of ADHD can be more nuanced and may change over time. In addition to the typical symptoms, they may also have:

• Other mental health disorders like mood disorders, depression, or substance abuse

• Difficulties at work

• Memory problems

• Difficulty with executive functions, making long-term tasks difficult

• Time management problems

• Procrastination issues

• Difficulty maintaining personal relationships

“Life with ADHD can be different for adults than children,” says Melendez. “If they weren’t diagnosed as a child. . .they’ve been masking in some capacity.” He goes on to say, “Adults have more complex relationships with emotional and physical intimacy and work relationships that are different from school. They impact adults differently from children with ADHD. Emotionally it’s felt different.” Consequently, adults may have a more difficult time maintaining relationships than children.

Did you know?

The CDC estimates that nearly 15.5 million adults in the United States have ADHD, yet research suggests that fewer than 20% of adults with the condition have ever received a formal diagnosis. Adults are significantly more likely than children to go undiagnosed, often because symptoms like inattention and emotional dysregulation can be mistaken for anxiety, depression, or personality traits.

Types of ADHD

ADHD can be subdivided into three types. The differences between the three determine the best management practices and treatment options.

Hyperactive/impulsive

This type is called predominantly hyperactive-impulsive ADHD and is the type most associated with ADHD. It’s also more frequently diagnosed in boys, though girls can have this type, too. Plus, with 11.7% of boys diagnosed with ADHD versus 5.7% of girls, they’re almost twice as likely to be diagnosed with ADHD. Yet, in adulthood, the percentages of adult women and men with ADHD are fairly equal.

A person with hyperactive-impulsive ADHD may talk and fidget excessively. Younger children may be constantly on the move and generally have poor impulse control.

Inattentive

Predominantly inattentive ADHD is frequently diagnosed in women and girls, though men and boys can have it too. This type of ADHD often doesn’t have the hyperactive component. Someone with this type may have difficulty with:

• Staying organized

• Finishing tasks

• Paying attention

• Following instructions

• Following conversations

• Avoiding distraction

• Details of a daily routine

Combined

A combined ADHD presentation is when someone shows nearly equal amounts of inattentive and hyperactivity/impulsivity symptoms.

Causes of ADHD: genetics, brain chemistry, and environmental factors

We don’t yet know the specific causes of ADHD, but there’s evidence of many factors that play a role. When these factors come together under the right circumstances and in the right combination, the chances of ADHD go up.

Various genes, both common and rare, affect brain development and ADHD. These genetic components and specific environmental conditions increase the risk factors for ADHD. ADHD often runs in families, though the genetic component remains elusive. A child diagnosed with ADHD may have a close relative, even if they’re not in the same immediate family group, who has ADHD.

Brain chemistry also plays a contributing role. In some cases, the brain develops differently for no apparent reason. In others, identifiable events may affect brain chemistry, such as exposure to alcohol, lead, cigarette smoke, and certain pesticides.

Epileptic disorders and traumatic brain injury can also change how the brain functions, leading to ADHD. The brain of an individual with ADHD also shows differences in volume and structure, which is still being explored. The mix of contributing factors means that ADHD isn’t preventable or curable but treatable.

Diagnosis of ADHD

An ADHD diagnosis doesn’t (and should not) come after a single visit to a medical professional. It takes time and multiple evaluations for a diagnosis. The first step is a medical exam that includes vision and hearing tests to eliminate other potential symptom sources.

Conditions like depression, sleep disorders or problems, anxiety disorders, and learning disabilities can all cause and share ADHD symptoms. You may also uncover health conditions that function alongside ADHD that must be addressed to manage its symptoms fully. Adults with ADHD often self-report, though spouses may also be involved with the evaluation.

ADHD occurs on a spectrum from mild to severe. During the evaluation process, you can begin to see where you or the person being evaluated falls on that spectrum. Diagnosis also goes beyond the symptoms listed on the inattentive and hyperactive/impulsive lists. The symptoms of ADHD must also:

• Be present in two or more settings

• Be present before age 12

• Interfere with everyday life

• Not have another condition to explain the symptoms

Treatment options for ADHD

Most physicians recommend medication and behavior therapy used together for ADHD treatment. However, each person and family is unique, so treatment varies from person to person to meet diverse needs.

Medication

An estimated 69.3% of children with ADHD take medication to help manage their symptoms. Of those who take medication, 70-80% see fewer symptoms when taking their medication. ADHD medications and dosages vary because people’s bodies respond differently.

Traditionally, stimulants, such as Ritalin and Adderall, are tried first. Both of these medications affect dopamine and norepinephrine, which are neurotransmitters that aid communication between nerve cells. However, side effects may include:

• Increased heart rate

• Increased blood pressure

• Increased breathing rate

• Increased blood sugar

• Decreased blood flow

• Insomnia

• Decreased appetite

• Sweating

• Tremors

• Flushed skin

• Vomiting

• Abdominal pain

If side effects become a problem, the next line of medication to treat ADHD involves non-stimulants, such as Atomoxetine, Viloxazine, and various antidepressants. Non-stimulants take longer to affect the body, but they can stay in the body for 24 hours and typically have fewer symptoms.

Therapy for ADHD

Melendez says, “The most common type of therapy is cognitive behavior therapy (CBT). It’s the cornerstone for most disorders because of its broad connections to thoughts, emotions, and behaviors and how everything we do has those three components.” He goes on to say, “It works by helping identify how our behaviors are influencing our thoughts and actions. We work to identify that connection and how to make that connection work for the individual.”

Parents of children diagnosed with ADHD may also participate in therapy. They learn behavior management skills and receive training to reinforce the tools and skills learned in therapy. Therapy is also a place to work on the effects of ADHD on self-esteem and personal relationships.

Lifestyle changes

Certain lifestyle changes have been found to improve ADHD symptoms. Adults diagnosed with ADHD can work on these changes themselves, but children may need the help of parents, siblings, and teachers to fully integrate these changes into their lives. Lifestyle changes that can help manage ADHD include:

• A healthy diet

• Daily exercise and activity

• (Reasonable) goal-setting

• Limiting choices

• Getting adequate sleep

• Creating a daily routine

• Reducing distractions at home

• Breaking down complex tasks into simple steps

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Coping with ADHD: strategies for managing symptoms and improving daily life

Classroom and professional work settings aren’t typically designed to accommodate people with ADHD, but there are time management and coping skills that can help. However, whether you’re the person with ADHD or the person assisting the person with ADHD, be patient. New skills and habits take time to form.

In the workplace

The same methods in a classroom setting often work well in the workplace. For example, try to:

• Create a routine

• Focus on one task at a time

• Write down ideas that don’t relate to your current task so you can stay focused

• Try self-talk to manage outbursts

• Learn and practice relaxation and meditation techniques

• Take notes during meetings to keep yourself busy and focused

• Keep checklists to remember important tasks

• Take movement breaks

• Use reminders and alarms to manage time better

• Break complex projects into smaller, manageable parts

Additionally, Melendez suggests, “Try to build transition time into your day to allow space for frustration, the external stimuli, and how they might affect you.” Time management is key to work success. Melendez says, “Appropriate time management also includes really identifying what you need from a routine and how the transition time can help. People have different symptoms, so some benefit from a stricter routine with calendars and reminders and getting those in place.”

In relationships

People with ADHD may have difficulty applying and following social norms consistently. However, social norms can be learned and practiced. A healthcare provider like a therapist can help you identify and learn the right skills. Therapy may include observing and role-playing to practice social skills. The learning process may include time management skills and behavior modifications to manage energy levels. A therapist tailors ADHD treatment based on what you need.

Couples can face unique challenges when one has ADHD and the other is non-ADHD. The non-ADHD partner may feel somewhat excluded from their partner’s life. Melendez, who also works as a couples therapist, says, “The non-ADHD partner often describes it as looking inside a house from the outside. No matter how hard she tries to see in the house, she’s always looking from the outside.” Couples therapy can address these issues to help both partners develop communication patterns that strengthen their relationship.

Final thoughts

The brain of someone with ADHD works differently than a neurotypical person’s. Those differences can make life a whirlwind of excitement while challenging other parts of life. Fortunately, early intervention to manage symptoms can help build healthy relationships with family, friends, and coworkers. A combination of therapy for ADHD, medication, and lifestyle changes can work wonders for many people. ADHD can change as you age, so you may need to adapt your coping strategies as time passes.

Let Grow Therapy help you manage ADHD by connecting you with a therapist at your convenience. Our licensed providers come from a wide range of specialties and include psychiatry services for medication management where needed. Book your first appointment and get the support you need to successfully manage ADHD.

ADHD is manageable. You don’t have to deal with by yourself.

A therapist who specializes in ADHD can help you build strategies for focus, relationships, and daily life that actually work for how your brain is wired.

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