- Attention-Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder characterized by a persistent pattern of inattention, hyperactivity, and/or impulsivity that interferes with daily functioning or development.
- Typically identified in childhood, ADHD often continues into adolescence and adulthood, although the expression of symptoms may change with age. The condition varies widely among individuals, ranging from predominantly inattentive to predominantly hyperactive-impulsive or a combination of both presentations.
- In individuals with inattentive symptoms, challenges include difficulty sustaining focus, being easily distracted, forgetting instructions, losing necessary items (like school supplies or tools), and making careless mistakes. These individuals may appear to be daydreaming or disinterested, when in fact they are struggling to maintain mental effort or organization. In hyperactive-impulsive presentations, symptoms include excessive fidgeting, difficulty remaining seated, interrupting others, talking excessively, and acting without thinking. The combined type—where both sets of symptoms are present—is the most commonly diagnosed form.
- The neurobiological basis of ADHD involves alterations in brain structure and function, particularly in regions related to executive functioning, such as the prefrontal cortex, basal ganglia, and cerebellum. These brain areas are crucial for tasks involving attention, impulse control, and planning. Abnormalities in dopaminergic and noradrenergic neurotransmission have also been implicated, contributing to difficulties in regulating arousal and motivation. Functional imaging studies often show reduced activity in brain networks responsible for self-regulation and task-oriented behavior.
- Genetics play a significant role in the development of ADHD. Family studies suggest a strong hereditary component, with first-degree relatives of individuals with ADHD being significantly more likely to develop the condition. However, environmental factors also contribute, including prenatal exposure to substances like tobacco, alcohol, or lead, premature birth, and low birth weight. Psychosocial stressors, although not causative, can exacerbate symptoms or affect coping and outcomes.
- Diagnosis of ADHD is clinical and based on criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). It typically requires the presence of several symptoms before age 12, lasting for at least six months, and occurring in two or more settings (e.g., home and school). Assessment tools may include structured interviews, behavior rating scales completed by parents and teachers, and observation of behavior over time. Due to overlapping symptoms with other conditions like anxiety, depression, or learning disabilities, a thorough evaluation is essential.
- Management of ADHD involves a multimodal approach, often combining behavioral therapy, educational interventions, parent training, and, when appropriate, medication. Stimulant medications such as methylphenidate and amphetamine-based drugs are the most widely used and have proven highly effective in reducing core symptoms. Non-stimulant medications, like atomoxetine or guanfacine, may be used in cases where stimulants are ineffective or not well tolerated. Behavioral interventions include reinforcement strategies, organizational skills training, and social skills development. For children, close collaboration with educators is crucial to implement classroom accommodations and support academic performance.
- ADHD often coexists with other conditions, including oppositional defiant disorder (ODD), learning disorders, anxiety disorders, depression, and sleep disturbances. Untreated ADHD can lead to academic underachievement, low self-esteem, strained relationships, and increased risk of accidental injury or substance abuse, particularly in adolescents and adults. However, with appropriate treatment and support, individuals with ADHD can thrive academically, socially, and professionally.
- In adults, ADHD may manifest more subtly, with difficulties in time management, organization, impulse control, and emotional regulation rather than overt hyperactivity. Many adults are diagnosed later in life, often after struggling with chronic disorganization or workplace challenges that prompt evaluation.
