ADHD or attention deficit hyperactivity disorder, is a neurobehavioral condition that affects between 3 and 5% of American children throughout the U.S. The diagnosis of this condition is fairly subjective and is impacted significantly by the area of the country and the social norms in the area. For instance, there are pockets of the country that have significantly higher percentages of children who are affected – ranging closer to 10 -12%
Children and adults who experience ADHD find that the condition interferes with their ability to stay on task and to exercise age-appropriate inhibition of behaviors. These criteria are more defined for teens and adults than for young children. This accounts greatly for the differences in diagnosis across the country since social expectations about age-appropriate behaviors can vary in certain cultures.
ADHD diagnosis and its treatment depends upon several factors, including culture, social norms, type of ADHD present and treatment options that may be available depending upon the persons age. While ADHD is usually diagnosed in childhood it does continue through the adult years and in mild forms may not be recognized until the individual reaches adulthood.
Researchers have found that a combination of behavioral therapy and medications make managing the condition much easier. However, optimal treatment protocols continue to be a matter of debate. The debate centers around the use of one therapeutic approach vs. the other (behavioral vs. medication) or as combination using which behavioral therapy and which medication protocols.
Treatment must also include support for the family members who are dealing with behavioral issues in children and adults which aren’t age appropriate and cause undue stress on an already stressed family situation.
When considering psychotherapeutic approaches the therapist may use psychotherapy, behavioral therapy, family therapy, social skills training, support groups for parents and children or a combination approach of several of these therapies. The best results happen when the therapeutic approach is used as team across parents, therapists, teachers and physicians who are all working together to help the child or teen gain the best control possible to improve their learning and ability to function in their social situations.
The medications that are the most popular are psychostimulants such as Ritalin, Concerta, Adderall and Dexedrine. This approach would seem to be counter-intuitive since giving stimulants to a child who appears to be already stimulated would appear to cause even more problems. However, because the method in which the medications work and the way that the ADHD affects the brain, these medications are a perfect match. These stimulants seem to boost and balance neurotransmitters in the brain responsible for the control of emotions and mood.
In patients who also suffer from depression, antidepressants may also be used – especially in adults or children who don’t also respond to the psychostimulants.
All of these medications are available in long acting or short acting forms. The shorting acting forms last about four hours and the longer acting forms about eight to twelve hours. Because the effects wear off quickly and the dosages vary between individuals, it can take some time to find the right dose to help the child or adult manage their hyperactivity disorder.
Although therapy doesn’t have negative side effects medications do. Children may suffer from decreased appetites, nervousness and problems with sleeping. Some children become irritable or have an increase in activity as the medication wears off. A small percentage of children can develop tics but these normally disappear as the dose is tapered down.
In adults the side effects are fairly similar. However, they also cause other side effects that are particular to adults such as a mild increase in blood pressure and because adults generally need higher doses to manage their condition they are also at greater risk for abuse or addiction to the drugs.
Experimental ADHD diagnosis and its treatment include biofeedback, brainwave biofeedback, and special diets and supplements. More information and research is needed to prove or disprove the effectiveness of any of these options for patients with attention deficit disorder.
Center for Disease Control and Prevention: Attention Deficity/Hyperactivity Disorder
HelpGuide: Add/ADHD Tests and Diagnosis
American Academy of Pediatrics: AAP Expands Ages for Diagnosis and treatment of ADHD in Children
Northwestern University: Diagnosis of ADHD on the Rise