Parents might have noticed that their child is restless and fidgety, forgets homework assignments on a regular basis, can’t seem to finish a task, or just sits there, staring into space instead of working. These children often perform poorly in school even though they are smart. These are all classical signs of ADHD.
The symptoms fall into three different categories: inattention, hyperactivity, and impulsiveness. Children can have problems in all three areas, or just one or two. In order to be diagnosed with ADHD, a child must show symptoms across different settings, such as school and family, and to a degree that clearly impacts normal functioning.
ADHD does not just affect a child’s school performance. Difficulties with organization and time management impact all areas of life, including social interactions. Also, if children don’t learn to control their impulsive behavior, they are at higher risk to engage in behavior that might lead to injuries and they are more likely to have unprotected sex or try illegal substances as adolescents.
In addition to that, children and adolescents who have ADHD have a higher rate of other problems, such as anxiety, depression, or learning disabilities. Both children and adults who suffer ADHD, often have serious issues with self-esteem as a result of chronic failures in academic and employment settings.
There is a natural tendency to think that ADHD sufferers are simply lazy and fail to apply themselves. However, we know that for people who truly have ADHD the issue is not a matter of intelligence or motivation. Detailed brain scans have shown that people suffering from ADHD process information differently. There is also very good evidence that the neurotransmitter dopamine is central to ADHD. People who have ADHD symptoms have low levels of dopamine in parts of their brains responsible for attention management. Not surprisingly, the medications for ADHD raise dopamine levels in those parts of the brain.
This explains the apparent paradox of ADHD medications. In people who don’t have ADHD, the medications raise dopamine above normal, resulting in overstimulation and loss of effective attention management. In people who have ADHD, those same medications raise dopamine from low to normal, giving the person the ability to correctly regulate their attention.
This explanation of brain chemistry gives us an understanding of why ADHD sufferers can’t just “try harder,” and the reason why rewards and punishments usually have little or no positive effect. It helps us to understand that the issue is not the parents’ fault or the result of too much sugar or soda, even though environment and diet can influence the symptoms.
Fortunately, there is a lot that can be done to help a person with ADHD. In my experience, the most effective strategy is usually a combination of appropriate medication and psychological therapy. Medication is often important because it is so hard for people to learn and implement coping skills while their brain activity is all over the place. In therapy, people develop coping strategies and learn time management, impulsivity control, organization skills and problem solving.
With adequate guidance, many children and adults are able to eventually reduce or discontinue medication, and still function normally. There are even some who never have to take medication in the first place. This is especially true of those people who are identified early and engage in consistent therapy as they progress through school.
It was believed for a long time that children would eventually “grow out of” this problematic behavior, but it is known now that about 50 percent of all children diagnosed with ADHD retain symptoms into adulthood. The hyperactivity often diminishes as people get older, but the impulsivity and inattention can remain.
So, in at least half of cases, ADHD is a lifelong condition that, if not adequately addressed, often substantially impacts quality of life and economic and social success.
Even if a person grows out of ADHD in adulthood, there is often substantial damage done due to the lack of success in school. For these reasons, parents should not be reluctant to have their child evaluated and, if necessary, treated. In my experience, those adults and children who seek treatment are surprised and grateful at the difference it can make.
Antje Rath, is a clinical mental health counselor who has a private practice in Moab. She can be reached at 435-719-5550, or by email at firstname.lastname@example.org.