Symptoms of ADHD
Attention-Deficit Hyperactivity Disorder (ADHD) is one of the best known but least understood mental health conditions. It is so well know because practically everyone knows someone with the diagnosis. Reports claim that between 5 percent of children and 2.5 percent of adults meet the criteria for the diagnosis. This means that 1 out of every 20 children and 1 out of every 40 adults have ADHD. ADHD affects students, teachers, doctors, lawyers, mothers and fathers.
ADHD is one of the least understood disorders because, despite its prevalence, there is still a bit of confusion regarding the symptoms. Some think that ADHD is only for children while others think that you can have ADHD as an adult without symptoms as a child. Some think that ADHD is over diagnosed or is a way to pathologize normal functioning. Some people still tell doctors that they have ADD even though that term has not been used in over 20 years.
To address something as tricky as ADHD, it is essential that you have a firm grasp on what it is and how it operates. Without a good understanding, you could be using your limited resources in inefficient or counterproductive ways. Read on to understand ADHD from a mental health professional’s point of view and to learn how to differentiate between ADHD, and what you can do to help along the way.
Mental health professionals use a book called the Diagnostic and Statistical Manual of Mental Disorders (DSM) to assess and diagnosis mental health issues. Since the book is currently on its fifth revision, you will hear professionals refer to the DSM5. The book contains every diagnosis, and what symptoms need to be present to receive the diagnosis.
ADHD criteria are broken up into two categories.
Luckily, ADHD is a very descriptive name for a mental health disorder so you can probably guess the two categories symptoms fall. The first is inattention. There are nine possible symptoms but the child in your life only needs six to meet the criteria in this section. Inattention symptoms include:
- Making careless mistakes or not paying attention to details at school, work or home.
- Difficulty paying attention for long periods of time.
- Difficulty listening when someone is speaking to them.
- Difficulty following directions and problems completing tasks and assignments due to poor follow through.
- Difficulty getting or staying organized, being messy with poor time management.
- Avoids, dislikes and is hesitant to engage in activities that require high levels of mental effort.
- Difficulty locating items/ often loses items and materials necessary for completing tasks.
- Is easily distracted by sights and sounds going on around them.
- Difficulty remembering assignments, chores and other responsibilities.
These nine items do a thorough job of outlining the symptoms likely to be found in someone with poor attention associated with ADHD. As always you have to judge their performance based on others their age. If a two-year-old cannot sit through a college lecture on organic chemistry, this does not mean that he has pathologically low attention. Just as a 22-year-old that can play video games for eight hours straight does not indicate good attention. Activities like video games and online surfing does not require sustained attention since there is constant motion and stimulation.
A major symptom to be aware of is the eighth item on the list. Kids that are easily distracted by extraneous stimuli are usually easy to spot. You can be talking to them or asking them a question with their full attention when they become completely distracted by something crossing their field of vision or a sound that they hear. After this happens, it will be extremely challenging to have them return to the topic of discussion.
Unsurprisingly because of its name, the second set of ADHD symptoms fall into the category of hyperactivity/impulsivity. Again, there are nine symptoms listed but children only need six to meet the requirement for this section. Hyperactivity/ impulsivity symptoms include:
- Being restless while sitting marked by fidgeting, tapping hands or feet and squirming.
- Because he cannot sit still will often get up and leave seat when staying seated is expected.
- Runs, climbs or walks quickly in situations that are inappropriate.
- Unable to play or engage in leisure activities.
- Difficulty staying still for long periods of time, always on the go with endless energy.
- Difficulty staying quiet/ will speak excessively.
- Difficulty taking turns in conversations and will blurt out answers or information inappropriately.
- Difficulty waiting for turn in games or waiting in lines.
- Frequently interrupts or interferes with the activities of others by butting into a game or activity without being invited.
One of the major symptoms to be aware of in this section is the fourth item. People with ADHD are often identified because of their inability to play by themselves. They will often complain of being bored or having nothing to do in the home. This fact leads parents to allow for longer periods of video game time since this seems to be the only activity that can satisfy them.
Making the Diagnosis
Review the above nine inattention items and the nine hyperactivity/impulsivity items. Gather information from others about performance in other environments and situations. If you are investigating your own symptoms, ask trusted supports for their opinion of your attention and activity levels. Track the impact these symptoms have on your life.
Making the Diagnosis
As mentioned above, having six or more of the symptoms from each group means that you meet that section. If you are or your child is over 17, only five of the symptoms need to be present. Meeting both sections indicates that the diagnosis is ADHD combined type. Meeting only the first section shows that the proper diagnosis is ADHD predominantly inattentive presentation. Meeting only the second group means that the diagnosis will be ADHD predominantly hyperactive/ impulsive presentation.
ADHD predominantly inattentive type tends to be more difficult to identify and diagnosis because these children are usually quiet in school, which leads the teacher to believe that they are being attentive. In actuality, they may be daydreaming throughout the school day. Eventually, poor grades will indicate that something is amiss. Similarly, at home, the child may seem symptom-free if they are engaging in pleasurable activities like video games, time on the computer or watching TV. Parent frustration will grow as the child is unable to complete chores and tasks due to forgetting.
Before someone can have the ADHD diagnosis, there are several other considerations. The first is that symptoms had to have been present before age 12. This means that if everything was fine until the child’s 14th birthday, the ADHD diagnosis cannot be given. The second consideration is that symptoms must be present in multiple settings. If a child is fine at school, friends’ houses and soccer but problematic at home only, the diagnosis cannot be given. In this case, it would be valuable to assess family dynamics, parenting styles and routines to find why symptoms are triggered. The last exclusion is that there must be evidence that the symptoms interfere with the person’s functioning. Having poor attention or hyperactivity are usually associated with getting in trouble at home or having poor school performance, but if someone can have high symptoms while maintaining good grades and avoiding home problems, no diagnosis is given.
Understanding ADHD and differentiating it from other mental health disorders can be a tricky proposition. ADHD shares many features with oppositional defiant disorder, intermittent explosive disorder, learning disorders, autism spectrum disorder and mood disorders like depression and bipolar. Relax, though. The good news is that it is not your job to diagnose yourself or anyone else with a mental health condition. Your task is only to identify, track and gain awareness of symptoms so that you can report your findings to a professional.
Primary care physicians (PCP), psychiatrists, psychologists and counselors/ social workers with a master’s degree are typically able to diagnosis a condition. More importantly than the diagnosis, they can create a treatment plan that is effective for you and the person with ADHD. The professional will work to gain information from teachers to create a more complete understanding of the situation.
Just because something is well-known does not mean that it is well-understood. Gaining awareness about signs and symptoms of ADHD gives you a better ability to identify it accurately. Knowing the inattentive symptoms and the hyperactivity/ impulsivity symptoms means that you are able to convey this information to a professional. Together as a team, you can make symptoms a thing of the past.