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Attention Deficit Hyperactivity Disorder (ADHD)
Attention Deficit Hyperactivity Disorder (ADHD) is a neuropsychiatric developmental disorder. Although it is frequently diagnosed during childhood, it often persists into adulthood. This disorder mainly affects the executive functions, which allow us to plan, organise and complete tasks. ADHD has three basic characteristics that globally affect the social, emotional, and cognitive development of an affected individual:
- Inattention: Inability to concentrate for long periods of time, the affected individual is continually distracted and has difficulty completing tasks that require sustained attention.
- Hyperactivity: Physically active to the extent that it is difficult to stay in the same position for long periods of time. Individuals with ADHD are always in motion, even if it is only one part of their body, such as shifting in their seat or shaking their leg.
- Impulsive behaviour: Characterised by emotional instability and difficulties in controlling behaviour.
Classification and Symptoms
ADHD is classified into three types based on the symptoms:
Predominantly hyperactive/impulsive type
- Often agitated
- Impatient
- Talks a lot and out of place
- Constantly moving
- Difficulty staying in one place
- Interrupts regularly
- Fidgets continually
- Lack of self-control
- No consideration of consequences before actions
Predominantly inattentive type
- Easily distracted
- Becomes bored and abandons tasks frequently
- Inattention to details
- Forgets and lose things
- Changes activity constantly
- Difficulty organizing tasks
- Daydreams often
- Difficulty following instructions
- Difficulty understanding information
- Seems inattentive when spoken to
Combined type
- Symptoms of both inattention and hyperactivity
It is said to be more common for boys to show symptoms of hyperactivity symptoms, while girls show more symptoms of inattention.
Comorbidity
ADHD often exhibits comorbidity with other disorders, hence the importance of a comprehensive assessment:
Learning Disabilities:
- About 20 to 30% of children with ADHD also have a learning disability and/or learning difficulties. ADHD itself is not considered a learning disability, however it often causes academic difficulties.
Behavioral Disorders:
- Oppositional defiant disorder (ODD) and conduct disorder (CD) are both common in people with ADHD. These disorders are characterized by antisocial behaviors such as aggression, tantrums, lying, and theft.
Bipolar Disorder:
- Adults with symptoms of ADHD sometimes have undiagnosed bipolar disorder. The symptoms of both disorders can be similar.
Anxiety Disorders, Obsessive-Compulsive Disorder, and Depression:
- These disorders can often occur simultaneously with ADHD and can be missed or undertreated.
Substance Use Disorder:
- Adolescents with ADHD and adults with undiagnosed ADHD are at increased risk of substance misuse.
Assessment of ADHD
To evaluate whether an individual suffers from ADHD, it is necessary to use psychological tests designed to measure the symptoms related to ADHD. The tests focus on measuring the individual’s attentional processes. They also evaluate the individual’s performance in the areas of memory, intelligence, processing speed, self-control or self-regulation, reasoning, and problem solving, among others.In addition to specialised tests used to assess ADHD, it is also necessary for the psychiatrist or psychologist to perform observation evaluations, interviews with parents and teachers, and symptom checks.
Treatment of ADHD
ADHD treatment can be divided into two broad areas: biological treatment and psychological treatment. Biological treatment refers mainly to psychiatric medication. Psychiatrists can prescribe and monitor medicines used for ADHD, both stimulants and non-stimulants. However, rules about medication vary by country. In the UK, medication is recommended as a first-line treatment for adults, but is only recommended for severe ADHD in children. However, in the US, medication is recommended for all ages. Psychiatrists prescribe ADHD medications as necessary for patients. They also fine-tune the medication type, dose, and preparation for each individual. This approach can reduce or eliminate side effects. While medications do not cure ADHD, they can significantly improve the symptoms for about 80% of people with ADHD, helping them function in their daily lives.
Psychologists, counselors, social workers and therapists can help children and parents understand ADHD and develop strategies to reduce symptoms and improve their daily lives. Behavioral and cognitive therapies exhibit effective results in the treatment of inattention for ADHD. These are usually the first line therapies recommended for those with mild symptoms or for younger children. Other psychological therapies include cognitive behavioral therapy (CBT), family therapy, school interventions, social skills training, parent management training, and interpersonal psychotherapy. Psychologists should work closely with teachers and school counselors to plan support and interventions at school to minimize the effects of ADHD on a child’s performance.
ADHD | What To Do
If you think you or your child are suffering from symptoms of ADHD, seek further assessment from a doctor to discuss what sort of treatment might be helpful. Come see us at our Tokyo Psychiatry Clinic at American Clinic Tokyo in Akasaka for assessment. Dr Andrew Kissane, our UK-trained, British psychiatrist is a native English speaker. He is on the General Medical Council’s specialist medical register in the UK, is a member of the Royal College of Psychiatrists, and holds a Japanese medical license.If you wish to have a complete evaluation and assessment for ADHD, please email us requesting our psychological testing service at our Shintomi office.
