What is ADHD? Attention Deficit Hyperactivity Disorder By Marcy Greenfield, English 106

Attention-deficit hyperactivity disorder (ADHD)  DEFINITION: Is the current term for a specific developmental disorder seen in both children and adults that is comprised of deficits in behavioral inhibition, sustained attention and resistance to distraction, and the regulation of one’s activity level to the demands of a situation (hyperactivity or restlessness). This disorder has had numerous different labels over the past century, including hyperactive child syndrome, hyperkinetic reaction of childhood, minimal brain dysfunction, and attention deficit disorder (with or without hyperactivity)

Some ADHD facts:  It’s one of the most common disorders, it has been shown that one in nine children as well as adolescents in the US alone have received an ADHD diagnosis. (including one boy in six)  Hyperactive and impulse disorders date back to the 1950’s  In million children were diagnosed with ADHD that is a 42% increase in diagnoses from to  In million children were taking ADHD medicine that is a 28% increase from to

Causes??  Researchers claim that heredity is the most common cause of ADHD  Other research suggest the frontal lobe basal ganglia and other areas of the brain play a significant role in ADHD  Some believe that the following factors could contribute as well: difficulties during pregnancy, prenatal exposure to alcohol and tobacco, premature delivery, significantly low birth weight or a postnatal injury to the prefrontal regions of the brain.  Scientists are still studying the cause(s) and risk factor in an effort to find better ways to manage and recue the changes of a person having ADHD…..So the cause and risk factors are still unknown.

How do you get an ADHD diagnosis?  There is no single test that can be used to diagnosis ADHD  It is diagnosed after the person has shown as little as six symptoms for the past six months.  Symptoms must be present in more than one setting. ( example must show the same symptoms at home as they do at school)  It involves gathering information from several sources including schools, caregivers and parents.  Healthcare providers such as the child’s pediatrician, psychiatrist and child psychologist can diagnose ADHD with the help of the standard guidelines set by the American Academy of Pediatrics

Three Groups of ADHD A diagnosis of one type or another depends on the specific symptoms: its been said that you only need to have six of the listed symptoms to be diagnosed.  Predominantly inattentive  Predominantly hyperactive/impulsive  Combined

ADHD-Predominantly inattentive type: (Children and Adults With, n.d., ).  Fails to give close attention to details or makes careless mistakes  Has difficulty sustaining attention  Does not appear to listen  Struggles to follow through on instructions  Has difficulty with organization  Avoids or dislikes tasks requiring sustained mental effort  Is easily distracted  Is forgetful in daily activities

ADHD-Predominately hyperactive/impulsive type: (Children and Adults With, n.d., ).  Fidgets with hands or feet or squirms in chair  Has difficulty remaining seated  Runs around or climbs excessively  Has difficulty engaging in activities quietly  Acts as if driven by a motor  Talks excessively  Blurts out answers before questions have been completed  Has difficulty waiting or taking turns  Interrupts or intrudes upon others

ADHD-Combined (Children and Adults With, n.d., ).  ADHD—Combined Type:  Meets both inattentive and hyperactive/impulsive criteria

Impairments associated with ADHD  Underachievement, school failure, employment: ADHD children are less likely to complete a secondary school and adults with ADHD show problems in the work place.  Social relationships: High levels of peer rejection which results in lost opportunities for gaining social skills, and close relationships for adults are often problematic.  Family interaction: parents typically head towards anger & sarcasm, divorce rates are higher for these families, mistreatment of the child is higher.  Accidents & physical health: Risk for accidental injuries are high ex: falls, burns, driving accidents later on and overall “risky behavior”.  Comorbidities, including substance abuse: children with ADHD often develop other conditions like substance abuse, suicidal ideas, depression anxieties etc.

Negative peer reputations can occur in as little as a few hours.

Who turned out the lights?

Structure of the ADHD brain  The frontal cortex of the brain which is responsible for the following: attention, reason, memory, planning and inhibition appears thinner and matures slower in children with ADHD.  The National Institute of Mental Health has found that in some cases this part of the brain lagged three years behind in age-appropriate development  Studies also show that the Motor cortex of the brain (the area that controls movement) grew much faster than normal in a child with ADHD. This could explain why hyperactive children have the need to be on the move all the time.  Lastly researchers have also found that children with ADHD have a lower brain volume and less grey matter than children without the disorder. This could explain why they struggle to pay attention and their impulsivity.

Function of the ADHD brain  It’s not just the structure of the brain that differs, but the way the ADHD brain functions as well.  Different areas of the brain communicate by sending signals via neurotransmitters. Dopamine and norepinephrine are neurotransmitters that help send messages between areas of brain associated with attention and motivation. The brain of a person with ADHD may have less of these chemicals available. This may explain why someone with ADHD has trouble paying attention or performing repetitive tasks.  When people with ADHD are prescribed methylphenidate (a stimulant), it helps increase the amount of dopamine and norepinephrine in the brain. This increase in the level of neurotransmitters seems to improve attentiveness and motivation.

Often misdiagnosed and over diagnosed

Adderall vs. Ritalin  Both medications are central nervous system (CNS) stimulants  Both speed up the transmission of electrical chemical signals throughout the CNS, and this is done by increasing the brain activity of Norepinephrine and Dopamine. These “feel good” chemicals are part of your body’s reward system and are the neurotransmitters link to ADHD  Side Affects are similar for both with the most common being: insomnia, loss of appetite, dry mouth, anxiety, increased heart rate, dizziness and headaches  Both are available in short acting and long acting  Both are a Schedule II drug which means the drug can be addictive and have high potential of abuse

Adderall side affects on the brain As you can see the brain activity is almost 50% more on the Adderall than it is off the substance.

Abuse is on the rise  With the explosion of the ADHD term that was coined in the 1990’s and the skyrocketing rates of ADHD drug sales comes the potential for abuse.  College students are taking them to stay focused on their studies and now the abuse is even being seen in adults to help them with the demands of their careers.  They often can get a prescription from their doctor by “faking” their symptoms, taking their children’s medications or buying the medicine on the street for $4 to $10 a pill.  Adderall with it’s mixture of amphetamine salts has the ability to make you as euphoric as a line of cocaine and keep you that way particularly if it’s a slow release version  Again this is a Class II drug that is along side cocaine and morphine and its being kept in the family medicine cabinet next to the aspirin???

Does Ritalin make ADHD worse?

Works cited  Adderall side effects on the brain [Photograph]. (n.d.). Retrieved from  ADHD and the brain: Structure and Function. (2012, December 17). Retrieved April 22, 2015, from the-brains-structure-and-function  Difficult Peer Relationships [Photograph]. (2015, March 18). Retrieved from  Morris, S. (2014, October 14). Adderal vs Ritalin What's the difference? Retrieved from adderall-vs-ritalin#Overview1  My ADHD. (n.d.). Retrieved from  No ADHD/ADHD [Photograph]. (2010, July). Retrieved from attention-deficit-hyperactivity-disorder/ adhd-differential-diagnoses-comorbidity-and-prognosis/  Thompson, D. (2012, June 12). Now School Children are snorting their ADHD medication. Retrieved from The Telegraph database.