ADHD - what it is, how it works, and how to get support
ADHD is one of those things that everyone seems to have now a days, mostly due to self-diagnosis via Tik-Tok videos. Here’s the thing though: everyone forgets things from time to time. Everyone gets brain fog or can’t focus on mundane tasks. Does that mean everyone truly has this ADHD thing? Let’s look into it.
Attention Deficit Hyperactivity Disorder, or ADHD, is classified as a neurodevelopmental disorder by the Diagnostic and Statistical Manual of Mental Disorders, Fifth edition (DSM-V). This means that it is not simply an acquired disorder, but rather that it is born from structural differences in the brain, namely the frontal lobe. The frontal lobe is often associated with personality and executive functions.
Check out the graphic below for some more information.
Do any of those executive functions - or rather, deficits in EF - remind you of anything?
If you said an ADHDer that you know, you’re spot on.
ADHD is classically divided into two main types: inattentive and hyperactive.
This is fairly misleading because when we think of hyperactivity, for example, we likely think of constant movement, like the Energizer bunny that never seems to shut off.
However, ADHD presents differently for everyone, and most people fall into the “combined” category which has some traits from both categories. Before we get too into that though, let’s take a step back and get some understanding of the disorder.
ADHD is believed to be heavily influenced by genetics, so a person is more likely to develop ADHD if one or both of their parents have it. Biologically, the brain matures in a normal pattern but there are delays in some regions like the frontal cortex. Read more about this here. This translates to about a 30% delay in maturation, so your average ADHDer may look one age but may act a bit younger, so to speak.
Now lets look into the two categories of ADHD: Inattentive and Hyperactive.
Click on the image to see a one-pager with some quick information on ADHD.
As you can see, inattentive is pretty straight-forward but hyperactivity doesn’t present how we initially assumed.
During childhood, ADHD can be seen as “bad behavior,” because of the child’s inherent inability to really stick to the demands of traditional school days. A child may begin “masking,” which is a term to describe the facade that ADHDers learn to “put on” in order to fit in better with their peers and get into less trouble. For instance, you may have a high-achieving pupil in the gifted program who always turns everything in on time and never disrupts class but is moody or irritable once they get home. This may indicate that this child is engaged in masking behavior at school, but masking is exhausting, so they let the mask slip once they’re in the comfort of their own home.
Further, ADHD often presents differently for biological males than it does biological females. In the example above, a female would likely present as the star student, while males often present with the class clown persona who can’t seem to sit still. This often leads to underdiagnosing for females with ADHD, who instead get diagnosed with comorbidities such as anxiety or depression. Generally, not understanding ADHD in childhood can cause frustration for the child, their families, teachers, and all others involved. It may also cause feelings of isolation for the ADHDer.
In adulthood, ADHD can impact relationships, careers, and self-esteem. Poor organization, forgetfulness, and a myriad of other symptoms can make getting through each day incredibly difficult. If left untreated, ADHDers may engage in thrill-seeking or risky behaviors, get into financial trouble due to impulse spending, show up late (or extremely early) to engagements (assuming they remembered said engagement), and a host of other concerns. I myself once purchased a truck on a whim because I was having a bad week and I “needed a win.” Yes, that actually happened, and yes, I took the truck back and ate the restock fee. Not my proudest moment (but at least I know why I did it now!)
Having ADHD isn’t all bad, though. ADHDers are generally highly empathetic and vastly creative humans. Many ADHDers grow up to be entrepreneurs (likely because they don’t respond terribly well to authority) and can develop amazing skillsets since they are always in search of new projects and tasks that maintain their interests (for now, let’s ignore the craft room graveyard once the hyperfocus wears off).
One big point that needs to be driven home: Having ADHD does not mean there’s an inability to do things, just that those things are more challenging to get done.
Treatment
Treatment for ADHD is often a combination of Cognitive Behavioral Therapy (CBT) techniques and medication. CBT centers around identifying cognitive distortions (or maladaptive thought patterns) and gently restructuring those patterns via creating new neural pathways. CBT is an evidence-based therapy and has shown to positively impact self-esteem and emotional regulation in ADHDers and non-ADHDers alike. For those with ADHD, it also helps to develop helpful habits, introduce new tools for organization and planning, and learn how to deal with negative emotions.
Medications for ADHD are available via stimulant and non-stimulant varieties. The most widely recognized stimulants are Adderall (generic name: amphetamine salts), Vyvanse (generic name: lisdexamfetamine), and Focalin (generic name: dexmethylphenidate). Stimulant medications work by increasing the availability of certain neurotransmitters like dopamine and norepinephrine. They are classified as Schedule II controlled substances, therefore requiring approval from a licensed prescriber (typically a psychiatrist) and must be filled every 30 days, but not sooner. Strattera (generic name: atomoxetine) and Qelbree (generic name: viloxazine) are two non-stimulant options for ADHD and are not classified as controlled substances, therefore they may be filled in larger amounts.
Often, people need to try several medications before they find the right one for them. Once they do, dosage may need tweaking, so be mindful that patience is necessary when introducing new medications. However, studies suggest that the most beneficial course for treatment of ADHD is a combination of therapy and medication.
Need to find a therapist or psychiatrist? Psychology Today is a helpful website where you can view various providers in your area and filter by treatment type, insurance acceptance, and other parameters. Likewise, you can search for clinicians via your insurance’s provider search tool.
Education and Resources
Dr. Russell Barkley is a mountain of information for all things ADHD. Below is one of his videos explaining ADHD and how it impacts executive function, but this is but one of a plethora of videos he has available for viewing on YouTube.
Below you will find several links to help you, the parent, to understand more about what ADHD is and how you can support your child. Click on the hyperlinks to download the documents.
80+ Accommodations for ADHD - this handout contains 17 pages’ worth of information for accommodations for the ADHDer in school, but portions of it can be easily applied to home life as well. This is a great resource to have in your back pocket!
Tips for Managing ADHD - This worksheet gives several useful tips like chunking tasks into smaller, more easily accomplished sections and identifying procrastination behaviors. This can be used by children through adults.
Focus Fish - this is an educational activity for children ages 5-10 with ADHD. It is available via TherapistAid.com, so you will need to make an account to access it. Don’t worry, it’s free!
ADHD Parenting Tips - This is a quick guide with several suggestions for how to structure your home life to accommodate a child with ADHD.
Using Praise - This handout is a parenting skill-builder for incorporating praise when teaching positive behaviors. Praise is a powerful tool - learn how to use it for ADHDers and non-ADHDers alike!
Free Prizes for Kids - ADHDers are not usually intrinsically motivated, so they rely on external factors for motivation to get things done. This list is intended for classrooms but has lots of great free or inexpensive ideas that can be adapted to home life to encourage motivation.
I hope you find these helpful! If you’d like to know more or want to offer suggestions for additional resources, please feel free to reach out!