Symptoms

ADHD symptoms will usually start to show from early childhood. Especially when an individual begins their formal education. However, many individuals are not diagnosed till adulthood. Many adults live successful lives without receiving a formal diagnosis of ADHD. Yet ADHD can significantly impact an individual's daily functioning, academic achievement, and social interactions. ADHD is characterized by a pattern of symptoms that can be grouped into two main categories: inattention and hyperactivity/impulsivity. These symptoms can vary in severity and may present differently in children, adolescents, and adults. Here are the typical symptoms associated with ADHD:

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Inattention:

• Difficulty sustaining attention in tasks or play activities.

• Often making careless mistakes in schoolwork, work, or other activities

• Difficulty organizing tasks and activities.

• Frequently losing items necessary for tasks and activities

• Being easily distracted by unrelated stimuli

• Forgetfulness in daily activities

• Difficulty with time-management

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Hyperactivity:

• Fidgeting or tapping hands or feet

• Frequently leaving one's seat in situations where it's expected to remain seated (e.g., classroom, workplace)

• Running or climbing excessively in inappropriate situations

• Difficulty engaging in activities quietly.

• Often talking excessively

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Impulsivity:

• Impatience with waiting turns or waiting for one's turn in conversations or activities.

• Blurting out answers before questions have been completed.

• Difficulty waiting for one's turn.

• Interrupting or intruding on others' conversations or activities

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Gender differences in symptoms

While ADHD symptoms can manifest similarly in both males and females, there are some differences in how they may present, especially in females. Here are some additional symptoms that may be more commonly observed in females with ADHD:

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• Daydreaming: Females with ADHD may exhibit excessive daydreaming or "zoning out" as a manifestation of inattention.

• Social Withdrawal: Rather than being hyperactive, some females with ADHD may be more withdrawn or shy, especially in social situations where they feel overwhelmed.

• Internalized Symptoms: Females with ADHD may internalize their symptoms more than males, leading to feelings of anxiety, depression, or low self-esteem.

• Emotional Sensitivity: Emotional dysregulation is common in individuals with ADHD, and females may be more prone to experiencing intense emotions or mood swings.

• Disorganization in Daily Life: While disorganization is a common symptom in both genders, females with ADHD may struggle with organizing their personal spaces, such as their bedrooms or workspaces.

• Perfectionism: Some females with ADHD may develop perfectionistic tendencies as a coping mechanism for their difficulties with attention and organization.

• Difficulty in Relationships: ADHD symptoms can affect relationships, and females may experience challenges in maintaining friendships or romantic relationships due to communication difficulties or forgetfulness.

• Difficulty Recognizing ADHD: Due to the differences in how ADHD symptoms present in females and societal stereotypes about ADHD being more common in boys, females may be underdiagnosed or misdiagnosed with other conditions such as anxiety or depression.

Causes Of ADHD

• Genetic factors – having a parent or sibling with ADHD can increase a person's risk of developing the disorder.

• Brain chemistry and structure – individuals diagnosed with ADHD have a different brain structure than individuals without the diagnosis. Specifically in the parts of the brain responsible for attention, impulse control, and executive function. Structural and functional differences in certain brain regions, such as the prefrontal cortex and basal ganglia, have also been observed in individuals with ADHD.

• Neurotransmitter imbalance – ADHD may cause disruptions in levels of certain neurotransmitters such as dopamine and norepinephrine which are responsible for regulating attention, behaviour, and mood.

• Prenatal and early childhood factors – factors such as prenatal exposure to toxins (e.g. alcohol, tobacco, illicit drugs), maternal stress during pregnancy, low birth weight, and premature birth may increase the risk of developing ADHD.

• Environmental factors – factors such as exposure to environmental toxins (e.g. lead, pesticide), high levels of stress, poor nutrition and early childhood adversity may contribute to the development or exacerbation of ADHD symptoms in susceptible individuals.

• Developmental factors – premature birth, low birth weight and early exposure to stress or trauma may contribute to the development of ADHD.

• Brain injuries – traumatic brain injuries or other neurological conditions affecting brain development or function can increase the risk of developing ADHD especially if areas of the brain associated with attention and impulse control are affected.

Treatment

• Medication – stimulant medications are often prescribed to help improve attention, focus and impulse control in individuals with ADHD. Non-stimulant medication and certain antidepressants may also be used, especially for those who don’t respond well to stimulants or have contraindications.

• Behavioural therapy – therapies such as Cognitive Behavioural Therapy can help individuals with ADHD learn coping strategies, organizational skills, and problem-solving techniques to manage their symptoms.

• Education and support – psychoeducation for the individual and their family members can provide a better understanding of the condition and how to effectively manage it. Support groups and peer networks can also offer valuable support and guidance.

• Environmental modifications – making environmental adjustments, such as creating structured routines, minimizing distractions, and breaking tasks into manageable steps, can help individuals with ADHD stay focused and organised.

• Lifestyle changes – regular exercise, a healthy diet, sufficient sleep and stress management techniques can all contribute to improved symptom management and overall well-being for individuals with ADHD.

• Parental education and training – teaching parents effective strategies for managing their child’s behaviour, setting up routines, providing positive reinforcement and fostering communication can benefit both the individual and the family.

References

1. Attention-Deficit/Hyperactivity Disorder. (2023, September). National Institute of Mental Health (NIMH). Retrieved March 1, 2024, from https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd

2. Magnus, W., Nazir, S., Anilkumar, A. C., & Shaban, K. (2023, August 8). Attention deficit hyperactivity disorder. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK441838/