Attention-Deficit/Hyperactivity Disorder (ADHD)

ADHD can affect children, adolescents, and adults. Children in general are often full of energy and have trouble sitting still, thinking before acting, and waiting for their turn. That’s why it can help to understand that ADHD involves behavior patterns and symptoms at a greater intensity than one would expect for an individual’s age or developmental level. ADHD symptoms—especially when undiagnosed and/or unaddressed—have the potential to cause substantial problems for a person with school, work, and/or interpersonal relationships. 

Children with ADHD may present hyperactivity symptoms by age 7. In many cases, parents or caregivers may notice signs much earlier, though many experts say that other ADHD symptoms may be difficult to detect until the child is old enough to attend elementary school. 

Signs and symptoms of ADHD can include some or most of the following, depending on the individual and the subtype they experience:

• Trouble focusing, concentrating, and staying on task, particularly in a structured school or work environment
• Frequent daydreaming
• Squirming, fidgeting, and otherwise being unable to sit still
• A tendency to talk excessively
• Difficulty controlling impulsive behaviors and resisting temptations
• A tendency to take unnecessary risks
• A tendency to lose or forget items and possessions
• Impatience, as evidenced by difficulty waiting for one’s turn
• Trouble following through with commitments
• A tendency to be easily distracted
• Trouble staying organized
• Trouble getting along with others
• Carelessness, which can lead to unintended mistakes or accidents

Many people diagnosed with attention-deficit/hyperactivity disorder (ADHD) also experience other health care conditions. Comorbid physical, cognitive, and behavioral conditions can exacerbate ADHD symptoms and increase disruption to daily life.

Conditions commonly comorbid with ADHD include:

• Learning disabilities
• Oppositional defiant disorder
• Bed-wetting
• Sleep disorders
• Conduct disorder²
• Anxiety disorders
• Tourette’s syndrome
• Depressive disorders
• Bipolar disorder
• Obsessive-compulsive disorder (OCD)³

If you notice ADHD symptoms in yourself or a loved one, it’s typically recommended that you contact a healthcare provider to discuss evaluation and treatment options. The most effective treatment plans generally involve therapy, sometimes in combination with medication, and usually along with lifestyle and behavioral changes. Note that not all mental health professionals can prescribe medication, and some states require in-person treatment with a psychiatrist in order to receive ADHD prescriptions.

Researchers have not identified a singular cause for attention-deficit/hyperactivity disorder, despite it being a thoroughly researched disorder. ADHD is believed to be caused by a complex interaction of multiple environmental, physiological, genetic, and lifestyle factors.

Common risk factors for ADHD

• ADHD is believed to have a genetic component, as having a close blood relative (a parent or sibling) with ADHD may increase the chances that an individual will develop the disorder
• Exposure to toxins (like lead or chemicals) or other environmental influences in utero or in early childhood may be a risk factor that can increase the likelihood of developing ADHD. 
• Diet and nutritional factors during early life may affect how likely someone is to develop ADHD in their lifetime. 
• A traumatic brain injury can change physiological brain structures, potentially causing disorders like ADHD.
• Lifestyle influences, such as time spent on electronics, may be related to the potential development of hyperactive behaviors, though more research is needed in this area.

Complications associated with ADHD

Potential complications that may affect an individual with ADHD can include but are not limited to:

• Challenges in a classroom setting, especially when these are incorrectly attributed to defiance or inability
• Frequent disciplinary problems as children, potentially making them perceive that they are always in trouble and possibly believe they are "bad" kids, which may lead to low self-esteem
• More accidents and injuries than those without ADHD due to a tendency to act impulsively 
• Challenges with interpersonal connections and acceptance from others
• A higher risk of substance use disorders and delinquent behavior, which may be due to impulsive tendencies and difficulty resisting temptations
• Comorbid mental health conditions such as anxiety, depression, or bipolar disorder can create a mix of complications surrounding the interaction of multiple symptoms that can be difficult or contradicting to manage

There is currently no cure for ADHD. Still, treatment can be an effective way to manage symptoms, learn practical coping skills, and minimize the impact of ADHD on daily life and functional ability. Many people respond well to ADHD treatment and show a substantial decrease in symptom frequency and severity. 

Medication

Some children and adults can benefit from ADHD medication. However, children go through many physical, emotional, and cognitive phases as they grow, which can alter their body and brain chemistry. As a result, parents and guardians may need to be prepared for their child to try different medications and doses to find a balance between side effects and benefits—and to repeat the process as time goes on. Caregivers are advised to monitor for medication side effects. Types of common ADHD medications include:

• Stimulants: The most widely used ADHD medications are stimulants. Research suggests that both children and adults treated with stimulant medications show reduced ADHD symptoms.
• Nonstimulants: According to the CDC, nonstimulant medications may not work as quickly as stimulants and often don’t have as much of an impact on behavior, but their effects may last up to 24 hours.
• Antidepressants: While antidepressants haven’t been approved by the Food and Drug Administration (FDA) for use as an ADHD treatment, healthcare professionals often prescribe antidepressants on their own or in combination with another ADHD medication as part of a comprehensive treatment plan.

Some parents and guardians hesitate to initiate medication as a treatment for ADHD symptoms in their children, despite a growing body of evidence suggesting that it may be helpful in many cases. The data indicates many potential reasons for the treatment gap, including concerns about the risks of treatment, pressure from family members, guilt, misunderstandings about how ADHD affects thinking and behavior, and misconceptions about how the medication works.

Do not start, stop, or change a medication without consulting with a physician or other qualified healthcare professional.

Other treatment options

While psychotherapy and medication are generally considered the first-line treatments for ADHD, they aren’t typically one-size-fits-all solutions. Here are some supplementary ADHD treatment options:

• Self-management and stress management techniques may help people with ADHD cope with their symptoms in a healthy way.
• Educational programs can teach parents and children skills to help them navigate daily life without significant disruption or interference from ADHD symptoms. 
• Assistance through school or work can help teach individuals social skills and appropriate behaviors if this is an area where they tend to have trouble.
• Research suggests that restriction and elimination diets may help reduce and manage the symptoms of ADHD and improve health in some cases.

Self-care

Self-care—everything a person does to safeguard their mental, physical, and emotional health and well-being—can make it easier to live with ADHD. By getting enough sleep, eating a balanced diet, and exercising regularly, those with ADHD may be able to improve emotional resilience and coping skills. Also, research suggests that engaging in brain games, practicing mindfulness techniques, and engaging in a journaling practice may also be helpful for some.

According to an ADHD coach with Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), self-care should center on a balance of five areas: physical needs; security and safety; self-esteem, self-respect, and self-efficacy; love and belonging; and fulfillment of potential and talent.

Numerous resources exist to help parents and guardians of children with ADHD as well as adults with ADHD find reliable, practical ways to manage the disorder. Research suggests that online therapy can be helpful for many people who experience symptoms of ADHD.

Here are some additional resources that may help those living with ADHD and their loved ones:

• People with ADHD can find multiple resources at Benefits.gov to help manage the condition and reduce its impact. 
• The American Academy of Child & Adolescent Psychiatry offers an online ADHD Resource Center. 
• CHADD provides a web page focused on ADHD resources for adults and children with ADHD as well as families and caregivers. 
• The CDC offers resources geared toward helping children succeed in school, with information for behavioral classroom management, organizational training, and other services. 

Living with ADHD or having a child with this condition can sometimes disrupt the balance in a person’s life or family dynamics. Learning to live with and adapt to ADHD symptoms can be easier with education and additional resources, many of which are free.

Data from a study published in 2021 in the Journal of Global Health indicates that the prevalence of both persistent adult ADHD (with childhood onset) and symptomatic adult ADHD (regardless of age of onset) seems to decrease with age. The study reports that approximately 2.58% of adults worldwide experience persistent ADHD and 6.76% of adults experience symptomatic adult ADHD.

Researchers in a 2016 study assessed multiple clinical trials to measure the potential benefits of herbal medicines and nutritional supplements as alternative or complementary ADHD treatments. The study reports that these methods show promise as additional modalities for treating the disorder, though more research is needed.

The results of a 2022 study report that researchers successfully identified genomic differences—shifts in gene activity—in people with attention-deficit/hyperactivity disorder. The study is the first of its kind to use postmortem brain tissues to study the genes of people with ADHD. The study indicates that people with ADHD may have differences in the genes related to the neurochemicals that brain cells use to communicate with one another.

1 in 10 children are diagnosed with ADHD

According to the CDC, approximately 9.8% of American children between ages 3 and 17 are diagnosed with ADHD, with boys more likely to be diagnosed than girls.¹

¹CDC

Below are some key statistics on attention-deficit/hyperactivity disorder: 

• According to the National Alliance on Mental Illness (NAMI), approximately two-thirds of children diagnosed with ADHD also have another condition. Comorbid cognitive or behavioral conditions often similarly impact adults with ADHD.   
• Although many believe high sugar intake is linked to hyperactive behavior, studies suggest otherwise. Data suggests that higher consumption of sugar may be a symptom rather than a cause of ADHD in children.
• According to the CDC, three out of four children in the U.S. with ADHD receive treatment—medication, behavioral therapy, or a combination of both.