ADHD - Attention-Deficit/Hyperactivity Disorder

Jan 2024

ADHD stands for Attention-Deficit/Hyperactivity Disorder. It is a neurodevelopmental disorder that affects both children and adults. ADHD is characterised by persistent patterns of inattention and/or hyperactivity or impulsivity that can interfere with a child’s development and daily functioning of adults. Whilst everyone can get distracted, be spontaneous or full of energy at times, someone with ADHD experiences these to a much greater degree than the average person. Someone with ADHD finds that these difficulties really impact their learning, friendships, or home/work life.

ADHD emerges in childhood and can persist into adulthood. Its impact on individuals can vary widely. ADHD is the most common mental disorder in Australian children with around 5-8% affected [1], with research suggesting 2-3%[2][3] of adults also have ADHD. ADHD is significantly more prevalent in males than females.

While ADHD will affect each individual differently, the condition is characterised by a consistent set of behavioural symptoms associated with inattention and/or hyperactivity and impulsivity. Some individuals may experience predominantly symptoms of inattentiveness, while other may experience mostly hyperactivity (often described as restlessness) and/or impulsivity. ADHD can also range from mild to severe.

Symptoms of inattentiveness include:

• Not attending to details or making careless mistakes
• Losing focus on or avoiding tasks that require sustained attention or are non-preferred tasks.
• Not listening when spoken to directly
• Missing instructions and not completing tasks
• Being disorganised
• Frequently losing things
• forgetful; and easily distracted.

Symptoms of hyperactivity or impulsivity include:

• Difficulty sitting still, restlessness, and/or wearing others out with one’s activity.
• Fidgeting, tapping hands or feet, or squirming in seat
• Being noisy and unable to engage quietly in leisure activities.
• Excessive talking
• Interrupting or intruding on others
• Answering questions before they are asked completely.
• Having difficulty waiting in line or taking turns

Diagnosis of ADHD can sometimes be a tricky task. ADHD arises from genetic and environmental factors, with brain functioning and chemistry playing a major role in symptoms. However, symptoms of inattention and hyperactivity can result from a broad range of other health conditions and lifestyle factors. For example, routinely poor sleep, stress or simply difficulty understanding a learning task can result in lack of focus and restlessness. Therefore, dedicated standardised assessment by a specialist clinician is critical to accurate diagnosis and determining the right treatment pathway. Many psychiatrists, psychologists and paediatricians specialise in diagnosing and treating ADHD.

In considering a diagnosis of ADHD, it is vital to examine symptoms and patterns of behaviour over a person’s life course including the impact the symptoms are having of their life and functioning. All children and adults forget things or act impulsively from time to time. For example, the average 3-year-old is very active and impulsive with a limited attention span, and a teenager who has stayed up late at night gaming will struggle to pay attention the next day in school. Similarly, a parent juggling stressful school and family commitments with a busy work schedule may feel disorganised and unfocussed. To confirm a diagnosis of ADHD, a specialist clinician will need to determine that the symptoms are more than what might be typically expected and that they have been persistent and pervasive for an extended period of time, that the symptoms cause significant distress and dysfunction in a person’s life, and that the symptoms can't be readily or better explained by another mental condition, health issue, environmental or lifestyle factors.  

ADHD can also impact on mental wellbeing especially when there is delay in recognising and treating symptoms. In fact, it is common that a deterioration in mental health is the trigger that prompts a person to seek a comprehensive assessment for ADHD. Children and young people with untreated ADHD may become very down and self-critical because they experience consistent frustrations and failures in social scenarios or keeping up with schoolwork. Some children may have had their symptoms of ADHD well managed through the early years and only notice difficulties as they progress through adolescence.  Adults with untreated ADHD may also experience depression and low self-confidence through a pattern of troubled friendships or strained work relationships due to impulsive behaviour or being unable to follow through with a plan of work.

ADHD is a lifelong condition. However, symptoms can be effectively treated or managed with several treatment approaches. Medication can produce a profound improvement in symptoms for many people with ADHD. Cognitive therapy can improve mental wellbeing and reduce symptoms of depression, anxiety and stress associated with ADHD. Behaviour therapy is also often very effective as a tool for learning new ways of managing symptoms (such impulsive behaviours) and for adapting daily routines and academic or work environments to achieve success. It is an excellent idea for parents and partners of people with ADHD to also participate in psychotherapy to adapt their own responses and beliefs to produce better health outcomes for themselves and their loved one.

Remember that whilst having ADHD can be challenging, it also comes with its strengths. Many people with ADHD are described as vibrant, energetic, adventurous, creative and thrive in fast-pace or busy environments. It's crucial to recognize and nurture these strengths while also addressing the challenges associated with ADHD. Building on these positive aspects can contribute to the overall well-being and success of individuals with ADHD in various aspects of their lives.