Attention Deficit Hyperactivity Disorder

I specialize in the diagnosis of ADHD in adults and children. I also treat adults with ADHD, helping them to better manage their lives and relationships.

Attention Deficit/Hyperactivity Disorder is a neurological disorder that a person is born with and in roughly 2 of out 3 cases will demonstrate symptoms well into adulthood. While attention deficits and hyperactivity are symptoms of ADHD, the disorder is best understood as a dysfunction of the Executive Functioning system in the brain. Examples of executive functioning include planning, organization, time management, emotional regulation, initiation and cessation of tasks, and the ability to use short term memory to mentally manipulate information and create novel or advantages solutions and adaptations to life’s challenges (otherwise known as using ones imagination).

ADHD affects approximately 4-7% of American children (similar rates are found in other industrial nations worldwide) and nearly 5% of the adult U.S. population. While some children seem to “out grow” their symptoms as they age, the majority of children continue to have deficits in functioning well into adulthood. While all people are occasionally spacey or forgetful, the ADHD person experiences significant impairment in two or more settings, particularly at school, home or work. Indeed significant impairment in these settings is what differentiates normal executive functioning hiccups with a true case of ADHD.

Signs and Symptoms of ADHD in Adults

There are three different types of ADHD, including:

• Combined ADHD (the most common type), which involves all of the symptoms
• Inattentive ADHD (previously known as ADD), which is marked by impaired attention and concentration
• Hyperactive-impulsive ADHD, which is marked by hyperactivity without inattentiveness

For a diagnosis of ADHD, some symptoms that cause impairment must be present before age seven. Also, some impairment from the symptoms must be present in more than one setting. For instance, the person may be impaired at home and school or home and work. Also, there must be clear evidence the symptoms interfere with the person's ability to function at home, in social environments, or in work environments.

Symptoms of ADHD There are three different categories of ADHD symptoms: inattention, hyperactivity, impulsivity.

Inattention may not become apparent until a child enters the challenging environment of school. In adults, symptoms of inattention may manifest in work or in social situations.

A person with ADHD may have some or all of the following symptoms:

• difficulty paying attention to details and tendency to make careless mistakes in school or other activities; producing work that is often messy and careless
• easily distracted by irrelevant stimuli and frequently interrupting ongoing tasks to attend to trivial noises or events that are usually ignored by others
• inability to sustain attention on tasks or activities
• difficulty finishing schoolwork or paperwork or performing tasks that require concentration
• frequent shifts from one uncompleted activity to another
• procrastination
• disorganized work habits
• forgetfulness in daily activities (for example, missing appointments, forgetting to bring lunch)
• failure to complete tasks such as homework or chores
• frequent shifts in conversation, not listening to others, not keeping one's mind on conversations, and not following details or rules of activities in social situations

Hyperactivity symptoms may be apparent in very young preschoolers and are nearly always present before the age of seven. Symptoms include:

• fidgeting, squirming when seated
• getting up frequently to walk or run around
• running or climbing excessively when it's inappropriate (in teens this may appear as restlessness)
• having difficulty playing quietly or engaging in quiet leisure activities
• being always on the go
• often talking excessively

Hyperactivity may vary with age and developmental stage.

ADHD? ADD? What's the difference?

There actually is a significant difference between ADHD and ADD. Whereas ADHD is more about inhibition and emotional control problems, restlessness, excess energy and a racing mind, ADD is different. ADD is best understood as difficulty with sustained attention, spaciness, head in a fog, daydreaming and a sometimes slow cognitive tempo. In fact leading ADHD expert Russell Barkley suggests that one day ADD and ADHD will be seen as two very different disorders. It is important to get an accurate diagnosis as they are very different disorders.