By: Isabella Peppersack
ADHD stands for attention deficit and hyperactivity disorder, it is one of the most common neurodevelopmental disorders. “It is a complex brain disorder that impacts approximately 11% of children and almost 5% of adults in the U.S'' (ADDitude Editors, 2017), it is first diagnosed in childhood and lasts all the way into adulthood. People who have ADHD may have trouble paying attention, controlling impulsive behaviors (may act without thinking), and may be overly active (Centers for Disease Control and Prevention, 2018). There are three types of ADHD, primarily hyperactive-impulsive ADHD, primarily inattentive ADHD (formerly ADD), and combined type ADHD. Primarily hyperactive-impulsive ADHD is as if someone is driven by a motor with little to no impulse control, they are almost always moving, squirming, talking at may be inappropriate times, they are impulsive, impatient, and they may interrupt others. The primarily inattentive ADHD type is when they have difficulty focusing, finishing tasks, following instruction, easily distracted and forgetful, they may be daydreamers who lose track of homework, cell phones, and may forget conversations with regularity. The combined type is when you have a mixture of all of those symptoms.
ADHD is a developmental impairment of the brain's executive functions and self-management system. It is not a brain disorder, a mental illness, or a specific learning disability, it is a confusing, contradictory, inconsistent, and frustrating condition. ADHD is the first disorder found to be the result of a deficiency of a specific neurotransmitter. The deficiencies in specific neurotransmitters underline many common disorders including anxiety, mood disorders, anger-control problems, and ocd. Low levels of a neurotransmitter called norepinephrine which is linked with dopamine make it harder to focus, causing symptoms of ADHD. Norepinephrine is a neurotransmitter in the central nervous system that increases alertness and reaction time, studies have also shown to play a role in someone's mood and concentration. Dopamine is a neurotransmitter that the body makes and the nervous system uses to send messages between nerve cells. It plays a role in how we feel pleasure, it helps us strive, focus, and find things interesting. The ADHD brain had impaired neurotransmitter activity in four functional regions of the brain: frontal cortex, limbic system, basal ganglia, and the reticular activating system. The frontal cortex controls high level functions such as attention, executive function, and organization. The limbic system is located deeper in the brain and regulates emotions and attention, the basal ganglia can cause inter-brain communication and information to “short-circuit” and results in inattention or impulsivity. Reticular activating system is the major relay system among the many pathways that enter and leave the brain, it can cause inattention, impulsivity, or hyperactivity. A deficiency in one region may cause a problem in one or more of the other regions, ADHD may be the result of this. Children and/or adults with ADHD have a higher raclopride binding, which is a synthetic compound that acts as a selective antagonist on D2 dopamine receptors, so we “see” that their dopamine levels are low. ADHD is not a difference in behavioral preference, but instead appears to be partially attributed to differences in how the brain is structured.
There are many symptoms of ADHD and the different types of ADHD. For the inattentive type of ADHD the symptoms can be simplified down to having a hard time organizing and/or finishing a task, paying close attention to details, following instructions or conversations, being easily distracted and forgetful of daily routines. They have trouble paying close attention to details or make careless mistakes in school or job tasks, trouble staying focused on tasks or activities, they don’t seem to listen when spoken to (seems to be somewhere else), does not follow through on instructions and has trouble completing school work, chores or job duties, they are easily distracted, forgets daily tasks and have a hard time organizing tasks and work. (ADDitude Editors, 2017; Centers for Disease Control and Prevention, 2018; Parekh, 2017). The hyperactive/impulsive type of ADHD will fidget with or taps hands or feet, they squirm in their seat, they are unable to sit still and stay seated. They may run about or climb on things where it is inappropriate, they seem to always be on the go and may feel restless and have trouble with impulse control. Unable to play or do leisure activities quietly, have difficulty waiting his/her turn, interrupting or intruding on others, they may talk too much. (ADDitude Editors, 2017; Centers for Disease Control and Prevention, 2018; Parekh, 2017). With the combined type of ADHD, you experience almost all or all of these symptoms, you have trouble focusing, sitting still, being organized, getting things done, impulse control, all of the symptoms from both types are present. There are some co-occurring with ADHD like anxiety, learning disabilities, mood disorders and symptoms that aren't really talked about like an interest-based nervous system, emotional hyperarousal, and rejection sensitivity. An interest-based nervous system is the trouble to focus, but ADHD causes the inconsistency of attention, people with ADHD can hyperfocus on something that causes a momentary sense of interest, competition, novelty, or urgency. Emotional hyperarousal is when you have passionate thoughts and emotions that are more intense then the average person, the highs are higher and the lows are lower, low frustration tolerance, they can experience both happiness and criticism more powerfully. It's hard to regulate feeling and emotions and can cause low self-esteem. People with ADHD, mostly females, are misdiagnosed because of this symptom. Rejection sensitivity is an intense vulnerability to the perception of being rejected, teased, or criticized by important people in your life, it causes extreme emotional pain and some may experience it as physical pain. It's hard to describe and people with ADHD who feel emotional hyperarousal and rejection sensitivity will often keep it hidden from other people (ADDitude Editors, 2017).
ADHD has a major impact on everyday functioning, experiencing significant and lasting impairments across multiple domains including, mental health, academic, cognitive, social, and family functioning (Silk et al., 2016).
People with ADHD have been found to have less chance to have graduated from high school or achieved a college degree because of the inability to to handle large workloads, inattention, disorganization, difficulty following directions and making careless mistakes. It isn't the failure to learn that creates an issue, but rather the gap in the ability to carry that understanding into their schoolwork, they might miss out on important instructions because of the need to move and being easily distracted, it's hard to remember what is being taught. Kids with ADHD go into school before they are diagnosed and it is normally the teacher that sees the signs of ADHD first. (Impact of ADHD - ADHD Institute, 2019).
ADHD symptoms may delay some forms of employment, with difficulties in time management and impaired social skills. They find it difficult to retain a job, but on the other hand, some forms of employment may be well suited for adults with ADHD, more creative and active jobs. People who have entreated ADHD face multiple issues with employment, lile interpersonal conflict, tardiness, high absenteeism, high error rate, inability to change and lack of dependability. (Impact of ADHD - ADHD Institute, 2019).
People with ADHD may have difficulty maintaining relationships with the people around them, they may experience irritability, inattention, impulsive talking and forgetfulness which can contribute to misunderstandings in social interactions. ADHD can cause problems within family relationships, may have less family togetherness, and more conflict for families that have a kid with ADHD, parents, siblings, and other family members can feel less satisfied with their everyday life. (Impact of ADHD - ADHD Institute, 2019).
ADHD can look different in girls and boys, girls will often display symptoms of the inattentive type of ADHD while boys show more of the hyperactivity. Girls with ADHD rarely get diagnosed with ADHD or they get misdiagnosed, and are less likely to receive appropriate treatment. Boys can also go undiagnosed because it can be seen as “boys being boys”, but males are still three times more likely to be diagnosed with ADHD than girls. The symptoms for ADHD are more externalized in boys, while with girls it is typically more internalized, the symptoms are more subtle and harder to identify in girls. And because it is more subtle and they often display fewer behavioral problems, their difficulties are often overlooked. Females with ADHD can experience greater emotional turmoil, they try harder than males to compensate and cover up the symptoms, they have a higher risk of developing mood disorders, self-injuring behavior, and eating disorders than males. Girls with ADHD seem to show a wider range of difficult outcomes than males, anxiety, stress, and low self-esteem that can come with ADHD feels almost intolerable by early adulthood for young women. Girls with ADHD usually turn their pain and anger inward, while boys externalize their frustrations. Both males and females share the risk of school failure, rejection by peers, and substance abuse. ADHD that is undiagnosed can have a negative impact on people's self-esteem and mental health.
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