ADHD

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition that affects millions worldwide, with a prevalence in Australia estimated at 4% for adults between 18 and 44 years of age. While often associated with childhood, ADHD can continue into adulthood or even be diagnosed for the first time in adults. It presents unique challenges, including difficulty with attention, impulsivity, and hyperactivity, which can impact various aspects of life—from work and education to relationships and self-esteem.

What’s the Difference Between ADHD and ADD? 

ADHD: Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterised by a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development.

ADD: Attention Deficit Disorder (ADD) is an outdated term that was previously used to describe a type of ADHD characterised primarily by inattentive symptoms without the hyperactive and impulsive behaviours. In 1987, the medical community transitioned to using the term ADHD to encompass all types of attention deficit disorders, including those that do not involve hyperactivity.

History of ADHD

The history of ADHD reflects a long-standing recognition of attention disorders, evolving understanding, and varied approaches to treatment. In 1798, Scottish physician Sir Alexander Crichton first described individuals who were easily distracted and unable to sustain attention, laying the groundwork for our understanding of ADHD. By the early 20th century, British paediatrician Sir George Frederic Still expanded this knowledge by identifying children who exhibited notable impulsivity and attention problems despite normal intelligence, with a higher prevalence observed in boys.

In 1932, German doctors Franz Kramer and Hans Pollnow introduced the term “hyperkinetic disease” to describe children with pronounced restlessness and difficulty following rules, significantly disrupting their school and social interactions. Shortly thereafter, in 1937, it was discovered that the stimulant Benzedrine improved behaviour and academic performance in hyperactive children, marking the beginning of pharmacological treatments for ADHD. The stimulant methylphenidate, known as Ritalin, was first synthesised in 1944 and marketed in 1954, becoming a widely used treatment.

The terminology and classification of ADHD have also evolved. The American Psychiatric Association (APA) first included the condition in the DSM-II in 1968, referring to it as “hyperkinetic reaction of childhood.” In the DSM-III (1980), the term Attention Deficit Disorder (ADD) was introduced, distinguishing between ADD with and without hyperactivity. However, in 1987, the APA consolidated these distinctions into a single diagnosis: Attention Deficit Hyperactivity Disorder (ADHD), encompassing inattentiveness, hyperactivity, and impulsivity.

In the DSM-IV (1994), ADHD was further classified into three subtypes: predominantly inattentive, predominantly hyperactive-impulsive, and combined presentation. The latest edition, DSM-5 (2013), maintained these subtypes but referred to them as “presentations,” acknowledging that symptoms can change over time. Today, ADHD is recognised as a common neurodevelopmental disorder affecting both children and adults, with diagnosis rates rising and treatment options expanding.

From an evolutionary perspective, some researchers propose that traits associated with ADHD may have conferred advantages in ancestral environments, contributing to survival and social cohesion. Heightened alertness and quick responses could have been beneficial for detecting and responding to threats, while impulsivity and hyperactivity might have supported exploratory and novelty-seeking behaviours. These traits, advantageous in early human societies, may have persisted through natural selection, explaining their prevalence in the modern population.

ADHD diagnoses have significantly increased over the past few decades, reflecting greater awareness and improved diagnostic criteria. Today, a variety of stimulant and non-stimulant medications, alongside behavioural therapies, continue to improve the quality of life for those with ADHD.

Signs and Symptoms of ADHD in Adults

Recognising ADHD can be the first step towards managing its impact on your life.

Inattention Symptoms:

• Difficulty sustaining attention in tasks or play activities.
• Frequently making careless mistakes in schoolwork, work, or other activities.
• Often seems not to listen when spoken to directly.
• Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace.
• Difficulty organising tasks and activities.
• Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework).
• Often loses things necessary for tasks and activities (e.g., toys, school assignments, pencils, books, or tools).
• Easily distracted by extraneous stimuli.
• Often forgetful in daily activities.

Hyperactive/Impulsive Symptoms:

• Fidgeting with hands or feet or squirming in seat.
• Leaving seat in situations when remaining seated is expected.
• Running or climbing in situations where it is inappropriate (in adolescents or adults, may be limited to feeling restless).
• Unable to play or engage in leisure activities quietly.
• Often “on the go” or acting as if “driven by a motor.”
• Talking excessively.
• Blurting out answers before questions have been completed.
• Difficulty waiting for turn.
• Interrupting or intruding on others (e.g., butting into conversations or games).

• Difficulty Focusing: Challenges in maintaining attention on tasks at work, during studies, or in daily activities.
• Impulsivity: Making quick decisions without considering the consequences, leading to issues in personal and professional settings.
• Hyperactivity: Feeling restless and having difficulty sitting still, which might not be as pronounced as in children with ADHD but can manifest as an inner feeling of restlessness.
• Disorganisation and Procrastination: Struggling to keep organised, meet deadlines, and start tasks that require significant effort.
• Mood Swings: Experiencing quick mood changes and frustration.

Combined Presentation:

• Some individuals exhibit symptoms of both inattention and hyperactivity/impulsivity.
• These individuals may struggle with tasks that require sustained mental effort, organisation, and following instructions, while also exhibiting excessive fidgeting, talking, and impulsive behaviours.

Common Symptoms of Both

Individuals with ADHD, whether primarily inattentive, hyperactive-impulsive, or combined, often experience a range of challenges that can affect their daily lives. Common symptoms across all presentations include difficulty maintaining attention, impulsivity, and problems with executive function (such as planning and organising tasks). These symptoms can lead to academic, occupational, and social difficulties, requiring comprehensive treatment approaches to manage effectively.

Causes of ADHD

The exact cause of ADHD is not fully understood, but it is believed to be a combination of genetic, neurological, and environmental factors.

Genetics:

• ADHD tends to run in families. Genetic factors play a significant role in its development.

Brain Structure and Function:

• Differences in brain structure and activity have been observed in people with ADHD. Areas involved in controlling attention and activity levels may be less active or smaller in individuals with ADHD.

Environmental Factors:

• Exposure to certain environmental toxins during pregnancy or at a young age.
• Maternal drug use, alcohol use, or smoking during pregnancy.
• Premature birth.

Other Potential Causes:

• Dietary factors, such as food additives and sugar intake, have been proposed but lack consistent evidence.

Diagnosis and Treatment: A Path Forward

At Wellvue, we understand that seeking help for ADHD can be daunting. Our team of experienced mental health professionals is here to guide you through every step—from initial consultation to personalised treatment planning.

Getting Started with us: 

1. Comprehensive Evaluation: Your journey begins with a thorough assessment conducted by our qualified psychiatrists, ensuring an accurate diagnosis of ADHD or any other underlying conditions.
2. Personalised Treatment Plan: We believe in tailored care. Based on your unique needs, we develop a comprehensive treatment strategy that may include medication, therapy, or a combination of both.
3. Medication Management: When appropriate, medication can be an effective tool in managing ADHD symptoms. Our psychiatrists will work with you to monitor and adjust your treatment as needed.
4. Supportive Therapy: Cognitive Behavioral Therapy (CBT) and other therapeutic approaches can equip you with strategies to manage symptoms and improve day-to-day functioning.

Why Choose Wellvue? 

• Convenience: Access our services from anywhere in Australia, thanks to our secure and user-friendly telehealth platform.
• Expert Care: Our team comprises experienced psychiatrists and psychologists specialising in adult ADHD, ensuring you receive the highest standard of care.
• Collaborative Approach: We believe in working together with you to achieve the best outcomes, tailoring your treatment plan to fit your lifestyle and preferences.
• Privacy and Confidentiality: Your privacy is paramount. Our platform uses secure technology to protect your information and communication.

Ready To Take The First Step? 

ADHD shouldn’t hold you back from leading a fulfilling life. If you’re ready to explore how we can support you in managing ADHD, start your journey and together, we can chart a path toward a more focused and balanced life.

Disclaimer:

The information in this article is for educational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 000 right away.