ADHD

Attention deficit hyperactivity disorder (commonly known as ADHD) is a condition that makes people feel restless, impulsive and hyperactive. With symptoms typically showing up in childhood, those with ADHD often struggle to concentrate for long periods of time.

While the condition is more commonly seen in children and teenagers, it can also affect adults. Here we’ll look into the types of ADHD, common symptoms and the different treatment options available.

What is ADHD?

Referred to as a behaviour disorder, ADHD can make everyday life difficult, especially for those at school. Key symptoms include hyperactivity, inattentiveness and impulsiveness. These tend to be noticed at an early age, often becoming more noticeable when a child’s circumstances change (for example if there is a change in school).

The symptoms usually improve with age, however, some adults continue to struggle. Sometimes the diagnosis isn’t made and therefore learning to manage it can be difficult.

There are three types of ADHD:

  • predominantly inattentive presentation (when there is more inattention than hyperactivity seen)
  • predominantly hyperactive-impulsive (when there is more hyperactivity and impulsiveness seen)
  • combined hyperactive-impulsive and inattentive (when six or more symptoms are present, from either inattentiveness category or hyperactivity and impulsiveness category)

Combined hyperactive-impulsive and inattentive is the most common type of ADHD seen by doctors.

The term ADD (attention deficit disorder) was used in the past, however it is generally no longer used. The criteria for ADHD changed to include the three subtypes described above, which includes what was currently in place to describe ADD (predominantly inattentive presentation).  

ADHD symptoms

There are two categories of ADHD symptoms, inattentiveness, and hyperactivity and impulsiveness. Most people will have a mix of the two, but this isn’t always the case. The lists below describe some of the common symptoms seen in children and teenagers.

Inattentiveness

Common signs of inattentiveness include:

  • short attention span, easily distracted
  • making careless mistakes
  • often losing things/forgetful
  • struggle to focus on tasks that take a long time
  • appearing unable to listen/carry out instructions
  • jumping from one task to another
  • finding organising tasks difficult

Hyperactivity and impulsiveness

Common signs of hyperactivity and impulsiveness include:

  • difficulty sitting still
  • constant fidgeting
  • unable to concentrate on tasks
  • excessive talking
  • excessive physical movement
  • interrupting other people’s conversations
  • little sense of risk or danger
  • difficulty waiting their turn

In environments like school, where young people are expected to sit quietly for long periods of time concentrating on tasks, it’s easy to see why those with ADHD struggle. Receiving a diagnosis and getting the right support can help make school and other social experiences easier.

As a child, I did not look like what most people picture as a kid with ADHD. I was shy and quiet. In school, I would daydream, only partially listening to my second-grade teacher drone on about long division.

- Read Liz’s story.

Sometimes, young people with ADHD can develop other conditions alongside ADHD. These can include anxiety disorders, depression, sleep problems, epilepsy, Tourette’s, learning difficulties and autism. If you’re worried about any of these, be sure to tell your doctor so they can investigate and ensure your child gets any additional support needed.

ADHD symptoms in adults

Symptoms in adults are less defined as currently, there is less research in adults with ADHD. Rather than developing at a later age, it’s believed that the condition will always have developed in childhood. Symptoms may then have been missed, or they may have been diagnosed, but symptoms have persisted into adulthood.  

ADHD tends to affect adults in a different way and the symptoms are often much more subtle. Some symptoms that may be seen in adults include:

  • lack of attention to detail
  • starting new tasks before finishing existing ones
  • poor organisational skills
  • difficulty focusing and prioritising
  • often losing/misplacing things
  • often forgetting things
  • restlessness
  • often interrupting other people's conversations
  • mood swings and irritability
  • difficulty coping with stress
  • impatience
  • risky behaviour

Just like children and teenagers, adults with ADHD can develop other conditions. In adults, these often include personality disorders, bipolar disorder and obsessive-compulsive disorder.

Causes

The cause of ADHD is not yet fully understood, however, a combination of factors are thought to contribute. Genetics are considered a significant factor, specifically the genes you inherit from your parents. There doesn’t appear to be a single genetic fault at play, however, so the way ADHD is inherited is likely to be complex.

Research has also shown that differences in the brain could contribute to ADHD. In brain scans, those with the condition are seen to have smaller areas in certain parts of the brain.

Certain groups have also been suggested as at higher risk of developing ADHD. This includes those who were born prematurely (or those with a low birth weight), those with epilepsy and those with brain damage.  

Getting a diagnosis

If you suspect your child has ADHD a diagnosis can be helpful in ensuring you get the right support for them. Your first step should be to see your GP. While they cannot formally diagnose ADHD, they will be able to refer you to a specialist if they feel it’s necessary.

They may initially suggest a period of ‘watchful waiting’ - a certain amount of time (usually 10 weeks) to keep an eye on symptoms and see if they improve. They may also suggest ADHD-focused parent training or education programme. This is no reflection on your parenting, instead its aim is to help you learn more about ADHD and how you can support your child.

If your child’s behaviour doesn’t improve and yourself and your doctor agree it’s affecting everyday life, they should refer you to a specialist for assessment.

If you’re an adult and you think you have ADHD, your doctor will talk to you about your symptoms and may refer you for an assessment if you meet the following criteria:

  • You were not diagnosed with ADHD as a child, but your symptoms started then and have never gone away.
  • Your symptoms can’t be explained by another mental health condition.
  • Your symptoms are affecting everyday life.

Treatment for ADHD

Treatment for ADHD usually involves medication or therapy, with a combination of the two working best for most people. Getting the right support and appropriate treatment can both help relieve symptoms and make day-to-day tasks easier.

Medication

There are various different types of medication that can be used to treat ADHD. While these should not be seen as a ‘cure’, they can help those with the condition concentrate better, feel calmer and more able to practise new skills.

Therapy

There are several different therapy options that can be helpful for those with ADHD. These can also help with additional difficulties such as anxiety. Some therapies that may be suggested are:

Cognitive behavioural therapy (CBT)

CBT is a type of talking therapy that helps you manage problems by looking to change the way you think and behave. This can be useful if there are certain situations you/your child find difficult. CBT is also a great way to help with any associated anxiety.

Our job as counsellors is to help our ADHD clients recognise what is working for them and see how they can move forwards with this.

- Read counsellor Sally Spinger’s article ‘What is it like to live with ADHD?.

Behaviour therapy

This is generally used to provide support for parents/carers of children with ADHD and may also involve teachers. This therapy aims to help with behaviour management, using a reward system to help children learn to manage behaviour.

Training and education

If your child has been diagnosed with ADHD, your doctor may recommend certain education and training programmes for both yourself and your child. These could include:

  • Psychoeducation - This encourages you/your child to talk about ADHD and its effects. The aim here is to help people understand what their diagnosis means and how they can learn to cope with the symptoms.
  • Parent training and education programmes - These programmes look to help parents of children with ADHD learn different ways of talking, playing and working with their child to improve attention and behaviour.
  • Social skills training - Using role-play, social skills training aims to teach those with ADHD how to behave in social situations. This includes learning how their behaviour may affect other people.

What should I be looking for in a counsellor or psychotherapist?

There are currently no laws in place stipulating what training and qualifications a counsellor must have in order to treat someone with ADHD. However, the National Institute for Health and Care Excellence (NICE) has developed a set of guidelines that provide advice for parents who have children with ADHD, about the recommended treatments:

  • If your child is old enough to go to school, they should not usually be offered medication first.
  • You should be offered a place on a course to help parents with their child's behaviour. Sometimes it is helpful if your child also attends a course of group treatment, which may be a psychological therapy such as cognitive behavioural therapy (CBT) or social skills training.
  • If your child is a teenager, one-to-one psychological therapy for them may be an option, instead of a course for both of you.
  • If your child has a learning disability as well as ADHD, you should be given the choice of group or one-to-one sessions for you and your child.
  • If the treatment so far has not helped, your child should be offered medication. This should be alongside other support and treatment including courses for parents and children. Medication may also be offered if you and your child would prefer not to attend a course for parents or have psychological treatment.

Read the full NICE guidelines:

Attention deficit hyperactivity disorder

Counsellors treating people with ADHD may have to adjust the way they work, therefore it may be worth seeking a professional who has had experience in this area.

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