ADHD

Written by Katherine Nicholls
Katherine Nicholls
Counselling Directory Content Team

Reviewed by Sean Tierney
Last updated 9th April 2024 | Next update due 9th April 2027

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that can impact day-to-day life. Counselling for ADHD can help both adults and children learn effective strategies to make everyday life easier, and cope with any associated mental health challenges.

What is ADHD?

Attention deficit hyperactivity disorder (also known as ADHD) is a condition that is defined by a pattern of inattention and/or hyperactivity-impulsivity. 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 diagnosed in younger people, more people are receiving a diagnosis of ADHD in adulthood.

In this video, counsellor and psychotherapist Val Teller explains more about adult ADHD. 

ADHD can make everyday life difficult. 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). Sometimes the diagnosis isn’t made and therefore learning to manage it can be difficult.

Types of ADHD

There are three types of ADHD:

  • predominantly inattentive presentation
  • predominantly hyperactive-impulsive
  • combined hyperactive-impulsive and inattentive (when six or more signs are present, from either the inattentiveness category or the hyperactivity and impulsiveness category). This is the most common type of ADHD seen by doctors.

You may be aware of the term 'attention-deficit disorder' (ADD), however, this is generally no longer used. The criteria for ADHD changed to include the subtypes described above, which includes what was in place to describe ADD (predominantly inattentive presentation).


Signs of ADHD

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 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 schools, 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.

Rejection Sensitivity Dysphoria (RSD)

Rejection Sensitivity Dysphoria, commonly known as RSD, is a condition that is often seen among those living with ADHD. People with RSD are highly sensitive to criticism and often hold on to these negative comments for long periods of time - sometimes up to years later. 

People with RSD might believe that they have let others down, feel that they have embarrassed themselves or have made a serious, irreversible mistake. In some cases, people living with RSD might even feel that they are deserving of the negative comments passed their way. This can lead to emotional pain, feelings of rejection and the person regularly criticising themselves. 

Signs that someone is living with RSD include having low self-esteem or self-worth, becoming angry when faced with perceived rejection, feeling ashamed and, in severe cases, thinking about self-harming behaviours. 

Being told to "stop taking things personally" is easier said than done and can be unhelpful for people living with RSD. There are, however, some things that can make an RSD diagnosis more manageable, such as practising self-compassion and focusing on the person's strengths. 

Learn more about RSD and read Sara's story on Happiful.

Sometimes, young people with ADHD may have other conditions or neurological differences 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.

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.

Signs of adult ADHD

Symptoms in adults are less defined as currently, there is less research on adults with ADHD. Rather than developing at a later age, it’s believed that the condition will always have been present in childhood, as it is thought the genes you inherit from your parents are a significant factor in developing ADHD. 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 of ADHD

The cause of ADHD is not yet fully understood and a combination of factors is thought to contribute. Genetics is 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 an ADHD diagnosis

If you suspect your child has ADHD, a diagnosis can help ensure 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 programmes. This is no reflection on your parenting, instead, it aims to help you learn more about ADHD and how you can support your child.

If your child’s behaviour doesn’t improve and you 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.

Counselling 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.

Therapists who can help with ADHD

Several different therapy options 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.

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 help those with ADHD understand social situations better. 

Medication

Various types of medication 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 be more able to practise new skills.

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.

- Counsellor Sally Spinger, MBACP Dip Couns in ‘What is it like to live with ADHD?.

What should I be looking for in a therapist?

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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