The Hyperactive, Impulsive Tasmanian Devils (Attention Deficit Hyperactivity Disorder)

(C) Warner Bros. Animation. All rights reserved.

Some people are born hyperactive – they cannot live by staying still in a corner. They love to wiggle around, running and strolling in the open space, and seem not to shut their mouths. They seem to get into trouble. They are like Taz as shown above. Others may be quiet, but daydream all the time and seem not to have attention when being called. Sometimes, there are people who are both hyperactive and inattentive. For teachers and bosses alike, they are called rascals and thus are subject to suspension and even expulsion from school or work. Maybe these poeple are lazy or snobbish. But unfortunately, not all of them are lazy or snobbish. Actually, they are born wih it and comes naturally as part of themselves. This condition they possess is called attention deficit hyperactivity disorder or more known as ADHD.

What is ADHD?

ADHD or hyperkinetic disorder is is a problem of not being able to focus, being overactive, not being able control behavior, or a combination of these. For these problems to be diagnosed as ADHD, they must be out of the normal range for a person’s age and development.[1] They usually begin between ages 6 and 12 and must persist for a period of 6 months or more to present this diagnosis.[2][3][4] A person with ADHD usually has problems in his or her academic, social, and work life.[4]

How common is ADHD?

ADHD is said to affect 6-7% of children when diagnosed via the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV)[4][5] and between 2–5% of adults have the condition.[4][6] About 30-60% of children with ADHD continue to have symptoms until adolescence and adulthood.[4][7]
ADHD affects males 3 times more than females.[4][8][9]

What causes ADHD?

ADHD has no known cause yet, but there are factors that may contribute to have ADHD. These include:

• having a relative with similar condition[10]
• traumatic brain injury [10]
• low birth weight[10]
• chemical exposure while pregnant[10]
• environmental toxin exposure[10]
• neurotransmitter (brain chemical) dysregulation[10]

What are the signs and symptoms of ADHD?

ADHD has a number of symptoms :

Inattentive Symptoms[1]:

• -Fails to give close attention to details or makes careless mistakes in schoolwork
• -Has difficulty keeping attention during tasks or play
• -Does not seem to listen when spoken to directly
• -Does not follow through on instructions and fails to finish schoolwork or chores and tasks
• -Has problems organizing tasks and activities
• -Avoids or dislikes tasks that require sustained mental effort (such as schoolwork)
• -Often loses toys, assignments, pencils, books, or tools needed for tasks or activities
• -Is easily distracted
• -Is often forgetful in daily activities

Hyperactivity Symptoms[1]:

• -Fidgets with hands or feet or squirms in seat
• -Leaves seat when remaining seated is expected
• -Runs about or climbs in inappropriate situations
• -Has problems playing or working quietly
• -Is often “on the go,” acts as if “driven by a motor”
• -Talks excessively

Impulsivity Symptoms[1]:

• -Blurts out answers before questions have been completed
• -Has difficulty awaiting turn
• -Interrupts or intrudes on others (butts into conversations or games)

As the child grows into an adult, the symptoms may tone down a bit, but the inattentiveness and impulsivity may still persist.

ADHD is divided into 3 subtypes[11]:

Predominantly Inattentive Presentation: It is hard for the individual to organize or finish a task, to pay attention to details, or to follow instructions or conversations. The person is easily distracted or forgets details of daily routines.[11]

Predominantly Hyperactive-Impulsive Presentation: The person fidgets and talks a lot. It is hard to sit still for long (e.g., for a meal or while doing homework). Smaller children may run, jump or climb constantly. The individual feels restless and has trouble with impulsivity. Someone who is impulsive may interrupt others a lot, grab things from people, or speak at inappropriate times. It is hard for the person to wait their turn or listen to directions. A person with impulsiveness may have more accidents and injuries than others.[11]

Combined Presentation: Symptoms of the above two types are equally present in the person.[11]

How it is diagnosed?

ADHD is difficult to diagnose, as it is hard to differentiate the ADHD itself from the disruptive or shy behavior some children have. It is more difficult to diagnose ADHD of the inattentive type, as the children who has it presents as well-behaved; in fact, their inattentiveness is not obvious until their teenage and adult years.

A psychiatrist or developmental pediatrician may diagnose an adult or child has possible ADHD through assessment of a person’s childhood behavioral and mental development, including ruling out the effects of drugs, medications and other medical or psychiatric problems as explanations for the symptoms.[4][12] A diagnostic checklist, such as found in the DSM-IV or DSM-V or International Statistical Classification of Diseases and Related Health Problems-10 (ICD-10) is made to base if the symptoms interfere with the child’s or adult’s life.[4]

How is ADHD treated?

There is no single treatment for ADHD. A combination of therapy, medication, and individualized classes or workshops are done to manage symptoms of ADHD. Psychological therapies used include: psychoeducational input, behavior therapy, cognitive behavioral therapy (CBT), interpersonal psychotherapy, family therapy, school-based interventions, social skills training, parent management training,[12] and neurofeedback.[13] Stimulant medications are the pharmaceutical treatment of choice[14] like methylphenidate[4]; however, stimulants have the potential for abuse and dependence.[15] To avoid dependence, non-stimulant medications, such as atomoxetine, bupropion, guanfacine, and clonidine that may be used as alternatives.[14]

What is the prognosis of ADHD?

A person with ADHD can succeed in life with treatment and management. Approximately half of ADHD children seem to “outgrow” the disorder in adolescence or early adulthood; the other half will retain some or all symptoms of ADHD as adults. With early identification and intervention, careful compliance with a treatment program, and a supportive and nurturing home and school environment, ADHD children can flourish socially and academically.[16]

If ADHD is not addressed, what will happen?

If ADHD is not identified, complications may arise to the person having it. These complications can begin with troubles in the classroom, but can also include a likelihood of accidents and injuries, trouble interacting with peers, and a disposition to alcohol or drug use.[17] It can also cause unstable relationships and financial stress.[18]

Can ADHD co-exist with other conditions?

Yes. People with ADHD are much more likely to experience a number of other nervous system disorders.[19] These may include:

• -learning disabilities in 25% to 30% of people with ADHD despite normal intelligence [19]
• -tic disorders (such as Tourette’s syndrome) in 20% of children with ADHD. More than 50% of children with Tourette’s are also diagnosed with ADHD. [19]
• -language problems, especially with expressive language (e.g., vocabulary) [19]
• -oppositional defiant disorder [19]
• -conduct disorder [19]
• -autism [19]
• -anxiety disorders (25%)[19]

Are there famous people with ADHD?

Yes and yes. A lot of personalities have diagnosed or suspected ADHD. Here they are:

Actors and Directors:[20]

Amy Adams
Ann Bancroft
Harry Belafonte
George Burns
Jim Carey
Cher
Bill Cosby
Tom Cruise
Kirk Douglas
Danny Glover
Tracey Gold
Whoopi Goldberg
Alfred Hitchcock
Dustin Hoffman
Steve McQueen
Jack Nicholson
Joan Rivers
George C. Scott
Will Smith
Tom Smothers
Steven Spielberg
Suzanne Somers
Sylvester Stallone
James Stewart
Lindsay Wagner
Henry Winkler
Jennifer Connelly
Hilary Duff
Eva Longoria
Liv Tyler
Paris Hilton
Cameron Diaz
Michelle Rodriguez
Brittany Snow
Ashley Olsen
Mary-Kate Olsen
Alison Lohman
Christopher Knight
Dakota Fanning
Daniel Bedingfield
Diane Kruger
Ellen Page
Emma Watson
Forrest Griffin
Glenn Beck
Howie Mandel
Jamie Oliver
Jason Earles
Megan Fox
Melissa Joan Hart
Rachel Hurd-Wood
Rory Bremner
Salma Hayek
Ty Pennington
Vince Vaughn
Willa Holland
Woody Harrelson
Zooey Deschanel
Jillian Michaels
Hayley Williams
Robin Williams

Musicians:[20]

William James Adams
Ludwig van Beethoven
John Denver
John Lennon
Wolfgang Amadeus Mozart
Ozzy Osbourne
Elvis Presley
Stevie Wonder
Avril Lavigne
Justin Timberlake
Adam Levine
Kurt Cobain
Steven Tyler

Entrepreneurs/Business People:[20]

Sir Richard Branson
Andrew Carnegie
Walt Disney
Malcolm Forbes
Henry Ford
Bill Gates
William Randolph Hearst
FW Woolworth

Artists:[20]

Ansel Adams
Salvadore Dali
Vincent Van Gogh
Pablo Picasso
August Rodin

Statesmen:[20]

Napoleon Bonaparte
Prince Charles
Winston Churchill
Dwight Eisenhower
John F. Kennedy
Robert F. Kennedy
Abraham Lincoln
Nelson Rockefeller
Woodrow Wilson

Writers:[20]

Lewis Carroll
Agatha Christie
Ernest Hemingway
Samuel Johnson
Edgar Allan Poe
George Bernard Shaw
Socrates
Henry David Thoreau
Leo Tolstoy
Jules Verne
William Butler Yeats
Lily Collins

Scientists and Inventors:[20]

Alexander Graham Bell
Thomas Edison
Albert Einstein
Michael Faraday
Benjamin Franklin
Galileo
Sir Issac Newton
Nostradamus
Leonardo Da Vinci
Orville & Wilber Wright
William Wrigley

Athletes:[20]

Terry Bradshaw
Josh Freeman
Bruce Jenner
Magic Johnson
Michael Jordan
Jason Kidd
Carl Lewis
Greg Louganis
Michael Phelps
Pete Rose
Babe Ruth
Nolan Ryan
Jackie Stewart

…and many more…

Bonus: The ADHD Brain

People with ADHD have brains different from the neurotypical (non-ADHD) brain as shown in this scan.

Comparison of a neurotypical brain with ADHD brain.[21]

Here, the ADHD brain has a smaller prefrontal lobe, which is the part of the brain responsible for planning, reasoning, and problem solving (what is known as executive functions). It’s generally about 10% smaller. The smaller right frontal lobe may be a cause of inattentive behavior in ADHD since it’s generally considered that the right side of the brain is involved in the attention process. Impulsivity and stimulus processing are also believed to be modulated there. An excessive amount of grey matter in the inferior parietal cortices has been noted in ADHD individuals as well. [21]

A bigger representation of ADHD brain is pictured below.

ADHD Brain.[22]

So, brain structure causes ADHD. But that doesnt necessarily mean abnormality. It may be just variation in human brain…

ADHD is only one of the conditions under the umbrella of Neurodiversity. More conditions will be discussed next time.

References:
[1] http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002518/
[2] “Attention-Deficit / Hyperactivity Disorder (ADHD)”. Centers for Disease Control and Prevention. National Center on Birth Defects and Developmental Disabilities. 19 September 2014. Retrieved 3 November 2014.
[3] Dulcan MK, Lake MB (2011). Concise Guide to Child and Adolescent Psychiatry (4th ed.). American Psychiatric Publishing. p. 34. ISBN 9781585624164. Retrieved 17 January 2014.
[4] http://en.m.wikipedia.org/wiki/Attention_deficit_hyperactivity_disorder
[5] Willcutt EG (July 2012). “The prevalence of DSM-IV attention-deficit/hyperactivity disorder: a meta-analytic review”. Neurotherapeutics 9 (3): 490–499. doi:10.1007/s13311-012-0135-8. PMC 3441936. PMID 22976615.
[6] Kooij SJ, Bejerot S, Blackwell A, Caci H, Casas-Brugué M, Carpentier PJ, Edvinsson D, Fayyad J, Foeken K, Fitzgerald M, Gaillac V, Ginsberg Y, Henry C, Krause J, Lensing MB, Manor I, Niederhofer H, Nunes-Filipe C, Ohlmeier MD, Oswald P, Pallanti S, Pehlivanidis A, Ramos-Quiroga JA, Rastam M, Ryffel-Rawak D, Stes S, Asherson P (2010). “European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD”. BMC Psychiatry 10: 67. doi:10.1186/1471-244X-10-67. PMC 2942810. PMID 20815868.
[7] Bálint S, Czobor P, Mészáros A, Simon V, Bitter I (2008). “[Neuropsychological impairments in adult attention deficit hyperactivity disorder: a literature review]”. Psychiatr Hung (in Hungarian) 23 (5): 324–335. PMID 19129549.
[8] Emond V, Joyal C, Poissant H (April 2009). “Structural and functional neuroanatomy of attention-deficit hyperactivity disorder (ADHD)”. Encephale (in French) 35 (2): 107–114. doi:10.1016/j.encep.2008.01.005. PMID 19393378.
[9] Singh I (December 2008). “Beyond polemics: science and ethics of ADHD”. Nat. Rev. Neurosci. 9 (12): 957–964. doi:10.1038/nrn2514. PMID 19020513.
[10] http://www.webmd.com/add-adhd/guide/adhd-causes
[11] http://www.cdc.gov/ncbddd/adhd/facts.html
[12] National Collaborating Centre for Mental Health (2009). Attention Deficit Hyperactivity Disorder: Diagnosis and Management of ADHD in Children, Young People and Adults. British Psychological Society. pp. 19–27, 23, 38, 130, 133, 317. ISBN 9781854334718.
[13] Arns M, de Ridder S, Strehl U, Breteler M, Coenen A (July 2009). “Efficacy of neurofeedback treatment in ADHD: the effects on inattention, impulsivity and hyperactivity: a meta-analysis”. Clin EEG Neurosci 40 (3): 180–189. PMID 19715181.
[14] Wigal SB (2009). “Efficacy and safety limitations of attention-deficit hyperactivity disorder pharmacotherapy in children and adults”. CNS Drugs. 23 Suppl 1: 21–31. doi:10.2165/00023210-200923000-00004. PMID 19621975.
[15] Oregon Health & Science University, Portland, Oregon (2009). “Black box warnings of ADHD drugs approved by the US Food and Drug Administration”. United States National Library of Medicine. Retrieved 17 January 2014.
[16] http://www.healthyplace.com/adhd/children-behavioral-issues/prognosis-for-adhd-in-children/
[17] http://www.healthline.com/health/adhd/complications
[18] http://www.mayoclinic.org/diseases-conditions/adult-adhd/basics/complications/con-20034552
[19] http://chealth.canoe.ca/channel_condition_info_details.asp?disease_id=14&channel_id=40&relation_id=55627
[20] http://www.famouspeoplearehuman.com/famous-people-adhd.htm
[21] http://www.healthguideinfo.com/adult-add/p97522/#.dpuf
[22] https://www.expressfocus.com

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