Attention-Deficit/ Hyperactivity Disorder (ADHD)
Attention Deficit/Hyperactivity Disorder (ADHD), formerly referred to as ADD, is a childhood neurodevelopmental disorder of which symptoms will usually continue into adulthood. ADHD is characterized by a cluster of inattentive, hyperactive, and/or impulsive symptoms that are more severe and frequent than typically observed in individuals at their respective developmental level. Inattentive refers to difficult starting, staying focused, organizing, or completing tasks. Hyperactive refers to excess movement, excess energy, or excess talking. Impulsive refers to acting or making decisions with little thought of the consequences of those actions. These symptoms can be present in individuals who do not have ADHD. However, ADHD is a very specific diagnosis related to executive functioning that is impacting various aspects of an individual’s life more severely and persistently and started in childhood. For more information visit the American Psychiatric Association.
All clinicians at Optimal Moments are able to work with individuals who have ADHD. Dr. Sadberry or the doctorate-level interns are able to complete comprehensive assessments to determine if your symptoms meet ADHD criteria.
Types of ADHD
There are three classifications of ADHD:
Predominately Hyperactive/Impulsive Type: Examples of symptoms that occur frequently
Fidgets, taps hands or feet
Not able to stay seated
Unable to play or do leisure activities quietly
Talks too much
Interrupts or intrudes on others
Predominantly Inattentive Type: Examples of symptoms that occur frequently
Doesn’t pay close attention to details or makes careless mistakes
Difficulty staying focused on tasks or activities
Doesn’t seem to be listening when spoken to
Has difficulty with organizing tasks or managing time
Forgets to complete tasks
Combined Type: These individuals would meet criteria for both inattentive and hyperactive/impulsive. Most people meet criteria for Combined Type.
How is ADHD different than other diagnoses?
It is always best to have a mental health professional conduct an assessment for an accurate diagnosis. We strongly advise against using symptoms presented online through sources like WebMD to diagnose yourself or others. Diagnosing ADHD is a complex process that is best conducted by trained professionals, such as psychologists or neuropsychologists. There is no blood test or routine imaging that can be used to determine if an individual has ADHD.
We are looking at a broad picture to understand the full spectrum of symptoms, duration and intensity of the symptoms, and the impact of the symptoms on an individual’s ability to function. The symptoms of ADHD are deficiencies in executive functioning. ADHD is a very specific reason why those deficiencies exist and is a neurodevelopmental disorder that begins in childhood. However, deficiencies in executive functioning can exist for other reasons, such as thyroid conditions, learning disabilities, traumatic brain injury, neurocognitive disorders, anxiety, depression, trauma or PTSD, substance use, etc. This is a key reason why a professional is best equipped to diagnosis ADHD, especially in adults. Check out our blog for more information about ADHD and Adults.
What are the causes of ADHD?
The exact cause of ADHD has not been identified. We consider it to be a neurodevelopmental disorder which means symptoms of ADHD begin during the early stages of brain development in childhood.
Genetic Vulnerability: Studies have shown that ADHD tends to run in families which suggests a genetic vulnerability to developing ADHD.
Environmental Factors: Studies continues to explore the impact of environmental factors, such as exposure to tobacco smoke, alcohol, or drugs during pregnancy and low birth weight or premature birth on the developmental of ADHD.
Brain Structure and Function: Studies have indicated differences in brain structure and function may be associated with ADHD, such as in dopaminergic areas and frontal lobe functioning. Neuroimaging studies have shown that individuals with ADHD often have differences in the size and activity of certain brain regions. Additionally, research is exploring how low beta waves and high theta wave production can contribute to ADHD symptoms.
What are treatment options for ADHD?
Every individual will experience a different combination of symptoms and will require a different treatment approach as a result. It is best to meet with a mental health professional to develop a treatment plan that addresses your specific symptoms.
At Optimal Moments, we take a holistic approach to treatment and individualize your treatment plan.
Comprehensive ADHD Evaluation: We recommend completing a comprehensive ADHD evaluation as this will allow for an accurate diagnosis of ADHD, it will also provide an individualized treatment approach to your specific symptoms. Comprehensive evaluations take several hours; ADHD cannot be diagnosed by reviewing a checklist of symptoms alone. If you suspect there may be other concerns such as Autism or Learning Disabilities, you will want to be clear about these concerns to ensure you schedule the evaluation with the proper specialist. These evaluations are best completed by a Psychologist or Neuropsychologist.
Psychotherapy: Psychotherapy can be beneficial in helping you explore the negative thoughts or low self-esteem that can be associated with the struggles of having ADHD. We see an increase in anxiety and depression symptoms in individuals with ADHD both as an emotional symptom of ADHD and because of the impact of ADHD on daily functioning or lack thereof. We encourage parental or family therapy as well so loved ones can provide alternative supportive environments for the individual with ADHD.
Lifestyle Modifications: Our providers can work with you on establishing routines and structure, improving sleep hygiene, establishing a healthy diet, and consistently engaging in moderate exercise as these all can assist in managing ADHD symptoms.
Medications: Our Psychiatric Mental Health Nurse Practitioner (PMHNP) can assist you in deciding whether or not a Stimulant or Nonstimulant would be better for you. Stimulant medications, such as methylphenidate (Concerta) and amphetamine (Adderall) work by increasing the levels of certain neurotransmitters in the brain, which helps improve attention and reduce hyperactivity and impulsivity. Non-stimulant medications, such as atomoxetine (Strattera) and guanfacine (Intuniv), can be used when stimulants are not effective or cause undesirable side effects. Stimulants can be hard on the heart and can lead to weight loss.
Neurofeedback: If you are not interested in medications or have tried medications before but would like alternatives, we recommend neurofeedback. Neurofeedback is similar to biofeedback as it allows the clinician to understand what is going on with your body. However, neurofeedback will assess your brain waves and the clinician will train you on having more control over your brain’s functioning.
Accommodations: Once our clinicians have an understanding of how your ADHD symptoms are affecting your functioning at work or school, we can work with you to request accommodations. The American Disability Act requires organizations to provide reasonable accommodations at work. In the school system, you can either receive an Individualized Educational Plan (IEP) for elementary school through high school or, at the university level, the Office of Accessibility will provide accommodation and documentation for your professors.
Community Referrals: We will work with you to identify community resources that may also assist in reducing ADHD symptoms, such as ADHD coaching where the provider can work directly with you on individualizing a plan for your daily functioning.
The most important thing to remember is you do not have to face this alone. We are here to help.
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