ADHD: Attention Deficit Hyperactivity Disorder
ADHD is a neurological disorder in which a person becomes hypersensitive/ gives less attention that hampers their growth and development. Some children have all the symptoms while some other have some signs. Its all depends upon the type of ADHD. Mainly ADHD is diagnosed when children’s starts schooling because, before this, parents see all its activities as of a minor child. They do not take its symptoms seriously. Parent takes it seriously only when their hyperactivities becomes out of control. The parent does not take first child having ADHD seriously as they neglect their hyperactivity due to their love. Even doctors do not recognize it in small children. Such children do not enjoy his social life and like to stay alone. They mainly have fewer friends or no friends at all.
Although the children of the today generation are more active than past generation children. But we cannot say that all suffer from ADHD. There are specific symptoms based on which we can say that our child is suffering from ADHD:
- Difficult to concentrate things
- Inability to socialize
- The problem for him to stay on talk
- Don’t like to sit in one place
- Speak before listening full question or instruction
- Problematic for him to hear when we talked directly
- Trouble staying organized
- Easily distracted by thing around him
- Forgetful in daily activities
- Running around and climbing on things where he is not supposed to do so
- shaking legs or twisting his hands while sitting
- Talk excessively in class, and we are unable to stop him talking
- Interrupt in the conversation
- Argue a lot
- The problem with memory with ADHD is not a long-term storage memory, but it’s with short-term working memory. I.e., people quickly forgot things after 2 minutes when they are put on other tasks.
Brief History about ADHD:
It was first diagnosed in 1902. But from 1902 to 1980, it is all about a little child who could not stand still, could not shut up, etc. It was just behavior problems. The title of this disorder was changed sometimes. Since 1980, it was first changed the name of this disorder to include “attention deficit.” At this time, we realized that this is not much behavior problem but far more a problem of brain management. We also learned that there are so many peoples who have ADHD but they have no behavioral problem. One of the myths that I want to clear is that ADHD does not affect how smart people are.
Types of ADHD:
To make the diagnosis and treatment simple and easy, American Psychological Association has divided it into three categories:
- Inattention type
- Hyperactivity/ impulsivity type
- Combined type
- As the name suggests, it means people have lack of attention issue, I.e., difficulty to follow instruction, concentrating things Less focused on their work as little disturbance breaks their focus, give less attention to what his instructor is saying to him.
- People with this type can’t complete his task in proper time.
- The people with this type of ADHD receive very low or no diagnosis because they may be the concentrate on exciting things like playing but can’t focus on irrelevant things like study.
- They tend to avoid a task that requires constant attention in school or at home. Teachers always think how can you focus on playing why not concentrate on study.
- While the following instruction, they generally miss it
- This type of ADHD is more common in girl child as compared to a boy child, and also they have less hyperactive as compared to boys.
- It tends to slow acting and slower processing of information.
- They are mostly daydreaming when other peoples are talking to them
- They have a problem with short-term working memory. One of the classic things about working memory is knowing where you put stuff, knowing the information you need to get your job done and knowing what time it is.
- In this type, the child shows hyperactivity and impulsive behavior.
- The child can’t sit in one place. While sitting, there is always arms or leg movement like twisting his arms and shaking his legs.
- They speak too much. They tend to interrupt other while talking, not able to wait for his turn.
- Many times child with this type of ADHD likes to run than sitting in one place. They are good at running sports like running, swimming, etc. than sitting games likes chess, cardboard, etc.
- The best-known example for it is Michael Phelps who won multiple gold medals.
- This type of ADHD is most common in boys as compared to girls.
- Leaves their seat when we expect him to stay at his position.
- Easily angered or lost temper
- As the name suggests, people with this type have both hyperactive and inattentive issues.
- It is the most common type we experience in the child as compared to an adult.
- It is most difficult children to manage as they easily irritate and lost temper.
These all the above classification made by APA makes the process of diagnosis and treatment easy for experts. In these types, if our kind changes with time, our treatment may vary. But diagnosis requires constant monitoring by psychiatrist, doctor, pediatrician or neurologist for at least six months because, for proper diagnosis, a person expects to keep these habits for a more extended period. It needs to be checked whether these symptoms are due to any other medical condition and medicine or not.
Irrespective of all the negatives, there is major positive in these children that they are above intelligent and are very creative children. Eg. Einstein which had ADHD from childhood. But the only issue for parents is that how can they handle them. Most of the child with ADHD, symptoms decrease as the time passage. But some children retained these symptoms in adult age. For this, proper treatment is necessary as the young age. Otherwise, it hampers their social and professional life. In adult ADHD patient, inattention decreases while hyperactivity and impulsivity increases.
Causes of ADHD:
Although the exact cause is not known to date and neither MRI or other scan shows specific changes in the brain. But there are so many factors which may or may not be a cause of ADHD.
Underdevelopment fo cortex:
As we know that cortex of the brain is the most developed part of the brain which is responsible for memory attention, thinking, perceiving, awareness, thought process, recognition, etc. From the five lobes of the cortex, there is frontal lobe which at pregnancy becomes thinner and weak. Due to this, the feeling of less attention develops in the child. There are also certain nerves in the brain suppressed at a time during pregnancy. It leads to the development of the symptoms of ADHD.
Environmental and genetic factors: The child with a parent have diagnosed with ADHD are more likely to develop with themselves. Further, if a parent has identical twins, then their chances of developing ADHD is considerably high. Though, having identical DNA doesn’t mean that twins have developed ADHD which suggests that both environmental and genetic factor plays a significant role in the developmental of ADHD. As to a specific gene, it’s probably not one single gene that leads to ADHD. But rather multiple genes that determine how severe a symptom is. The genes likely influence the production or regulation of neurotransmitter which is signaling the molecule in the brain. One neuron releases it and the receptor of another neuron receives it. These cause the symptoms of ADHD.
Deficiency of dopamine:
There are theoretical claims that dopamine is the likely cause of ADHD. Dopamine is a neurotransmitter which helps in triggering emotional response and movement. Scientists called dopamine a motivational neurotransmitter. It helps in focusing or concentrating on things. It allows us to live life openly. Research shows that a deficiency of these neurotransmitter causes ADHD. But causes of the lack of dopamine is still unknown, and researching is going on till date.
Deficiency of gray matter:
The central nervous system is constructed by two types of tissues, i.e., Gray matter and White matter. Neuronal cells and axon builts the gray matter. The gray matter has an essential function in our body to process the information. It processes the signals generated from the sensory cells of the muscle, skin and other areas. It helps us in sensory perception such as seeing, thinking, self-control, hearing, thinking, and memory. Its deficiency causes the symptoms of ADHD.
Smoking and alcohol:
Smoking drinking alcohol at the time of pregnancy causes ADHD because it possesses nicotine which decreases the supply of oxygen to the brain. Decreases in oxygen supply to the mind lead to underdevelopment of various parts of the brain which causes the symptom of ADHD.
There may be other causes, but we don’t know its exact reasons as many pieces of research are going on. The interesting fact is that the boy is three times more affected by ADHD syndrome as compared to girls.
Significant dietary changes for ADHD:
Eat protein rich food and less sugar intake:
A person with ADHD needs to consume too much protein-rich food Because it can aid the brain to produce more neurotransmitters. Also, eating too much protein helps them to curb a sudden spike in blood sugar level. As per the study, spike in blood sugar level has been linked with disruptive behavioral among ADHD’s children. This is because a sudden increase in blood sugar level can turn into an elevated energy level — an excessive amount of energy children with ADHD to intensify their disruptive behavior. So parents are required to gradually cut down their sugar level and increase their protein intake. For protein-rich food, children are required to consume eggs, nuts, soybeans, and lean meats.
Increase the intake of complex carbohydrates:
Increase intake of complex carbohydrates because complex carbohydrates provide energy without spiking blood sugar level. Complex carbohydrates should comprise nearly sixty percent of the diet of a child with ADHD. Green leafy vegetables, whole grains, legumes, and fruits are all good source of complex carbohydrates.
Increase omega three fatty acid consumption:
Increase intake of omega three fatty acids can decrease negative symptoms associated with ADHD like poor concentration, hyperactivity, impulsiveness, and disruptive behavior. Omega 3 fatty acids help to improve overall brain function and control different kinds of neurodevelopment and psychiatric disorder including ADHD. Since children with ADHD has a lower amount of omega three fatty acids as compared to a normal child, these children should be fed omega three rich foods with six or more months, to manage ADHD symptoms better. Flax seeds, salmon, soybeans, and walnuts all contain a considerable amount of omega three fatty acids.
Eat iron-rich foods:
Researches have shown that child with ADHD has the significantly lower level of iron despite not being anemic. To raise the iron level in the body, children need to eat iron-rich food like spinach, red meat, chard, broccoli, beans, turkey, etc.
Other than changing diet plan, children with ADHD need to do yoga, meditation as researches revealed its impact to help children combating the symptoms of ADHD.
Treatment of ADHD:
It is a tricky process as symptoms of the ADHD may vary from patient to patient. Although most often involve behavioral psychotherapy, medication or both. Behavioral psychotherapy is most often targeted at children, focus on teaching the children better time management and organizational skills. E.g., they have to follow a structured routine. And rewards are given to them when they stick to those routines.
Also, behavioral parent training and behavioral classroom management have been shown to help children. For an adult, behavioral psychotherapy might focus on ways of decreasing distraction and increasing organizational skills.
If we prescribe drugs, the first line of treatment is stimulants. Since the low level of neurotransmitter is involved in ADHD, stimulants are used because they tend to increase the number of neurotransmitters like dopamine. It, therefore, reduces the symptoms. Typical and well know stimulant medication used are chemically similar to illicit stimulants like methamphetamine. But there is the crucial difference to keep in mind here. All these medications increase the release of dopamine from neuron A, but ADHD medication causes a slow release of dopamine whereas illicit stimulants cause a fast release of dopamine. It’s this incredible surge of dopamine that disrupts the healthy communication between neurons and produces euphoria. This is the reason that illicit substance like methamphetamine is highly addictive. The slow and controlled release of dopamine caused by ADHD medication is vital and helps a lot of patients to increase their focus.