Hyperactive disorder and attention deficit (2023)

Attention deficit/hyperactivity disorder (ADHD) is characterized by an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development. People with ADHD experience an ongoing pattern of the following types of symptoms:

• inattentionit means that a person may have difficulty concentrating on a task, staying focused and organized, and these problems are not due to challenges or a lack of understanding.
• hyperactivitymeans that a person may appear to be in constant motion, even in situations where it is inappropriate, or excessively agitated, to hit or talk. In adults, hyperactivity can mean extreme fidgeting or talking too much.
• impulsivenessit means that a person may act without thinking or have difficulty with self-control. Impulsivity can also include a desire for immediate rewards or an inability to delay gratification. An impulsive person may interrupt others or make important decisions without considering the long-term consequences.

Some people with ADHD have mainly inattentive symptoms. Others have mostly hyperactive-impulsive symptoms. Some people have both types of symptoms.

Many people experience some inattention, unfocused motor activity, and impulsivity, but for people with ADHD, these behaviors:

• they are more serious
• occurs more often
• Interfere with or reduce the quality of your functioning socially, at school, or at work.

inattention

People with symptoms of inattention can often:

• Neglecting or missing details and making seemingly careless mistakes in school work, at work, or during other activities
• Has difficulty sustaining attention during play or tasks such as long conversations, reading, or reading.
• Does not seem to listen when spoken to directly
• You find it difficult to follow directions or finish schoolwork, chores, or duties at the workplace, or you can start tasks but lose focus and are easily distracted.
• Has difficulty organizing tasks and activities, sequencing tasks, keeping materials and belongings in order, managing time, and meeting deadlines.
• Avoid tasks that require sustained mental effort, such as homework, or for adolescents and older adults, preparing reports, completing forms, or reviewing lengthy documents.
• Losing things needed for tasks or activities, such as school supplies, pencils, books, tools, wallets, keys, paperwork, glasses, and cell phones.
• Being easily distracted by unrelated thoughts or stimuli
• Being forgetful in daily activities, such as household chores, running errands, returning calls, and keeping appointments.

Hyperactivity-Impulsivity

People with symptoms of hyperactivity-impulsivity can often:

• Fidgeting and squirming while sitting
• Leaving their seats in situations where they are expected to remain seated, such as in a classroom or office
• Jogging, jogging, or climbing at inappropriate times or, in adolescents and adults, often feeling restless
• Not being able to play or engage in hobbies quietly
• Being constantly on the go or in motion, or acting as if driven by a motor
• talk excessively
• Answer questions before they are asked, finish other people's sentences, or speak without waiting for a turn in conversation.
• Has difficulty waiting their turn
• Interrupt or intrude on other people, for example, conversations, games or activities.

Primary care providers sometimes diagnose and treat ADHD. They can also refer people to a mental health professional, such as a psychiatrist or clinical psychologist, who can perform a comprehensive evaluation and diagnosis of ADHD.

For a person to receive a diagnosis of ADHD, the symptoms of inattention and/or hyperactivity-impulsivity must be chronic or long-standing, affect the person's functioning, and cause the person to fall behind in typical development for their age. . Stress, sleep disturbances, anxiety, depression, and other physical conditions or illnesses can cause ADHD-like symptoms. Therefore, a thorough evaluation is required to determine the cause of the symptoms.

Most children with ADHD are diagnosed during their elementary school years. For an adolescent or adult to receive a diagnosis of ADHD, the symptoms must be present before the age of 12.

ADHD symptoms can appear between the ages of 3 and 6 and can continue into adolescence and adulthood. ADHD symptoms can be confused with emotional or disciplinary problems or go completely unnoticed in children who primarily show symptoms of inattention, leading to a delay in diagnosis. Adults with undiagnosed ADHD may have a history of poor academic performance, problems at work, or difficult or failed relationships.

ADHD symptoms can change over time as a person ages. In young children with ADHD, hyperactivity-impulsivity is the most prevalent symptom. By the time a child reaches elementary school, the symptom of inattention may become more prominent, causing the child to struggle academically. In adolescence, hyperactivity appears to subside, and symptoms may include feelings of restlessness or restlessness, but inattention and impulsiveness may remain. Many teens with ADHD also struggle with antisocial behaviors and relationships. Inattention, restlessness, and impulsivity tend to persist into adulthood.

Researchers aren't sure what causes ADHD, although many studies suggest that genes play a role. Like many other disorders, ADHD is likely the result of a combination of factors. In addition to genetics, researchers are looking at possible environmental factors that may increase the risk of developing ADHD, and are studying how brain injury, nutrition, and social environments may play a role in ADHD.

ADHD is more common in men than women, and women with ADHD are more likely to have symptoms of inattention. People with ADHD often have other conditions, such as learning disabilities, anxiety disorder, conduct disorder, depression, and substance use disorder.

Although there is no cure for ADHD, currently available treatments can reduce symptoms and improve functioning. Treatments include medication, psychotherapy, education or training, or a combination of treatments.

medicine

For many people, ADHD medications reduce hyperactivity and impulsivity and improve their ability to focus, work, and learn. Sometimes several different drugs or dosages must be tried before finding the one that works for a particular person. Anyone taking medication should be closely monitored by the prescribing physician.

stimulantsThe most common type of medication used to treat ADHD is called a "stimulant." While it may seem unusual to treat ADHD with a medication that is considered a stimulant, it works by increasing the brain chemicals dopamine and norepinephrine, which play essential roles in thinking and attention.

Under medical supervision, stimulant medications are considered safe. However, like all medications, they can have side effects, especially when used incorrectly or taken in excess of the prescribed dose, and require the healthcare professional to monitor how they may be reacting to the medication.

Not stimulating.Some other ADHD medications are not stimulants. These drugs take longer to start working than stimulants, but they can also improve focus, attention, and impulsivity in someone with ADHD. Doctors may prescribe a non-stimulant: when a person has bothersome side effects from stimulants, when a stimulant has not been effective, or in combination with a stimulant to increase effectiveness.

Although not approved by the US Food and Drug Administration (FDA) specifically for the treatment of ADHD, some antidepressants are used alone or in combination with a stimulant to treat ADHD. Antidepressants can help with all ADHD symptoms and may be prescribed if the patient is having bothersome side effects caused by stimulants. Antidepressants may be helpful in combination with stimulants if the patient also has another condition, such as an anxiety disorder, depression, or another mood disorder. Non-stimulant ADHD medications and antidepressants can also have side effects.

Doctors and patients can work together to find the best drug, dosage, or combination of drugs. Learn the basics about stimulants and other mental health medications atNIMH Mental Health Drugs Webpageand check thefda sitefor the latest drug approvals, warnings, and patient information guides.

Psychotherapy and Psychosocial Interventions

Several specific psychosocial interventions have been shown to help people with ADHD and their families manage symptoms and improve daily functioning.

For school-age children, frustration, guilt, and anger may have built up in the family before the child is diagnosed. Parents and children may need expert help to overcome negative feelings. Mental health professionals can educate parents about ADHD and how it affects the family. They will also help the child and parents to develop new skills, attitudes and ways of relating.

All types of therapy for children and adolescents with ADHD require parents to play an active role. Psychotherapy that includes only individual treatment sessions with the child (without parental involvement) is not effective in controlling ADHD symptoms and behavior. This type of treatment is more likely to be effective in treating symptoms of anxiety or depression that may co-occur with ADHD.

behavioral therapyIt is a type of psychotherapy that aims to help a person change their behavior. It may involve practical assistance, such as helping with organizing chores or completing school work or dealing with emotionally difficult events. Behavior therapy also teaches a person to:

• Monitor your own behavior
• Give yourself praise or rewards for acting the way you want, such as managing anger or thinking before you act.

Parents, teachers, and family members can also provide feedback on certain behaviors and help establish clear rules, to-do lists, and structured routines to help a person manage their behavior. Therapists can also teach children social skills, such as taking turns, sharing toys, asking for help, or responding to teasing. Learning to read the facial expressions and tone of voice of others, and how to respond appropriately, can also be part of social skills training.

Cognitive Behavioral Therapyhelps a person learn to be aware of and accept their own thoughts and feelings to improve focus and concentration. The therapist also encourages the person with ADHD to adjust to the life changes that come with treatment, such as thinking before acting or resisting the temptation to take unnecessary risks.

Family and couples therapyit can help family members and spouses find productive ways to deal with disruptive behaviors, encourage behavior change, and improve interactions with the person with ADHD.

Parenting Skills Training (Behavioral Parenting Management Training)teaches parents skills to encourage and reward positive behaviors in their children. Parents are taught how to use a system of rewards and consequences to change a child's behavior, provide immediate positive feedback for behaviors they want to encourage, and ignore or redirect behaviors they want to discourage.

Specific behavioral interventions for classroom management and/or academic accommodationsfor children and adolescents have been shown to be effective in managing symptoms and improving functioning in school and with peers. Interventions may include behavior management plans or teaching study or organizational skills. Accommodations may include preferential classroom seating, reduced class hours, or additional time on tests and exams. The school may provide accommodations through a so-called 504 Plan or, for children who qualify for special education services, an Individualized Education Plan (IEP).

For more information on the Individuals with Disabilities Education Act (IDEA), visitUS Department of Education IDEA website..

Stress Management TechniquesIt can benefit parents of children with ADHD by increasing their ability to deal with frustration so that they can calmly respond to their child's behavior.

Support groupsit can help parents and families connect with others who have similar problems and concerns. The groups often meet regularly to share frustrations and successes, exchange information about experts and recommended strategies, and talk with experts.

The National ADHD Resource Center, a program for Children and Adults with Attention Deficit Hyperactivity Disorder (CHADD®) supported by the Centers for Disease Control and Prevention (CDC), has information and many resources. You can get to this centeronlineor by calling 1-866-200-8098.

For more information about psychotherapy, see thepsychotherapies pageno site does NIMH.

Tips to Help Kids and Adults with ADHD Stay Organized

For children:

Parents and teachers can help kids with ADHD stay organized and follow directions with tools like:

• Keep a routine and a schedule. Keep the same routine every day, from the time you wake up to the time you go to bed. Include times for homework, outdoor games, and indoor activities. Keep the schedule on the refrigerator or on a bulletin board. Write changes in the schedule as far in advance as possible.
• Organize everyday items. Have a place for everything (like clothes, backpacks, and toys) and keep everything in its place.
• Use of task organizers and notebooks. Use organizers for supplies and school supplies. Emphasize to your child the importance of writing homework and bringing home the necessary books.
• Be clear and coherent. Children with ADHD need consistent rules that they can understand and follow.
• Give praise or rewards when the rules are followed. Children with ADHD often receive and expect criticism. Look for good behavior and praise it.

For adults:

A professional counselor or therapist can help an adult with ADHD learn how to organize their life with tools such as:

• Maintaining routines.
• Make lists for different tasks and activities.
• Use a calendar to schedule events.
• Use of reminders.
• Designate a special place for keys, bills, and paperwork.
• Break large tasks into smaller, manageable steps so that completing each part of the task provides a sense of accomplishment.

Clinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions. The purpose of clinical trials is to find out if a new test or treatment works and is safe. Although people can benefit from being part of a clinical trial, participants should be aware that the main goal of a clinical trial is to gain new scientific knowledge so that others can be better helped in the future.

Researchers at NIMH and around the country conduct many studies with patients and healthy volunteers. Today we have new and better treatment options thanks to what clinical trials discovered years ago. Be part of tomorrow's medical discoveries. Talk to your doctor about clinical trials, their benefits and risks, and whether one is right for you.

For more information or to find a study, visit:

• NIMH Clinical Trials Page: Information about participation in clinical trials
• Clinicaltrials.gov: Current Studies on ADHD: List of NIH-funded clinical trials taking place across the country
• Take Part in a Study: Children - ADHD: List of studies conducted on the NIH campus in Bethesda, MD

Free handouts and resources to share

• Attention Deficit Hyperactivity Disorder in Children and Adolescents: What You Should Know: This brochure provides information about attention deficit/hyperactivity disorder (ADHD) in children and adolescents, including symptoms, how it is diagnosed, causes, treatment options, and helpful resources. also availablein Spanish.
• Adult Attention Deficit Hyperactivity Disorder: What You Need to Know: This booklet provides information about attention deficit/hyperactivity disorder (ADHD) in adults, including symptoms, how ADHD is diagnosed, causes, treatment options, and resources to find help for yourself or someone else. also availablein Spanish.
• Shareable resources on ADHD:Help support ADHD awareness and education in your community. Use these digital resources, including graphics and messages, to spread the word about ADHD.

Multimedia

• Mental Health Minute: ADHD: Take a mental health minute to learn about ADHD.
• NIMH expert discusses managing ADHD: Learn about the signs, symptoms, and treatments of ADHD, as well as tips to help kids and teens cope with ADHD during the pandemic.

Federal Resources

• ADHD:The CDC offers fact sheets, infographics, and other resources on signs, symptoms, and treatment for children with ADHD.
• ADHD:(MedlinePlus – also availablein Spanish.)

Research and Statistics

• newspaper articles:This web page provides reference information and abstracts from MEDLINE/PubMed (National Library of Medicine).
• ADHD Statistics:This webpage provides statistics on the prevalence and treatment of ADHD among children, adolescents, and adults.

Ultima revision:September 2022
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