Attention-Deficit/Hyperactivity Disorder (ADD or ADHD) is one of the
most common neurobehavioral disorders of childhood and unfortunately
most of its causes are unknown. It can persist through adolescence and
into adulthood. According to the estimation of American Psychiatric
Association's Diagnostic and Statistical Manual-IV (DSM-IV-TR) 3%-7% of
children suffer from ADHD. Some studies have estimated higher rates in
community samples. Surprisingly, this dis-ease is diagnosed
approximately three times more often in boys than in girls.
ADHD
is a diagnosis applied to children and adults who consistently display
certain characteristic behaviors over a period of time. The most common
core features include:
· Distractibility (less concentration and poor sustained attention to tasks)
· Impulsivity (impaired impulse control and delay of gratification)
· Hyperactivity (excessive activity and physical restlessness)
ADHD
does not often come alone and there are many other conditions that are
commonly associated with ADHD like depression, bipolar disorder,
oppositional defiant disorder, conduct disorders and learning
disabilities. These are just some of the conditions that can appear with
ADHD. Some studies have indicated that between 50% and 70% of
individuals with ADHD also have some other conditions.
Early
diagnosis and treatment can often times prevent problems later.
According to studies, anywhere from 24% to 30% of patients with ADHD
also suffer from depression. In the past it was thought that depression
might have been the result of constant failures due to ADHD symptoms.
Therefore, if ADHD was successfully treated, the depression should
disappear. Based on this assumption, ADHD was considered to be the
primary diagnosis and the depression was ignored. However, a study by
the Pediatric Pharmacology Department at Massachusetts General Hospital
in Boston indicated that depression and ADHD are separate and both
should be treated one after the other or sometimes simultaneously
(depending upon the individual case).
Clinical experience has
shown that the most effective treatment for ADHD is a combination of
medication (when necessary), therapy or counseling to learn coping
skills and adaptive behaviors, and ADD coaching for adults.
Indeed,
diagnosis can be very difficult. Stimulant medications, commonly used
to treat ADHD, can sometimes cause side effects that mimic depressive
symptoms. These medications can also increase symptoms of depression and
bipolar disorders, making it hard to distinquish what are the true
symptoms and which are caused from medication. Many physicians will,
therefore, treat the depression first, and, once that has been
controlled will begin to treat ADHD.
So in that case pepression
becomes the “primary” diagnosis and ADHD becomes the “secondary”
diagnosis. Other physicians will argue that treatment must be
simultaneous, with treatment occurring at the same time. Arguments for
this method of treatment say that in order to have either condition
under control, both must be under control.
We should also
understand that medication is often used to help normalize brain
activity, as prescribed by a physician. Stimulant medications, like
Ritalin, Dexedrine and Adderall are commonly used because they have been
shown to be most effective for most people with ADHD. However, many
other medications may also be used at the discretion of the physician.
Not
just the medication, but behavior therapy and cognitive therapy are
also often helpful to modify certain behaviors and to deal with the
emotional effects of ADHD. Many adults also benefit from working with an
ADHD coach to help manage problem behaviors and develop coping skills,
such as improving organizational skills and improving productivity.
Moreover, the role of parents cannot be underestimated in either case.
As
it is one of the most common and deadly diseases, so it is recognized
as a disability under federal legislation (the Rehabilitation Act of
1973; the Americans With Disabilities Act; and the Individuals With
Disabilities Education Act). Appropriate and reasonable accommodations
are sometimes made at school for children with ADHD, and in the
workplace for adults with ADHD, which help the individual to work more
efficiently and productively. The idea is to make them feel comfortable
as they are already challenged as a human being we should help and
respect them.
It is also believed that psychology does nothing to
treat or even to address the real ADHD symptoms. Usually psychologist
and counselor help you and your child live with and accept the
condition. So everybody, including the doctors, agree that the current
state-of-the-art treatment for ADHD does nothing really to treat the
actual disorder. Some experts recommend that all individuals receiving a
diagnosis of ADHD should also have a complete and thorough
psychological evaluation to determine the presence (or absence) of any
co-existing disorders. Once this has been completed, a treatment team,
sometimes consisting of family physician, psychologist and psychiatrist,
can work together to create a treatment plan geared specifically for
that individual.
