Problems that Usually Need Psychotherapy or Psychiatry Treatment

Attention-Deficit Hyperactivity Disorder or ADHD

Many people have difficulty concentrating at times, or become restless and fidgety when they feel bored.  But when these kinds of difficulties are happen all time in most or all settings, and don’t improve with age or maturity, then the possibility of Attention- Deficit Hyperactivity Disorder may be of concern.  Attention-Deficit Hyperactivity Disorder, or ADHD as it is commonly called, is comprised of three central features:  inattention, hyperactivity, and impulsivity.  People diagnosed with ADHD may have mild, moderate, or severe symptoms of the disorder and, because of it, struggle with varying degrees of impairment.  ADHD typically manifests itself before the age of seven and may be diagnosed as being ADHD, inattentive type, ADHD hyperactive-impulsive type, or ADHD combined type.

Children and adults with ADHD inattentive type, primarily have difficulties with attention, focus, and concentration, but do not have difficulties related to impulsivity and hyperactivity.  These individuals, sometimes referred to as having ADD (note the omission of the “H” for the absence of hyperactivity in this subtype), frequently struggle with difficulties in learning because their abilities for focusing, attending, concentrating, and remembering are relatively poor compared with their peers.

Children and adults with ADHD hyperactive-impulsive type, on the other hand, have relatively normal abilities for attending and concentrating, but struggle with difficulties connected to impul- siveness and hyperactivity.  For school-age children with this subtype of ADHD learning is relatively intact and only minimally impacted by the disorder.  Problems are more likely to occur with students’ and adults’ peer relationships, her/his behavior in the classroom or at work (e.g., because of the difficulties in remaining quiet and on-task), and in the home (because of difficulties in following directions and controlling impulses).

Children and adults with ADHD combined type exhibit difficulties in all of the areas described above.  These individuals have difficulty with attention and concentration as well as difficulties with hyperactivity and impulsivity.

ADHD differs from depression, bipolar disorder, anxiety, and other emotional and psychiatric disorders that people seek treat- ment for because the underlying causes for ADHD are centered on the frontal lobe of the brain and involve mostly neurological difficulties.  Unlike mood disorders that are typically linked to abnormalities of the emotional centers of the brain (i.e., the limbic system), ADHD symptoms arise from impairments in the brain regions responsible for planning and controlling purposeful actions and behavior.  Mood issues do occur in ADHD, as do problems in social functioning, but these problems are largely secondary in nature and more closely linked to underlying problems in behavioral control and poor abilities for managing emotional reactions.

Unfortunately, individuals with ADHD (because of their difficulties with learning and behavioral control) are at a much higher risk than typical children for developing a host of other problems.  Children with ADHD, for example, are at a much higher risk for developing anxiety and poor self-esteem.  As they become aware of the differences between themselves and their more self- controlled peers, feelings of frustration often become more pronounced.  As this happens the students’ perseverance and investment in the learning process often start to diminish and the student begins to give up more easily.  At the same time, the student may become more alienated from peers and may also be- come the target of frequent correction and admonishment from teachers.  The cumulative effects of these problematic interactions tend to mount over time and frequently result in school failure, delinquency, and substance abuse problems later on (if not adequately addressed).  Fortunately, there are a variety of interventions and medications that are very effective at helping those with ADHD function better in the classroom, at home, and at work, and most people are helped with medication, therapy (primarily behavioral therapy, which teaches techniques to cope with ADHD symptoms and changes to make in their environment to help make working and studying more effective) or some combination of both.  

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Edward Callaghan, Ph.D.

Frequently Asked Questions

What is ADHD, and what are its main symptoms?

Attention-Deficit Hyperactivity Disorder (ADHD) is a condition associated with persistent patterns of inattention, hyperactivity, and impulsivity that can interfere with functioning at home, at school, at work, or in relationships. Some people primarily experience difficulties with attention, focus, organization, and concentration, while others experience more prominent hyperactivity and impulsivity. Some people experience a combination of these symptoms.

What are the different types of ADHD?

ADHD can present in different ways depending on the pattern of symptoms. Inattentive presentation primarily involves difficulties with attention, focus, concentration, organization, and memory. Hyperactive-impulsive presentation involves greater difficulty with restlessness, impulsive behavior, and controlling actions. Combined presentation involves significant symptoms of both inattention and hyperactivity or impulsivity. The way ADHD appears can also change as a person develops and encounters different demands at school, work, and home.

How does ADHD affect children and adults differently?

ADHD can affect people throughout life, but the difficulties may look different at different ages. Children may struggle with attention, following directions, completing schoolwork, controlling impulses, or remaining focused in the classroom. Adolescents and adults may experience difficulties with organization, time management, work responsibilities, relationships, or managing competing demands. The specific challenges depend on the individual's symptoms, environment, and developmental stage.

How is ADHD different from anxiety, depression, or other mental health problems?

ADHD can involve difficulties with attention, impulse control, activity level, and executive functioning, while anxiety and depression primarily involve patterns of fear, worry, low mood, loss of interest, or other emotional symptoms. However, these conditions can overlap, and a person with ADHD may also experience anxiety, depression, or other mental health concerns. A professional evaluation can help determine whether attention or behavioral difficulties are related to ADHD, another condition, or a combination of concerns.

How is ADHD diagnosed?

ADHD is diagnosed through a professional evaluation that considers a person's symptoms, developmental history, functioning in different settings, and the extent to which difficulties interfere with everyday life. Because problems with attention, concentration, restlessness, or impulsivity can occur for many different reasons, an evaluation may also consider other possible explanations. A qualified professional can help determine whether the overall pattern of difficulties is consistent with ADHD and whether additional concerns should also be addressed.

Can ADHD cause problems with school, work, relationships, or self-esteem?

Yes. Difficulties with attention, organization, impulse control, or completing tasks can interfere with academic performance, employment, relationships, and everyday responsibilities. Repeated struggles or negative feedback can also contribute to frustration, discouragement, or low self-esteem. These effects can become more significant when ADHD symptoms are not recognized or when a person does not have effective strategies for managing them.

What treatments are available for ADHD?

ADHD can be treated in several ways depending on the individual's symptoms, age, circumstances, and treatment needs. Treatment may include medication, behavioral therapy, psychotherapy, practical strategies for organization and time management, or a combination of approaches. Behavioral approaches can help people develop ways to manage ADHD symptoms and make changes in their environment that support more effective functioning at home, school, or work.

Can ADHD occur along with anxiety, depression, or other mental health problems?

Yes. People with ADHD may also experience anxiety, depression, low self-esteem, or other emotional and behavioral difficulties. Sometimes these concerns develop partly as a result of the challenges associated with ADHD, while in other cases they represent separate conditions that occur at the same time. Understanding all of the concerns affecting a person can be important when developing an appropriate treatment plan.

Can individual therapy help someone manage ADHD?

Yes. Individual Therapy can help people address the emotional, behavioral, and practical difficulties associated with ADHD. Therapy may focus on understanding patterns that interfere with daily functioning, developing more effective ways of responding to frustration or stress, improving self-awareness, and building strategies for managing challenges in relationships, school, work, or other areas of life. Treatment can be tailored to the individual's needs and may be used along with other approaches to ADHD treatment.

When should someone seek professional help for ADHD?

Professional help may be appropriate when difficulties with attention, organization, impulsivity, hyperactivity, or emotional regulation persist and interfere with school, work, relationships, or other areas of daily life. An evaluation may also be helpful when someone has been struggling for a long time without understanding why, or when ADHD symptoms occur alongside anxiety, depression, or other concerns. For more information about ADHD and other mental health problems that may benefit from professional evaluation or treatment, see Problems that Usually Need Psychotherapy or Psychiatry Treatment.

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