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.  

Edward Callaghan, Ph.D.

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