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Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that affects approximately 5% of children and 3% of adults (actual prevalence may be much higher). ADHD can be characterised by symptoms of hyperactivity (high energy, impulsiveness, trouble sitting still) or inattentiveness (difficulty concentrating, organising and focusing). Sometimes people with ADHD will exhibit symptoms from both of these categories.
Signs of ADHD are usually present during childhood, although a growing number of people are receiving a diagnosis in their adult life because the signs were missed or attributed to a different cause. A late diagnosis is sometimes a light-bulb moment for people that starts making sense of some of the struggles they have had all of their life.
Early diagnosis and intervention can empower people to understand and manage their condition better, leading to improved outcomes, reduced stress and a better quality of life.
ADHD is thought to run in families, with research suggesting that a person with a parent or sibling with ADHD may be more likely to have it themselves.
Other potential risk factors include:
- Premature birth (before 37 weeks)
- Low birth weight
- Drug or alcohol abuse during pregnancy
It is important to note that ADHD is still being researched and there is a lot about the condition that we still don’t fully understand. Many people still believe harmful myths and stereotypes about the condition, linking it to poor parenting, class or a bad diet, none of which have been conclusively proven to be true.
Early intervention is key in improving outcomes for people with ADHD; in addition, it is also important to acknowledge facts about the condition and not to spread misinformation or add to the stigma around the condition.
The Significance of Early Diagnosis
ADHD can have an impact on our:
- Social life
- Education
- Work life
- Family and relationships
Early diagnosis can lead to improved outcomes and a better understanding of the condition, and it gives people time to understand how having ADHD affects them in different areas of life. It also gives them additional time and space to reflect on how the condition might affect them long term and how their symptoms can be managed as they are growing up and their bodies and lives are also going through significant changes.
Early diagnosis and the appropriate treatment can result in:
- Improved academic performance
- Enhanced social skills
- Better understanding
- Increased self-esteem
Benefits of Timely Intervention
The earlier that a person receives a diagnosis, the sooner they can begin to find strategies and interventions that work for them. Early intervention also means that people can start to learn these strategies before they have started to develop unhelpful or unhealthy coping mechanisms.
Children and young people may also be less concerned with how they look or appear to others, making them more likely to be able to engage with certain treatment options such as role play activities or talking therapies.
The brains of people with ADHD work differently; therefore, a timely intervention and diagnosis means that they can begin to understand and accept themselves earlier, which reduces stress and upset. Adults who are diagnosed with ADHD often find they have wasted a lot of time trying to ‘fit in’ or do things the way everybody else can, which is often just not possible. As a result, they may develop low self-confidence, depression or anxiety.
Early intervention and effective treatment mean that people with ADHD can learn coping strategies and individual tweaks to their routine, school or work life that make things easier in the long term, such as:
- Planning everything in advance and giving yourself extra time to get ready, get out of the house etc
- Setting clear boundaries and avoiding overwhelm or burnout
- Keeping a diary or lists of to-do items
- Setting alarms or reminders on your phone for meetings, tasks and appointments
- Requesting adjustments at school, in exams or at work (such as regular breaks, longer time to complete tasks, a quiet, private place to take medication)
- Exercising regularly
- Finding support groups, networks or charities
- Learning to be kind to yourself and not compare yourself to others
With early intervention and a timely diagnosis, people with ADHD and their families can start to explore treatment options and strategies sooner and find what works best for them in both the short and long term.
Evidence-Based Treatment
Treatment options for ADHD include medication, therapy and lifestyle changes. Many people find that a combination approach works best.
Initially, you will usually speak to your GP if you suspect that you or your child has ADHD and, if you receive a diagnosis, they will usually oversee your treatment in collaboration with a specialist such as a paediatrician or psychiatrist.
Currently, there are only five types of medicine licensed to treat ADHD. These medications are:
- Methylphenidate
- Lisdexamfetamine
- Dexamphetamine
- Atomoxetine
- Guanfacine
Most ADHD medicine falls into the category of stimulants. They work by increasing activity in certain areas of the brain, especially the parts that control our:
- Behaviour
- Impulsivity
- Decision-making
Atomoxetine works differently to other ADHD meds. Atomoxetine is a type of selective noradrenaline reuptake inhibitor (SNRI). It works by increasing the amount of a chemical, called noradrenaline, in the brain.
Most ADHD medicine is available for children over the age of five. The use of prolonged medication to control behaviour in children and teens is controversial and parents are usually advised to begin with low doses. Some children may be advised to only take their medicine on school days. One benefit of getting a timely diagnosis is you are able to spend more time finding what works for you and learning how best to live with the condition to reduce the adverse effects it has on your life.
As with any medicine, ADHD medication does come with the risk of side effects. These range from nausea and headaches to problems sleeping, drowsiness and even aggression.
Some people opt to treat ADHD with therapy in addition to medication or they decide not to take medication at all. Sometimes people with ADHD will start taking medication and then decide it is not for them either due to side effects, inefficacy or how it makes them feel.
With an early diagnosis, you have more time to explore non-drug-related options whilst you are still young. Some of the available options may be more suitable for younger children (or their families) and some may be more suitable as they grow and develop. Many non-medical options are aimed at children, which makes an early diagnosis even more important.
Some options to help support people with ADHD that do not involve medicine include:
- Psychoeducation – this can be beneficial for children and teens. Psychoeducation aims to help youngsters to understand their condition and learn to navigate life and how to live with ADHD. They will be encouraged to discuss their symptoms, challenges and emotions.
- Behaviour Therapy – this usually involves behavioural management plans which may consist of a ‘reward system’. The aim of these plans is to promote positive behaviour and encourage children to manage their ADHD symptoms as far as possible. Reward systems can be a useful tool for parents, carers and teachers to try and they also place some responsibility and power back onto the young person themselves.
- Cognitive Behavioural Therapy (CBT) – CBT is a popular form of talking therapy that helps you to break problems down into smaller parts and reframe the way you think, react and behave.
- Social Skills Training – this can be useful for children who need practical guidance on how to behave in certain situations. It involves learning through acting out and role play activities.
Parents may also benefit from taking part in training or education programmes designed to teach strategies that help with:
- Behaviour management
- Communication
- Concentration
Sometimes this training is offered to parents before a child has even received a formal diagnosis but is showing signs of being affected by ADHD. These education programmes are usually run as group sessions, consisting of two-hour meetings for up to 16 weeks. The goal of this kind of training is to help parents to build their confidence, increase their awareness around ADHD and develop skills to improve their relationship with their child.
The earlier the diagnosis, the sooner your family and support network are able to get the information and education that they require to help you to live a happier, easier and less stressful life. These types of collaborative efforts are really helpful in supporting youngsters and making them feel supported, accepted, valued and less alone.
Alternative Treatments
In addition to evidence-based treatments, some people like to explore alternative treatments for their ADHD. Some of these can also be done alongside family members as a collaborative effort. Alternative treatments might not work in the way traditional methods do; however, many people report how they boost their wellbeing and self-esteem or help to reduce their symptoms in the moment.
Some alternative treatments that people try to help with ADHD symptoms are:
- Mindfulness
- Yoga
- Exercise (this can be especially effective if you have excess energy or trouble sleeping)
- Meditation
- Herbal remedies or supplements
- Aromatherapy
Spending time outdoors in nature is also thought to be highly beneficial to those with ADHD. Studies suggest that being in green space reduces our cortisol levels (the stress hormone) and reduces feelings of anxiety. A 2011 study of 421 children found that children who played regularly in green spaces showed milder ADHD symptoms than children who played mainly indoors or in built-up settings.
In addition to exploring traditional and alternative therapies, it is important that you look after your overall health which means eating a healthy, balanced diet, staying hydrated and getting enough sleep.
With an early diagnosis, you and your family can begin to find ways to fit these natural interventions into your regular routine. This time can be used as an opportunity for family bonding, such as visiting a yoga studio together, attending a cooking class or taking a weekly walk in the countryside.
Collaborative Efforts for Support
Early intervention and treatment are key to helping people live with ADHD and outcomes are further improved when they have a strong and supportive network of people around them. This may include:
- Parents and families
- Educators
- Healthcare professionals
- The wider community
Collaborative efforts for support of people with ADHD should include effective information sharing between parties, good communication and a consistent and proactive approach.
In adult life this support system may also consist of employers, romantic partners and even our children, who may need to learn to accept that sometimes mum or dad needs some extra time or does things a little differently, and this is nothing to be ashamed of!
Empowering Early Action and Advocacy
It is important that we understand the power of early action in helping people reduce the impact that ADHD has on their lives.
DO:
- Talk about the condition with candour
- Be compassionate and understanding
- Reach out for help as soon as possible
- Fight for a diagnosis if needed; resources are stretched and it is important to persevere and stay focused on getting diagnosed
- Look after your physical and mental health
- Find what treatment works for you – there is no ‘one size fits all’ treatment for ADHD
DON’T:
- Perpetuate harmful myths and stereotypes about ADHD
- Make assumptions or judgements that are not based on fact
- Be embarrassed about having ADHD or any condition or mental health issue
- Make harmful comparisons that affect your self-esteem
- Feel that your condition defines you – it doesn’t!
Advocating for people with ADHD or any other neuro difference can help to reduce stigma. Sometimes it only takes small and simple changes to help people with attention deficit hyperactivity disorder to thrive in the workplace, in education and in general society.
By refusing to acknowledge symptoms of ADHD early on, avoiding a timely diagnosis and not exploring the full range of interventions available, we are failing our young people at a time when there is a skills shortage in the workplace and a national mental health crisis unfolding.
