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Restless with a Cause— Understanding ADHD

I always wondered why I was so hyperactive. It wasn’t until I became an adult, and was doing some research on Attention Deficit Hyperactivity Disorder (ADHD) that I discovered I not only live with the condition now, but I had also been the classic poster child for it. It dawned on me that I was reprimanded for much of my childhood due to an undiagnosed medical condition. I began to feel incredible empathy and compassion for children who live with constant belittling, name-calling, and punishment for behavior that they have little or no control over. I realized the desperate need to educate the general public, especially parents and teachers, as well as healthcare providers, particularly in the developing world, about recognizing symptoms of ADHD and how to seek help.

ADHD is a neurodevelopmental disorder that affects a person’s ability to pay or sustain attention. The disorder could also affect impulse control and make a person hyperactive or fidgety. It is independent of how intelligent a person is, and the severity of symptoms varies from one person to the next. Virtually all affected persons show symptoms before the age of 12 years, but the condition often goes unrecognized, as my case was. 

When I was a child, I couldn’t sit still. I seemed to lose items more often than the average kid. Sometimes, it was my school supplies; at other times, it was the oddest of items —like the day I arrived home after school with only one sandal. My parents couldn’t understand how I could have been inattentive enough not to notice the heat of the pavement on just one foot. In addition to forgetfulness in daily activities, I seemed incapable of being quiet. My teachers put comments in my report card about how I was an intelligent and energetic student, who would shine, if only I could sit still and stay focused on the teacher, instead of drawing pictures on my class work and engaging in side talk. Each morning, I was determined to change my ways to please my teachers, but I always fell short. In those days, children were customarily smacked for such behaviors, and heaven knows, I got more than my fair share of whippings!

ADHD interferes with daily life at school, work, home or in social situations. There is a tendency for it to affect academic achievement due to distractibility, an abundance of careless mistakes, the propensity to be slow at completing work and forgetting to turn work in. There may be inconsistent performance based on how distracted a person was when the work was being done or how pleasurable the activity was, since people living with ADHD may be able to hyper-focus on activities that they genuinely enjoy.

A diagnosis of ADHD is not a sentence to a life of gloom and doom. I managed to graduate with good grades and was accepted into medical school at the age of 15 years. In spite of struggles and academic detours, I have made a success of my life. Left undiagnosed and untreated, not everyone with ADHD will be that fortunate. Many are erroneously labeled as lazy, disobedient, disorganized or badly behaved. Some eventually give up on school, or holding down a job due to symptoms such as poor time management or an inability to follow through with directions or assigned tasks. 

Three types of ADHD are currently recognized:

  • inattentive (not generally hyperactive; this used to be called attention deficit disorder or ADD)
  • hyperactive-impulsive
  • combined (symptoms of both inattention and hyperactivity)

Some symptoms of ADHD include:

  • Fidgeting or squirming / difficulty remaining seated
  • Running or climbing at inappropriate times
  • Talking excessively / inability to play quietly
  • Difficulty waiting for one’s turn in conversations or activities
  • Appearing not to listen, even though spoken to directly
  • Starting tasks but not completing them
  • Difficulty staying organized /difficulty with executive functioning skills
  • Avoiding activities that require sustained mental effort (such as homework)
  • Often losing needed items (glasses, cell phone, keys, pencils, books, etc.)
  • Being easily distracted
  • Forgetfulness in daily activities /forgetting to turn in homework or do chores
  • Impulsivity
  • Difficulty controlling emotions (like anger, frustration, etc.)

Scientific evidence indicates that while ADHD is mainly a genetic disorder, environmental and social factors may contribute. It is not a result of indiscipline or irresponsible parenting. Some ADHD symptoms are developmentally appropriate for children of certain ages, so it is important not to self-diagnose. While focus and attention difficulties are common to all people with ADHD, not all ADHD symptoms are present in everyone with the condition.

If you suspect that you or your child may have ADHD, you need to contact a mental health professional, like a psychiatrist or a clinical psychologist. You can start by speaking to your general doctor or your child’s pediatrician. You will have to complete a battery of questionnaires and may have to take computer-based assessments.  Concomitant conditions such as anxiety or mood disorders may be identified during this process.

In some cultures, there is stigma associated with seeing a mental health professional. Do not let this keep you from seeking the help you need and deserve.  Healthcare professionals are trained to keep your medical information confidential. 

Although there is no cure for ADHD yet, there are medications that can significantly alleviate symptoms. In most developed countries, ADHD is recognized as capable of impairing the individual (that is, it can be disabling). Thus, laws are in place to ensure that children with ADHD receive accommodations at school, if recommended by their doctors. These might include extra time on tests and assignments and preferential seating. If you live in a country where ADHD accommodations are not legislated, make an appointment with an administrator at your child’s school to discuss your child’s diagnosis and the appropriate accommodations.

Living with ADHD can impact a person’s self-esteem. Therefore, it is important to focus on positive traits, and channel hyperactivity into sports or other productive extra-curricular activities. For example, my passionate speaking was channeled into the debate club. This enhanced my self-confidence and helped me see what others saw as a flaw as a blessing.

Above all, remain positive. You and your child can accomplish great things, in spite of an ADHD diagnosis.

                                                                        Contributed by ‘Nike Aina, Ph.D.