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ADHD Overview

Attention-deficit hyperactivity disorder (ADHD) is a neurobehavioral disorder affecting children and adults. ADHD is the most common neurological disorder in children. ADHD in children is characterized by inattentiveness, hyperactivity and impulsivity.

According to the Center for Disease Control, ADHD affects 7.4 percent of children between the ages of 3 and 17 and 4 percent of adults. Boys are 2.3 times more likely to be diagnosed with the disorder than girls, and roughly 60 percent of children with ADHD will continue to exhibit symptoms into adulthood. Symptoms range from severe inattentiveness to aggression and are categorized into three types: predominately inattentive, predominately hyperactive-impulsive or “combined.”

Whereas the exact cause of ADHD is unknown, research supports the use of both conventional and alternative therapies. As ADHD affects each person differently, a customized comprehensive plan is recommended.

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History

See the naughty restless child
Growing still more rude and wild
Till his chair falls over quite,
Philip screams with all his might1

The first historical reference of ADHD appeared in 1846.2 Dr. Heinrich Hoffman, a German psychiatrist described a boy with the classic signs of ADHD in the poem “Zappel Philip” (“Fidgety Philip”).

Children have been experiencing the symptoms of ADHD long before a formal diagnosis was created. However, prior to the 20th century, people viewed the symptoms of ADHD as a breach in morality rather than a neurological disorder.3

Starting in the 1920s, kids with ADHD were diagnosed as brain damaged following the observation that children with encephalitis often exhibited restlessness, personality changes and learning difficulties.4 Following this finding, psychiatrists coined the term “minimal brain damage” for anyone exhibiting symptoms of ADHD.5

One of the most significant findings took place in 1937. Dr. Charles Bradley prescribed stimulants to help relieve headaches in hyperactive boys only to discover that they helped them to focus. Prior to this discovery, hyperactive boys were typically thrown into reform schools where they were beaten for their deviant behavior. Bradley’s research changed the perception of hyperactive children as being morally flawed to being physically impaired; the discovery kicked off a flurry of ADHD research.

Up until the 1960s, researchers focused on the hyperactive aspect of the disorder. In the second edition of the Diagnostic Statistical Manual of Mental Disorders (DSM-II), ADHD was described as the “hyperkinetic reaction in childhood.” Indeed, it wasn’t until the 1970s that researchers started to associate ADHD with inattentiveness leading to the adoption of the term “attention-deficit disorder” in the DSM-III. (The disorder’s most recent moniker was adopted in 1987 and describes both individuals with predominantly hyperactive-impulsive and predominantly inattentive symptoms.)

The 1970s were also a time when researchers discovered that children with ADHD don’t always outgrow it. Researchers found this to be the case in roughly 60 percent of the cases, paving the road for a new area of focusing on ADHD in adults. Later research found the disorder in girls and adult women.6

Brain scan technology advanced ADHD research even further in the 1990s. Using positron emission tomography (PET), Alan Zametkin showed that adults with ADHD metabolize glucose differently than people without the disorder. Similarly, studies using magnetic resonance imaging showed that the people with ADHD have slightly less brain volume than people without the disorder. Researchers found this to be the case in the frontal lobes, the corpus callosum, the caudate nucleus, and the vermis of the cerebellum.7

More recent studies have linked ADHD with genetics. Thanks to the human genome project, researchers have been able to identify specific genes that play a role in the production of neurotransmitters, enzyme and carrier molecules. Meanwhile the 21st century has shown a rise in pharmacotherapy research in addition to the use of alternative therapies.8

Prognosis

ADHD has no known cure.9 The criteria for diagnosing the disorder is far more restrictive in Europe than in the U.S. suggesting that under a different set of standards some of the cases may not even exist.10 Of the children who are diagnosed, about 60 percent will continue to exhibit symptoms into adulthood. However, many children learn to work around their symptoms to the point where they are no longer noticeable. Indeed the majority of adults with ADHD are diagnosed as “predominantly inattentive.” With or without treatment, most people with ADHD go on to live happy, productive and fulfilling lives.11 Oftentimes the symptoms that earn them an ADHD diagnosis in childhood become the very traits that make them invaluable in adulthood. For example, due to their need for stimulation, individuals with ADHD often excel in deadline-oriented careers such as business, publishing, technology and the entertainment industry. ADHDers are also artistic, creative, intuitive, inventive, enthusiastic, empathetic and loving. Indeed, Parenting magazine recently released a list of celebrities who have admitted to having the disorder. Among those listed were TV starlit Paris Hilton, comedian Jim Carrey, Major League baseball player Pete Rose, star chef Jamie Oliver and JetBlue Airways founder David Neeleman.

Despite all their great qualities, people with ADHD are also known to be at a higher risk for a variety of mood disorders, anxiety, substance abuse, conduct disorder and learning disabilities. Roughly 25 percent of people with ADHD suffer from a mood disorder such as dysthymia (mild depression), depression or bi-polar disease whereas 40 percent are at risk of substance abuse. Additionally, 15 percent will suffer from antisocial personality disorder and another 20 percent will struggle with learning disabilities.12 Each of these associated disorders is considered a serious condition and should be treated separately. That said, sometimes when the ADHD is treated, these associated issues spontaneously clear.

References

  1. Heinrich Hoffman, “The Story of Fidgety Philip,” Struwwelpeter, 1994–1999. http://www.fln.vcu.edu/struwwel/philipp_e.html
  2. Rob Santich, “Attention deficit hyperactivity disorder,” (presentation, the National Herbalists Association of Australia’s 6th annual conference, Canberra, Australia, September 2007).
  3. Edward M. Hallowell, M.D., and John J. Ratey, M.D. Delivered from Distraction: Getting the Most out of Life with Attention Deficit Disorder. (New York: Ballantine Books, 2005), 53.
  4. Sami Timimi. Naughty Boys, Anti-social Behaviour, ADHD and the Role of Culture. New York: Palgrave Macmillian, 2005.
  5. Rob Santich, “Attention deficit hyperactivity disorder,” (presentation, the National Herbalists Association of Australia’s 6th annual conference, Canberra, Australia, September 2007).
  6. Edward M. Hallowell, M.D., and John J. Ratey, M.D. Delivered from Distraction: Getting the Most out of Life with Attention Deficit Disorder. (New York: Ballantine Books, 2005), 54.
  7. Edward M. Hallowell, M.D., and John J. Ratey, M.D. Delivered from Distraction: Getting the Most out of Life with Attention Deficit Disorder. (New York: Ballantine Books, 2005), 55.
  8. Carol K. Whalen. “ADHD treatment in the 21st century: Pushing the envelope,” Journal of Clinical Child Psychology 30, no. 1: 136–140.
  9. “Prognosis of ADHD,” WrongDiagnosis.com, 14 June 2010, http://www.wrongdiagnosis.com/a/adhd/prognosis.htm
  10. Rob Santich, “Attention deficit hyperactivity disorder,” (presentation, the National Herbalists Association of Australia’s 6th annual conference, Canberra, Australia, September 2007).
  11. “Prognosis of ADHD,” WrongDiagnosis.com, 14 June 2010, http://www.wrongdiagnosis.com/a/adhd/prognosis.htm
  12. Edward M. Hallowell, M.D., and John J. Ratey, M.D. Delivered from Distraction: Getting the Most out of Life with Attention Deficit Disorder. (New York: Ballantine Books, 2005), 133.

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