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Mental Health Series

Recently there have been many articles reporting that there is a rise in the number of diagnosed and treated for ADHD. While some of this might be due to more awareness, it might also be due to the fact that people are now getting more mental health treatment overall. More and more adults are now being diagnosed as well. Could it be that the stigma is lessening? Let’s hope!

ADHD (Attention-Deficit/Hyperactivity Disorder) is a neurodevelopmental disorder that affects both children and adults. People with ADHD typically have difficulties with attention, impulsivity, and hyperactivity. People with ADD (Attention-Deficit Disorder) are now lumped in with the ADHD label. ADHD and ADD do have some clear differences. This disorder is real despite what some may claim.

There are numerous sub-categories or sub-types under the ADHD umbrella. For this post, we will discuss the main 2; ADD and ADHD.

Some of the symptoms of ADHD include:

• Difficulty paying attention to details and staying focused on tasks
• Making careless mistakes and frequently losing or forgetting things
• Difficulty following through on instructions and completing tasks
• Fidgeting, squirming, and restlessness
• Interrupting others, blurting out answers, and difficulty waiting their turn
• Inability to sit still or engage in quiet activities

Some of the symptoms of ADD include:

• Difficulty paying attention to details and staying focused on tasks
• Increased distractibility
• Making careless mistakes and frequently losing or forgetting things
• Difficulty following through on instructions and completing tasks

ADD (Attention Deficit Disorder) was a term used previously to describe a subtype of ADHD where hyperactivity was not present. However, currently, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) no longer recognizes ADD as a separate diagnosis. ADD is now considered ADHD with predominantly inattentive presentation.

Unfortunately ADD/ADHD is often underdiagnosed or misdiagnosed. It is my opinion that the DSM-5 has done a disservice to people by removing the individual categories, which can lead to more stigma in regard to how people perceive those who do have this disorder. For example, if you do not have the “hyper” characteristics, but are labeled as ADHD, teachers, peers and family might assume you must be hyper or fidgety as well and may treat you differently.

Recently with the widespread use of social media (some of my favorites for insights include Pinterest and TikTok), people have been sharing their experiences and stories and it has become more obvious that that there are additional signs and symptoms of ADHD and ADD, especially in women. I highly encourage you to follow some people posting about ADHD on social media for real life examples and tips on how to manage it. It helps to relate to others that are going through the same thing. As always make sure you know if the information people provide is accurate.

I encourage both parents and people suffering to learn as much as possible about the disorder and customize your treatment accordingly. As a parent of a child with ADD, it has been immensely helpful to realize that we are not alone and have embraced the positive aspects of this disorder (listed below).

Some of these symptoms in women include:

• Thriving in crisis or chaotic environments
• Not realizing when to ask for help/support or HOW to ask for help/support
• Feeling overwhelmed in general
• Impatience, rushing, clumsiness
• Issues with short term memory, even forgetting to eat
• Insomnia
• Need for organization, but lack of will to organize
• Needing stimulation but that stimulation can lead to a feeling being over-stimulated
• Tendency to overreact or be easily upset

Most of the research that has been done on ADHD started in the 1960’s and was focused more on male subjects. Over the last few decades research and treatments have improved, but we still have much farther to go.

Since ADHD symptoms can present differently in girls compared to boys, it can be harder to diagnose in girls. Some of the reasons for this difference include:

Inhibition: Girls with ADHD/ADD tend to internalize their symptoms, meaning they may not display the hyperactive and impulsive behavior that is often more common in boys with ADHD. Instead, females may appear withdrawn or daydreamy. This can lead to a misdiagnosis of anxiety or depression (although these mental health conditions may also co-occur).

Socialization: Girls with ADHD/ADD are typically better at socializing than boys with ADHD, which can mask their symptoms. However, this can also lead to feelings of anxiety and rejection, which can exacerbate their ADHD/ADD symptoms.

Coping mechanisms: Girls with ADHD/ADD may develop coping mechanisms that help them manage their symptoms, such as hyper focusing on a task or becoming overly organized. While these coping mechanisms can be effective, they can also lead to additional stress and anxiety.

Gender bias: There may be a gender bias in diagnosing ADHD/ADD, with girls being less likely to be referred for testing or receiving a misdiagnosis. This can delay treatment and lead to long-term consequences.

It is imperative to recognize that ADHD can present differently in girls, and healthcare professionals should be aware of these differences to provide an accurate diagnosis and appropriate treatment.

Causes

The exact cause of ADHD is not yet fully understood. However, research suggests that a combination of genetic, environmental, and neurobiological factors can contribute to the development of the disorder.

Genetic factors: Studies have shown that ADHD is highly heritable, meaning that it can run in families. It is estimated that up to 80% of the risk for ADHD can be attributed to genetic factors. Certain genes that are involved in regulating dopamine and norepinephrine, two important neurotransmitters, have been identified as potential risk factors for ADHD.

Environmental factors: Environmental factors such as prenatal exposure to tobacco or alcohol, premature birth, low birth weight, and exposure to toxins such as lead, have been suggested as potential risk factors for ADHD.

Neurobiological factors: Research has shown that certain areas of the brain that are responsible for attention, executive function, and impulse control may function differently in people with ADHD. Specifically, there may be differences in the prefrontal cortex, basal ganglia, and cerebellum regions of the brain.

It is likely that ADHD is caused by a complex interplay of genetic, environmental, and neurobiological factors. Further research is needed to better understand the underlying causes of ADHD.

Dr. Gabor Maté described what he believes is a major factor contributing to developing ADHD/ADD. I have linked this podcast below. You can find out more about him here. I feel most of what he describes makes sense and is spot on.

Treatment

Developing effective coping skills can help individuals with ADHD manage their symptoms and improve their quality of life. Along with coping skills, improving organization, sticking to a routine and medication can help.

Here are some additional coping skills to utilize:

• Break tasks into smaller steps
• Use organizational tools (planners, to do lists, calendars, apps) to help get you organized
• Minimize distractions especially when focus is required (turn off devices, noise reduction headphones, etc.)
• Practice mindfulness (Yoga, deep breathing, meditation) helps to manage stress and improve focus
• Exercise regularly (especially helpful for those that need to move)
• Seek support (both psychiatric and with family or friends)

ADHD/ADD medications have gotten a bad rap over the years but has also been tremendously helpful for people. The medications now available are not all stimulants. As always with any medication there are risks and benefits, as well as side effects. Make sure you do your own research and continue to advocate for yourself with your healthcare provider. Just because one medication doesn’t work, does not mean that all medications won’t work. These medications can help, but they cannot be abused, so it is critical that you follow the prescribed dose.

Other treatments such as behavioral therapy, organizational skills training, and lifestyle changes may also be effective for managing ADHD/ADD symptoms.

Diet

What you eat with ADHD/ADD has been found to be very influential in how you function. Becca over at The Nutrition Junky has an entire blog dedicated to ADHD/ADD nutrition. You may have heard that ADHD/ADD can be managed with diet alone. Becca writes that, “It is important to note that ADHD is not caused by diet and diet cannot cure ADHD. Someone with ADHD may find it challenging to plan and prepare foods due to executive dysfunction. This is a limitation in how the brain manages thoughts, tasks, time and decisions.” She stressed the importance of not skipping meals and a balanced diet, with adequate protein, iron, Vitamin D, magnesium and zinc (all shown to improve ADHD symptoms). I highly recommend you check out her blog for more details.

Outlook

While the stigma of having ADHD/ADD is not entirely gone, there are people who have learned to use this disorder to excel in life. Having ADHD/ADD is not a death sentence, it just means you and your family will need to make some adjustments and do things a little differently than average people. Having ADHD/ADD essentially means that your brain just processes things differently than average people and sometimes it processes things better and faster.

Positive aspects of ADHD/ADD include:

• Higher creativity
• Ability to focus on things that interest them more intensely
• Higher energy
• Higher resilience
• Better communicators
• Outside-of-the-box thinking

These people have all struggled with ADHD/ADD and have created lives that they love using their unique strengths.

• Michael Phelps
• Justin Timberlake
• Simone Biles
• Richard Branson
• Emma Watson
• Michelle Rodriguez
• Will Smith
• Ryan Gosling
• Walt Disney

It is known that people with ADHD have unique strengths, as a result of their brain functioning difference. They are often more spontaneous, creative, energetic, intuitive, imaginative, and inventive. They also have the ability to hyperfocus on subjects that interest them to a far greater extent than average people.

People with ADHD/ADD are outside-of-the-box thinkers and often produce original and creative ideas. Their superior energy means that they can achieve more and work harder and faster than most others.

People with ADHD might consider working in professions that allow them to direct their need for physical activity, creativity, imagination, or sense of innovation into a career in which they can utilize it positively and in which it will stand as an asset. Some optimal professions for people with ADHD are becoming an entrepreneur, inventor, artist, interior designer, graphic designer, paramedic, firefighter, police officer, teacher, computer programmer, or working in sports.

ADHD can be diagnosed by a healthcare professional, and treatment typically involves a combination of medication, therapy, and lifestyle changes. With proper management, people with ADHD can lead successful and fulfilling lives.

If you have any unique experiences or tips to manage ADHD/ADD please leave a comment below.

When to get emergency help

If you think you may hurt yourself, someone else or attempt suicide, call 911 in the U.S. or your local emergency number immediately.

Also consider these options if you’re having suicidal thoughts:

• Call your doctor or mental health professional. Or 211 to speak to a live person about mental health options.
• Contact a suicide hotline.
  • In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. Or use the Lifeline Chat. Services are free and confidential.
  • U.S. veterans or service members who are in crisis can call 988 and then press “1” for the Veterans Crisis Line. Or text 838255. Or chat online.
  • The Suicide & Crisis Lifeline in the U.S. has a Spanish language phone line at 1-888-628-9454 (toll-free).
• Numerous Apps are now available to talk with someone in the privacy of your own home. Click here for a free app list. Other Apps include: Talkspace, BetterHelp, and Sanvello.
• Reach out to a close friend or loved one.
• Contact a spiritual leader or someone else in your faith community.

If you have a loved one who is in danger of suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you think you can do so safely, take the person to the nearest hospital emergency room. DO NOT leave them alone.