ADHD is not a “new” mental health problem and is not a disorder created for the purpose of personal gain or financial gain from pharmaceutical companies, mental health or the media. This is a very real behavioral and medical disorder that affects millions of people across the country. According to the National Institute of Mental Health (NIMH), ADHD is one of the most common mental disorders in children and adolescents. According to the NIMH, the estimated number of children with ADHD is between 3% and 5% of the population. The NIMH also estimates that 4.1 percent of adults have ADHD.
Although it has been common practice for our society to take ADHD as an excellent mental health and / or medical disorder, in fact this is a problem that has been noted in modern literature for at least 200 years. Back in 1798, ADHD was first described in the medical literature by Dr. Alexander Crayton, who was called "Mental anxiety." In 1845, Dr. Heinrich Hoffman wrote the book The Story of the Disastrous Philip. In 1922, ADHD was recognized as post-encephalitic behavior. In 1937, stimulants were found to help control hyperactivity in children. In 1957, methylphenidate (Ritalin) became commercially available for the treatment of hyperactive children.
Formal and accepted mental health / behavioral diagnosis of ADHD is relatively recent. In the early 1960s, ADHD was called Minimal Brain Dysfunction. In 1968, the disorder became known as the "hyperkinetic reaction of childhood." At this point, emphasis was placed on hyperactivity rather than inattentive symptoms. In 1980, the diagnosis was changed to “ADD - attention deficit disorder, with or without hyperactivity,” which made the same emphasis on hyperactivity and inattention. By 1987, the disorder was renamed Attention Deficit Hyperactivity Disorder (ADHD) and was divided into four categories (see below). Since then, ADHD has been considered a medical disorder that leads to behavioral problems.
Currently, ADHD is defined by DSM IV-TR (adopted diagnostic guide) as one disorder, which is divided into four categories:
1. Attention / hyperactivity disorder disorder, predominantly inattentive type (formerly known as ADD) is marked by impaired attention and concentration.
2. The conflict-free attention deficit / hyperactivity disorder, predominantly hyperexptive, impulsive type (formerly known as ADHD) is marked by hyperactivity without inattention.
3. Attention deficit / hyperactivity deficit, the combined type (the most common type) includes all the symptoms: inattention, hyperactivity and impulsivity.
4. Asymptomatic attention deficit / hyperactivity deficiency unless otherwise indicated. This category refers to ADHD disorders that include severe symptoms of inattention or hyperactivity - impulsivity, but do not meet the criteria for DSM IV-TR for diagnosis.
To better understand ADHD and its four subcategories, it helps illustrate hyperactivity, impulsivity and / or inattention through examples.
Typical hyperactive symptoms in young people include:
- Often "on the go" or acting as "engine driven",
- Anxiety
- Moving arms and legs nervously or wriggling
- Often climbing to walk or run
- Too much running or climbing when it's inappropriate.
- It is difficult to play calmly or engage in quiet leisure.
- Speaking excessively or too quickly
- As a rule, leaving a place for separation
- Often can not be involved in social activities quietly
Typical symptoms of impulsivity in young people include:
- Act rashly or suddenly without first thinking
- Smoothing answers before questions are completely asked.
- Having a hard time waiting for a turn
- Often interrupting others, conversations or events
- Poor judgments or decisions in social situations that lead to the child not being accepted by their own peer group.
Typical symptoms of inattention in young people include:
- Disregarding the details or not making careless mistakes
- Trouble concentrating and easily distracted
- Appearance do not listen when talking
- Often forgotten in daily activities.
- Problems with the organization, planning and completion of projects
- Loss or non-removal of homework, books, toys or other items
- Does not seem to listen when
- Not following instructions and not completing work, school work, duties or responsibilities at the workplace
- Avoiding or disabling tasks that require constant mental effort or concentration
Of the four sub-categories of ADHD, the Hyperactive-Impulsive Type is the most recognizable, recognizable, and easiest to diagnose. Hyperactive and impulsive symptoms manifest themselves differently in different environments in which the interaction with the child takes place: for example, at home, with friends, at school and / or in extracurricular or sports activities. Due to the hyperactive and impulsive behavior of this subcategory, these children naturally cause attention (often negative) to those around them. Compared to children without ADHD, it is more difficult for them to teach, teach, train and communicate with. In addition, they tend to be destructive, seemingly oppositional, reckless, accidents and socially underdeveloped.
Parents of ADHD youth often report frustration, anger, and emotional exhaustion due to their children's inattention, impulsivity, and hyperactivity. By the time they receive professional services, many parents of children with ADHD describe complex feelings of anger, fear, despair, and guilt. Their many “failures” in forcing their children to focus, pay attention and follow through directions, duties and tasks were reflected in feelings of hopelessness and despair. These parents often report feelings of guilt for their resentment, loss of patience and a reactive style of discipline. Both psychotherapists and psychiatrists worked with the parents of ADHD children, who “joked”, saying, “If someone does not help my child, give me a cure!”
The following statistics (Dr. Russell Barkley and Dr. Tim Willens) illustrate the far-reaching implications of ADHD among young people.
- In ADHD, the incidence of children is 6-8%, and the disease continues in adolescence in 75% of patients, and 50% of cases persist into adulthood.
- Boys are diagnosed with ADHD 3 times more often than girls.
- Emotional development in children with ADHD is 30% lower than that of their peers with ADHD.
- 65% of children with ADHD show problems in calling or problems with authoritative data. This may include verbal hostility and tantrum.
- Teenagers with ADHD have almost four times more traffic than non-ADD / ADHD drivers. They have four times as many traffic accidents and seven times more often have a second accident.
- 21% of teenagers with regular school ADHD regularly attend school and 35% drop out of school before they graduate from high school.
- 45% of children with ADHD were suspended from school at least once.
- 30% of children with ADHD repeated the year of study.
- Young people treated for drugs are six times less likely to develop a substance abuse disorder in adolescence.
- The juvenile justice system consists of 75% of children with undiagnosed learning disabilities, including ADHD.
ADHD is a genetically transmitted disorder. Studies sponsored by the National Institute of Medical Health (NIMH) and the US Public Health Service (PHS) have shown clear evidence that ADHD works in families. According to recent studies, more than 25% of first-degree relatives in a family of children with ADHD also have ADHD. Other studies show that 80% of adults with ADHD have at least one child with ADHD, and 52% have two or more children with ADHD. The hereditary relationship to ADHD has important implications for treatment, since other children in the family may also have ADHD. In addition, there is a certain likelihood that parents may also have ADHD. Of course, the questions are complicated when parents with undiagnosed ADHD have problems with their ADHD child. Therefore, it is imperative to assess the familial occurrence of ADHD when evaluating ADHD in youth.
Diagnosing Attention Deficit Disorder Inattention Type in youth is not an easy task. More harm than good is done when a person is misdiagnosed. An incorrect diagnosis can lead to unnecessary treatment, i.e. Prescription for the treatment of ADHD and / or unnecessary psychological, behavioral and / or educational services. Unnecessary treatment, such as an ADHD drug, can be emotionally and physically harmful. Conversely, when a person is properly diagnosed and subsequently treated for ADHD, the potential for dramatic life changes is limitless.
A physician (preferably a psychiatrist) or other licensed, trained and qualified mental health professional can diagnose ADHD. Only some medical professionals can prescribe medication. These are doctors (MD or DO), nurse practitioners and medical assistants (PA) under the supervision of a doctor. However, psychiatrists, because of their training and experience in mental disorders, are the best specialists for prescribing ADHD medications.
While a young person with a hyperactive type of ADHD is easily noticed, those with an inactive type of ADHD are late to be mistakenly diagnosed or, even worse, not even noticed. In addition, ADHD inattentive type of a young person is often mislabeled, misunderstood and even accused of a disorder over which they have no control. Because the inattentive type of ADHD appears more internally and less behavioral, these young people are not so often marked by potential treatment providers. Thus, these young people often do not receive a potential improvement in life, i.e. Psychotherapy, school counseling / coaching, educational services and / or medical / psychiatric services. Unfortunately, many “fall between the cracks” of social services, mental health, juvenile justice and educational systems.
Young people with unrecognized and untreated ADHD can develop in adults with poor self-esteem and low self-esteem associated with emotional, educational, and labor problems. According to reliable statistics, adults with unrecognized and / or untreated ADHD are more likely to develop problems with alcohol and drugs. For adolescents and adults with ADHD, it is customary to try to calm themselves or self-treat themselves using drugs such as alcohol, marijuana, drugs, tranquilizers, nicotine, cocaine, and illegally prescribed or street amphetamines (stimulants).
About 60% of people who have had ADHD symptoms in childhood still have symptoms like adults. And only one of 4 adults with ADHD was diagnosed in childhood - and even less treated. Thanks to increased awareness of the public and pharmaceutical companies in marketing their drugs, more adults seek help in ADHD. However, many of these adults, who were not considered children, carry emotional, educational, personal, and professional "scars." Because the children, these people, did not feel “smart, successful, and / or cute,” as their non-ADHD colleagues. Without explaining why they fought at home, with friends and at school, they naturally turned inward to explain their shortcomings. Sometimes they assimilate negative messages about themselves, thereby creating fewer opportunities for success than adults.
Like young people, adults with ADHD have serious problems concentrating or paying attention, or are overactive (hyperactive) in one or more areas of life. Some of the most common problems include:
- Problems with work or career; often lose or leave work
- The problems that you do and also you have to work or at school
- Problems with everyday tasks, such as household duties, paying bills, and organizing things
- Relationship problems, because you forget important things, you can’t finish assignments or get upset about trifles
- Constant stress and anxiety because you don’t meet goals and responsibilities
- Constant, intense frustration, guilt, or guilt
According to adult ADHD research:
- ADHD can affect 30% of people with ADHD in childhood.
- ADHD does not develop into adulthood. Only those who have had a disorder since early childhood will actually suffer from ADHD.
- The key criterion for ADHD in adults is “disinhibition” - the inability to stop acting on impulse. Hyperactivity is much less likely to be a symptom of a disorder in adulthood.
- Adults with ADHD tend to forget about the purpose and are often socially released - they make rude or offensive remarks - and are disorganized. They find priority difficult.
- Adults with ADHD find it difficult to form long-term relationships.
- Adults with ADHD have problems with short-term memory. Almost all people with ADHD suffer from other psychological problems, especially depression and substance abuse.
Despite the lack of consensus about the cause of ADHD, there is a general consensus on biological issues in the medical-mental health communities. Some common explanations for ADHD include: chemical imbalances in the brain, nutritional deficiencies, early head trauma / head injury, or impediments to normal brain development (i.e. using cigarettes and alcohol during pregnancy). ADHD can also be caused by brain dysfunction or neurological disorders. Dysfunction in the areas of the frontal lobes, the basal ganglia and the cerebellum can negatively affect behavioral regulation, inhibition, short-term memory, planning, self-control, verbal regulation, motor control and emotional regulation.
Because successful treatment of this disorder can have positive positive emotional, social and family outcomes, an accurate diagnosis is extremely important. Requirements for diagnosing ADHD include: professional education (graduate student and graduate student), continuing education, supervision, experience, and licensing. Even with the necessary professional qualifications, cooperation, and contributions from current or former psychotherapists, parents, teachers, school personnel, medical practitioners, and / or psychiatrists create more reliable and accurate diagnoses. The value of cooperation cannot be underestimated.
Sound ethical practice forces clinicians to provide the least restrictive and least risky form of therapy / treatment for young people with ADHD. Medications or intensive psychotherapeutic services should be provided only when the client does not respond favorably to less invasive treatment approaches. It is therefore crucial to determine whether there is a “functional impairment” or not. Customers who are functionally impaired will not be able to succeed in their environment without special assistance, services, and / or psychotherapeutic or medical treatment. Once functional impairment is established, then the work of the treatment team should cooperate on the most effective treatment method.
Too often, a person is mistakenly diagnosed with ADHD, not because of problems with insufficient attention, but rather because of their unique personality, learning style, emotional composition, energy level and activity and other psycho-social factors that better explain their problematic behavior. Diagnosis may also be related to other mental or emotional states (see below), life circumstances, including parenting, divorce, family dysfunction, or medical conditions. In a small but significant number of cases, this diagnosis of ADHD better represents the adult’s need to manage a complex, deliberate, and oppositional child who, even with these problems, may not have ADHD.
It is imperative that before the diagnosis of ADHD is reached (especially before prescribing medications), the doctor believes that other concomitant mental or medical disorders may be responsible for hyperactive, impulsive and / or inattentive symptoms. Since other disorders have similar symptoms with ADHD, it is necessary to take into account the likelihood of one mental / psychological disorder associated with another, which may explain the client's symptoms. For example, generalized anxiety disorder and depression are characterized by disorganization, lack of concentration, and problems with completion. Обученный и квалифицированный специалист ADHD рассмотрит дифференциальные диагнозы, чтобы прийти к наиболее логичному и клинически обоснованному диагнозу. Типичные нарушения, которые следует исключить, включают: генерализованное беспокойство, депрессия, посттравматическое стрессовое расстройство и нарушения злоупотребления психоактивными веществами. Кроме того, медицинские объяснения следует также носить: нарушения сна, недостатки питания, нарушения слуха и другие.
Когда не-врач практически диагностирует клиента с СДВГ, то есть лицензированного психотерапевта, рекомендуется, чтобы второе мнение (или подтверждение диагноза) было взято у психиатра. Психиатры - это врачи, которые специализируются на медицинской стороне психических расстройств. Психиатры могут назначать лекарство, которое может потребоваться для лечения СДВГ. В сотрудничестве родители, школьный персонал, психотерапевт и психиатр будут следить за эффективностью медицинского компонента лечения СДВГ.
Таким образом, СДВГ является психическим здоровьем и медицинским расстройством, которое становится все более приемлемым и последовательно оценивается более эффективно. Для достижения высоких стандартов профессиональной оценки, диагностики, образования и лечения важно, чтобы квалифицированные и квалифицированные специалисты понимали многоплановые аспекты СДВГ: историю, диагноз, статистику, этиологию и лечение. Обучение, опыт, большой интерес к деталям, прочная основа информации и система сотрудничества создают потенциал для положительных результатов в лечении СДВГ.
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