Understanding ADHD

By carolinianweb on November 18, 2015 • ( 0 )

ADHD och ADD/ Flickr

Alison McKane
Staff Writer

What is ADHD? It is not merely characterized as difficulty focusing in a boring class or continuous procrastination on a paper. It’s not that simple.

Attention-deficit/hyperactivity disorder, known by its acronym as ADHD, has no simple definition.

According to the DSM-5 (the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), ADHD is defined as, “A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development.” That, however, is only the first part of the criteria for diagnosis. The symptoms are split into two categories: “inattention” and “hyperactivity/impulsivity.”

Symptoms of inattention can manifest through careless mistakes, difficulty sustaining attention to tasks, tuning out sounds, avoiding tasks requiring sustained mental effort, losing things and the tendency to be easily distracted and forgetful.

Symptoms of hyperactivity/impulsivity can be seen by an individual who fidgets, leaves their seat, runs about or climbs excessively, blurts out answers, has difficulty waiting their turn and interrupts or intrudes.

Not all of these symptoms are necessary to be present order to make a diagnosis. However, while there is no formal test to diagnose ADHD, there are agreed-upon diagnostic criteria from the DSM-5.

The first criterion is that an individual must exhibit at least five symptoms from either or both category. However, the symptoms must be inconsistent with development level. Some of the symptoms must be evident by age 12 and must impair at least two settings in life, such as social, school, familial or work settings.

When testing for ADHD, the administrator must be sure that these symptoms couldn’t be accounted for by another disorder.

There are three main ways in which ADHD can present itself: predominantly inattentive, predominantly hyperactive/impulsive or a combination of both.

Not everyone with ADHD has the same symptoms, so it is important for those testing to adhere to the DSM-5, and remember to not just count symptoms, as impairment is a necessary part of diagnosis.

While that defines the disorder and gives the what, it doesn’t explain why the disorder occurs. There are three possible explanations the DSM-5 cites as reasons for the occurrence of ADHD; they are neuropsychological, neurobiological or genetic.

The neuropsychological explanation of ADHD is defined as, “Underaroused/under active areas of the brain that are involved in behavioral inhibition.”

Behavioral inhibition is more commonly described as a “mental filter.”

However, the filter does not just apply to speech. It also means those with ADHD can struggle with controlling their initial emotions and behavioral reactions. This also affects things like working memory, internalization of speech (holding one’s tongue, so to speak), self-regulation of emotion and reconstitution.

The neurobiological reason for ADHD can be explained as, “Abnormalities in the prefrontal-limbic areas of the brain.”

This part of the brain regulates inhibition; again, it’s the “filter.”

Biologists have attributed a few causes for ADHD, including: prenatal and birth complications, neurological illness or injury, or genetics, which is the most widely agreed upon. ADHD is generally found to run in families. If a parent is diagnosed with ADHD, there is a 50 percent chance their child will have the disorder as well.

How can ADHD be treated? Many people think medication is the best (and only) method to treat ADHD.

But in adults, cognitive behavioral therapy (CBT) has been proven to be very effective. The main underlying idea of CBT is that thoughts relate the feelings — that how a person thinks influences how they feel.

And while this is not the case for everyone, it is prevalent among people diagnosed with ADHD. Something which is quite common among those with the disorder is automatic thoughts, which lead to what are called maladaptive thinking patterns, which affect mood whether they are true or not. These thoughts and thinking patterns can attribute to feelings of depression, anxiety and frustration.The goal of cognitive behavioral therapy is realistic, positive thinking.

CBT, especially in the case of ADHD, works to combat what are called Maladaptive Thinking Patterns.These are thinking patterns many people will first have, but those without ADHD, may have an easier time quelling them. Examples of maladaptive thinking patterns include: all-or-nothing thinking, jumping to conclusions, overgeneralization, imagining catastrophic scenarios, mental filtering (only hearing the negative), disqualifying the positive (saying something positive was a fluke), labeling (if one does something bad they’re a bad person), personalization and emotional reasoning (one feels bad about something, therefore it is true).

There are two parts to combat maladaptive thinking patterns: recognizing them and challenging them.

Recognizing maladaptive thinking processes requires focusing on a situation in which one felt an automatic thought, naming what compels the thought and understanding how the thinking pattern relates to emotions.

In addition, there are questions one can ask a person with ADHD to challenge Maladaptive Thinking Processes, such as: “What is the evidence that this is true? Is there an alternative explanation? What reasons do you think cause these unrealistic or disturbing thoughts?”

There are two things those who are struggling with ADHD and those around them should know. The first is that ADHD is a “disorder of performance variability, not inability.”

This means that those with ADHD act differently in situations (differently from those without ADHD and those who do have ADHD, too). If they are given the tools they need to succeed, they can.

However, even with these tools, those who don’t succeed aren’t “lazy,” even if they seem that way. They just process in a way that does not necessarily meet the demands of productivity present in academia or the workforce.

The second is for those who are being treated for ADHD (and anything, really): Progress isn’t linear. There are days that might not be the best. But that’s what they are — bad days. They don’t define a person. They just define a day.

UNCG students who struggle with ADHD, or feel as though they may be struggling with ADHD, may want to consider the ACCESS (Accessing Campus Connections and Empowering Students) Program.

To find out more information, visit adhdclinic.uncg.edu or contact Dr. Kristen King, the ACCESS Project Coordinator at kaking@uncg.edu.