ADHD: These four little letters get tossed around a lot on social media. Stereotypes abound of kids and adults with Attention-Deficit/Hyperactivity Disorder, but what is it actually? Let’s look at the specific diagnosis criteria – some of which might surprise you – and see where they overlap with other mental health diagnoses.
The main criteria is someone who has trouble staying focused on a task, thus the name “attention deficit.” In children, this might be someone whose mind wanders off to fanciful daydreams while the teacher gives instructions. Or it might be an adult that starts to empty the dishwasher but gets sidetracked by multiple other tasks that arise during that process.
If you or your child struggles to stay focused, keep a clean room, has trouble remembering to turn in assignments, loses things often, is more fidgety than peers, and/or is frequently finding an excuse to get up and move around, you might consider asking a doctor or mental health professional about the possibility of ADHD.
Having a diagnosis isn’t just to slap a label onto someone and stick them in an immovable box. The goal is to help the person realize their brains are wired differently, not better or worse, just different.
This understanding is important because people with ADHD can develop additional mental health concerns when they struggle to meet standards designed for those who are more neurotypical. This can result in anxiety, depression, feelings of low self-worth, and even suicidal thought. In these cases, it’s important to find a mental health professional to help the individual and/or family process and navigate these thoughts and feelings.
Tips to help loved ones with ADHD.
Here are just a few tips to keep in mind if you are in a relationship with someone with ADHD:
- Big projects seem overwhelming; they might need help breaking big assignments into smaller, more manageable tasks. For example, instead of telling a child with ADHD to “get ready for bed,” provide them a checklist they can use each night with the specific tasks, such as: change into pajamas; put dirty clothes in the hamper; brush teeth; put out tomorrow’s clothes.
- When you provide information or instruction, ask them to repeat back the information to ensure they heard it correctly. Having it written down in a consistent location that doesn’t get lost (i.e. a note pad attached to their bedroom wall) allows them to go back and review the information if they forget.
- When at home, allow them the opportunity to fidget and move freely – yes, this can be important for adults, too.
- Encourage them to find a passion where they can practice staying focused and on task, such as a sport, dance, music, theater, art, robotics.
- Focus on their strengths not their struggles. For parents or teachers, catch them being good more often than redirecting or punishing. For spouses, friends or co-workers, look for ways to encourage them in their strengths.
- Provide a safe place for them to express their emotions.
- Join them in a morning walk, dance or fun exercises before they might have to sit still in a classroom or at work.
- Understand that people with ADHD struggle with time management and can become hyper-focused on an enjoyable activity. Helping them to establish a schedule and set alarms can be beneficial.
- Provide love, grace, acceptance, humor, and flexibility.
What ADHD is – and isn’t.
Social media is full of various definitions of ADHD, but below is the actual criteria established by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th edition.
To meet criteria for ADHD, the symptoms and behaviors must negatively interfere with daily functioning and appear in at least two different settings: typically at home and at school or work. This can be helpful in ruling out other diagnoses. ADHD behaviors typically show up before age 12 and negatively impact their daily function for more than six months.
It’s important to note that some symptoms and behaviors of ADHD are found in other diagnoses. If the person is acting DIFFERENT than they used to, that’s important to note. For example, did your child used to follow instructions, turn in assignments, clean their room, and get good grades before a big event in their life, such as a move, divorce, major illness, or accident? Then perhaps it’s not ADHD, but possibly Adjustment Disorder, Major Depressive Disorder, or PTSD.
Poor focusing and difficulty paying attention can also be a sign of grief, anxiety, depression, trauma, bipolar, adjusting to a big life change, physical difficulties such as trouble seeing or hearing, another type of learning disability, psychosis, substance use, etc. Because of the overlap of symptoms, it’s important to have a thorough assessment before determining the diagnosis.
Three types of ADHD.
While there used to be a distinction between ADD (Attention-Deficit Disorder) and ADHD (Attention-Deficit/Hyperactivity Disorder), both types are now classified as ADHD.
Under the category of ADHD are three different presentations: inattentive, hyperactive/impulsive, and combined. Typically, inattentive presentations can go undiagnosed longer than the child with hyperactive/impulsive or combined types, because the person appears compliant and quiet instead of unfocused. These students might get passed from grade to grade, often being told they “don’t live up to potential,” without anyone realizing their brains function differently.
Diagnostic criteria for ADHD.
Below is the list of criteria for each ADHD type. For children 16 and under, six symptoms are needed to qualify for the diagnosis; for those ages 17 and above, five symptoms are required. Individuals can meet criteria in just one category – “inattention” or “hyperactive/impulsive” – they do not need to meet criteria for both categories.
- Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities.
- Often has difficulty sustaining attention in tasks or play activities.
- Often does not seem to listen when spoken to directly.
- Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace.
- Often has difficulty organizing tasks and activities (e.g. difficulty managing sequential tasks; difficulty keeping materials and belongings in order; messy, disorganized work; has poor time management; fails to meet deadlines).
- Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort.
- Often loses things necessary for tasks or activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).
- Is often easily distracted.
- Is often forgetful in daily activities.
Hyperactivity and impulsivity.
- Often fidgets with or taps hands or feet, or squirms in seat.
- Often leaves seat in situations when remaining seated is expected.
- Often runs about or climbs in situations where it is not appropriate.
- Often unable to play or take part in leisure activities quietly.
- Is often “on the go” acting as if “driven by a motor.”
- Often talks excessively.
- Often blurts out an answer before a question has been completed.
- Often has trouble waiting their turn.
- Often interrupts or intrudes on others.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Arlington, VA., American Psychiatric Association, 2013. If you would like to discuss ADHD and its impact on your mental health and/or relationships, please reach out to one of our mental health professionals.
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