Disclaimer
I am not a doctor.
My comments on this page are for general research and discussion
purposes only and are not intended to be relied upon as medical
advice.
If you have (or believe you may have) ADHD, you should contact a
qualified medical professional for diagnosis and treatment.
A Description of ADHD
What is it?
Attention Deficit/Hyperactivity Disorder (ADHD)
is a lifelong condition which can seriously interfere with an
individual's ability to cope with school, work, or social situations.
At various times in the past, ADHD has been called
"hyperactivity", "hyperkinesis", or "minimal brain dysfunction".
ADHD is characterized by inattention, impulsivity,
and hyperactivity.
When hyperactivity is not a significant factor for a given
individual, the condition is sometimes referred to as
Attention Deficit Disorder (ADD).
ADHD can affect boys and girls, men and women.
Boys are somewhat more likely to exhibit hyperactivity symptoms
than girls or adults.
Indeed, at one time, hyperactivity was really the only generally
understood ADHD symptom; the inattention and impulsivity aspects
were either not noticed or were dismissed as individual personality
quirks or character flaws.
In order to support a diagnosis of ADHD, the behavior in
question must be excessive, debilitating,
long-term (since childhood),
and pervasive (many different settings -- e.g.,
school, home, work, or social situations).
Also, other possible causes -- such as anxiety, depression, thyroid
disorders, allergies, or epilepsy -- must be ruled out before
diagnosing ADHD.
Is it really a problem?
In a word, YES.
Just about everyone, of course, sometimes exhibits some
ADHD-like symptoms.
When an individual has lots of these symptoms most of
the time, however, and to such an extent that they get in the way of
normal living, then ADHD may be a genuine concern.
ADHD is no laughing matter.
It can frequently be the cause of such life-complicating difficulties
as the following:
- inability to perform adequately in school
(despite often being clearly "gifted")
- general problem with "following through" on projects or
commitments; may start out with gusto, but the enthusiasm
routinely peters out at the first obstacle
- generally cluttered and unkempt lifestyle, including remnants
of old, abandoned interests (besides, something else is
always more interesting than cleaning house!)
- "hyperfocussing" on "interesting", possibly inappropriate,
activities or things (e.g., enthralled by a novel when one's time
might be better spent doing school work or household chores)
- tendency to put off critical tasks to the very last minute
- difficulty remembering names/faces, appointments, etc.
- trouble getting (or keeping) a job
- poor financial management skills
- general ineptitude in social situations
(school, work, dating, etc.)
- own feelings easily hurt, even though often insensitive to
feelings of others
- "hair-trigger temper" response to frustration or disappointment
- tendency to engage in risky activities
(daredevil stunts, fast cars, extramarital affairs, etc.)
-- either because the risk is not appreciated,
or else for the "adrenaline rush"
- trouble getting married (social ineptitude),
or staying married (financial problems, can't hold down a job,
infidelity, etc.)
- attraction to "soft" drugs (caffeine, alcohol, tobacco) --
often in an unconscious effort to calm oneself via "self-medication"
- occasionally, attraction to "hard" drugs (marijuana, cocaine,
heroin) -- for the thrill of the risk, or perhaps for
self-medication
- general feeling of discouragement and lack of self-worth
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If you have ADHD -- or believe you may have ADHD -- you should know
that there is hope, because a lot more is known about this condition
now than was known just a few years ago, and treatments exist that can
make life with ADHD a lot more tolerable than it used to be. An ADHD
diagnosis, to be sure, may not reunite a broken home or make up for
missed opportunities now long gone, but there is still a future to look
forward to, and anything you can do to make it an easier and happier
future will be worth the effort.
If you know someone who you think may have ADHD, please
encourage them to get help. You could make their life much happier;
indeed, if an ADHD diagnosis and appropriate treatment leads them to
curtail risk-taking behavior, stop smoking, etc., you could literally
be a life-saver.
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What causes it?
The exact cause of ADHD is still not known. However, current research
is pointing toward genetic abnormalities in brain tissue and function.
Things which once were thought to cause ADHD, but are no longer
considered to be responsible for the condition, include
sugar, food allergies,
artificial food colorings or flavorings,
and poor home or school environment.
Most cases of ADHD are currently believed to be genetic and inherited.
That is, if someone exhibits ADHD symptoms, it is likely that one or
both of his/her parents have ADHD, and there is a fairly high chance
that his/her children may also have ADHD.
Can it be outgrown?
ADHD is a lifelong condition.
If someone has it, he/she has always had it and always will have it.
ADHD-related hyperactivity frequently subsides as a child
grows up. However, the other classes of symptoms (inattention and
impulsivity) generally persist into adulthood and throughout life.
Can it be cured or treated?
At present, no cure is known for ADHD.
Many children and adults with ADHD benefit from medications
that modify brain function.
The medications most commonly used for treating ADHD are
the stimulants
Ritalin (methylphenidate),
Dexedrine (dextroamphetamine),
and Cylert (pemoline).
Many researchers believe stimulant medications help alleviate ADHD
symptoms by compensating for the brain's difficulty in processing
neurotransmitter chemicals, such as dopamine and serotonin.
Although the stimulants used to treat ADHD do have abuse potential,
they are generally quite safe when taken at the proper dosage levels
and under competent medical supervision.
Stimulants work for only a few hours at a time -- so they must be taken
every day (and possibly more than once a day) -- but at the dosages
appropriate for treating ADHD, they are not addictive and can
be taken for years at a given amount and frequency without losing their
effectiveness.
Medication, by itself, is almost never sufficient to treat ADHD.
The patient needs to learn (or re-learn) skills to enable him to cope
with the world in a more "normal" way. The medication simply makes
this possible -- or, at least, a lot easier.
Isn't ADHD just an excuse?
If you think someone with clinical depression can just "snap
out of it" all by himself if he really wants to -- or that someone
with schizophrenia can "will" himself to see the world as it
really is and stop listening to those voices in his head -- then
perhaps you'll conclude that ADHD is just the latest fad for today's
generation of lazy misfits.
But if you are willing to accept that the mind has, at least to some
degree, a physical nature -- and that a physical problem in the brain
(whether the result of genes, germs, or injuries) can have an effect
on one's ability to perceive the world and function in it -- then the
idea that certain personality "quirks" may be treatable through medical
means shouldn't be that threatening.
Research Articles
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Science
News, 4 Dec. 1999:
Researchers have identified a gene which appears to influence whether
or not ADHD patients will benefit from taking Ritalin.
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NIMH
(National Institute of Mental Health), 1999:
A detailed description of ADHD.
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Stanford
Report, 2 Dec. 1998:
Stanford neuroscientists have found a clear difference in brain
functioning between boys who have ADHD and those who do not.
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WebMD
Health Topics A-Z, Dec. 1988:
A detailed description of ADHD and related disorders in children
and adults.
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Proceedings of
the National Academy of Sciences,
24 Nov. 1998:
Functional MRI revealed differences between children with ADHD and
healthy controls.
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Scientific
American, Sep. 1998:
A new theory suggests ADHD may arise when key brain circuits do
not develop properly, perhaps because of an altered gene or genes.
News Stories
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CNN,
1 Oct. 2001:
The American Academy of Pediatrics has issued guidelines for treating
ADHD, suggesting that stimulant drugs may be most effective but that
behavior techniques should also be used.
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CNN,
29 Aug. 2001:
Many children may be receiving an ADHD diagnosis at the insistence of
school personnel, without adequate examination by a physician.
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CNN,
19 Jun. 2001:
Use of medications to treat ADHD in the US varied widely from state to
state in 2000.
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CNN,
8 Jan. 2001:
Students at many American universities are abusing Ritalin in order to
help them study more effectively.
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CNN,
19 Sep. 2000:
Attendees at the Surgeon General's Conference on Children's Mental
Health discuss issues relating to diagnosing and treating ADHD --
including the problem of misdiagnosis.
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CNN,
10 Sep. 2000:
A survey of doctors suggests that many children with ADHD go undiagnosed
and untreated.
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CNN,
2 Aug. 2000:
The FDA has approved Concerta -- an extended-release form of the
widely used ADHD medication, methylphenidate (Ritalin).
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CNN,
14 Dec. 1999:
A recent study suggests ADHD can be managed more effectively with
medication, or with a combination of medication and behavioral
treatment, than through behavioral treatment alone.
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CNN,
24 Sep. 1999:
The Centers for Disease Control and Prevention (CDC) is starting to
get involved with ADHD, amidst growing concern that the condition is
a major health concern for both children and adults.
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CNN,
10 Sep. 1999:
Edited transcript of a chat with Dr. Michael Gordon, SUNY Health
Science Center, Syracuse, NY.
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ABC News,
4 August 1999:
A Massachusetts study shows ADHD affects girls as severely as boys.
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CNN,
9 July 1999:
A number of conditions can mimic ADHD, so careful diagnosis by a
trained professional is essential to proper treatment.
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USA
Today, 2 Aug. 1999:
A Massachusetts study suggests that hyperactive boys treated with
stimulants such as Ritalin were less likely to abuse alcohol and other
drugs as teen-agers.
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CNN,
14 Jan. 1999:
New research shows that common ADHD medications boost levels of both
dopamine and serotonin in the brain. A better understanding of how
these drugs work could lead to more effective medications.
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CNN,
24 Nov. 1998:
Stanford researchers have found a distinctive signature in brain scans of
children with ADHD versus those who do not.
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Time,
30 Nov. 1998:
How dreamy is too dreamy? Where is the line between an energetic child
and a hyperactive one? Is there something wrong with the kids -- or is
there something wrong with us?
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CNN,
18 Nov. 1998:
A recent conference of the National Institutes of Health (NIH) studied
the diagnosis and treatment of ADHD.
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CNN,
9 Nov. 1998:
Ritalin and other psychostimulant medications may be associated with
increased cardiovascular risks in some children.
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CNN,
15 Sep. 1997:
While thousands of children benefit from stimulant therapy for ADHD,
some children who don't do well in school may have other problems.
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CNN,
4 May 1997:
For some older students, Ritalin is the latest drug of choice for misuse
and abuse.
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CNN,
14 Jan. 1996:
Researchers at the Food and Drug Administration (FDA) have found signs
that high doses of Ritalin may cause cancer in mice.
Editorials
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Fox
News, 25 Aug. 2001:
Four out of five class-action lawsuits filed in 2000, challenging the
legitimacy of ADHD and Ritalin, have been dismissed or withdrawn --
most recently in Florida.
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San Francisco Chronicle,
18 Mar. 1999:
EDITORIAL: Blindly accepting ADHD is as foolish as rigidly rejecting it.
ADHD is chronic, but treatable. Effective treatments need to be well
targeted but readily available.
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San Francisco Chronicle,
18 Mar. 1999:
EDITORIAL: Each culture decides at what point an impulsive personality
becomes a disorder. There is an intolerance of temperamental diversity
in our country today.
Organizations
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