What is ADHD?

Symptoms of ADHD

The symptoms of ADHD can be divided into two general categories: symptoms of inattention and symptoms of hyperactivity-impulsivity. Below are the symptoms as laid out in the fifth edition of the Diagnostic and Statistical Manual (DSM-5), the American Psychiatric Association’s diagnostic manual.

Symptoms of inattention

• Failure to pay close attention to details or making careless mistakes at school or work
• Difficulty staying focused on tasks or play
• Not listening (or appearing not to listen) when spoken to directly
• Failure to follow through on instructions or finish schoolwork, chores or workplace duties (e.g., losing focus or getting sidetracked)
• Trouble organizing tasks or activities
• Avoidance of tasks that require extended mental effort, such as homework
• Frequently losing things that are required for tasks and activities (e.g., school supplies, pencils, books, tools, wallets, keys, paperwork, glasses, phones)
• Being easily distracted
• Exhibiting forgetfulness in everyday activities

Symptoms of hyperactivity-impulsivity

• Fidgeting, squirming or tapping hands and feet
• Frequently leaving your seat in a classroom or office
• Running around or climbing in situations where it’s inappropriate (or, in adolescents and adults, often feeling restless)
• Being unable to play or participate in activities quietly
• Being “on the go” or acting as if “driven by a motor”
• Talking excessively
• Blurting out the answer before a question has been finished
• Trouble waiting your turn
• Interrupting or intruding on others

These symptoms can have a significant impact on daily life, including in school and at work.

To officially be diagnosed with ADHD, children under 17 need to have six or more symptoms of inattention and/or hyperactivity-impulsivity, while adolescents over 17 and adults need five or more symptoms.

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Other ADHD criteria

• Several of the symptoms must have been present before the age of 12 (although you don’t need to have been diagnosed before the age of 12).
• Several of the symptoms must be present in two or more settings: at home, school, or work or out with friends and family.
• There should be clear evidence that the symptoms impact functioning at school or work or socially.
• The symptoms can’t be better explained by another mental disorder and don’t only happen during the course of schizophrenia or another psychotic disorder.

What causes ADHD?

ADHD is relatively common. An estimated 6% of U.S. adults have a current ADHD diagnosis, according to the Centers for Disease Control and Prevention, and roughly 10% of 3- to 17-year-olds in the U.S. have been diagnosed with ADHD at some point.

The exact cause of ADHD is unknown, but it’s believed to involve a combination of genetic, neurological and environmental factors.

The genetic component appears to be especially significant, shown by the tendency of ADHD to run in families:

• A child has a 57% chance of developing ADHD if a parent has it.
• A child has a 32% chance of developing ADHD if a sibling has it.
• If a twin has ADHD, the other twin has between a 70% to 80% chance of also having it.

Aside from family history, other risk factors for ADHD include prenatal exposure to alcohol or tobacco, premature birth and early exposure to high levels of lead.

ADHD is typically present from early childhood and is most often diagnosed by school age. However, symptoms can evolve and become more apparent over time. Symptoms sometimes diminish as children grow up and enter adulthood, but this isn’t always the case: Roughly half of U.S. adults with ADHD received the diagnosis when they were 18 or older.

Diagnosing ADHD

An ADHD diagnosis is based on a combination of the following:

• A detailed history of behavior and symptoms: This may include interviews with parents, teachers and employers.
• Clinical interviews with the child or patient: The professional making the diagnosis will likely want to speak to the patient, even if they’re a child. They’ll ask questions to help determine which symptoms are present and their effects.
• Behavior rating scales: Tests such as the Conners scale and Vanderbilt ADHD Diagnostic Rating Scale (VADRS) are often used to help determine the presence and severity of ADHD.

ADHD diagnoses are typically made by pediatricians, psychologists, social workers or psychiatrists who specialize in ADHD and related disorders.

ADHD treatment

ADHD treatment can consist of medication, therapy, lifestyle changes or a combination of these.

• Medication: The most commonly prescribed medications for ADHD are stimulants. These include methylphenidate and various amphetamines, such as Adderall and Vyvanse. Stimulants increase brain activity, which can help with focus and impulse control.
• Therapy: Therapy can help people with ADHD learn to manage their behavior, learn effective coping and organizational strategies and work through negative thought patterns. Behavioral therapy and cognitive behavioral therapy (CBT) are frequently used to help manage ADHD.
• Lifestyle changes: Various lifestyle changes, such as incorporating regular exercise and meditation, ensuring quality sleep and eating a more nutritious diet, can potentially help improve ADHD symptoms. If nothing else, these changes can improve overall health and well-being, which could make ADHD symptoms feel more manageable.

Support groups can also help in navigating the challenges that may come with ADHD. Being surrounded by people who understand what you’re dealing with helps reduce loneliness and isolation, and it gives you a chance to share strategies and skills for handling various situations.

Several organizations maintain directories of ADHD support groups. The two below are a good start, but if you don’t find anything that works for you, keep searching:

• Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) Affiliate Locator
• Attention Deficit Disorder Association (ADDA) Support Groups for Adults

Common misconceptions about ADHD

Misconceptions about symptoms and who can or can’t have ADHD may result in misdiagnoses or treatment delays.

A few of the most common misconceptions about ADHD:

• ADHD is a childhood disorder and people grow out of it: Although ADHD is most often diagnosed in children, evidence indicates that it's a lifetime condition for many. One study showed that ADHD continued into adulthood in approximately one-third of cases, and many people are diagnosed with ADHD for the first time as adults.
• Only boys can have ADHD: It’s true that ADHD is more commonly diagnosed in boys than girls (according to the CDC, 8% of girls ages 5 to 17 have been diagnosed with ADHD, compared with 14.5% of boys). However, this may point to the condition being underdiagnosed in girls, who tend to show fewer of the more noticeable hyperactive symptoms.
• You have to be hyperactive to have ADHD: Hyperactivity isn’t a requirement for diagnosis. You can officially be diagnosed if you have six symptoms related to inattention or hyperactivity, so you could receive a diagnosis with zero hyperactivity. This is called inattentive ADHD (previously called attention deficit disorder or ADD). The term ADD has been phased out, and all symptoms are now housed under ADHD. Today, there are actually three subtypes of ADHD: inattentive, hyperactive-impulsive and combined (when you meet the criteria for both inattentive and hyperactive-impulsive ADHD).

Bottom line

ADHD is a relatively common disorder, but that doesn’t make it any less impactful for the people who have it. People with ADHD may have difficulties with attention, memory and organization, which can make everyday tasks difficult.

The good news is there are a number of effective treatments, including medication and therapy. It’s also important to note that increased awareness of ADHD from friends, family and coworkers can help correct misunderstandings and bridge gaps between those with ADHD and those without.