Attention Deficit Hyperactivity Disorder (ADHD)

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder marked by symptoms of inattention, hyperactivity, and impulsivity (Mahone & Denckla, 2017). This common disorder can impact the brain's ability to plan, focus, and execute tasks, affecting interpersonal relationships, academic and professional accomplishments, and daily functioning (Mahone & Denckla, 2017). With that in mind, ADHD can lead to an increase in self-criticism, resulting in poor self-esteem, sensitivity to criticism from others, and poor social function (Mahone & Denckla, 2017).

Some Symptoms of ADHD include (APA, 2014):

• Inattentions

• Lack of focus

• Hyperactivity

• Hyperfocus

• Poor time management

• Weak impulse control

• Exaggerated emotions

Three Types of ADHD

Predominately Inattentive

The inattentive subtype relates to challenges with focusing, finishing tasks, and organization (APA, 1994). Other symptoms may include daydreaming, getting easily distracted, forgetting daily tasks, and not appearing to listen.

Predominately Hyperactive

The hyperactivity subtype refers to excessive movement expressed through fighting, being talkative, and not sitting still (APA, 2014). Impulsivity is more apparent within this type. Other symptoms include the inability to sit quietly, blurting out words, interrupting others, and difficulty waiting their turn.

Predominately Combined Type

The combined type includes both inattentive and hyperactive types, displaying a combination of both types.

Diagnosis

For diagnosis of ADHD, the individual must exhibit at least six of the nine symptoms outlined in the Diagnostic and Statistical Manual of Mental Health (DSM-V).

Inattentive Type Symptoms (APA, 2014):

  •  Often fails to pay close attention to details, making careless mistakes

  • Often does not appear to listen when speaking with others

  • Often avoids and dislikes tasks that require sustained mental efforts such as homework or in adults completing forms

  • Often forgetful

  • Often has difficulty maintaining attention in tasks

  • Often fails to follow through on instructions

  • Often displays complex organizing tasks

  • Often lose things necessary for tasks such as eyeglasses

  • Often easily distracted

Hyperactive Type Symptoms (APA, 2014):

  • Often fidgeting

  • Often find difficulty remaining seated

  • Often runs or climbs in inappropriate situations

  • Often uncomfortable being still for an extended period

  • Often has difficulty waiting their turn

  • Often unable to engage in activities quietly

  • Often talks excessively

  • Often bursts out answers or responses

  • Often interrupts others

ADHD Comorbidity

ADHD is most commonly comorbid with Anxiety Disorder (Pliszka, 2019). Considering the nature of ADHD, daily activities can feel overwhelming and more stressful. Anxiety refers to a response to a perceived threat. That being said, looking towards the day ahead can be challenging, perpetuated by a level of uncertainty evoking anxiety.

Self-Care Tips

Celebrate small wins. Individuals struggling with ADHD can view goals as unattainable as they often run out of steam to reach them. Reaching those big goals involves many incremental steps. The ADHD brain runs on immediate gratification, so conceptualizing goals far away can appear daunting (Mahone & Denckla, 2017). Celebrating those small milestone steps can provide that sense of gratification.

Dance it out. Dancing helps channel the energy into an activity that is less disruptive, reducing stress and emotional dysregulation.

Good sleep hygiene. Sleep can become difficult to regulate (Mahone & Denckla, 2017). It is important to manage and modulate sleep by developing an effective sleep routine, such as shutting down electronics 30 minutes before sleep, using your bed only for sleep, and creating a soothing bedtime ritual.

ADHD Treatment

Effective treatment strategies for ADHD include multimodal approaches of a combination of therapy and medication interventions. Behavioural therapy and Parent-Child Interaction Therapy (PCIT) are recommended as evidence-based treatments to help young children manage symptoms (APA, 2014). Contact counsellors Jovita and Charmin at Vaughan Counselling and Psychotherapy to help support your child’s symptoms. Other therapeutic interventions include Cognitive Behavioural Therapy (CBT) and Dialectical Behavioural Therapy (DBT) for adolescents and adults (Lopez et al., 2018; Halmoy et al., 2022). CBT is a goal-oriented approach to reframing negative thinking patterns that client may feel regarding their symptoms of ADHD.

Similarly, DBT focuses on the emotional and social challenges presented to individuals with ADHD. The session focuses on the application of skills to improve emotional regulation. Other therapists at Vaughan Counselling and Psychotherapy including Gauri , available to support those searching for treatments for ADHD with a focus on CBT and DBT.

American Psychiatric Association (APA). (2014). Diagnostic and statistical manual of mental disorders (5 th ed.). Washington, DC.

Halmoy, A., Ring., A. E., Gjestad, R., Moller, M., Ubostad, B., Lien, T., Munkhaugen, E. K., and Fredriksen, M. Dialectical behavioral therapy-based group treatment versus treatmenr as usual for adults with attention deficit hyperactivity disorder: a multicenter randomized controlled trial. BMC Psychiatry. 22, 738. https://doi.org/10.1186/s12888-022-04356-6

Lopez, L. P., Torrente, F. M., Ciapponi, A., Lischinsky, A. G., Cetkovich-Bakmas, M., Rojas, J. I., Romano, M., and Manes, F. F. (2018). Cognitive-behavioural interventions for attention deficit hyperactivity disorder (ADHD) in adults. Cochrane Database System Review. 3(3). https://doi.org/10.1002%2F14651858.CD010840.pub2

Mahone, M. E., and Denckla, M. B. (2017) Attention-deficit/hyperactivity disorder: A historical neuropsychological perspective. Journal of the International Neuropsychological Society. 23(9- 10), 916-929. https://doi.org/10.1017%2FS1355617717000807

Plisaka, S. R. (2019). ADHD and anxiety: Clinical implications. American Professional Society of ADHD and related disorders. 23(3). https://doi.org/10.1177/1087054718817365

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