Introduction to ADHD
What is ADHD?
ADHD, short for Attention-Deficit Hyperactivity Disorder, and ADD (which has less hyperactivity), are conditions that impact how someone focuses, controls their actions, and learns. While many of us might occasionally daydream, forget things, or make hasty decisions, those with ADHD experience these challenges more frequently and intensely.
Many people might say, "I'm so ADHD today" when they're feeling scatterbrained or extra energetic. But there's a big difference between occasionally losing your keys and having ADHD. For those with this condition, these challenges are a regular part of life and can make things like school, work, and relationships much tougher.
It's essential to know that ADHD isn't about just being a bit forgetful or spontaneous. It's a real condition, known as a neurodevelopmental disorder, that can deeply affect daily life. If you're wondering if you have ADHD or are just having a few distracted days, the real question is: How often and how much do these feelings disrupt your life?
What’s the difference between ADHD and ADD?
ADHD is the official term used for the condition. When somebody does not have significant symptoms of hyperactivity, this is called ADD (Attention Deficit Disorder; inattentive subtype). However, the terms ADHD and ADD can be used interchangeably. People often use the term ADHD even if they are describing somebody without the hyperactivity component. In this article, we use the term ADHD referring to both ADHD and ADD.
How frequent is ADHD?
ADHD is much more common than you might think, with the global prevalence estimated at around 7% of the population. In the UK alone, 1.5 million adults are estimated to have ADHD. But here's the catch: only 200,000 of these people with ADHD have an official diagnosis.
The number of adults who receive treatment for their ADHD symptoms is even less. So, while ADHD is common, many people miss out on a diagnosis and the help they could get.
When it comes to females and minority groups, ADHD is just as common, but the diagnosis rates are even lower. They might have ADHD, but their symptoms can be different. Instead of the "classic" signs like being hyperactive or acting without thinking, they might show less noticeable signs. Because of this, they're more likely to go undiagnosed.
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- Recognised Experts: Many of our clinicians have been at the forefront of ADHD treatment, even leading the development of specialist Adult ADHD clinics in the NHS.
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Symptoms of ADHD
Symptoms of ADHD typically fall under three main categories of inattention, impulsiveness and hyperactivity. While we all might daydream or make a hasty decision now and then, those with ADHD face these challenges more often and intensely.
- Ever find it hard to focus or keep zoning out during conversations?
- Often become distracted, daydream, or procrastinate easily?
- Do you have to start a task multiple times before you can finish it?
- Struggle with planning ahead and often miss deadlines?
If staying focused, planning, and organising feel like uphill tasks (particularly when you’re not interested in something), you might be experiencing inattention.
- Acting without thinking things through?
- Impatient or snappy with people and sometimes even completing their sentences?
- Maybe you've bought something on a whim or interrupted someone mid-conversation.
This is impulsiveness, where decisions are made in the heat of the moment, often leading to regrets.
- Does tapping your fingers or feet, fidgeting, whistling, or humming make it easier for you to concentrate on tasks?
- Are you always in a hurry to finish things, even when there's no time pressure?
- Places like libraries, offices, or long flights might feel like a challenge because sitting still isn't your thing.
If you're always on the move, fidgeting, or feeling restless, that's physical hyperactivity.
- Ever been so engrossed in something that you lost track of time?
- Or the opposite, where you can't muster interest no matter how hard you try?
- Does your brain go into overdrive when you cram for a deadline?
This is your brain's way of being hyperactive, swinging between extremes of focus.
If these symptoms sound familiar and they're affecting your work, studies, or relationships, it might be time to seek help. Remember, understanding is the first step, and there are professionals ready to guide you through an ADHD assessment.
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The spectrum of ADHD symptoms
ADHD symptoms exist in a spectrum across the general population. Although everyone might have a touch of the symptoms occasionally, people with ADHD experience them more intensely and more often.
Imagine a volume knob on a speaker. Some people like their music at a moderate volume, some prefer it whisper-quiet, and others love it at full blast. ADHD symptoms are like that volume knob but for behaviours. While many might occasionally get distracted or act without thinking (moderate volume), those with ADHD might constantly struggle with focus or impulsivity (full blast).
Just like with introversion and extroversion, ADHD symptoms vary in intensity. So most people are in the middle and enjoy occasional social events, while others are more extreme and either love constant socialising or prefer complete solitude. But for those diagnosed with ADHD, behaviours like inattention and impulsiveness are always turned up high and can significantly affect their daily lives.
Types of ADHD
There are three main subtypes of ADHD that are classified according to the person’s symptoms:
When somebody doesn’t have significant symptoms of hyperactivity, this is called ADD (Attention Deficit Disorder, inattentive subtype). People with ADD struggle more with attention and concentration.
- Easily distracted and prone to daydreaming.
- Struggling to listen, follow instructions, or meet deadlines.
- Procrastinates often even though it leads to negative consequences.
- Often restart tasks multiple times before finishing them.
- Challenges with planning and organising time.
As the name suggests, this type of ADHD is primarily marked by two major challenges: impulsive behaviour and hyperactivity. However, inattention symptoms aren’t as much of a problem.
- Physical Hyperactivity: Constant fidgeting, restlessness, and difficulty staying still.
- Brain Hyperactivity: Swinging between extreme disinterest and obsession over topics.
- Impulsiveness: Acting without thinking, making impulsive purchases, interrupting others, and making hasty decisions.
Combined ADHD is a mix of inattention, hyperactivity, and impulsiveness symptoms. It’s usually more severe than the two other subtypes of ADHD, and the interplay of these symptoms can significantly impact various aspects of daily life.
For example, people with combined ADHD might:
- Struggle with sitting still during a meeting (hyperactivity).
- While also finding it hard to follow the discussion (inattention).
- And they might impulsively chime in without waiting for their turn (impulsivity).
ADHD in adults
What does ADHD look like in adults?
Adults with ADHD might feel different from their friends or colleagues and wonder why no one else seems to struggle with the same issues that they do. If others aren’t aware of your symptoms, they may think you are lazy or unfocused. This can lead to arguments and fights, or people might perceive your behaviour as ‘inconsiderate’ or ‘rude’ at times. Over time, these feelings can become internalised, and people believe they are personal faults or failures, which can lead to anxiety or depression.
Curious about how ADHD is diagnosed in adults? Learn more.
What are common adult ADHD struggles?
Adults with ADHD may experience any of the following issues:
- Finding it hard to focus on tasks that they dislike, and avoiding them.
- On the other hand, being able to hyperfocus and spend lots of time on tasks they enjoy (to the point of often overdoing it).
- Making careless mistakes unless they are deliberately paying a lot of attention.
- Having a tendency to start tasks and not finish them, because they are easily sidetracked.
- Difficulty finishing admin tasks, chores, or duties in the workplace or starting tasks due to a loss of focus.
- Struggling with organisation or failing to keep a diary.
- Leaving things to the last minute.
- Procrastinating even when it has negative or severe consequences.
- Being easily distracted (for example by their own thoughts).
- Problems organising tasks and activities, such as what to do in sequence.
- Keeping materials and belongings in order, having messy work and poor time management.
- Failing to meet deadlines.
- Finding it hard to pay attention in conversations.
- Feeling restless inside (too much mind wandering).
- Fidgeting or finding it hard to sit still for long periods of time (tendency to move around more than other people).
- Feeling a need to be constantly "doing something" (even if it is just checking the phone).
- Talking most of the time, interrupting other people or finishing their sentences.
- Being quite impatient, finding it hard to wait for their turn.
What does ADHD look like in adult women?
ADHD in women often goes unnoticed or misdiagnosed, and there are several reasons for this:
- Historical Bias: Traditionally, ADHD has been more frequently diagnosed in men than in women. This is partly because the symptoms women exhibit can be different from the classic hyperactive behaviour often associated with ADHD in men.
- Subtle Symptoms: Women with ADHD might not appear hyperactive. Instead, they may come across as daydreamers, inattentive, or underachievers. This subtlety can lead to missed diagnoses or misinterpretations of their behaviour.
- Misdiagnoses: Some women might be diagnosed with other conditions, like depression, anxiety, or bipolar, before realising that their symptoms align more with ADHD. In some cases, they might have been misdiagnosed altogether.
- Motherhood and ADHD: Becoming a mother can amplify ADHD symptoms, especially when paired with the sleep deprivation common after childbirth. It's not unusual for women to recognise their own ADHD symptoms for the first time when they become mothers. Additionally, when seeking help for their children's ADHD, mothers might recognise similar patterns in their own behaviour.
- Menstrual Cycles: Some women find that their ADHD symptoms or mood fluctuations intensify with their menstrual cycles, adding another layer of complexity to their experience.
It's essential to challenge the gender stereotypes about ADHD to ensure women get the help they need. While we might picture hyperactive boys when we think of ADHD, women can be just as hyperactive. The key is understanding that the manifestation of hyperactivity might differ. For instance, women with ADHD can experience hyperactivity just as men do, but the way they express these symptoms might vary.
Causes and Risk Factors
What causes ADHD? The short answer is we're not entirely sure. Scientists are still researching the exact cause, but a combination of genetic, environmental and health factors are thought to increase the risk of ADHD.
ADHD is a neurodevelopmental disorder. This means that certain areas of the brain develop differently in those with ADHD, potentially from birth. Contrary to some beliefs, ADHD isn't a condition one simply outgrows or develops due to poor parenting, playing video games, or an unhealthy diet. While an unhealthy lifestyle can make symptoms worse, it's not a root cause.
Genetics & family risk
If you have ADHD, it's likely that some of your parents, brothers, sisters, or kids will have it too. This is because ADHD often runs in families. In fact, many adults only realise they might have ADHD when their child is diagnosed. That’s why it's beneficial to involve the whole family in understanding and managing ADHD, as it can make home life smoother for everyone.
About 74% of ADHD cases can be linked to genetics. But it's not just one or two genes causing it. Instead, many tiny changes in various genes together increase the risk of ADHD. Because so many genes are involved, it makes things quite complicated, and researchers are still trying to figure out the full picture of why some people have ADHD and others don't.
Certain environmental factors can increase the risk of ADHD. These include:
- Smoking, alcohol, or drug use during pregnancy.
- Exposure to environmental toxins.
- Being born prematurely.
- Traumatic brain injury (TBI).
These factors can stress the body and increase the risk of triggering someone to develop ADHD, especially if they already have a genetic predisposition to ADHD (inherited from their parents).
Research suggests that inflammation might play a role in worsening ADHD symptoms. Stress is often linked to higher levels of inflammation, especially if the stress occurs over a long period of time or during childhood. For instance, studies show that some people with ADHD have lower levels of cortisol, an anti-inflammatory hormone that helps our body function properly. Cortisol helps our body to absorb nutrients from food and is involved in regulating brain function and reward-seeking behaviour.
While it might sound daunting, the upside is that many ADHD treatments target these health factors, helping balance things like cortisol levels and brain activity. Getting diagnosed and treated for ADHD can reduce stress, knowing there's a reason behind the challenges faced. Lower stress can lead to numerous health benefits, including reduced inflammation and better cognitive function. By focusing on overall health, many find their ADHD symptoms also improve.
Conditions associated with ADHD
ADHD and co-occurring conditions
People with ADHD might feel different from their friends or colleagues and wonder why no one else seems to struggle with the same issues that they do. Over time, these feelings can become internalised. Adults with ADHD might believe they are failures, which could lead to anxiety or depression.
People with ADHD may develop other mental or physical health conditions. Common issues that typically co-occur with ADHD include:
- Borderline Personality Disorder (BPD)
- Sleep problems
- Physical health conditions (epilepsy, allergies, gastrointestinal problems)
The same genes that make someone more susceptible to ADHD can also increase the risk for conditions like depression, anxiety, and Borderline Personality Disorder.
While having multiple conditions can complicate diagnosis and treatment, a comprehensive approach to care can be transformative. By addressing all conditions, ADHD symptoms often become more manageable.
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Addiction & ADHD
People with ADHD are more likely to develop alcohol or drug addictions. This is partly because the genetic factors that increase the risk for ADHD are similar to those that increase the risk for certain addictions. People with ADHD might have used or developed a substance addiction at a much younger age compared with their friends.
Cannabis and ADHD
Demonstrating the link between genetics and ADHD, recent genetic studies have highlighted a strong link between ADHD and cannabis use. The research suggests that the genetic predisposition for ADHD also increases the likelihood of cannabis use. It's not necessarily that ADHD directly causes cannabis use, but rather that shared genetic factors play a role.
Almost half of the risk of being a regular cannabis user can be attributed to genetics. Many of these genes overlap with ADHD, explaining why those with ADHD might be more inclined to use cannabis.
Untreated ADHD & Addiction Treatment
If ADHD goes untreated, it can lead to significant challenges, including a higher risk of addiction and other impulsive behaviours. Before starting any addiction treatment, it's essential to assess for ADHD. While ADHD symptoms may not require targeted treatment itself, a diagnosis will be crucial for designing an effective addiction treatment.
Due to limited ADHD support, some individuals resort to using substances like alcohol, cocaine, cannabis, or caffeine for relief (or self-medication). This can sometimes result in mislabeling them as having substance use disorders, potentially barring them from the help they need. However, treating ADHD has been shown to reduce substance use significantly.
At the London Psychiatry Clinic, we believe many people with ADHD turn to substances as a way to cope. To genuinely treat the underlying cause of substance use, we will conduct a comprehensive assessment to screen for ADHD along with other conditions. Without understanding and addressing these underlying issues, breaking the cycle can be tough.
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Treatments for ADHD
Everyone's experience with ADHD is different, from their symptoms to how it affects their life. That's why we work closely with you to create a treatment plan that's just right for you. Whether you're newly diagnosed, have been living with ADHD, or are still seeking answers, we're here to support you every step of the way.
The first thing your specialist will do is dive deep into understanding your specific ADHD symptoms and how they impact your daily life. We also check for any other conditions that might be linked to or intensify your ADHD. With a clear understanding of your individual experiences and challenges, we'll develop a plan tailored to your needs. Our treatment plans are designed to not only manage your symptoms, but help you lead a life full of purpose, success, and connection.
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Psychological education (Psychoeducation)
Receiving an ADHD diagnosis can be a mix of emotions. Whether it's relief, surprise, or confusion, the most common question we hear is, "What's next?"
Before going ahead with treatment, it's essential to understand your unique ADHD symptoms first. This is where "psychoeducation" comes in. Think of it as an educational session about your ADHD. The National Institute for Health and Care Excellence (NICE) in England recommends psychoeducation as the first step for everyone, no matter how mild or severe the symptoms.
In these sessions, your specialist will explain your specific ADHD symptoms in a way that's easy to grasp. We're here to guide you through this journey, answer your questions, and help you find your place in the world with your new understanding of yourself.
Therapy is a powerful tool to help you navigate the challenges of ADHD. At the London Psychiatry Clinic, we believe in the transformative power of talking therapy. It offers a safe space to explore your feelings, understand your symptoms, and learn strategies to manage them. Many of our patients have found lasting benefits from therapy.
Some types of therapy we might recommend for ADHD:
- Cognitive Behavioural Therapy (CBT): Helps you identify and change negative thought patterns.
- Psychodynamic Therapy: Explores past experiences to understand present behaviours.
- Interpersonal Therapy: Focuses on improving your relationships.
- Mindfulness-based Cognitive Therapy: Teaches you to be present and aware of your thoughts and feelings.
Find the best kind of therapy for your ADHD symptoms. Speak with us today.
Why is therapy helpful for ADHD?
Therapy is incredibly helpful for neurodivergent people, particularly those with ADHD. You might have been told you're not trying hard enough or felt misunderstood, especially during your younger years. These feelings can impact your self-worth and lead to doubts or anxiety later in life. Therapy can help you navigate these feelings, improve social interactions, and excel in your personal and professional life. We're here to help you set goals, enhance focus, and unlock your full potential.
Specialist ADHD coaching can provide practical guidance for managing your symptoms. The journey with ADHD often involves knowing what needs to be done but struggling with how to implement it. Our coaching is designed to bridge that gap. Together, we'll navigate the practical steps of "how to move forward" and "how to put insights into action," ensuring you lead a life that's both fulfilling and authentic. Coaching can help with many areas of your life, such as establishing a routine, increasing productivity, developing healthy habits, improving your work/life balance, and navigating relationships or parenthood.
Many people find regular weekly or bi-weekly sessions beneficial, helping maintain momentum and ensuring life's challenges don't become overwhelming.
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After an ADHD diagnosis, you might wonder about medication options. Taking medication for ADHD is completely optional, and the role of the psychiatrist is to provide professional advice while taking into account your personal preferences to help you through your journey.
Here's what you need to know:
- The choice is yours: Medication is an option, and not always necessary. Our role is to guide you, providing expert advice tailored to your preferences and needs.
- Tailored to your routine: Everyone's daily routine is different. Some need focus during the day, while others need it into the evening. We'll help align medication with your lifestyle for optimal benefits.
- Informed decisions: We'll discuss all available medication options, ensuring you understand the benefits and potential side effects. Our aim is for you to feel confident in your choices.
- Addressing concerns: Some medications might affect appetite or sleep. We're here to help, whether it's adjusting meal times, changing medication schedules, or suggesting sleep strategies.
Types of ADHD medications:
- Stimulant Medications: These are common for ADHD treatment. They boost brain chemicals like dopamine and norepinephrine, enhancing focus and impulse control. Examples include Elvanse, Dexedrine, Amfexa, Ritalin, Concerta, and Medikinet.
- Non-Stimulant Medications: These can be alternatives for those who don't respond well to stimulants. They might take a bit longer to show effects. Examples are Strattera and Intuniv.
- Some other medications, like certain antidepressants, have been used in the past but are less common now due to potential side effects.
Making small, simple changes in your daily routine can have a big impact on managing ADHD. Whether it's adopting stress-relief techniques, choosing healthier meals, or incorporating regular exercise, these changes can help bring balance and focus to your life. We understand how hard it can be to develop consistent habits if you have ADHD, so we’ll work with you to incorporate small changes into your lifestyle and develop a structured routine over time.
Diet & Supplements
For those with ADHD, maintaining a regular and healthy diet can sometimes be a challenge. Indulging in unhealthy snacks, eating at random times throughout the day, or forgetting to eat for hours are all common habits in people with ADHD. But eating balanced meals can boost your energy, reduce ADHD symptoms, and ensure you get the right nutrients. We'll guide you on when and what to eat, especially if you're on medication, to get the most benefits and reduce potential side effects.
Some supplements have shown potential in managing ADHD symptoms. However, it's essential to note that everyone's body reacts differently, and what works for one might not work for another. We're here to help you find what's best for you.
Dive into nutritional strategies with our Specialist Dietitian. Book your consultation.
Regular exercise and spending time outdoors can uplift your mood and sharpen your focus. Whether it's a brisk walk, a jog, or any other form of exercise, moving your body can enhance focus, reduce impulsiveness, and boost memory. We'll help you find an exercise routine that fits into your life and brings the most benefits.
Mindfulness is more than just a buzzword. It's a practice that helps you become more aware of your thoughts and feelings. For those with ADHD, it can be a game-changer, helping to improve attention, reduce stress, and manage impulsive reactions. Studies have shown that regular mindfulness practices can significantly improve ADHD symptoms. We'll guide you on how to integrate mindfulness into your daily routine.
A restful night's sleep is essential, but many with ADHD struggle with sleep. Whether it's difficulty falling asleep or staying asleep, disrupted sleep can exacerbate ADHD symptoms. We offer specialised treatments, like cognitive behavioural therapy for insomnia (CBTI), sleep hygiene, and circadian rhythm optimisation. These approaches can help you establish better sleep patterns and ensure you wake up refreshed.
From understanding to action, let our experts guide you. Find an ADHD Specialist.
Living with ADHD
While ADHD is a lifelong condition, there's hope. With the right treatment, many symptoms can improve, making life more manageable.
The highs and lows of ADHD
People with ADHD have a unique blend of traits. On one hand, they have the ability to be intensely focused, especially when engaged in activities they're passionate about. This hyperfocus allows them to tap into their full brain potential, often leading them to excel beyond expectations.
However, the flip side presents challenges. Everyday tasks or activities they find dull can be a significant hurdle. This often results in putting off these tasks until the last moment, leading to feelings of stress and guilt. Fortunately, therapy and medication can help manage and reduce these challenges, making daily tasks more approachable.
Discover personalised strategies for living with ADHD. Find an ADHD Specialist.
ADHD and masking
Many with ADHD are brilliant thinkers and innovators. They often excel in school or work, sometimes by subtly hiding or "masking" their ADHD symptoms. However, even if they appear to be thriving, recognising and addressing their ADHD can unlock even greater potential.
Despite their achievements, without a proper diagnosis, they might face challenges like anxiety, depression, or feelings of being out of place among peers. Moreover, undiagnosed ADHD can pose risks, including a higher likelihood of addiction later in life, emphasising the importance of early support and intervention.
The paradox of intelligence and ADHD
People with a high IQ often have a unique challenge when it comes to ADHD. Their natural intelligence allows them to create workarounds or strategies to cope with ADHD symptoms. Because of these coping mechanisms, they might not even realise the extent to which ADHD affects them. In essence, their brilliance can conceal the challenges of ADHD, potentially preventing them from recognising that they could achieve even more if their ADHD symptoms were addressed.
ADHD and sleep problems
While insomnia isn't directly a symptom of ADHD, many with ADHD find it hard to fall asleep, a condition known as sleep-onset insomnia. They often feel most alert and productive during the night, especially when it's quiet and free from distractions or when they're racing against a deadline. Their minds remain active at night, with thoughts racing, sometimes about the most random topics.
To cope with these sleep challenges, individuals with ADHD have found various ways to help them relax. Some might resort to alcohol or sleeping pills, while others distract their active minds with TV, podcasts, or audiobooks. Often they might fall asleep with the TV on!
Curious to learn more?
Wrapping up our exploration into ADHD, it's clear that this condition is multifaceted, with both challenges and strengths. Remember, every individual's journey with ADHD is unique. While some days might feel like an uphill battle, there are also moments of brilliance, creativity, and hyper-focus that set you apart.
At the London Psychiatry Clinic, we're not just here to diagnose and treat; we're here to understand, support, and celebrate the uniqueness in you.
Dive deeper into our website for more insights, stories, and expert advice about:
- Adult ADHD Assessments
- The evolution of ADHD
- ADHD in children and teenagers
- ADHD Assessments for children and teenagers
Watch our Clinic Director Dr Alberto Pertusa’s presentation on ADHD at the Global Exchange Conference: