Attention deficit in adults diagnosis. Symptoms and treatment of ADHD in adults. Drugs are a tool, not a cure for ADHD in adults

Attention deficit hyperactivity disorder (ADHD) is a neurobehavioral disorder that is typically characterized by the following symptoms:

inattention;
- distractibility;
- impulsiveness;
- hyperactivity.

Kinds

Attention Deficit Hyperactivity Disorder is divided into three subtypes:

Predominantly hyperactive or impulsive type. The behavior is marked by hyperactivity and impulsivity, but not by inattention;
- mostly inattentive type. The behavior is marked by inattention, but not by hyperactivity and impulsivity;
- combined type. The combination of symptoms of hyperactivity and impulsivity - with symptoms of inattention. This is the most common type of Attention Deficit Hyperactivity Disorder.

in children

Attention Deficit Hyperactivity Disorder (ADHD) is sometimes described as a decrease in brain function. It refers to the cognitive abilities needed to plan, organize, and complete tasks. Deficiency in the performance function can cause the following problems:

The inability to store information in short-term memory;
- violation of organization and planning skills;
- Difficulties in establishing and using behavioral guidelines such as the choice of strategy and monitoring objectives;
- overwhelming inability to cope with emotions;
- inability to effectively move from one mental activity to another.

Symptoms of Attention Deficit Hyperactivity Disorder in Children

- Hyperactivity. The term "hyperactive" is often misleading as it suggests to some that the child is in constant, non-stop motion. However, boys with ADHD, while playing a game, for example, may have the same level of activity as children without the syndrome. But when a child is given increased attention, his brain increases motor activity. In a busy environment - a classroom or a crowded store - children with ADHD are often distracted and overreact to everything. They can take goods from the shelves without asking a parent, beat people - in a word, everything gets out of control for them, resulting in unstable and strange behavior.

- Impulsivity and hysteria. Tantrums, which are normal in young children, are usually exaggerated in children with ADHD and are not necessarily associated with a specific negative event.

- Attention and concentration. Children with Attention Deficit Hyperactivity Disorder (ADHD) tend to become distracted and inattentive to their surroundings (such as a large class). In addition, they are inattentive when the atmosphere is calm or boring. On the contrary, they may have a kind of "super concentration" when there is a high stimulating activity (for example, a video game or very specific interests). Such children may even become overly attentive - they are so absorbed in an activity that is interesting for them that they cannot completely change the direction of their attention.

- Violation of short-term memory. An important feature in attention deficit hyperactivity disorder, including in learning, is a violation of working (or short-term) memory. People with ADHD cannot hold groups of sentences and images in their minds long enough to generate clear, coherent thoughts. They are not necessarily careless. A person with ADHD may not be able to remember a complete explanation (such as homework) or be unable to complete processes that require sequential memorization (such as a building model). Children with ADHD are often attracted to activities (television, computer games, active individual sports) that do not overload working memory or produce distractions. Children with ADHD do not differ from other children in long-term memory.

- Inability to manage time. Children with Attention Deficit Hyperactivity Disorder (ADHD) may have difficulty being everywhere on time and scheduling the right time for certain tasks (which may coincide with short-term memory problems).

- Lack of adaptability. Children with Attention Deficit Hyperactivity Disorder (ADHD) often find it very difficult to adapt to even minor changes in routines, such as getting up in the morning, putting on shoes, eating new foods, or changing sleep patterns. Any situation with a change in something can cause them a strong and noisy negative reaction. Even when they are in a good mood, they can suddenly become hysterical if they are faced with an unexpected change or disappointment. These children can focus their attention directly on cues in a particular place, but have difficulty shifting their attention to something else.

- Hypersensitivity and sleep problems. Children with ADHD are often hypersensitive to objects, sounds, and touch. They may complain of excessive stimuli that seem minor or mild to others. Many children with ADHD often have trouble sleeping during the night.

Attention Deficit Hyperactivity Disorder in adults

Attention Deficit Hyperactivity Disorder (ADHD) is a chronic disorder that begins in childhood. Adult Attention Deficit Hyperactivity Disorder (ADHD) is an extension of the symptoms of childhood ADHD.

Symptoms of attention deficit hyperactivity disorder in adults

- Mental disorders. About 20% of adults with ADHD also have major depression or bipolar disorder. Up to 50% have anxiety disorders. Bipolar disorders can be very difficult to distinguish from ADHD, not only in adults but also in children.

- Disorders accompanying learning. About 20% of adults with Attention Deficit Hyperactivity Disorder have learning disabilities in the brain. These are usually dyslexia and auditory processing problems.

- Influence on work. Compared with adults without ADHD, those with ADHD tend to have lower levels of education, earn less money, and as a result, are more likely to be fired.

- Substance abuse. About 1 in 5 adults with ADHD also struggle with substance abuse. Studies show that teens with ADHD are twice as likely to smoke cigarettes than their peers who do not have ADHD. Smoking during adolescence is a risk factor for the development of substance abuse in adulthood.

Causes attention deficit hyperactivity disorder

- The structure of the brain. Research using modern imaging techniques shows differences in the size of certain parts of the brain in children with attention deficit hyperactivity disorder compared to children without ADHD. Areas with changes include: prefrontal cortex, caudate nucleus, globus pallidus, and cerebellum;

- Brain chemicals. Increased activity of certain brain chemicals in the prefrontal cortex may contribute to ADHD. The chemicals dopamine and norepinephrine are of particular interest. Dopamine and norepinephrine are neurotransmitters (chemical messengers in the brain) that affect mental and emotional functioning. They also play a role in reward response. This response occurs when a person experiences pleasure in response to certain stimuli (such as food or love). Research shows that elevated levels of the brain chemicals glutamate, glutamine and GABA - interact with dopamine and norepinephrine;

- Genetic factors. Genetic factors most likely play an important role in ADHD. Relatives of children with ADHD (boys and girls) have a much higher percentage of ADHD, as well as antisocial anxiety and disorders, substance abuse, than families without children with attention deficit hyperactivity disorder. Some twin studies show that up to 90% of children diagnosed with ADHD share it with their twin. Most research is being done on the underlying genetic mechanisms of the neurotransmitter dopamine. Changes in the genes that regulate specific dopamine receptors have been found in a large number of people with ADHD.

Risk factors attention deficit hyperactivity disorder

- Floor . ADHD is more commonly diagnosed in boys than girls. Boys are more likely to have a combined type of ADHD. Girls are more likely to have a predominantly inattentive type;

- Family history. A child who has parents or siblings with Attention Deficit Hyperactivity Disorder has an increased risk of also getting ADHD;

- Environmental factors. Some studies show that maternal alcohol consumption, drug abuse, and smoking during pregnancy can lead to the development of attention deficit hyperactivity disorder in a child. Low birth weight may be associated with ADHD. Environmental exposure to lead before age 6 may also increase the risk of ADHD;

- Nutritional factors. Several nutritional factors have been investigated in relation to ADHD, including sensitivity to certain chemicals in the diet, deficiencies in fatty acids (compounds from fats and oils) and zinc, and sensitivity to sugar. However, there is no clear evidence that any of these dietary factors imply risk factors for ADHD.

Diagnostics attention deficit hyperactivity disorder

Diagnosis of Attention Deficit Hyperactivity Disorder in Children

There is no single test to diagnose ADHD. The doctor conducts a physical examination of the child to make sure that the underlying condition is not causing ADHD symptoms. However, the diagnosis of "ADHD" is based mainly on the child's observations and questionnaire, as well as on the patterns of behavior of the SAO (this is the Scale of activity and optimism). A child with SAD may be referred by a pediatrician to a psychiatric hospital where doctors are experienced in dealing with childhood disorders such as ADHD.

- History of behavior. The doctor will ask questions for a detailed history of the child, will identify SAO of his behavior. Parents should describe specific problems with the child, SAO development, family history of ADHD, and any recent family life changes that may have affected the child. The doctor will learn everything important about the child, about all the details of his life outside the home: written reports from teachers, school psychologists, guardians or others related to the child, etc.

- Medical examination. The physical examination should include a hearing test to rule out any hearing problems for the child. The doctor should ask about a history of medical problems, including allergies, sleep disturbances, poor eyesight, and chronic ear infections.

For the diagnosis of ADHD to be made, at least six of the following symptoms must have been present for at least 6 months (in preschool children, 9 months).
Symptoms of inattention (at least six of them should be):

The child often fails to pay close attention to details or makes inattentive mistakes;
- often has difficulty maintaining attention in tasks or games;
- often does not seem to listen when spoken directly to him;
- often does not complete tasks, assignments;
- has difficulty organizing tasks and activities;
- avoids or dislikes tasks that require sustained mental effort;
- often loses things necessary for tasks or activities;
- often easily distracted by extraneous stimuli;
- Often forgetful in daily activities.

Symptoms of hyperactivity and impulsivity (at least six of them must be present):

Often fidgets or writhes while sitting;
- has difficulty sitting when required;
- often works or often rises in inappropriate situations;
- can't play calmly;
- often on the move
- often talks too much
- often blurts out answers to questions before they have been asked to the end;
- has difficulty waiting in line
- often interrupts others.

Based on these symptoms, a child may be diagnosed with predominantly inattentive ADHD, predominantly hyperactive - impulsive ADHD, or combined ADHD.

Diagnosis of Attention Deficit Hyperactivity Disorder in Adults

Children's Attention Deficit Hyperactivity Disorder can affect children between the ages of 4 and 18. Adult ADHD always occurs as a continuation of childhood ADHD. Symptoms that begin in adulthood are due to factors unrelated to ADHD.

Attention deficit hyperactivity disorder in adults is often difficult to diagnose. The doctor should find out the history or symptoms of childhood ADHD. The patient may ask parents or former teachers for school records or other useful information about the patient. The doctor will ask the patient questions about the following types of symptoms:

Inattention and problems with memory (the patient may forget or lose things, being absent-minded, not finishing things, underestimating the time, the order of things, he has problems starting or changing work, halfway through it);
- hyperactivity and anxiety (the patient is always on the go, fussy, slightly bored, he strives for an active and fast pace in work and activities);
- impulsiveness and emotional instability (the patient says things without hesitation, interrupts others, gets irritated with other people, is easily disappointed, his mood is unpredictable, reckless);
- problems with self-esteem (the patient avoids new tasks, he has confidence in others, but not in himself).

Complications attention deficit hyperactivity disorder

Attention Deficit Hyperactivity Disorder (ADHD) can be a problem for children and their loved ones.

- Emotional problems. Children with ADHD, especially those who also have anxiety or depressive disorders, usually suffer from low self-esteem.

- Social problems. ADHD can affect children in their relationships with peers. Children with ADHD may have difficulty with social skills and appropriate behaviors that can lead to bullying (both victim and perpetrator) and rejection. Impulsivity and aggression can provoke fights and negative relationships with other children. Children with Attention Deficit Hyperactivity Disorder and high levels of aggression may have a higher risk of delinquent behavior (the antisocial illegal behavior of an individual, embodied in his misdeeds - actions or inactions that harm individuals and society as a whole) in adolescence and to criminal activity in adulthood.

- Risk of injury. Impulsivity in young people with ADHD can put them at risk of not thinking about the consequences. Children with Attention Deficit Hyperactivity Disorder have an increased risk of accidents and injuries. For example, a child with ADHD cannot be tested for responsiveness to oncoming traffic while riding a bicycle, or whether they can participate in high-risk, high-impact groups. All these problems of children with ADHD carry over into their adult lives.

- Abuse of alcohol or drugs. According to research, young people with ADHD - in particular those with conduct or mood disorders - have an above-average risk of substance abuse that starts at a young age. Biological factors associated with ADHD may make these individuals susceptible to substance abuse. Many of these young people can bring themselves out of this condition on their own.

- Problems with learning. Although speech and learning disorders are common in children with ADHD, they do not affect their intelligence. People with attention deficit hyperactivity disorder have the same IQ (intelligence quotient) range as the general population. Many children with ADHD are falling behind in school. Some evidence suggests that inattention may be a major contributor to underachievement in these children. Difficulties in reading can also create problems for them. Poor academic performance can affect a child's self-esteem and self-confidence, and influence various social problems in peer relationships.

- Influence on the family. The time and attention required to deal with problems in children with ADHD can change internal family relationships and lead to conflicts with parents and siblings.

Other disorders associated with ADHD

Some disorders may mimic or accompany ADHD. Many of these disorders require other treatments and must be diagnosed separately, even if they accompany ADHD.

- Opposition-producing disorder (THIEF). It is often associated with Attention Deficit Hyperactivity Disorder. The most common symptom of this disorder is negative, cocky, and hostile behavior towards authority figures that lasts for more than half a year. In addition to inattention and impulsive behavior, these children exhibit aggression, frequent tantrums, and display antisocial behavior. A significant number of children with VOR also have anxiety and depression, which should be considered separately. Many children who develop VOR at an early age go on to develop conduct disorder.

- Conduct disorder. Some children with ADHD also have conduct disorder, which is described as a complex group of behavioral and emotional disorders. It includes aggression towards humans and animals, destruction of property, seduction, deceit, theft, and general violation of social rules.

- Developmental disorder. The developmental disorder is rare and is usually characterized by behavioral autism, hand-clapping, repetitive statements, and slow speech and motor development. If a child who has been diagnosed with ADHD does not respond to treatment, parents may see it as a developmental disorder that often responds to antidepressants. Some of these children may also benefit from stimulant medications.

- Auditory disorders. Hearing problems can mimic the symptoms of ADHD and should be evaluated at the time of diagnosis. Auditory disorders are another condition that can affect children's ability to process sound information. Children with this type of disorder have normal hearing, but something in their brain prevents them from filtering out background noises and distinguishing between similar sounds. An auditory disorder may be misdiagnosed as ADHD and may occur along with it.

- Bipolar disorder. Children diagnosed with Attention Deficit Disorder may also suffer from Bipolar Disorder, formerly known as Manic-Depressive Psychosis. Bipolar disorder is characterized by episodes of depression and mania (with symptoms of irritability, rapid speech, thoughts turning off). Both disorders often cause inattention and distractibility and can be difficult to tell apart, especially in children. In some cases, ADHD in children and adolescents can be a marker for developing bipolar disorder.

- Anxiety disorders. Anxiety disorders often accompany ADHD. Obsessive Compulsive Disorder is a specific anxiety disorder that shares many of the characteristics of ADHD, with some genetic components. Young children who have experienced a traumatic event (including sexual or physical abuse or neglect) may exhibit ADHD characteristics, including impulsivity, emotional outbursts, and oppositional behavior.

- Sleep disturbance. Sleep disorders are often associated with attention deficit hyperactivity disorder: these are insomnia, restless leg syndrome and sleep apnea (breathing disorders during sleep).

Diseases with similar symptoms

- Tourette syndrome and other genetic disorders. Several genetic disorders cause ADHD-like symptoms, including Tourette's syndrome. For many patients with Tourette's syndrome and ADHD, some of the treatments are similar.

- Lead poisoning. Children who ingest even small amounts of lead may experience symptoms similar to ADHD. The child can be easily distracted, disorganized and unable to think logically. The main cause of lead poisoning is exposure to paint containing lead, especially in older houses that are in poor condition.

Ltreatment attention deficit hyperactivity disorder

Attention Deficit Hyperactivity Disorder is considered a chronic condition that requires long-term, ongoing monitoring and adjustment of symptoms, medications, and other treatment programs. While symptoms may lessen over time, ADHD usually doesn't "go away." Patients can, however, learn to control their condition through behavioral techniques, which are often supported with medication.

Treatment for attention deficit hyperactivity disorder does not reverse the condition, but focuses on controlling the symptoms and improving the functioning of the affected person. Treatment usually involves a combination of psychostimulants. These are usually: Methylphenidate (Ritalin) and behavioral therapy (other drugs may also be used for older children and adults). Treatment often involves a systemic approach that includes: the child's pediatrician, other healthcare professionals, parents, and teachers.

For preschool children (ages 4-5), behavioral therapy provided by parents and teachers should be considered first. For many children, behavioral therapy alone leads to significant improvement. If further treatment is needed and the benefits likely outweigh the risks, the doctor may prescribe the stimulants Methylphenidate (Ritalin, etc.);
- For school-age children (ages 6-11) a combination of medication, stimulant and behavioral therapy is needed. Stimulant alternatives, in order of recommendation: Atomoxetine (Strattera), Guanfacine (Tenex), or Clonidine (Catapres);
- Adolescents (aged 12-18 years) should be treated with medication and, if necessary, behavioral therapy. Some patients at this age may temporarily stop taking their medications. The doctor at this time should carefully monitor the child. Adolescents should also have their doses of medication adjusted as they grow and change during puberty;
- treatment of adult ADHD. As with children, treatment for adults with ADHD is a combination of drugs and psychotherapy. For medications, stimulant drugs, or non-narcotic stimulants, atomoxetine (Strattera) is usually the first-line treatment, and with antidepressants, it is the secondary option. Most stimulant medications, as well as Atomoxetine, are approved for adults with ADHD. Adults who have heart problems or risk factors should be aware of the cardiovascular risks associated with ADHD treatment.

Medications for the treatment of attention deficit hyperactivity disorder

Several types of medications are used to treat Attention Deficit Hyperactivity Disorder:

- Psychostimulants. These are the main drugs used to treat Attention Deficit Hyperactivity Disorder. Although these drugs stimulate the central nervous system (CNS), they have a calming effect on people with ADHD. These drugs include methylphenidate and amphetamine. These drugs increase dopamine, a neurotransmitter important for cognitive functions such as attention.

- Alpha-2 agonists. Alpha-2 agonists stimulate the neurotransmitter norepinephrine, which may be important for concentration. They include guanfacine and clonidine. Alpha-2 agonists are used for Tourette syndrome and may be useful when other drugs fail to help children with attention deficit hyperactivity disorder with severe impulsivity and aggression. These drugs may be prescribed in combination with stimulants.

- Antidepressants. Because antidepressants work just as well as behavioral therapy, doctors recommend that patients first try psychotherapy before using antidepressants.

Behavior Correction

Behavioral management in a child with ADHD is not immediately clear to most parents and teachers. To get to know them, they all may need the help of qualified psychologists and medical professionals or ADHD support groups. At first, the idea of ​​changing the behavior of a very energetic and stubborn child is intimidating. It is useless and harmful to force a child with attention deficit hyperactivity disorder to be like most other healthy children. It is possible, however, to limit his destructive behavior and to instill in a child with ADHD a sense of self-worth that will help to overcome all the negative.

Raising a child with ADHD, like raising any child, is a complex process. The child's self-esteem will develop as the ability to take a step back and think about the consequences of a possible action increases, and then control the action before taking it. But it doesn't happen quickly. The growing child with ADHD is different from other children in very specific ways and presents challenges at any age.
Parents must first create their own tolerance levels. Some parents are calm and can accept a wide range of their child's behaviors, while others are not. Helping a child achieve self-discipline requires empathy, patience, love, and loyalty.

- Setting agreed rules for the child. Parents should be as consistent as possible in their approach to their child, should reward good behavior and discourage destructive behavior. The rules of conduct for the child should be clearly defined but flexible enough to include harmless features. It is important to understand that children with ADHD have a much harder time adapting to change than other children. Parents should create predictable situations and ensure a neat and stable environment at home (especially in the children's room).
Also, through useful literature and work with psychologists and doctors, parents should learn how to competently manage the aggression of their child with attention deficit hyperactivity disorder. .

In addition, it is absolutely necessary for parents of children with attention deficit hyperactivity disorder to learn how to reward such children for all good and calm behavior. Ways are many.

- Improved concentration and attention. Children with ADHD perform much better on learning tasks when they have an interest in the subject. Parents should be on the lookout for all activities that keep the child's concentration. Options include: swimming, tennis, and other sports that focus attention and limit peripheral stimuli (children with ADHD may have difficulty with team sports that require constant alertness, such as football or basketball).

- Interaction with the school. Even if one parent successfully manages their child at home, it is common for a child with ADHD to have difficulty at school. The ultimate goal of any educational process is the happy, prosperous and healthy social integration of children with Attention Deficit Hyperactivity Disorder with their peers.

- Teacher training. Any teacher should be prepared for the peculiarities of the behavior of children with attention deficit hyperactivity disorder in order to competently manage these children. They also, like the parents of such children, need to study the relevant medical, pedagogical and other literature and also actively consult with psychologists and doctors on this matter.

- The role of parents in the school. Parents can help their child by talking to the teacher before the start of the school year about their child's situation. The first priority for parents is to develop a positive, and not aggressive, impatient, overly strict, attitude of the teacher towards the child. Finding a mentor who can help your child keep going after school can also be very helpful.

- Special education programs. High-quality special education can be very helpful in improving learning and developing a child's self-esteem. However, programs vary in their ability to provide quality education. Parents should be aware of some of the limitations and issues with special education:

Special education programs in a normal school environment often increase a child's sense of social exclusion;
- if the educational strategy focuses only on the abnormal, morbid behavior of the child, it will not be able to take advantage of the creative, competitive and dynamic energy that often accompanies ADHD;
- the best approach may be to treat this syndrome - the training of teachers to manage such children in normal classes.

Other treatments attention deficit hyperactivity disorder

- Dietary approach. Certain diets have been suggested for people with ADHD. Several well-conducted studies do not support the effects of dietary sugar and food additives, suggesting that they negatively affect the behavior of ADHD patients, except perhaps in a very small percentage of children. However, various studies have shown behavioral improvement with diets that limit potential allergens (such as citrus fruits) in the diet. Parents may want to discuss with their doctor the elimination of a food-focused diet.

Possible stimuli that influence behavior change include:

Any artificial dyes (in particular, yellow, red or green);
- other chemical additives;
- milk;
- chocolate;
- eggs;
- wheat;
- foods containing salicylates, including all berries, ground red pepper, apples and cider, cloves, grapes, oranges, peaches, peppers, plums, prunes, tomatoes;
- essential fatty acids. Omega-3 fatty acids, found in fatty fish and certain vegetable oils, are important for normal brain function and may provide some benefits for people with ADHD. It has not yet been clarified whether additives to polyunsaturated fatty acid compounds, such as docosahexaenoic and eicosapentaenoic acids, provide benefits;
- zinc. Zinc is an important metabolic mediator that plays a role in ADHD. Its deficiency in some cases may be associated with ADHD. Long-term use of zinc, however, can lead to anemia and other side effects in people without deficiencies, and in these patients it has no effect on ADHD. In any case, testing for micronutrients such as zinc is not a standard procedure in evaluating children with suspected ADHD;
- sugar. Although parents often believe that sugar is bad for children, because. because of it, they become impulsive or hyperactive, - studies do not confirm this.

- Alternative methods. A number of alternative approaches help children and adults with mild symptoms of ADHD. For example, daily massage may help some people with ADHD feel happier, less agitated, less hyperactive, and focus on tasks. Other alternative approaches that may be helpful include: relaxation training and music therapy. These treatments may be helpful for symptomatic treatment, but have not been shown to benefit the underlying disorder.

- Herbs and supplements. Many parents resort to alternative remedies - psychostimulants and other medications. These products include: St. John's wort, ginseng, melatonin, pine bark extract, etc. However, there is no scientific evidence that they are effective.

One of the fundamental problems in the field of ADHD treatment in adults is related to the fact that the professional medical community is still not fully aware of the fact that ADHD in a child often does not go anywhere as they grow up. The behavioral “masks” of the syndrome and forms of adaptive compensation are modified, but the characteristic deficit of basic psychological functions – impaired attention and insufficiency of inhibitory mechanisms – does not disappear and continues to seriously impede the cognitive activity of an adult, on the basis of which a whole bunch of various psychological problems “blooms” - persistent depressive nature of behavior, increased anxiety, insecurity, a decrease in the level of self-esteem due to numerous failures in school, at work and in personal relationships. At the same time, such adults often develop the so-called "learned helplessness syndrome", which is accompanied by the desire to avoid difficult situations. Numerous evidence of this fact has been obtained over the past decade in numerous scientific studies by psychologists, neuropsychologists and neurophysiologists. The study of the age dynamics of the main manifestations of ADHD showed a relative age-related "softening" of the manifestations of hyperactivity and, conversely, the relative persistence of manifestations of attention deficit and impulsivity over the entire life span.

Basic treatments for ADHD in adults.

In official American medicine, unlike Russian medicine, the first choice in the treatment of attention deficit disorder in adults is drug therapy with psychostimulants (methylphenidate) and some drugs that are not psychostimulants (Strattera). However, it is becoming increasingly clear that the majority of adult patients with ADHD (at least 75%) require concomitant treatment with other non-drug approaches to achieve a long-term and maximally high therapeutic effect. In addition to the already mentioned biofeedback therapy, which is the most promising in terms of effectiveness and safety, one of the most popular methods is psychological counseling. Despite its usefulness and effectiveness, there are certain psychological barriers on the part of patients that prevent the correct course of therapy. First, there is a lack of knowledge about the nature and causes of ADHD, especially in the adult population. In adult patients with newly diagnosed ADHD, there is no understanding of what this syndrome is, where it comes from, what consequences this disorder can have, and, most importantly, there is no understanding of the lifelong nature of these disorders and the resulting need for constant correction in one way or another. Hence the false belief that the patient can cope with the problems created by ADHD on his own and completely control them, one has only to strongly want to. However, the real dynamics of key indicators with an independent option to deal with ADHD looks like one step forward - two steps back, and the inevitable consequence of these fruitless attempts to treat hyperactivity in adults is growing frustration, depression and a decrease in self-esteem against the background of problems at school, college or at work, often even leading to exclusions and layoffs.

The importance of psychological correction of ADHD in adults.

As the practice of a large number of clinicians shows, the greatest successes in combating the main manifestations of the ADHD syndrome are demonstrated by those adult patients who "accept" their diagnosis and are involved in an active and constant struggle with it, using all available educational, technological and medical opportunities. In this regard, the results of a large American study, which analyzed the course of ADHD for 20 years, deserve special consideration. It turned out that in patients with signs of ADHD of both sexes at the age of about 20 years, during the first 10 years, there was a dominant tendency to deny that they had a disorder, and therefore to evade any form of treatment. According to the results of their self-reports, their condition improved and the severity of ADHD problems decreased, if not completely disappeared. At the same time, the results of objective testing, as well as the evaluation characteristics of close relatives, spoke quite the opposite - about the increase in the severity of symptoms and the increase in the number of related problems in school, at work, in communication. And only after the patient was able to bring to consciousness, and he accepted the idea of ​​the real existence of a certain disorder, requiring his constant attention and persistent desire for deliverance, the clinical picture began to change for the better, and the symptoms of ADHD were reduced.

ADHD and pathological forms of addiction in adults.

The available scientific evidence suggests that a significant proportion of adult patients diagnosed with ADHD (from 30% to 50% according to various sources) eventually become dependent on either alcohol/drugs or some other form. At the same time, the dependence that has appeared is explained either as a way of a kind of psychological relaxation against the background of problems created by ADHD, or as a manifestation of innate genetic mechanisms that determine the etiological and pathophysiological commonality of the ADHD syndrome and forms of pathological dependence. In this regard, it is necessary to emphasize those scientific data that confirm the positive effects of therapy, primarily biofeedback therapy in terms of EEG, both in relation to the main manifestations of ADHD - attention deficit and insufficiency of inhibitory systems and related impulsivity, and in relation to the resulting forms of pathological addiction.

A common behavior disorder today, which psychologists call ADHD, or Attention Deficit Hyperactivity Disorder, is characteristic of many school-age children. Children with this syndrome are naughty, impulsive and inattentive.

However, few people know that this diagnosis is also found in adults. Between 30 and 70% of "little ADHDs" carry their condition into adulthood.

Both in childhood and in adulthood, ADHD causes many problems. Study, work, relationships with people suffer. In order to help you learn to "calmly" live with this disease, psychologists give the following recommendations.

Attention is the only door of our soul.
Konstantin Dmitrievich Ushinsky

Down and Out trouble started

Symptoms of ADHD

“Forewarned is forearmed,” sounds an ancient Latin saying. When confirming this disease, you need to get as much information as possible on the problem. Literature, Internet sources, seminars and webinars, consultations of doctors - the more information the patient has, the better he knows the situation.

Attention Deficit Disorder has a physiological basis. In this disease, the flow of chemical reactions in the brain is disrupted. In this case, the doctor prescribes medication, which should be individualized for each patient suffering from ADHD.

Attention Deficit Hyperactivity Disorder (ADHD) in the English interpretation of the disease - Attention Deficit Hyperactivity Disorder (ADHD)

Treatment for ADHD

Usually, a correctly chosen course immediately gives its results and this can be seen in everyday life: the time of concentration on a task increases, a good mood and motivation are observed.

If you experience anxiety, tension, numbness and indifference while taking medication, you should consult a doctor.

Changes in the patient's life

1. Before you say or do something, you need to take a deep breath and mentally give yourself the installation: “Let's think about it” or put a finger to your mouth, stretching the time of thinking;
2. Speak measuredly, allowing the brain to process information. When solving monetary issues, think over several options and choose the most reasonable one;
3. In the store, before buying a new item, ask yourself: “Do I really need it? Will I be ashamed if I tell my husband or friends what I spent such a sum on?

The ADHDs' failure to see things through to the end is due to their inability to foresee the positive aspects of the expected outcome, or the consequences of failing the task. In this situation, you need to think: “How will I feel when I complete this task?”

It is advisable to focus on positive feelings - pride, relief - and try to feel them in the present moment. If that doesn't work, you might want to motivate yourself with some rewarding moment, like "After completing this task, I'll have coffee, go to dinner at a good restaurant, watch my favorite movie in the evening, etc."

For people with Attention Deficit Disorder, proper nutrition and exercise are especially important. During exercise, the hormone dopamine is produced, which contributes to better concentration, and a healthy diet and drinking plenty of water stimulates brain activity and improves memory.

We should also not forget that sometimes our brain does not concentrate on doing work, only because its resources have already been exhausted and it needs rest. Short, but frequent breaks in complete isolation from noise and other stimuli will reset the brain, and increase efficiency at work.

9 tips to help control your condition

1. Get rid of external irritants to the maximum.
2. Do the work piecemeal.
3. Do not put off tasks for later, try to complete them before the deadline.
4. Make plans to get things done.
5. Keep your workspace in order.
6. Sort documents and other necessary papers, check e-mail every day.
7. Maintain a to-do calendar.
8. Set up automatic bill payments.
9. Join a support club for adults with ADHD.

The occurrence of complications with concentration and concentration, as well as the appearance of a neurobehavioral disorder, indicate the disease "Attention Deficit Disorder" or ADD for short. Children are primarily affected by the disease, but the manifestation of the disease in adults is not excluded. The problems of the disease are characterized by varying degrees of severity, so ADD should not be underestimated. The disease affects the quality of life, its susceptibility, as well as relationships with other people. The disease is quite complex, so patients have problems with learning, performing any work and mastering theoretical material.

It is the children who partly become hostages of this disease, therefore, in order to prevent such a deficiency, it is worth learning as much as possible about it, and this material will help in this.

Description and types

This disease is a deviation in a person that is caused by high intelligence. A person with such an indisposition has difficulties not only with mental development, but also with physical development, which is already referred to as Attention Deficit Hyperactivity Disorder.

Children are the main contingent that is prone to the manifestation of this disease, but in rare cases there are symptoms of malaise in adults. According to many years of research, it has been found that the occurrence of attention deficit hyperactivity disorder in adults is associated solely with the nature of genes.

In children, attention deficit hyperactivity disorder is quite common, and it can be detected both after birth and at a later age of the child. Mostly the syndrome occurs in boys, and only in rare cases in girls. If you look at the example, then in almost every classroom there is one child with attention deficit hyperactivity disorder.

The syndrome is divided into three types, which are called:

• Hyperactivity and impulsivity. This species is characterized by inherent signs of impulsivity, irascibility, nervousness and increased activity in humans.
• Carelessness. Only one sign of inattention appears exclusively, and the possibility of hyperactivity is excluded.
• Mixed look. The most common form, which manifests itself even in adults. It is characterized by the predominance of the first and second signs in humans.

In the language of biology, ADHD is a dysfunction of the central nervous system, characterized by the formation of the brain. Brain problems are the most dangerous and unpredictable diseases.

Causes

The development of attention deficit hyperactivity disorder is hidden in several reasons that have been established by scientists on the basis of facts. These reasons include:

• genetic predisposition;
• pathological influence.

genetic predisposition is the first factor by which the development of malaise in the patient's relatives is not excluded. Moreover, in this case, both distant heredity (i.e., the disease was diagnosed in ancestors) and near (parents, grandparents) play a huge role. The first signs of attention deficit hyperactivity disorder in a child lead caring parents to a medical institution, where it turns out that the predisposition to the disease in a child is associated precisely with genes. After examining the parents, it often becomes clear where this syndrome came from in the child, since in 50% of cases this is exactly the case.

Today it is known that scientists are working on isolating the genes that are responsible for this predisposition. Among these genes, an important role is given to DNA regions that control the regulation of dopamine levels. Dopamine is the main substance responsible for the correct functioning of the central nervous system. Dysregulation of dopamine due to genetic predisposition leads to the disease of attention deficit hyperactivity disorder.

Pathological influence plays an important role in answering the question about the causes of attention deficit hyperactivity disorder. Pathological factors can serve as:

• the negative impact of drugs;
• influence of tobacco and alcoholic products;
• premature or prolonged labor;
• interrupt threats.

If a woman allowed herself to use illegal substances during pregnancy, then the possibility of having a child with hyperactivity or this syndrome is not excluded. There is a high probability of the presence of attention deficit hyperactivity disorder in a child born at 7-8 months of pregnancy, i.e. premature. In 80% of such cases, pathology occurs in the form of ADHD.

The causes of the development of the disease in children are also distinguished if a woman, being in a position, is fond of taking artificial food additives, pesticides, neurotoxins and other things. It is also possible to provoke this syndrome in adults due to the passion for bioadditives, artificial hormones, etc.

Until the end, the unexplored causes of provoking attention deficit hyperactivity disorder are:

• the presence of infectious diseases in a pregnant woman;
• chronic diseases;
• incompatibility of Rh factors;
• environmental degradation.

It follows that attention deficit hyperactivity disorder is an unusual disorder that occurs due to the action of one or more of the above factors. The most basic and proven is the cause of genetic influence.

Symptoms of the disease

Symptoms of the disease have a pronounced manifestation in children, so consider the main signs of attention deficit hyperactivity disorder in childhood.

Most often, the impetus for contacting treatment centers is educators, teachers and educators who discover some deviations in children. Symptoms of the disease have the following signs:

Impaired focus and attention. The child cannot focus on one thing, he is constantly going somewhere, thinking about something of his own. The performance of any task ends with errors, which is caused by a disorder of attention. If the child is addressed, then there is a feeling of ignoring speech, he understands everything, but cannot assemble the heard speech into one whole. Children with attention disorder are completely unable to plan, organize and perform a variety of tasks.

Symptoms are also expressed in the form of absent-mindedness, while the child tends to lose his things, be distracted by any trifles. Forgetfulness appears, and the child categorically refuses to take on mental affairs. Relatives have a feeling of remoteness of the child from the whole world.

Hyperactivity. It manifests itself together with the syndrome, therefore, in addition, parents can track the following symptoms in the child:

1. There is frequent movement of the arms and legs. The child is constantly in a hurry somewhere, but at the same time he never gets hung up on performing any actions.
2. Restlessness in place, constant body movements and haste: the child is somewhat reminiscent of a spinning wheel, which is constantly in a wound up action.
3. Constantly climbs where it is not allowed and at the same time does not stop at almost anything.
4. When hanging out with his peers, he behaves restlessly, actively and cannot simply play one game.
5. Along with these signs, the patient has a persistent character, which does not affect the attention deficit disorder in children.

Impulsiveness. Symptoms of impulsivity include the following manifestations:

1. A premature answer to a question that was not voiced to the end.
2. Wrong and quick answers to the questions asked.
3. Refusal to complete any task.
4. Does not listen to the answers of his peers, can interrupt them during the answer.
5. Constantly talking off-topic, perhaps a manifestation of talkativeness.

Symptoms of attention deficit hypersensitivity syndrome have their own characteristics of manifestation for different categories of children, depending on age. Let's consider in more detail.

Symptoms in children of different ages

Consider what symptoms are inherent in children of the following ages:

• preschool;
• school;
• teenage.

At preschool age from three to seven years, the symptoms are difficult to trace. ADHD at an early age is diagnosed by a doctor.

From the age of three, caring parents may notice the manifestation of hyperactivity in the form of a constant movement of the child. He cannot find something to do, constantly rushes from one corner to another, does not take on various mental tasks and constantly chats. Symptoms of impulsivity are due to the impossibility of restraining oneself in a given situation, the child constantly interrupts his parents, shouts over them, takes offense and even becomes irritable.

Games with such children lead to devastating consequences: they break toys, splashing out all their energy; it costs them nothing to harm their peers and even older children. Patients with ADHD are a kind of vandals for whom nothing is essential. Their brains have little to no control over their movements. There are also symptoms of developmental delays from their peers.

Reaching the age of seven When it's time to go to school, children with ADHD have more and more problems. Children with Attention Deficit Hyperactivity Disorder are unable to keep up with their peers in terms of mental development. In the classroom, they behave unrestrainedly, do not pay attention to the teacher's remarks, and do not listen to the material presented at all. They can be taken to complete the task, but after a while they actively switch to another one without finishing the first one.

At school age, ADHD in children manifests itself more clearly, as this is actively noticed by the teaching staff. Among all the children in the class, ADHD patients are visible even to the naked eye, for this it is enough to spend a couple of lessons, and it will not be difficult even for a person without a medical education to identify the presence of the syndrome in children.

Children not only lag behind in development, but also try in every way to incite their peers to this: they disrupt lessons, prevent their classmates from performing any actions, and at a later age they can argue and even snap with the teacher. For a teacher in the classroom, such a child is a real test, because of which the lessons become unbearable.

Reaching adolescence, the symptoms of ADHD begin to subside a little, but in fact there is a certain change in the signs of the disease. Impulsivity is replaced by fussiness and a feeling of inner restlessness. Teenagers are taken to perform certain tasks, but everything also ends unsuccessfully, no matter how hard they try.

Irresponsibility and lack of independence are all signs of attention deficit hypersensitivity syndrome in adolescents. They are not able (even at this age) to do the lessons on their own, there is no organization, planning of the day and distribution of time.

Relationships with peers are deteriorating, as they do not communicate at the proper level: they are rude, do not restrain themselves in their statements, do not observe subordination with teachers, parents and classmates. Along with this, failures lead to the fact that adolescents have low self-esteem, they become less and less psycho-resistant and more and more irritable.

They feel negative attitudes towards themselves from parents and peers, which leads to the emergence of negative and even suicidal thoughts. Parents constantly set them as a bad example, thereby causing dislike and antipathy towards their sisters and brothers. In the family, children with attention deficit hypersensitivity become unloved, especially if more than one kid grows up in the house.

Symptoms of the disease in adults

Symptoms in adults are different compared to children, but this does not change the final result. The same irritability is inherent, plus depressive disorders and the fear of trying oneself in a new field are added to this. In adults, the symptoms are more secretive, since at first glance the signs are due to calmness, but at the same time, imbalance.

At work, adults with ADHD are not smart, and therefore work as simple clerks is their maximum. Often they find it difficult to cope with mental types of work, so they do not have to choose.

Mental disorders and isolation lead to the fact that the ADHD patient finds painkillers for problems in alcohol, tobacco, psychotropic and narcotic substances. All this only aggravates the situation and causes complete degradation of a person.

Diagnostics

Diagnosis of the disease is not confirmed on any special equipment, but is carried out by observing the behavior of the child, his development and mental abilities. The diagnosis is established by a qualified doctor who takes into account all the information from parents, teachers and peers.

Diagnosis of ADHD is carried out using the following methods:

1. Collection of information about the child regarding the visit to the doctor.
2. Study of dopamine metabolism.
3. To identify the diagnosis, the doctor may prescribe the passage of Doppler ultrasound, EEG and video EEG.
4. A neurological examination is carried out, on which the use of the NESS technique is not excluded.
5. Genetic examination of parents to identify the causes of the disease.
6. MRI. A complete study of a person will show other deviations that may have influenced the provocation of the disease.
7. Conducting methods of neuropsychological testing for children of school and older ages is not excluded.

Based on all these methods, the preliminary diagnosis of ADD and hypersensitivity is either confirmed or refuted.

Treatment

Treatment of ADHD should include a complex impact, which should be due to the use of methods for correcting behavior, psychotherapy and neuropsychological correction. Treatment also implies the impact not only through various methods on the patient, but also the help of parents, teachers and relatives.

Initially, the doctor conducts a conversation with the people around the child and explains to them the features of the disease. The main feature is that such negative and reckless behavior of the child is not intentional. For a positive influence on the patient, contributing to his recovery, it is necessary that the people around him treat him positively. After all, first of all, it is with this that the treatment begins.

Parents have two main tasks that they must perform and monitor this:

Task #1: upbringing should not include a pitiful attitude towards the child and permissiveness. One should not feel sorry for him, address him with excessive love, this will only exacerbate the symptoms.

Task #2: do not impose increased requirements and tasks with which he cannot cope. This will contribute to the fact that his nervousness will increase and self-esteem will fall.

For children with ADHD, the change in the mood of the parents has a much more negative impact than for normal children. Treatment must also come from the teachers with whom children spend most of their time. The teacher should control the situation and relations of children in the classroom and in every possible way instill love and integrity. In case of manifestations of aggression by a patient with ADHD, one should not scold and even more so call the parents, but it is worth trying to explain to him the correct attitude. After all, it is worth remembering that all manifestations of it are unintentional.

For your information! It is also impossible for the child to feel from those around him that he is being treated as if he were sick. This will lower his self-esteem and will only lead to an exacerbation of symptoms.

Medication treatment

The complex uses treatment with the help of taking medications, which are formed according to individual indicators. Medications to treat ADHD include the following:

1. For CNS stimulation: Methylphenidate, Dextroamphetamine, Pemoline.
2. Tricyclic antidepressants: Imipramine, Amitriptyline, Thioridazine.
3. Substances of the nootropic series: Nootropil, Cerebrolysin, Semax, Phenibut.

It is stimulants that have a huge impact on the recovery of a person with ADHD. It was found that treatment with these drugs implies the influence of pathogenetic factors that have a targeted effect on the brain system.

Attention Deficit Disorder (ADD) is most common in childhood, although it can also occur in adults. With ADD syndrome, a person has problems with concentration, focusing on one thing, as well as keeping it.

Such problems come in varying degrees of severity, but always negatively affect the quality of life, communication and relationships with others. Children and adults suffering from this syndrome have difficulties in mastering the educational process, in the performance of work duties, as well as in other areas of life.

Today, the topic of our conversation with you will be attention deficit disorder, treatment, symptoms, causes of this pathology. Since ADD is quite common and requires mandatory treatment, many will be interested in learning more about it:

Causes of Attention Deficit Disorder

Science is not yet able to answer the exact causes of ADD. However, the factors and prerequisites for the development of this disorder are known:

genetic reasons. In this case, the syndrome is observed in another close relative. True, there is no evidence that attention deficit disorder is inherited. But it has been observed that children whose parents suffer from ADD are 4-5 times more likely to also have this disorder.

Features of the brain. It has been observed that the areas of the brain that are responsible for controlling attention in people with ADD are less active than in other people. In addition, scientists have found that the frontal lobes in people with the syndrome do not function quite as they should. It was also found that most patients have some deviation from the norm in terms of the level of dopamine and norepinephrine in the body.

Influence of toxins during pregnancy. There is some evidence that the likelihood of having a child with ADD is greatly increased in women who smoke, as well as those who use alcohol and drugs during pregnancy.

Other reasons. These include premature birth, intrauterine head injuries, brain injuries in the first months and years of a child's life, etc.

Symptoms of Attention Deficit Disorder in Children

If children suffer from the syndrome, they cannot keep their own attention on one thing for a long time. Therefore, they are often inattentive in the classroom, they listen poorly, they remember. They are forgetful, distracted.

For example, they constantly lose something, they forget to do their homework, etc. Such children are often distracted by everything, they have problems with the organization and implementation of the daily routine.

A child with ADD cannot concentrate on a given task if its completion requires effort and takes a lot of time. The parents of such a child should understand that it is not a matter of his laziness. To find out the reason, just show the child to a specialist. Especially when the child, moreover, shows signs of hyperactivity. That is, he cannot sit in one place, talks a lot, became pugnacious, impulsive.

Symptoms of Attention Deficit Disorder in Adults

Adult patients with this syndrome also have difficulty concentrating when solving a task. Very often, a person with ADD is careless when doing work, they are not attentive enough to details. Such a person often abandons the work he has begun without completing it, and immediately takes on a new job. Patients with ADD are forgetful, they often lose small things. They show impatience, are irritable. They have frequent mood swings.

It is very common for people with ADD to have comorbidities. For example, they are prone to depression. They often have bipolar and obsessive-compulsive disorder.

Attention Deficit Disorder Treatment

It is impossible to completely get rid of this violation. However, modern medicine has effective means, methods that will help reduce the severity of symptoms, alleviate the patient's condition, thereby improving his quality of life.

Therapy for attention deficit disorder includes drug treatment, as well as methods of psychotherapy, behavioral therapy.

Among the drugs prescribed to patients, it is worth noting: Methylphenidate, Dexamphetamine and Atomoxetine. They have a fairly long action (from four to twelve hours). After taking these drugs, the ability to concentrate improves. Impulsiveness disappears, the ability to assimilate new information increases.

It should be noted that these drugs are prescribed for the treatment of children and adolescents with ADD. They are also effective in the treatment of adult patients, if the syndrome was detected in them in childhood. However, no drugs have yet been developed to treat adults diagnosed with the syndrome after 20 years of age. In such cases, the doctor prescribes treatment, taking into account the intensity of clinical manifestations, the individual characteristics of the person.

Psychotherapy

Treatment with medications should be complemented by psychotherapy, methods of behavioral therapy. When conducting psychotherapeutic sessions, the doctor explains in detail, calmly to a child or an adult patient how his diagnosis can negatively affect their quality of life. This helps a person to more fully realize his condition, learn to correct it.

When ADD is accompanied by a manifestation of hyperactivity (which happens very often), in addition to drugs, psychotherapeutic sessions, they are prescribed physical exercises. It is recommended to do some kind of single sport. Team types are not easy for such people, because there you need to be in a group of people, interact with them. When such interaction is difficult, self-esteem may decrease, which in turn affects the quality of treatment. Be healthy!