BYU NewsNet - Living with ADHD

As early as 1902, scientists sought to pin down a specific reason for the poor "inhibitory volition" and "defective moral control" of children that English physician George Still identified as displaying symptoms of over-activity.

In the 1940s and '50s, children diagnosed with minimal brain damage or minimal brain dysfunction, perplexed scientists as they displayed behavior problems, then associated with mental retardation, while showing no signs of brain injury.

With the acceptance of hyperkinesis, or the poor filtering of stimuli entering the brain, as the cause of hyperactive child syndrome in the late '50s came a more definite, albeit incomplete, picture of what is now referred to as attention deficit hyperactivity disorder or ADHD.

In the ongoing search to determine the cause of this disorder, recent statistical data provides compelling evidence of a genetic influence on ADHD.

According to emedicinehealth.com, one-third of the biological relatives of people with ADHD also have the disorder, and there is a 60 percent chance that children of a parent with ADHD will have it as well.

But because ADHD is a complex and chronic disorder of the brain, behavior and development, any explanation that focuses on just one cause is likely to be inadequate to explain the disorder in its entirety.

Recent MRI findings suggest that people with ADHD have some brain abnormalities, primarily in their frontostriatal circuitry. This region consists of the prefrontal cortex, and interconnected areas of gray matter are areas of the brain associated with attention, executive functions, delayed responding and response organization.

People with ADHD are identified by the National Institute of Mental Health as those displaying "persistent age-inappropriate symptoms of inattention, hyperactivity, and impulsivity that are sufficient to cause impairment in major life activities."

Because people with ADHD can only be identified by characteristic behaviors that vary considerably from person to person and their behavior is often contradictory, it can be difficult to understand what they are experiencing.

Classification of ADHD

The symptoms that children and adults with ADHD exhibit are divided into three main categories. John M. Call, the academic accommodations and technology coordinator at the University Accessibility Center, explained that, "a person with ADHD is classified as either inattentive or hyperactive/impulsive or a combination of both."

Those classified as inattentive find it difficult, during work or leisure, to focus on one task or follow through on requests or instructions. Although they may automatically pay attention to enjoyable things, they have difficulty focusing on new or less interesting tasks.

With this tendency toward distraction comes the ability to "multi-mind task better than others, but that, too, can be a hazard," John Call said. "When they learn control so there is an awareness of alternate stimuli instead of a hyper focus on various stimuli, then awareness of their environment can be enhanced."

People with this disorder also have a hard time with sustained attention, the ability to maintain a persistent focus over time or when fatigued. Although no one likes to work on uninteresting or repetitive tasks for long, most people will when they are forced to.

But people with ADHD have a hard time continuing with a task even when they want to.

"Someone with ADHD can be working hard on a project and really enjoying it, but leave that project for another that is more exciting," Call said. "Once they have left one project for another, it's hard to go back because they lost the excitement."

People who are classified as hyperactive and impulsive have more trouble regulating motor behavior. Their activity is excessively energetic, intense, inappropriate and not goal-directed. So although they have a lot of energy, they don't necessarily accomplish much.

The inability to bridle immediate reactions or think before acting are characteristic of the impulsivity associated with ADHD.

"Impulsiveness can take different forms," Call said. "Sometimes it's blurting things out before thinking things through, buying things or getting impulsively angry."

While acknowledging the fact that everyone has some attention concerns from time to time, for someone with ADHD, these concerns actually "put them at a disadvantage," Call said. "A disorder is something that impairs a person from a life function -- whether it's reading, writing, speaking or attention."

Many adults with ADHD have never been diagnosed and, as a result, may feel that something is wrong with them, but they just can't figure out what.

Even though ADHD does not contribute to a lack of intelligence, rather a difficulty in applying intelligence to everyday life, people with the disorder commonly feel that they are never fully living up to their potential.

Treatment and Medication

There is no known cure for ADHD although a variety of treatments can be used to help cope with symptoms and any secondary problems that may arise.

Stimulants have been used in the treatment of ADHD since 1937 and today they are the most studied, most effective, and most commonly used treatment for the disorder.

With ADHD, "electrical and chemical responses are inhibited because there is a random firing or not a consistent firing of neurotransmitters," Call said. "The medication is so effective because it calms the transmitters down and makes them fire more steadily."

As a result, stimulant medications dramatically increase sustained attention, impulse control, persistence of work effort and decrease irrelevant activity and noisy, disruptive behavior for about 70 percent of people who take them, Call explained.

But because about 50 percent of people with ADHD also have anxiety, depression, or other emotional concerns, Call encourages a multi-faceted approach to managing the disorder.

The University Accessibility Center offers counseling, which is more emotion specific, in addition to something they call "coaching."

"Coaching deals with the student's lifestyle which is where the hazards associated with ADHD are," Call said. "Students learn how to use time, set up routines and structure."

Although he remains hopeful and optimistic about the possibility of a successful and fulfilling life for those living with ADHD, Call also acknowledges that there are some difficulties associated with helping someone with this disorder,

"The biggest problem I have in working with ADHD students is that they beat themselves up when [treatment] doesn't work," Call said. "You have to keep trying to be successful. You can gain control but sometimes it's part of the nature of life that it's not going to work so you have to backup, regroup, and try again. [ADHD] doesn't have to destroy their lives."