called ADD? ADHD? What's the difference?
The only difference is one of terminology, which can get confusing at times. The "official" clinical diagnosis is Attention Deficit Hyperactivity Disorder, or ADHD.
The DSM-5 defines three
main types of presentations for
ADHD Combined Presentation
ADHD Predominantly Inattentive Presentation
ADHD Predominantly Hyperactive/Impulsive Presentation
Many people use the term ADD as a generic term for all types of ADHD.
Some people use ADD to mean the presentation type of ADHD without
hyperactivity (Predominantly Inattentive Presentation) which is not accurate and should not be done. The
"ADD" is still commonly used among the general public, in the media, and even among
some professionals. We are still talking about the same thing however, whether we call it ADD or ADHD.
ADHD occurs on a spectrum of severity. Not every person
with ADHD presents all the possible symptoms that are associated with
ADHD, nor do the symptoms cause the same level of impairment in all
people. Some people have mild ADHD and may experience only transient
periods of impairment. In others ADHD may be severe,
characterized by more symptoms, more severe symptoms, and chronic
impairments in ability to function. ADHD can be diagnosed and treated at
any point in the lifespan when it causes significant levels of
impairment for the individual.
Attention Deficit Hyperactivity Disorder (ADHD)
is a neurobiological condition that affects an estimated 5-7% of the population. ADHD is an ongoing condition that affects children,
adolescents, and adults of all ages. It occurs in both males and
females, and in people of all races, socioeconomic status, and cultural
backgrounds. ADHD may cause significant impairments in many areas of
life such as school, home, the workplace, and in family and social
relationships. ADHD is genetically influenced and runs in families.
Definition of ADHD
ADHD is a
diagnosis applied to children and adults who consistently display certain characteristic behaviors over a period of time. The most common core features include:
- distractibility (poor sustained attention to tasks)
- impulsivity (impaired impulse control and delay of gratification)
- hyperactivity (excessive activity and physical restlessness)
In order to meet diagnostic criteria these behaviors must be excessive, long-term, and pervasive.
An important consideration is that the behaviors must create
a significant handicap in at least two areas of a person's life, such as school, home, work, or social settings. These criteria set ADHD apart from the "normal" distractibility and impulsive behavior of childhood, or the effects of the hectic and overstressed lifestyle prevalent in our society.
It is certainly not true that "everybody has ADHD."
According to the DSM-5 (the Diagnostic and Statistical
Manual of Mental Disorders, Fifth Edition) some
common symptoms of ADHD include: often fails to give close attention to details or makes careless mistakes; often has difficulty sustaining attention to tasks; often does not seem to listen when spoken to directly; often fails to follow instructions carefully and completely; losing or forgetting important things; feeling restless, often fidgeting with hands or feet, or squirming; running or climbing excessively; often talks excessively; often blurts out answers before hearing the whole question; often has difficulty awaiting turn.
It should be kept in mind that the exact nature and severity of ADHD symptoms varies from person to person. Approximately one-third of people with ADHD do not have the hyperactive or overactive behavior component, for example.
Who has ADHD?
According to research data, approximately 5% to 7% of the U.S.
population has ADHD. ADHD has also been diagnosed in many other
countries. It is not affected by race or culture.
ADHD usually persists throughout a person's lifetime. It is NOT
limited to children. Most children with ADHD will continue
to have significant problems with ADHD symptoms and
behaviors as adults, which impacts their lives on the job,
within the family, in relationships, and in many areas of
daily living. Common problems for adults involve severe
difficulties with organization at home and work,
difficulties planning and prioritizing, poor time
management, chronic problems with procrastination, and
difficulty sustaining attention and concentration on tasks.
Is there a
cure for ADHD?
No. ADHD is not a disease or illness, therefore there is nothing
to “cure.” ADHD is a biological, genetic condition that people have for
their entire lives. ADHD symptoms can be managed however, most
effectively with a combination of behavioral strategies and routines and
appropriate medication (for those individuals who need medication). The
goals of treatment are to help the individual understand how ADHD
affects his or her behavior and to manage the symptoms better.
What research shows about
ADHD is NOT caused by poor parenting, family problems, poor teachers or schools, too much TV, food allergies, or excess sugar. One early theory was that attention disorders were caused by minor head injuries or damage to the brain, and thus for many years ADHD was called "minimal brain damage" or "minimal brain dysfunction." The vast majority of people with ADHD have no history of head injury or evidence of
any type of brain damage however.
Another old theory was that refined sugar and food additives
make children hyperactive and inattentive. Scientists at the
National Institutes of Health concluded that this may apply to only about 5 percent of children with ADHD, mostly either very young children or children with food allergies.
ADHD IS very likely caused by biological factors which influence neurotransmitter activity in certain parts of the brain, and which have a strong genetic basis. Studies at NIMH using a PET (positron emission tomography) scanner to observe the brain at work have shown a link between a person's ability to pay continued attention and the level of activity in the brain. Specifically researchers measured the level of glucose used by the areas of the brain that inhibit impulses and control attention. In people with ADHD, the brain areas that control attention used less glucose, indicating that they were less active. It appears from this research that a lower level of activity in some parts of the brain may cause inattention and other ADHD symptoms.
These differences are associated with lower levels of
available neurotransmitters in those areas of the brain,
There is a great deal of evidence that ADHD runs in families, which is
strongly suggestive of genetic factors. If one person in a family is diagnosed with ADHD there is a 25% to 35% probability that any other family member also has ADHD, compared to a
5% to 7% probability for someone in the general population.
Twin studies have shown that if one twin has ADHD, there is
a 90% probability that the other twin will also have ADHD.
qualified to diagnose ADHD?
A comprehensive ADHD evaluation can be provided by a licensed
health care professional with training and knowledge about ADHD
(Physician, Clinical Psychologist, School Psychologist, Licensed
Clinical Social Worker, etc.). ADHD should never be self-diagnosed based
on symptom checklists, internet questionnaires, etc.
How is ADHD
A diagnostic evaluation should be provided by a qualified health
care professional, based on scores from standardized ADHD tests and a
thorough life history. ADHD cannot be diagnosed accurately just from brief
office observations, or just from talking to the person. For more
information please see the diagnosis page.
Can ADHD be
Yes. With accurate diagnosis and treatment, ADHD can be managed
effectively during childhood, adolescence, or adulthood. Research and
clinical experience have shown that the most effective treatment for
ADHD includes a combination of therapy/counseling and medication. Some
of the common goals for therapeutic interventions are to develop an
understanding of ADHD from a biological perspective, learn appropriate
behavioral strategies and coping skills for the individual, improve
self-esteem, alleviate feelings of frustration and guilt, and improve
communication and social skills. Behavioral coping skills that are
often addressed in therapy include improving organization,
improving time management skills, and improving efficiency and
productivity in school, the workplace, and in tasks of everyday living.
I was never
hyperactive as a child. Is it still possible that I may have ADHD?
Yes. Approximately one-third of people with ADHD never have
symptoms of hyperactivity or excessive impulsivity. Females with ADHD are less likely to have
symptoms of hyperactivity compared to males.
medical insurance cover costs for diagnosis and treatment of ADHD?
Most types of health insurance policies cover diagnostic and
treatment services for ADHD that are provided by licensed health care
professionals. Terms of coverage depend on your health insurance policy.
About The Author:
Peter Jaksa, Ph.D., is a licensed clinical
psychologist with over 25 years experience working with children,
adolescents, and adults with ADHD, Dr.
Jaksa is the author of numerous articles and columns about ADHD,
including articles published in ADDitude Magazine, Attention
Magazine, Organize Magazine, and FOCUS. He has provided
interviews to national publications and news organizations including the
Wall Street Journal, CNN,
Chicago Tribune, and Men's Health Magazine. He has presented
at national conferences
to health care professionals, educators, and the general public.