WHAT IS ADHD AND WHY IS IT SO MISUNDERSTOOD?

DR. JAN NEWMAN

Why Is ADHD So Misunderstood?

You may hear people flippantly volunteer such labels as “I’m ADD” or “I think I have ADHD” when they forget something or zone out during a conversation. Yet this usage doesn’t reflect increased awareness or sensitivity or a reduction in stigma. Instead, it reflects the widespread misunderstandings about ADHD.

Most of us have experienced many of the symptoms.

ADHD, a Very Real Condition

Because everyone knows what it’s like to occasionally procrastinate, forget something, or be easily distracted, they may assume they know what ADHD feels like. In turn, they may inaccurately include that ADHD is “no big deal” and that people with ADHD and their loved ones are making much ado about nothing.

Some have even perpetuated the myth that ADHD is not real and is just a scheme from pharmaceutical companies to make money. Because training in neurodevelopmental disorders is relatively rare, there are even medical and mental health professionals who have made this argument.

Nothing could be farther from the truth. ADHD is a very real neurodevelopmental disorder that was identified long before the advent of ADHD medications. At Momentum Psychology, our therapists understand this and are here to help break the stigma and offer you the help and support you need to fully understand your diagnosis.

So Exactly What is ADHD?

ADHD is a neurodevelopmental disorder that impacts an estimated 8.4 percent of children and 2.5 percent of adults. It is much more common in boys than girls. Notably, in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), ADHD is classified as a neurodevelopmental disorder, not a mental disorder.

Although many people will use the terms ADD and ADHD interchangeably, there are only three subtypes of ADHD.

Predominately Inattentive Type (This is usually the one that people mean when they say “ADD”)
Predominately Hyperactive Type
Combined Type

The requirements for ADHD subtype are noted below.

Predominantly Inattentive Type

Requires six (or five for people over 17 years) of the following symptoms occurring often:

Doesn’t pay close attention to details or makes careless mistakes
Has trouble maintaining attention on tasks or activities (e.g., long lectures or reading assignments)
Doesn’t seem to listen when spoken to directly (i.e., seems preoccupied or zoned out)
Doesn’t follow through on instructions and fails to finish tasks and activities (i.e., may start tasks but gets easily sidetracked)
Struggles with organizing tasks and activities or loses things necessary for tasks and activities (e.g. has problems with time management, scheduling, and keeping up with tasks and materials)
Takes the “path of least resistance” and avoids or dislikes tasks requiring sustained mental effort over a long period (i.e., this is often unintentional and more of a cognitive style)
Easily distracted
Forgets daily tasks such as chores and errands.

Predominantly Hyperactive Type

Requires six (or five for people over 17 years) of the following symptoms occurring often:

Fidgets with or taps hands or feet or squirms or moves in seat
Can’t stay seated (e.g., in classroom, workplace, meetings)
For children, often runs about or climbs in situations where it is not appropriate—for older teens and adults, this may be limited to feeling restless
Unable to play or participate in leisure activities quietly.
Always “on the go” or acts as if “driven by a motor”
Talks excessively or blurts out an answer before a question has been completed
Has trouble waiting their turn in line
Interrupts or intrudes on others (e.g., cuts into conversations, games, or activities, using other people’s things without permission)

Combined Type

For a combined type diagnosis, the individual must have qualifying symptoms from both symptom categories.

Due to the neurobiological systems that are impacted by ADHD, individuals with ADHD are at risk to develop other problems such as depression and anxiety. Due to the later maturation of the prefrontal cortex, which is most impacted in individuals with ADHD, early intervention in ADHD is key.

Notably, Russ Barkley, Ph.D., an internationally recognized expert has argued that ADHD affects more than attention and activity. He argues that ADHD is a disorder of the entire executive functioning system.

How is ADHD Diagnosed?

A diagnosis of ADHD requires a thorough assessment and usually involves testing and collecting data from the individual, parents, teachers, coaches, or employers. Symptoms and impairment must be observed in multiple settings. This assessment should be conducted by an individual trained in administering psychological and/or neuropsychological tests and with specific training and experience in assessing ADHD.

If your child has been given a diagnosis of ADHD without a thorough assessment involving parents and teachers or others, then you may want to consider getting a second opinion.

What Causes ADHD?

ADHD has strong neurobiological roots. Although we have not identified definite causes of the disorder, we do know that the strongest contributor is likely genetics. For example, three out of four children with ADHD will have a relative with ADHD. Other risk factors include certain birth or pregnancy complications, prenatal exposure to alcohol or cigarette smoke, and low birth weight.

How is ADHD Treated? Can it Be Cured?

Although there is no cure for ADHD, there are certain treatments that can manage it. However, current research suggests that, with appropriate intervention, many people will not meet the criteria for ADHD later. According to experts, this could be anywhere from 14-35% depending on how strict the definition of recovery is.

This is a primary reason why early intervention is so key in ADHD.

Current best practice recommendations for intervention include the following:

Diagnosis by an appropriate assessment by a trained professional
Psychoeducation about ADHD
Stimulant medications or non-stimulant medications supported by current research
Behaviorally-based psychological treatments, specifically behavioral therapy and behavioral parent training, and cognitive behavioral therapy
Accommodations at school and at work to facilitate better executive functioning (e.g., sitting in a less distracting environment, use of assistive technologies)

Diagnosis

Under the DSM-5, diagnosis requires the following:

A review of symptoms shows that other requirements have been met for the last six months.
Symptom number:
- For children up to age 16, six or more qualifying symptoms for children that have been present for six months.
- For those 17 and up, five or more qualifying symptoms have been present for six months.
Age of onset:
- Several symptoms were present before the age of 12 and the symptoms are disruptive and inappropriate for the person’s developmental level.

Medication

Finding the right medication and dosage for an individual with ADHD can be tricky. Many people find that one trial of medication will have undesirable side effects and stop taking the medication. You must work with your physician to discuss all side effects and any concerns you have so that you can work together to get the dosage right. Although some medications are highly effective for inattention symptoms, they may not work as well for hyperactivity symptoms. Finding the right medication is often a complex process but worth the effort. In 2021, the FDA approved the first new non-stimulant medication in over 20 years called Quelbree.

Therapy for ADHD and Coaching

Effective ADHD treatment often requires a comprehensive multidisciplinary approach and the cooperation of a variety of professionals for optimal results. Children with ADHD often have motor coordination difficulties and learning problems. So, in addition to medical and behavioral interventions, they may also require occupational therapy and physical therapy or tutoring, or learning assistance.

For adults with ADHD, behavioral therapy or coaching specific to ADHD could be helpful. If adults with ADHD are dealing with comorbid anxiety or depression, evidence-based therapies like CBT or ACT can be helpful and tailored to the unique issues that come with ADHD.

Accommodations in School and Work

Children with ADHD are now eligible for special education services in public schools under both the Individuals with Disabilities in Education Act (IDEA) and Section 504 of the Civil Rights Act.

Adults with ADHD are also eligible for accommodations in their workplace or educational settings under the Americas with Disabilities Act (ADA) if there is sufficient impairment. Most public colleges and universities support students with ADHD through their disability services programs.

Early intervention and accommodations are critical for ADHD and can possibly lead to remission from the more disruptive effects of the disorder.

Can ADHD be a Good Thing?

ADHD is also associated with several characteristics that could also be considered to be “superpowers” like creativity and imagination. Tony Stark and Spiderman might agree!

And did you know that many successful CEOs with ADHD consider it to be their superpower in business? None of this makes light of the difficulties faced by individuals with ADHD, yet it’s important to remember there are possible gifts – especially if the person knows and understands how to leverage their strengths to troubleshoot any weaknesses. With ADHD, knowledge is definitely power.

Harness the Power of Your ADHD! Begin Therapy for ADHD in North Carolina and Beyond Today!

ADHD does not have to be a negative diagnosis. Our team of skilled ADHD Therapists at Momentum Psychology is here to help you harness the hidden powers of ADHD and work towards reaching your full potential professionally and personally. We utilize evidence-based treatment methods that include ACT, DBT, CBT, and Trauma-Informed Practices.

We currently offer online ADHD Therapy in North Carolina and all PSYPACT states including, but not limited to North Carolina, Texas, Virginia, and Georgia.

If you are ready to take control of your life and build Momentum moving forward to a bright future, follow the steps below to get started.

Get to know more about our skilled team of therapists here.
Fill out our convenient online contact form.
Schedule an intake appointment with our available ADHD therapists.
Begin the journey to regaining control of your life

OTHER SERVICES OFFERED BY MOMENTUM PSYCHOLOGY

As well as having extensive training in the treatment of anxiety and its related issues, our team of therapists also offers a wide variety of online therapy services in North Carolina and all PSYPACT states. We work with lawyers, entrepreneurs, students, parents, and teens who are dealing with stress and burnout, trauma and loss, ADHD, depression, and life transitions. Our goal is to help you find success both professionally and personally so you can gain Momentum to excel in a bright future.

RESOURCES OFFERED BY MOMENTUM PSYCHOLOGY IN NORTH CAROLINA

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The information provided on this website and in this blog is for educational purposes only. The contents of this website and newsletter are provided solely for informational purposes and are not meant to provide professional medical or psychiatric advice, counseling, or services

Resources for Further Reading:

Barkley, R. A. (2013). Taking charge of ADHD: The complete, authoritative guide for parents. Guilford Press.

Dawson, P., & Guare, R. (2009). Smart but scattered: The revolutionary” executive skills” approach to helping kids reach their potential. Guilford Press.

Guare, R., Dawson, P., & Guare, C. (2012). Smart but scattered teens: The executive skills program for helping teens reach their potential. Guilford Press.

Nadeau, K., Littman, E., & Quinn, P. (2015). Understanding girls with ADHD: How they feel and why they do what they do. Advantage Books.

Ted Talk – Failing at Normal: An ADHD Success Story

Edge Foundation, Dav Pilkey Using ADHD Superpowers to Create Super Heroes for Kids

Momentum Psychology’s resources are for informational purposes only and are not intended to assess, diagnose, or treat any medical and/or mental health disease or condition. Our resources do not imply nor establish any type of therapist-client relationship. The information should not be considered a substitute for consultation with a qualified mental health or medical provider who could best evaluate and advise based on a careful evaluation.