17,99 €
Mehr erfahren.
- Herausgeber: John Wiley & Sons
- Kategorie: Fachliteratur
- Sprache: Englisch
- Veröffentlichungsjahr: 2024
Demystify ADHD with simple explanations of the basics and the latest research Attention deficit hyperactivity disorder (ADHD) is one of the most globally prevalent neurodevelopmental disorders. ADHD For Dummies explores living a healthy and fulfilling life with ADHD, from seeking diagnosis to choosing the right treatment path for you or your loved one. You'll read about the latest in ADHD research, equipping you with valuable knowledge as you care for a child with ADHD or explore your own ADHD symptoms as an adult. This book provides the answers you need on how to deal with day-to-day challenges at home, school, and work, and how to find support and counseling. With appropriate management, anyone can live a great life with ADHD. * Learn what ADHD is--and what it isn't * Get up to date with the latest information on ADHD, including medications and non-medical treatments * Find the right professional to help you get the support you or your children need This is the perfect Dummies guide for both parents of children with ADHD and adults with ADHD looking to learn more. Teachers, counselors, and therapists--this is also a great resource to educate yourself and your clients.
Sie lesen das E-Book in den Legimi-Apps auf:
Seitenzahl: 566
Ähnliche
ADHD For Dummies®
To view this book's Cheat Sheet, simply go to www.dummies.com and search for “ADHD For Dummies Cheat Sheet” in the Search box.
Table of Contents
Cover
Title Page
Copyright
Introduction
About This Book
Foolish Assumptions
Icons Used in This Book
Beyond the Book
Where to Go from Here
Part 1: The ABCs of ADHD
Chapter 1: ADHD Basics
Identifying Symptoms of ADHD
Clueing in on ADHD’s Origins
Getting a Diagnosis of ADHD
Viewing Various Treatment Approaches
Recognizing ADHD’s Role in Your Life
Chapter 2: Exploring the Causes of ADHD
Gaining Perspective from Past Theories
Coming at ADHD Research from All Sides
Examining Self-Regulation’s Role in ADHD
Exploring Current ADHD Research
Getting Down to the Bottom Line
Chapter 3: The Many Facets of ADHD
Picturing the Primary Symptoms of ADHD
Considering Some Secondary Symptoms
Facing ADHD in Different Populations
Part 2: Diagnosing ADHD
Chapter 4: Moving Forward with a Diagnosis
Help Wanted: Searching for the Right Person or People
Examining Your Values
Evaluating Your ADHD Professional
Getting a Second Opinion
Managing Your Care
Being Eligible for Services
Chapter 5: Navigating the Evaluation Process
Preparing for the Evaluation Process
Mental Health Evaluations
Medical Testing
Educational Testing
Motor, Cognitive, and Social Skills Testing
Behavioral Assessment
Performance Testing and Your Ability to Maintain Attention
Knowing What to Do after Diagnosis
Chapter 6: Investigating Conditions with ADHD-like Symptoms
Understanding Differential Diagnosis: Sorting Out Your Symptoms
Mental Disorders Sharing Features with ADHD
Medical Conditions: Making a Physical Connection
Sensory Processing Disorders Overlapping with ADHD
Pseudo-ADHD and Environmental Influences
Part 3: Treating ADHD
Chapter 7: Choosing the Best Treatment Options for You
Understanding the Three Levels of Treatment
Trying Multiple Treatments Together
Developing Your Plan for Treatment
Keeping Up-to-Date on New Therapies
Chapter 8: Managing Medication
Considering Whether Medication Is Right for You
Understanding How ADHD Medications Work
Exploring Medication Types
Monitoring Your Success with Medication
Chapter 9: Queuing Up Counseling, Coaching, and Training
Thinking about How Counseling Can Add to Your Treatment Plan
Exploring Counseling and Therapy Options
Adding an ADHD Coach to Your Treatment Team
Looking at Training to Help You Develop Important Skills
Finding the Right Counselor, Coach, or Trainer for You
Chapter 10: Managing Problem Behaviors
Taking Behavior 101
Looking at Behavioral Treatment Strategies
Chapter 11: Considering How Nutrition, Supplements, and Your Environment May Impact ADHD
Digging Into a Healthy Diet
Viewing Vitamin and Herb Supplements
Nutraceuticals: Combining Vitamins and Herbs
Addressing Possible Aggravators in Your Environment
Chapter 12: Examining Neuromodulation Therapies
Altering Brain Activity Through Neurofeedback
Using Auditory Brain Stimulation to Ease ADHD Symptoms
Using Electrical Brain Stimulation to Dim Your ADHD Symptoms
Making Sense of Magnetic Brain Stimulation
Chapter 13: Getting a Handle on Rebalancing Therapies
Balancing Energy through Acupuncture
Helping Your Body Heal Itself with Homeopathy
Using Manipulation Therapies
Assisting Your Brain with Processing Sensory Information
Looking Into Vision Therapies
Part 4: Living with ADHD
Chapter 14: Accentuating the Positive
Seeing the Positive in Your Symptoms
Examining Areas of Aptitude
Finding and Nurturing the Areas Where You Excel
Chapter 15: Creating Harmony at Home
Laying the Foundation for a Healthy Homelife
Improving Your Homelife When You Have ADHD
Being Single and Dating with ADHD
Parenting a Child with ADHD
Living with a Partner Who Has ADHD
Adopting Good Habits
Chapter 16: Creating Success at School
Overcoming Challenges at Any Age
Getting to Know Your Legal Rights
Addressing Your Child’s Needs: Developing an Educational Plan
Getting the Most from Your Child’s Teachers
Documenting Your School Experiences
Dealing with Difficult Times in School
Exploring Schooling Alternatives
Working with Your Child at Home
Chapter 17: Winning at Work
Getting an Overview of ADHD Challenges at Work
To Tell or Not to Tell: Sharing Your Diagnosis with Coworkers
Managing Yourself
Working on Work Relationships
Doing Day-to-Day Tasks
Creating Overall Success for Yourself
Going It Alone: Being Self-Employed
Part 5: The Part of Tens
Chapter 18: Ten (Plus) Tips to Organize Your Life
Writing Down Ideas and Appointments
Setting Reminders
Organizing Your Time
Employing Technology
Charting Your Schedule
Planning Ahead
Completing Your Projects
Cutting Clutter Off at the Source
Putting Things in Their Places
Creating a Color-Coding System
Deciding What’s Really Important to You
Chapter 19: Ten (or So) Ways to Improve Your Family Relationships
Taking Responsibility
Focusing on the Positive
Releasing Anger and Resentment
Getting Rid of Guilt
Talking It Out
Working Together
Having Regular Family Meetings
Being Realistic
Having Fun Together
Walking Away before Blowing Up
Prioritizing Time to Destress
Chapter 20: Ten Resources for More Information and Ongoing Support
Internet Forums
Websites
Support Groups
Your Child’s School
Local Colleges and Universities
Your ADHD Professional
Books on Specific Aspects of ADHD
The Library
Family and Friends
Talk Therapy
Appendix: Treatment Tracking Forms
Keeping Daily Tabs on Your Treatment
Performing Periodic Effectiveness Assessments
Index
About the Authors
Connect with Dummies
End User License Agreement
List of Tables
Chapter 4
TABLE 4-1 Diagnosis and Treatment Capabilities
Chapter 11
TABLE 11-1 Examples of Simple and Complex Carbohydrates
List of Illustrations
Chapter 2
FIGURE 2-1: Research indicates that several areas of the brain handle executive...
FIGURE 2-2: The dopamine–norepinephrine connections in the brain may have a lot...
Chapter 7
FIGURE 7-1: The biopsychosocial model of treatment is the most effective.
FIGURE 7-2: A successful treatment plan consists of these steps.
Guide
Cover
Table of Contents
Title Page
Copyright
Begin Reading
Appendix: Treatment Tracking Forms
Index
About the Authors
Pages
iii
iv
1
2
3
5
6
7
8
9
10
11
12
13
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
191
192
193
194
195
196
197
198
199
200
201
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
297
298
299
300
301
302
303
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
ADHD For Dummies®, 2nd Edition
Published by: John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030-5774, www.wiley.com
Copyright © 2024 by John Wiley & Sons, Inc., Hoboken, New Jersey
Published simultaneously in Canada
No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning or otherwise, except as permitted under Sections 107 or 108 of the 1976 United States Copyright Act, without the prior written permission of the Publisher. Requests to the Publisher for permission should be addressed to the Permissions Department, John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, (201) 748-6011, fax (201) 748-6008, or online at http://www.wiley.com/go/permissions.
Trademarks: Wiley, For Dummies, the Dummies Man logo, Dummies.com, Making Everything Easier, and related trade dress are trademarks or registered trademarks of John Wiley & Sons, Inc. and may not be used without written permission. All other trademarks are the property of their respective owners. John Wiley & Sons, Inc. is not associated with any product or vendor mentioned in this book.
LIMIT OF LIABILITY/DISCLAIMER OF WARRANTY: WHILE THE PUBLISHER AND AUTHORS HAVE USED THEIR BEST EFFORTS IN PREPARING THIS WORK, THEY MAKE NO REPRESENTATIONS OR WARRANTIES WITH RESPECT TO THE ACCURACY OR COMPLETENESS OF THE CONTENTS OF THIS WORK AND SPECIFICALLY DISCLAIM ALL WARRANTIES, INCLUDING WITHOUT LIMITATION ANY IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. NO WARRANTY MAY BE CREATED OR EXTENDED BY SALES REPRESENTATIVES, WRITTEN SALES MATERIALS OR PROMOTIONAL STATEMENTS FOR THIS WORK. THE FACT THAT AN ORGANIZATION, WEBSITE, OR PRODUCT IS REFERRED TO IN THIS WORK AS A CITATION AND/OR POTENTIAL SOURCE OF FURTHER INFORMATION DOES NOT MEAN THAT THE PUBLISHER AND AUTHORS ENDORSE THE INFORMATION OR SERVICES THE ORGANIZATION, WEBSITE, OR PRODUCT MAY PROVIDE OR RECOMMENDATIONS IT MAY MAKE. THIS WORK IS SOLD WITH THE UNDERSTANDING THAT THE PUBLISHER IS NOT ENGAGED IN RENDERING PROFESSIONAL SERVICES. THE ADVICE AND STRATEGIES CONTAINED HEREIN MAY NOT BE SUITABLE FOR YOUR SITUATION. YOU SHOULD CONSULT WITH A SPECIALIST WHERE APPROPRIATE. FURTHER, READERS SHOULD BE AWARE THAT WEBSITES LISTED IN THIS WORK MAY HAVE CHANGED OR DISAPPEARED BETWEEN WHEN THIS WORK WAS WRITTEN AND WHEN IT IS READ. NEITHER THE PUBLISHER NOR AUTHORS SHALL BE LIABLE FOR ANY LOSS OF PROFIT OR ANY OTHER COMMERCIAL DAMAGES, INCLUDING BUT NOT LIMITED TO SPECIAL, INCIDENTAL, CONSEQUENTIAL, OR OTHER DAMAGES.
For general information on our other products and services, please contact our Customer Care Department within the U.S. at 877-762-2974, outside the U.S. at 317-572-3993, or fax 317-572-4002. For technical support, please visit https://hub.wiley.com/community/support/dummies.
Wiley publishes in a variety of print and electronic formats and by print-on-demand. Some material included with standard print versions of this book may not be included in e-books or in print-on-demand. If this book refers to media such as a CD or DVD that is not included in the version you purchased, you may download this material at http://booksupport.wiley.com. For more information about Wiley products, visit www.wiley.com.
Library of Congress Control Number: 2024930171
ISBN: 978-1-394-21908-7 (pbk); ISBN 978-1-394-21910-0 (ebk); ISBN 978-1-394-21909-4 (ebk)
Introduction
A lot of people have attention deficit/hyperactivity disorder (ADHD). Researchers estimate that in the United States, people with ADHD constitute anywhere from 3 to 6 percent of the population (or more, depending on which study you read). On the low side, this totals about 9 million people. Almost everyone knows at least one person with ADHD (whether they’re aware of it or not). So rest assured that if you have ADHD, or are related to someone who does, you’re not alone.
Even though so many people have ADHD, the condition is widely misunderstood. Some people — including many healthcare professionals — believe that ADHD isn’t real. These people believe ADHD is a made-up excuse for bad behavior and bad parenting.
We want to assure you right from the start that ADHD is a real condition that affects millions of people. For many, it makes life very difficult. ADHD has a biological cause and can’t be willed away through discipline or hard work. And the symptoms of ADHD can’t be ignored in the hopes that the person will simply grow out of them.
To reduce (and sometimes eliminate) the symptoms of ADHD, you need to understand this condition and receive knowledgeable intervention. The purpose of ADHD For Dummies, 2nd Edition, is to help you gain a better understanding of ADHD and discover where to look for help. Our goal is to give you the tools to effectively address ADHD in your life, whether you, your child, your spouse, or your friend is the one with ADHD.
About This Book
ADHD For Dummies, 2nd Edition, is unique among books on this condition in that we’ve written it with the ADHD person in mind. We don’t go into long explanations with obscure points; we go right to the heart of the matter and give you the information you need to know with as little fuss as possible.
When we set out to write this book, obviously we wanted to offer basic information about what ADHD is and where it comes from. But we also wanted to provide information on cutting-edge treatment approaches and simple, effective strategies to help you start getting the symptoms under control and begin living the life you want to live. As a result, this book is short on background details and jargon and long on real-world advice. Both of us have many years’ experience working with people with ADHD, and we draw heavily from these experiences in the pages that follow.
In this book, we don’t assume that you’re the person with ADHD. Instead, we try to offer a view of this condition as if you, your spouse, your child, your grandchild, your friend, or your student has ADHD. (Whew, that’s a lot of perspectives in one book!) Given the enormity of perspective that we try to cover, we can’t very well list each of the possible relationships you may have with ADHD in each paragraph. To keep things simple, we generally refer to you throughout the book as if you’re the person who has ADHD. However, in some instances we do mention a specific perspective as it relates to a particular relationship, and in those cases we write about your child, your spouse, and so on.
Another convention we want to clarify up front is how we reference the condition we’re writing about. In the mental health field, this condition is called attention deficit/hyperactivity disorder, or ADHD. Most likely, you’ve also heard it called simply attention deficit disorder, or ADD. We’re talking about the same condition; we’ve simply chosen to use its formal name in this book. (As you find out in Chapter 2, this condition has had many names over the years).
Foolish Assumptions
In this book, we make only one assumption about you: We assume that you want to read a book about ADHD that doesn’t dilly-dally around with poetic descriptions and lengthy anecdotes, because you have very little time and want to get the bottom line quickly. We don’t waste your time with lengthy explanations, but we do want to make this book engaging to read, so we include some references to people we’ve worked with to give you insights into life with ADHD.
Icons Used in This Book
As with all For Dummies books, we use a few icons to help you along your way.
Certain ideas and techniques are very important and worth remembering. This icon gives you those gentle nudges to keep you on track.
This icon sits next to paragraphs that are interesting but ultimately aren’t critical to understanding the discussion at hand. You can skip them if you need to.
The Tip highlights expert advice and ideas that can help you to better deal with ADHD in your life.
This icon alerts you to instances when you need to take special care not to hurt yourself or someone else.
Beyond the Book
In addition to the abundance of information and guidance related to ADHD that we provide in this book, you get access to even more help and information online at Dummies.com. Check out this book’s online Cheat Sheet. Just go to www.dummies.com and search for “ADHD For Dummies Cheat Sheet.”
Where to Go from Here
This book is set up so that you can read it cover to cover or jump around and read only those parts that interest you at the time. For instance, if you don’t know anything about ADHD and want to get up to speed on the basics, start with Chapter 1. On the other hand, if your child is having trouble in school and you want to find some ways to deal with their challenges, you can head straight for Chapter 16. If you want to find out about the latest alternative treatment methods for ADHD, check out Chapter 11, 12, or 13 first.
Regardless of where you start in this book, if you run across a term or idea that’s covered in more detail somewhere else, we offer a cross reference so you can locate the background information you need.
Part 1
The ABCs of ADHD
IN THIS PART …
Understand what ADHD is.
Check out theories about what causes ADHD.
Survey the symptoms that most people with ADHD experience.
Chapter 1
ADHD Basics
IN THIS CHAPTER
Recognizing symptoms of attention deficit/hyperactivity disorder
Understanding the origins of ADHD
Looking at ADHD diagnosis and treatment
Coping with ADHD in your life
In 1980, a new term entered the common vocabulary: attention deficit disorder. It described a condition that has been recognized since the latter part of the 19th century but called a variety of other names. This term — which later morphed into attention deficit/hyperactivity disorder (ADHD) — often rears itself whenever someone has difficulty in school or work, can’t sit still, or is unable to control their behaviors. The symptoms of ADHD can affect anyone — people of all ages, genders, and socioeconomic backgrounds. Because of this fact, and because the symptoms of ADHD are simply extremes of everyday behavior, this condition is often misunderstood and misdiagnosed.
In this chapter, we introduce you to ADHD. We give you a brief overview of the common symptoms, biological causes, diagnosis, treatment approaches, and life strategies for coping with ADHD. This chapter gets you up to speed on the basics, and we deal with each of these topics in much more detail in the rest of the book.
As we point out in the Introduction, ADHD is a complex condition that’s estimated to affect between 3 and 6 percent of the people in the United States. Rest assured that many happy, successful people live with ADHD, including both of us.
Having so many people around you with ADHD means that quality information, support, treatments, and life strategies are available that can help minimize the negative effects and maximize the positive. (And yes, ADHD does have positive attributes. You can read about these in Chapter 14.)
Identifying Symptoms of ADHD
If you have ADHD, you may have trouble regulating yourself. This difficulty can exist in the areas of attention, behavior, and motor movements. ADHD looks different in almost everyone. For example, one person may have no problem sitting still but gaze off into space unable to focus at all. Another person may constantly fidget but be able spend seemingly endless amounts of time focusing on one thing, often to the exclusion of everything else in their life. Yet another person may not be able to stop themself from impulsive and often dangerous behaviors but may be able to sit calmly in school. The following sections break down both primary and secondary ADHD symptoms.
Peering into primary symptoms
Despite all the different ways that ADHD manifests, the condition has three basic symptoms:
Inattention/distractibility:
People with ADHD have problems focusing. You may be able to focus sometimes but not others. This variable nature of being able to pay attention is one of the main features of ADHD. Because attention is inconsistent, people can easily rationalize or dismiss this symptom.
Impulsivity:
Many people with ADHD have trouble regulating their behavior. In this case, you often act without thinking, perhaps talking out of turn or taking unnecessary risks.
Hyperactivity:
Someone who is
hyperactive
is frequently moving in some way. You may be able to sit but may need to move some part of your body when doing so; leg rocking or shaking is one common example. This hyperactivity is more of a problem with children than adults because most ADHD adults have less physical restlessness as they get older and often find activities to channel it.
The term attention deficit/hyperactivity disorder (ADHD) comes from the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-V). The DSM-V outlines three types of ADHD:
Inattentive type:
Having this type of ADHD means that you have difficulty focusing but are able to sit still.
Hyperactive/impulsive type:
If you have this type of ADHD, you struggle to sit still and have difficulty considering consequences before doing or saying something, but focusing isn’t an issue.
Combined type:
If you have a hard time focusing as well as difficulty sitting still or doing things without thinking, you have the combined type.
The DSM-V also rates the current severity of ADHD from mild to moderate to severe. These ratings are helpful to understand where you fit within the overall spectrum of the condition.
Seeing a few secondary symptoms
Aside from the basic three symptoms of inattention, impulsivity, and hyperactivity (which we discuss in the preceding section), ADHD has a ton of other symptoms. These symptoms can include, but aren’t limited to, the following:
Worry
Boredom
Loss of motivation
Frustration
Low self-esteem
Sleep disturbances
Hopelessness
In Chapter 3, we discuss these and other symptoms in detail.
These secondary symptoms are also connected to other common disorders. The overlap of symptoms among a variety of disorders is called comorbidity and is one of the reasons that diagnosing ADHD is so difficult. (See the “Getting a Diagnosis of ADHD” section later in this chapter, or check out Chapter 5.)
Clueing in on ADHD’s Origins
Many people used to believe that ADHD (before it even had this name) was merely a behavioral disorder and had no biological basis. However, research since then has shown that people with ADHD have something different happening biologically than people without the disorder. What exactly that biological basis is no one knows for sure. Some of the discoveries that researchers have made include the following:
Genetic links:
Having the disorder frequently is a genetic predisposition. ADHD runs in families; you’re more likely to see a child with ADHD born into a family where at least one parent has it.
Neurological activity:
Some studies show that people with ADHD have brain function differences. For example, some studies have shown a lower level of activity in the front of the brain — the area that controls attention. Others have discovered activity abnormalities in other regions deep within the brain.
Chemical differences:
Certain chemical activity, such as dopamine and norepinephrine, seems to be different in people who have ADHD. Several studies suggest that there are differences in the responses when neurochemicals are created and released by people with ADHD compared to people who don’t have the condition. This is an important component when it comes to choosing medication (
Chapter 8
explores ADHD medications in more detail).
Even after decades of research, the actual cause(s) of ADHD aren’t known. But despite this lack of completely detailed understanding of the causes, they do know a lot about how to treat the disorder. We give you an introduction later in this chapter in the section “Viewing Various Treatment Approaches,” and we write about treatment options in detail in Part 3 of this book.
Getting a Diagnosis of ADHD
Diagnosing ADHD can be frustrating for some people because there’s no definitive way to check for it. You can’t see it in a brain scan. You can’t test for it with a blood sample. The only way to diagnose ADHD is to do a detailed evaluation of your (or your loved one’s) past and present behaviors. This job involves finding a professional who understands the subtleties and variations of ADHD and can make a differential diagnosis (a list of conditions that have the same symptoms). The following sections give you an overview of this important process.
Choosing your professional
The first step to finding out whether you have ADHD involves finding the right healthcare professional. You may start with your family doctor or pediatrician, but in order to get an accurate diagnosis (as accurate as possible, anyway), you need to see a professional who understands all the different ways ADHD looks and can review your history properly. Your options can include, but aren’t limited to, the following:
Psychiatrist:
A
psychiatrist
is a medical doctor who specializes in mental illness and behavioral disorders. A psychiatrist can prescribe medication and often is up-to-date on the neurological factors of ADHD.
Neurologist:
A
neurologist
is a medical doctor whose specialty is the brain. This person often views ADHD from a biological basis and can prescribe medication. They may not be up-to-date on the best ADHD life strategies or alternative treatments.
Psychologist:
A
psychologist
is trained in matters of the mind. Most psychologists understand the criteria for diagnosing ADHD and can offer many treatment options; some can prescribe medication depending on their license.
ADHD specialist:
An
ADHD specialist
can be anyone from a teacher to a therapist who has experience and expertise in working with people with ADHD. Specialists likely have knowledge of many treatment and coping strategies, but they aren’t able to prescribe medication.
ADHD coach:
An ADHD coach
helps you improve your functioning in the world. Coaches can come from many backgrounds — education, business, psychology — and their focus tends to be on practical, day-to-day matters, such as skills training. Like an ADHD specialist, a coach has expertise in working with people with ADHD but usually can’t prescribe medication.
Each professional will immediately recommend the approaches that they’re most familiar with and that fit with their treatment philosophy, so choosing the best professional for you depends partly on your values regarding medication and partly on how open you are to unconventional ways of approaching treatment.
In Chapter 4, we help you explore your values and how they fit with each type of ADHD professional. You also find out how to question a professional to see whether their philosophy fits with yours. Knowing this information prevents you from feeling pressured to attempt treatments you don’t agree with and helps you find treatments that fit your style.
Preparing for the evaluation process
After you’ve chosen a professional to work with (as we explain in the preceding section), you can dig into the actual process of evaluation. This process involves answering a lot of questions and looking at your past. Chapter 5 gives you a heads up on the types of questions you have to answer, as well as the official criteria for being diagnosed with ADHD.
Diagnosing ADHD isn’t easy, and a diagnosis either way isn’t the final word. ADHD is one of many similar conditions, and even the best professional can place you or your loved one in the wrong category. We recommend that you seek a second opinion, especially if you have any doubts about the diagnosis. Chapter 6 introduces you to many conditions and symptoms that can appear to be ADHD or that can accompany it.
Viewing Various Treatment Approaches
Treating ADHD has so many approaches that one of the main struggles most people have when they’re diagnosed with the disorder is to weed through all the treatment options and choose the best ones to try.
Treatment options break down into several broad categories, which include the following. The most conventional treatment methods for ADHD are medication and behavior modification. Both are useful and effective approaches, but many other types of treatment can work wonders with the right person:
Medication
Counseling and therapy
Coaching
Training
Behavior management
Nutrition and supplements
Herbs and homeopathies
Neuromodulation therapies
Rebalancing therapies
Social skills training
We discuss each option in detail in Chapters 8 through 13. Each treatment approach has a place, and many of them work well together. Knowing how to choose and what to combine can be difficult. Our goal is to make this challenge more manageable, which is why we wrote Chapter 7, where we help you develop and implement a plan for treatment success.
Recognizing ADHD’s Role in Your Life
One of the best ways to deal with the symptoms of ADHD is to have a toolbox of strategies you can reach into when you run into difficulties. The more tools you have in this box, the easier life becomes. As we explain in the following sections, we dedicate an entire section of this book (Part 4) to helping you fill your box with the best tools possible.
Accentuating the positive
ADHD doesn’t just create challenges. In some areas, people with ADHD have multiple strengths. When you understand these positive attributes — such as heightened creativity, high energy, hyperfocus, and a willingness to take risks — you can discover ways to maximize and amplify them to help you succeed in the world. For example, you can identify your style of working to keep you on task and motivated to get a job done. We created Chapter 14 to inspire and encourage you to find your strengths and make the most of them.
Dealing with daily life
Whether you’re at school, at home, or at work, you can develop ways to minimize the negative impacts of your ADHD symptoms by using some strategies that have worked well for other people, including us. In Chapters 15 through 17, we offer you insights, tools, and ideas for making daily life as successful and stress-free as possible.
For example, we suggest ways to help you develop healthy family relationships, motivate your child with ADHD to do their homework, know your legal rights at school and in the workplace, keep organized on the job, develop a solid career path, and much more. We hope the information in these chapters also spurs you on to create your own unique ways of dealing with ADHD in your life.
Chapter 2
Exploring the Causes of ADHD
IN THIS CHAPTER
Reaching back for historical views of ADHD
Seeing how researchers investigate the roots of ADHD
Investigating the potential genetic, neurobiological, and chemical factors involved with ADHD
Looking ahead at the future focus of ADHD research
No one completely understands the causes of ADHD. However, significant advances in brain science mean researchers understand more about the chemistry, structures, and workings of this complex organ than ever before.
In this chapter, we review several theories about the causes of ADHD — both those that have broken new ground and others that have severely missed the mark. We also explain some studies that indicate that ADHD has a biological basis and/or neurodevelopmental basis and others that address the role of genes and gene behavior. We explore where the worldwide research on ADHD is heading and what it means for the future of diagnosis and treatment.
Gaining Perspective from Past Theories
The earliest reference to the symptoms of ADHD comes from the ancient Greek Hippocrates, who thought it was an elemental imbalance (too much fire over water). Sir Alexander Crichton, a Scottish physician, made the first medical reference to these symptoms in 1798. In 1902, British physician George Frederic Still lectured about patients he’d seen with symptoms of ADHD, and since then numerous theories about the causes of ADHD have been considered.
In the following list, we offer a brief overview of the more common past theories of ADHD for a historical perspective. Some of these theories have been based on behavioral problems (bad parenting, willful children), but many have viewed ADHD as having some biological basis:
Bad parenting: Blaming parents for the behaviors a child with ADHD exhibits is, on the surface, logical. After all, plenty of kids act inappropriately when adults don’t supervise them properly. The difference is that children with ADHD can’t be disciplined into not having the symptoms. They can be taught ways to cope and strategies to lessen their symptoms, but these strategies don’t remove the ADHD.
The blame-the-parents theory is, without a doubt, the number-one misconception about ADHD. Unfortunately, a lot of people still believe it. Don’t buy into this theory — it’s just not true.
Defiance/willfulness:
Like the bad parenting theory, the theory of defiance is based in logic, because when kids without ADHD act out, they can be taught not to behave that way. The problem is that people with ADHD can’t concentrate better by trying harder, and they can’t stop hyperactivity or restlessness by willing it away. This theory is still perpetuated among people who don’t understand ADHD.
Poor diet:
After researchers realized that ADHD wasn’t caused by bad parenting or willful defiance, they started looking at other causes. Diet was one theory that garnered a lot of attention. A poor diet can, in fact, cause some ADHD-type symptoms in people without the condition, and it can worsen the symptoms of ADHD (see
Chapter 11
), but it doesn’t cause ADHD.
Allergies and sensitivities:
Much like a poor diet, allergies and sensitivities can create symptoms similar to ADHD, such as inattention and forgetfulness. And these sensitivities can worsen symptoms for some people with ADHD. People who have these symptoms (but not ADHD) see them disappear when they get their allergies or sensitivities under control. Red dye No. 3, which has been banned in California, is a good example of this type of substance sensitivity.
Brain damage:
One of the early nonbehavioral theories involved the idea that people with ADHD have some sort of brain damage. This view was partly a result of the 1918 influenza epidemic, when some children who had influenza encephalitis developed hyperactivity, inattentiveness, and impulsivity.
Toxic exposure:
Exposure to lead and the accumulation of lead in the brain were once considered the cause of ADHD. Studies have suggested that some people with lead exposure may display symptoms similar to ADHD. However, lead exposure isn’t the cause of ADHD for most people who have it. And lead isn’t the only offender; exposure to other environmental toxins during pregnancy or after birth can also cause ADHD-like symptoms.
Traumatic brain injury:
Like the brain damage theory, some people have believed that ADHD stems from lack of oxygen during birth or a head injury early in childhood. Although brain injuries can induce the same symptoms as ADHD (depending, of course, on where the injury is), they aren’t the cause of ADHD.
Several theories on the origins of ADHD actually led to the identification of disorders that are distinct from ADHD. This connection illustrates how the primary symptoms of ADHD can be found in more conditions than just ADHD. We discuss various disorders that share the same basic symptoms as ADHD in Chapter 6.
WHAT’S IN A NAME?
ADHD has been called many things since it was first observed. Two early names were Minimal Brain Damage and later — because at the time no one actually saw any damage in the brain — Minimal Brain Dysfunction. Since its inclusion in the American Psychiatric Association (APA) listing of mental disorders, ADHD has been officially called the following names:
Minimal Brain DysfunctionHyperkinetic Reaction of ChildhoodAttention Deficit Disorder With or Without Hyperactivity (ADD, a name that’s still widely used outside the professional community)Attention Deficit/Hyperactivity Disorder (ADHD)Coming at ADHD Research from All Sides
Since the first edition of this book, scientists have a much greater understanding of genetics and epigenetics (how your environment and behavior cause changes that affect how your genes work without actually changing your DNA). This explosion of knowledge is due in large part to the mapping of the human genome, which led to new theories about and treatments of many diseases, particularly cancer.
So how do neuroscientists come up with a working hypothesis that can be turned into a theory? They start by trying to understand how the brain and the mind (your thoughts and memories, for example) interact to produce particular types of learning, emotions, and behaviors. Then they try to understand how the study group (in this case, people with ADHD) functions differently from the general population, and they try to find evidence of some biological difference to explain the differences they’ve observed.
Studies for looking at causes of mental health conditions, including ADHD, are global and widescale. In practice, scientists from different disciplines are trying to understand ADHD from different angles:
Geneticists are looking for unique characteristics of the genes that people with ADHD inherit. Epigeneticists are looking at how different genes are expressed and what environments influence that (because environmental factors seem to heavily determine whether a gene gets turned on and expressed or turned off).
Neuroscientists and physiologists are trying to find differences in brain function between people with ADHD and people without it.
No single factor — genetic or environmental — causes ADHD. Rather, developing ADHD involves a complex (and not yet fully understood) interplay between them. Both the genetic/biological and the environmental determinants sides have their theorists. More research is necessary to understand the roles of risk factors before birth, of epigenetics, and even of intergenerational trauma.
Examining Self-Regulation’s Role in ADHD
The ADHD research taking place today is rooted in the recognition that people with ADHD have one core problem: the inability to consistently regulate their attention and behaviors. The following sections explore the nature of this problem and the various brain functions that contribute to it.
Recognizing self-regulation as a core issue
ADHD may be primarily a problem with self-regulation. Self-regulation refers to your ability to attain and maintain particular states of functioning in a consistent and predictable way. Although anyone can struggle with self-regulation, especially when they’re tired or uninterested, people with ADHD are more likely to have problems controlling their attention, managing their impulses, modulating their moods, and managing their activity levels.
You must be able to self-regulate to be able to plan, organize, and perform complex thoughts and behaviors like you want, when you want. Otherwise you aren’t confident that you can call on the skills you already have when you need them, and you have no guarantee of being able to learn something new.
On the surface, self-regulation seems to depend on your desire to control your behavior. That’s true, but much more than simple willpower is involved. All higher brain functions are partly hard-wired from birth and partly learned. (Learning is just modifying the wiring through experience.) In other words, your ability to self-regulate is a characteristic of the brain you were born with as it developed through the experiences that helped you learn how to use it. Neuroscientists use the saying “What fires together wires together.”
The areas you try to regulate — such as sustaining your attention on a specific task or sitting still when you’re asked — are things you can learn to do more effectively as you grow older if you get the right kinds of experiences. The ability to use your experiences to learn is partly dependent on your ability to attain and maintain consistent brain states — which comes full circle back to self-regulation.
Linking executive brain functions and self-regulation
Executive functions are the brain functions necessary for you to be able to regulate your behaviors. Executive functions primarily cover these areas:
Response inhibition:
Response inhibition
includes impulse control, resistance to distraction, and delay of gratification. According to researcher Dr. Russell A. Barkley, response inhibition is the core problem in ADHD; the rest of the executive functions draw off it.
Working memory:
Working memory
is divided into two categories:
Nonverbal:
Nonverbal working memory
allows you to refer to past events to gauge your behavior. For example, if you don’t remember that interrupting someone while they’re talking results in a negative social interaction, you may interrupt them.
Verbal:
Verbal working memory
allows you to internalize speech, which results in the ability to understand other people as well as to express yourself clearly.
Motor control:
This function not only allows you to keep from moving impulsively but also helps you plan your movements.
Regulation of your emotions:
Without this function, you may find yourself getting frustrated easily or reacting extremely to a given situation.
Motivation:
This function helps you get started and persist toward a goal.
Planning:
This function works on many levels, but the most significant involves being able to get organized and to develop and implement a plan of action.
Executive functions are controlled in several areas of the brain, including the following (see Figure 2-1):
Frontal lobe
Basal ganglia, including the caudate nucleus (which is located deep inside the brain and therefore not indicated in
Figure 2-1
)
Cerebellum (the small area by the back and base of the brain)
As we discuss in the later section “Anatomical,” current research is finding that at least one of these brain areas seems to work differently in people with ADHD from the way it does in people without ADHD.
Kathryn Born (co-author)
FIGURE 2-1: Research indicates that several areas of the brain handle executive functions.
Exploring Current ADHD Research
Although the exact cause of ADHD is still unknown, you can find no shortage of research into the biology of ADHD. This research fits into four broad categories: genetic, anatomical, functional, and chemical.
If you know someone with ADHD, the focus on biological causes shouldn’t surprise you. When you watch someone struggle with ADHD symptoms, you know that this person wants to pay attention, sit still, or control their impulses. But try as they may, they aren’t able to (as we discuss in Chapter 3).
Because we want to focus most of this book on ways to treat and cope with the symptoms of ADHD, we have to limit the amount of research we cover. In the following sections, we include a sampling of studies to give you an idea of what researchers are looking at and what they’re discovering.
Genetic
ADHD runs in families — so much so that when diagnosing the condition, an ADHD professional’s first step may be to look at the person’s family to see whether anyone else has it.
Along those lines, many studies have examined ADHD from a genetic perspective. These include studies that look at adoptive versus biological parents, the prevalence of ADHD in families, twins’ tendency to share ADHD, and specific genes associated with ADHD. Here’s a short sampling of some of these areas of investigation:
In 2023, a large international study identified 27 places in the human genome with genetic variants that increase the risk of ADHD. This number of locations is more than twice as many as previous studies have found.
Researchers at the National Institutes of Health have identified differences in gene activity in the brains of people with ADHD. The NIH study, led by scientists at the National Human Genome Research Institute, found that people diagnosed with ADHD had differences in genes tied to chemicals that brain cells use to communicate. In other words, this study’s results show how genetic differences may contribute to ADHD symptoms.
This research is one of the only studies to use brain tissue post mortem.
Several studies by Dr. Joseph Biederman and his colleagues at Massachusetts General Hospital have shown that ADHD runs in families. In one study, Dr. Biederman and his colleagues found that first-degree relatives (parents or siblings) of someone with ADHD have a five times greater chance of also having ADHD than someone who has no close relatives with the condition.
A 2016 published in
The Journal of Child Psychology and Psychiatry
showed that identical twins were almost 60 percent more likely than fraternal twins to share an ADHD diagnosis and that fraternal twins were still significantly more likely to share a diagnosis than nontwin siblings.
Anatomical
Researchers have conducted a few studies into the size and shape of the brains of people with ADHD compared to those of people without it. A lot of conflicting data exists in this area, but a few basic ideas have been suggested:
One study suggested that the size of the
corpus collosum
(a bundle of nerves that ties the hemispheres of the brain together) is different in some people with ADHD than in some people without it. Other researchers have suggested that this part of the brain operates differently in people with ADHD than in others.
A 2017 imaging study found that overall brain volume and specific brain regions were slightly smaller in participants with ADHD than in those without ADHD.
Although anatomical research continues, most of the ADHD research being done right now focuses on differences in brain activity between the ADHD and non-ADHD populations.
Functional
The brains of people with ADHD seem to function differently from the brains of people without it. This area of study is important not only because it helps explain the cause of ADHD but also because these studies use relatively new technologies for imaging — specifically, functional MRI (fMRI).
Here are some highlights from this field:
Much attention is being paid to the task positive network (TPN) and the default mode network (DMN). Functional MRIs show that when you do a task, the cluster of neurons in the
task positive network
light up. When you daydream or use your imagination, you use your
default mode network.
fMRI shows that in people with ADHD, the TPN and the DMN are turned on simultaneously, whereas in a neurotypical brain the DMN is turned off when the TPN is turned on. (You can read more about this “glitchy switch” in
ADHD 2.0
by Drs. Edward M. Hallowell and John J. Ratey [Random House Publishing Group].) This inconsistency is one theory on why some people with ADHD show such a difference in both distractibility and negativity compared with people who don’t have ADHD.
A study by Dr. Alan Zemetkin using PET scans on adults with ADHD discovered that when the subjects concentrated, the level of activity in the front part of the brain (the frontal lobe) decreased from its level at rest. People without ADHD have an opposite response — an increase in activity in the frontal lobe when they concentrate.
Chemical
For information to pass from one part of the brain to another requires the action of neurotransmitters — chemical messengers within the brain.
A neurotransmitter allows one neuron (nerve) to communicate with another. When the upstream neuron gets excited and wants to pass on information to the downstream neuron, it releases the neurotransmitter molecules into a closed connection (like an airlock in a submarine or a spaceship) called a synapse. The neurotransmitter then crosses the space to the downstream neuron’s membrane and binds to specific receptors that cause an effect inside the receiving nerve.
As we explain in Chapter 8, certain medications are generally effective for treating ADHD symptoms, and most of these medications affect one or both of two neurotransmitters: norepinephrine (also called noradrenalin) and dopamine. This effectiveness indicates that these two neurotransmitters are involved in causing the condition. These neurotransmitter systems are distributed throughout the brain in specific locations, and they have different effects based on the types of receptors that the downstream neurons have on their membranes. The receptors determine what effect a neurotransmitter has, and different types of receptors exist in different regions of the brain.
A lot of research has been done in this area showing a link between certain brain chemicals and the symptoms of ADHD. Some of the more elegant theories about ADHD consider the balance between norepinephrine and dopamine in the various areas they affect, including the idea that one neurotransmitter has more effect in one hemisphere of the brain than the other (see Figure 2-2). Most of the neurons that have norepinephrine as their transmitter are contained in one area of the brainstem, the locus coeruleus. It’s part of the reticular activating system, which is the area of the brain that controls the general level of activation of your nervous system (how aroused you are — whether you’re awake or asleep). Dopamine is found in several different areas of the brain, but the area that seems most important for ADHD is the part that projects to the prefrontal cortex and is probably responsible for significance, meaning, and motivation.
Kathryn Born (co-author)
FIGURE 2-2: The dopamine–norepinephrine connections in the brain may have a lot to do with ADHD.
One way to think about ADHD is that it’s a problem of deficiency in the activities of norepinephrine and dopamine. When you have too little norepinephrine working, you aren’t paying attention to your environment. When you have too little dopamine activity, then you lack motivation, determination of salience, sustained attention, and engagement.
Getting Down to the Bottom Line
The human brain is neuroplastic, which means the networks in the brain change through growth and reorganization. So if you’re trying to rewire your brain, have hope. You can teach an old dog new tricks, metaphorically speaking.
The fields of genetics, neuroscience, epigenetics, and neuroimaging continue to expand at rapid rates. We imagine that knowledge of the causes of ADHD and the brain functions and chemicals involved will increase dramatically in the near future. As this all becomes clearer, you can expect that clinicians will have much better ways to help someone with ADHD cope with the condition.
Chapter 3
The Many Facets of ADHD
IN THIS CHAPTER
Examining the primary symptoms of ADHD
Discovering secondary symptoms
Exploring ADHD in a variety of demographics
Everyone has a unique nervous system. In fact, the infinite variability in how humans’ brains work has given rise to the popular term neurodivergence. ADHD fits into this concept.
ADHD can look different in everyone. One person may be able to sit still but not focus, another may have very little trouble sitting still but constantly speak without thinking, and yet another may not be able to sit still for any length of time while also having problems keeping focused on a task. Such is the nature of ADHD and one of the reasons many people have a difficult time believing this condition exists.
In this chapter, we list the primary symptoms of ADHD and discuss how these symptoms often give rise to others. We also examine how gender, age, race, and sexual orientation create special issues for people with ADHD.
Picturing the Primary Symptoms of ADHD
ADHD has three primary symptoms: inattention/distractibility, impulsivity, and hyperactivity. These symptoms don’t all have to be present for you to have ADHD, and if you do have one or more of them, they may not be present all the time. (Chapter 5 explains how this inconsistency works.) The following sections explore these symptoms and many of the ways in which they manifest in people with ADHD.
Inattention/distractibility
Inattention means you have a hard time focusing on something. Distractibility means your attention is easily pulled from one thing to another.
Inattention is at the core of ADHD, and it isn’t as simple as never being able to focus. Nothing about this condition is as clear-cut as that. Inattention is more accurately a problem in being able to control or regulate how and when you focus on something. (Regulation is a key word for people with ADHD; check out Chapter 2 for more about regulation.)
We much prefer thinking about attention as variable or inconsistent. This point is where distractibility comes in. External and internal stimuli pull on people with ADHD much harder than on people without it. As a result, people with ADHD have a hard time staying focused on one thing.
A key thing to know about this symptom is that it can look different in almost everyone, and it can change from day to day in each person. But even with such variability, a few basic characteristics of inattention and distractibility occur in people with ADHD:
Not being able to concentrate:
Try as you may, keeping focused on something is difficult and, at times, impossible. The worst part is that the harder you try, the harder concentrating is. Your mind may go blank, or you may have other thoughts come into your mind.
Being able to focus well on some things but not on others: This symptom is one of the most confusing aspects of inattention in ADHD. Many people think that just because a person can concentrate on something means they must be able to concentrate on everything if they just try hard enough. That’s not the case for people with ADHD.
For example, your coauthor Jeff worked with a 9-year-old boy who couldn’t stay on task at school. He often stared out the window, spaced out, and sometimes almost dozed off. At home, whenever he had to do homework, he had the same difficulties. However, if you gave him a model rocket to build or a book about rockets, he was in his element and could often focus for hours. In fact, he’d get so engrossed that he often forgot to eat or go to the bathroom.
Some people with ADHD claim that they don’t have the condition because they can focus “as long as it’s something I’m interested in.” The criterion for ADHD isn’t about being unable to focus ever; instead, it’s about not having control over when and how this focusing happens. This discrepancy leads to another aspect of ADHD, which we describe in the next bullet.
Being able to focus sometimes but not other times:
For many people, this feature of ADHD is one of the most frustrating. As an example, the same 9-year-old boy we mention in the previous bullet experienced many times when he couldn’t even focus on the model building that he loved so much. Some days he’d start putting a section together and lose track of what came next or end up gluing that section to the wrong part of the main model. This scattered thinking made tackling complex projects very difficult for him because he’d often lose track of what he was doing.
Being easily distracted by things happening around you: Many people with ADHD are unable to filter out all the things going on around them and are easily pulled away from what they want to focus on.
For example, Jeff worked with a man in his 40s whose relationship was in trouble because he was unable to effectively listen to his wife when she talked, which led her to believe that he didn’t care about her. This man explained that as he tried to listen, he found himself distracted by the sound of the refrigerator turning off or on, a passing car, or some other sound that his wife didn’t even notice. For him, these sounds were irresistible. As much as he tried to ignore them, they seemed to draw him in. The result was that even though he genuinely wanted to listen to his wife, he caught only parts of the conversation and often ended up misunderstanding what she said.
Being easily distracted by your own thoughts:
For many people with ADHD, having a series of unrelated thoughts flowing through their minds is common. Many people think of this issue as “daydreaming.”
Losing track of your thoughts (spacing out):
An extension of being easily distracted is spacing out. This symptom is common for people with ADHD — they seem like they have gaps in their awareness.
Being forgetful:
A lot of people with ADHD tend to lose their keys, forget to turn in assignments, space appointments, can’t remember simple instructions, and get lost.
Being late:
Because many people with ADHD have trouble organizing their time, they’re often late to appointments. Sometimes they’re purposely early everywhere they go because they know they tend to be late.
Being unable to finish things:
People with ADHD are notorious for starting a project and then moving on to something else before finishing it. Jean, a woman in her late 30s whom Jeff worked with, was extremely bright and ambitious, with tons of great ideas and the talent to back them up. The only problem was that every time she’d work on one of her projects, she’d leave it half finished. She always had an excuse for abandoning a project, such as another, more important project coming up. She also had a long history of quitting jobs after just a few months even though she performed them very well.
Procrastinating:
Because people with ADHD are often poor at organizing their thoughts and time, they often fail to even start something. Also, after repeated failures, many people avoid starting projects because of the fear that they’ll fail again. Many people with ADHD wait until the last minute to do things because the pressure helps them focus.
Not attending to details:
