ADD

What is ADD?

• Attention deficit disorder, a condition now known as attention-deficit hyperactivity disorder, or ADHD
• Administration on Developmental Disabilities, of the United States Administration for Children and Families

Attention Deficit Disorder, or ADD/ADHD, is a psychological term currently applied to anyone who meets the DSM IV diagnostic criteria for impulsivity, hyperactivity and/or inattention.  The diagnostic criteria are subjective and include behavior which might be caused by a wide variety of factors, ranging from brain defects to allergies to giftedness.  ADD, as currently defined, is a highly subjective description, not a specific disease. 

Confusion and controversy is caused by the tendency of some mental health professionals to assume that everyone diagnosed with ADD has some mysterious, irreversible brain defect.  This assumption has its roots in the very first group of severely ADD people ever studied, who suffered from encephalitis, or a swelling of the brain.  We also have learned that birth defects and brain injury from toxic chemicals such as lead often cause ADD.  However, over the last several decades the ADD diagnostic criteria have been so broadened as to include many people with no brain defects at all. Experts in the fields of temperament and creativity have objected that perfectly healthy people are being classified as disordered.  Huge numbers of these new types of people being added to the diagnostic pot have changed the way ADD is viewed in some circles, including people like Thom Hartmann, who popularized the idea of ADDers being "Hunters in a Farmer's World".  On the other hand, many argue that such people aren't ADD in the first place.  Both may be correct.  This website was started with the first viewpoint in mind (hence the title), but as time passes I find myself more likely to just say that many so-called ADD people are simply not ADD in the classic sense.

Causes of Adult Attention Deficit Disorder (ADD and ADHD)

Despite intensive research, the exact origins of ADD and ADHD have yet to be determined. There are, however, several theories about the causes of Attention Deficit Disorder and Attention Deficit Hyperactivity Disorder. 

Chemical Imbalance of Neurotransmitters

Neurotransmitters help the human brain to form thoughts, store and recall information, and translate thoughts into physical actions. One of these neurotransmitters, dopamine, is abnormally low in those who diagnosed with ADD and ADHD. Since problems with memory and attentiveness are attributes of those with ADD and ADHD, researchers believe that low dopamine levels may be responsible. Research had indicated that in 60% of ADD and ADHD sufferers, the genes controlling dopamine production are in some way abnormal .

Another neurotransmitter, Acetylcholine, has also been linked to Attention Deficit Hyperactivity Disorder. Acetylcholine plays a key role in the body by helping to control cognitive functions such as awareness, perception, reasoning, judgment, memory and attention. Learn more about Chemical Imbalance 

 Attention Deficit Disorder (ADD) is one of the most frequently clinically referred psychological disorders in children. It can occur with (more common) or without hyperactivity, and has a higher incidence in male children. The disorder typically onsets by age 2 or 3 years, but help is generally not sought until these children enter school and experience difficulties. This article will examine what ADD is and its possible causes.

The prognosis is not good - children with ADD tend to carry their academic and social problems into adulthood, when some may improve, but the vast majority experience life-long problems.

ADD has been recognized since 1902 when it was referred to as hyperactivity, but extensive research into this condition did not begin in earnest until the 1960s. Since then, there has been a boom in the amount of research that has been carried out in this area.

There have been major disagreements in the diagnosis of ADD - mainly between the American and European scientific communities:

1. The Americans have defined ADD as a situational disorder (the symptoms depending on the circumstances the child is in), while the British see it as a pervasive disorder (these children are overactive in all situations)

2. Americans are more likely to diagnose ADD, while the British are more likely to give a diagnosis of Conduct Disorder.

3. Americans believe that the diagnosis of ADD should only be given if the child's IQ is over 70, while the British say the IQ should be less than 70 before such a diagnosis is given.

4. American and British professionals are thus different with regard to how they label this disorder, and so, not surprisingly, the incidence of ADD is quoted at a higher rate (20% of the population) in America compared to the quoted incidence rate in Britain (1.6%).

SYMTOMS 

 ADHD stands for attention deficit hyperactivity disorder. The condition used to be known as attention deficit disorder, or ADD. In 1994, ADD was renamed ADHD. As is common in conversation, for this article we will use ADD, ADHD, and AD/HD interchangeably to mean the same condition.

The principal ADHD symptoms are (as explained in the most recent version of the Diagnostic and Statistical Manual of Mental Disorders

• Inattention
• Hyperactivity
• Impulsivity

Today's definition of ADD symptoms does not include the hyperactivity or impulsivity components of this list.

Symptoms of ADD appear early in a child's life. Because many normal children may have possible ADD symptoms, but at a low level (or the symptoms may be caused by another disorder), it is important that the child receive a thorough examination and appropriate ADD diagnosis by a well-qualified professional.

Inattention

Children with symptoms of inattention:

• Often do not give close attention to details or make careless mistakes in schoolwork, work, or other activities
• Often have trouble keeping attention on tasks or play activities
• Often do not seem to listen when spoken to directly
• Often do not follow instructions and fail to finish schoolwork, chores, or duties in the workplace (not due to rebellious behavior or failure to understand instructions)
• Often have trouble organizing activities
• Often avoid, dislike, or don't want to do things that take a lot of mental effort for a long period of time (such as schoolwork or homework)
• Often lose things needed for tasks and activities (e.g., toys, school assignments, pencils, books, or tools)
• Are often easily distracted
• Are often forgetful in daily activities. 

Hyperactivity and Impulsivity

As defined today, ADD does not have a hyperactive or impulsivity component. For more information about these symptoms, see the full eMedTV article on ADHD Symptoms.

ADD Symptoms and Types

There are three patterns of behavior that indicate ADD. People with ADD may show several ADD symptoms of being consistently inattentive. They may also show ADHD symptoms of being hyperactive and impulsive far more than others of their age. Or they may show all three types of behavior.

This means there are three different subtypes of ADHD. Professionals recognize these different subtypes based on the symptoms the person has. These ADHD types are:

• Predominantly hyperactive-impulsive type (the person does not show significant inattention)
• Predominantly inattentive type (the person does not show significant hyperactive-impulsive behavior)
• Combined type (the person displays both inattentive and hyperactive-impulsive symptoms).

Progression of Symptoms

Symptoms of ADD appear over the course of many months, often with the ADHD symptoms of impulsiveness and hyperactivity preceding those of inattention, which may not emerge for a year or more.

Different ADD symptoms may appear in different settings, depending on the demands the situation may pose for the child's self-control. A child who "can't sit still" or is otherwise disruptive will be noticeable in school, but the inattentive daydreamer may be overlooked. The impulsive child who acts before thinking may be considered just a "discipline problem," while the child who is passive or sluggish may be viewed as merely unmotivated. Yet both may have different types of ADD.

ADHD Treatment

There is no "cure" for ADHD, however, many treatment approaches may alleviate or significantly decrease ADHD symptoms. As a result, improvements are evident in school/work performance, relationships with others improve, and self esteem increases.

No single treatment works for every individual. Treatment options should be explored with a health care provider who will consider the patient's needs, and family, medical, and personal history. Some people respond well to medications, some to behavioral interventions, many respond to a combination of the two. Counseling, education, and support services are often helpful. Typically, a multimodal approach to treatment works best.

Medications

Stimulant medications have been found to be effective in alleviating ADHD symptoms. Common stimulants include Ritalin, Dexedrine, Concerta, Metadate, Focalin, and Adderall. Some people respond better to one kind of stimulant and not another. Read more about Stimulant Medications.