Attention Deficit Hyperactivity Disorder

April 4, 2004

By Gary Schillhammer, MD


“My, he’s an active one isn’t he? Where does he get all his energy?”
“It’s as though his mind is somewhere else.”

Attention Deficit Hyperactivity Disorder (ADHD) isn’t a new concept anymore. This disease has been around a long time and receives a lot of attention, and rightfully so. Affecting over 8% of children in some areas, this disorder can hinder the way children think and learn. It seems more prevalent in boys at first but later, in adolescence, the gender ratio becomes even. With behavior ranging from withdrawn to rude and violent, children with ADHD can have a negative impact on all around them, including family, friends, classmates and others. This may lead to disabling and potentially devastating consequences. Children with this disorder are at increased risk for depression, school failure and dropout, various conduct disorders, failed relationships, underachievement, substance abuse, and legal prosecution. ADHD warrants attention!

So what is wrong with these children? Is it all in their head, their environment, or is it genetic? Well, the answer may be a little of each. ADHD is neurobiologic. Yeah, right!

There are chemicals, called neurohormones, in your brain that influence your actions. A certain area of the cerebrum processes information and relays it to the prefrontal areas. Here it is analyzed and an appropriate response is initiated or inhibited. Dopamine and norepinephrine are two of these chemicals that appear to be “out of balance” in those with ADHD. Several areas of the brain have been studied but precise measurements or imaging of these areas is not yet possible.

It’s no surprise that there is a genetic linkage. What doesn’t? So far two genes have been identified as carrying this link. The majority of children have at least one first degree relative with the disorder and at least one-third of fathers who had the disease will produce affected children.

Diagnosing ADHD may sound easy but requires cooperation from many disciplines. There is no easy blood test or x-ray that gives us the definite answer. Observations at home, in school and an examination by your physician can usually eliminate other disorders quickly and allow attention and treatment. Parents provide the most important history. After all, they’ve been around them the most. Understanding something may be wrong, and bringing it to the attention of experts who care, can make a huge difference in your child’s lifetime of learning.

The symptoms of ADHD are noted in the table, but not all are required for the disease to be diagnosed. Some children, in fact, do not have many of the hyperactivity symptoms. They still may have Attention Deficit Disorder (ADHD without the H) and also benefit from early diagnosis and treatment. Your doctor will know the specific criteria for correct diagnosis and, therefore, appropriate treatment. He or she will want to be careful not to overlook the possibility of other disorders or metabolic problems.

Most of the controversy concerning ADHD revolves around appropriate treatment. Foremost, a behavioral approach is certainly needed for everyone who has this disorder. Making the diagnosis is important so the patient, family, teachers, peers and workmates can all understand a different approach towards learning and functioning is useful. Medications in many cases are necessary and can have a huge positive impact on the individual’s learning ability and performance. Keeping on track leads to success. Traditionally “stimulant” medications have been extremely successful in helping alleviate the symptoms.

These medicines are safe and not addictive, as many people fear. Newer preparations have fewer side effects and can often be effective even when taken just once a day! Additionally, other adjunctive agents can be helpful for extreme symptoms, and newer agents are now available to provide alternatives in treatment. All these medications have been found to be very safe, effective, and non-addictive.

More recently, it has been noted ADHD/ADD does not just involve children. More adults are now realizing they still have difficulty “staying on task” but have coped or developed skills that have allowed them to survive. Adult manifestations include an “inner” restlessness, need for activity, and continually feeling overwhelmed. Those that still find their attention span a problem could well benefit from treatment as well. It may change a life of struggle to fulfillment. Do not be afraid to discuss it with your family physician, pediatrician or internist. Have a good life!





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Symptoms of ADHA
Lack of Attention
Trouble staying on task
Doesn’t seem to listen
Difficulty organizing tasks
Forgetful
Easily distracted
Loses things
Avoids mental efforts

Overly Active
Fidgety
Always on the go
Talks excessively
Difficulty remaining quiet when asked
Impulsive behavior
Interruptive
Difficulty waiting their turn