Understanding ADHD in Children and Adults

October is Global ADHD Awareness Month. Here, Optimum Performance Institute/OPI Intensive clinical therapist Kim Jensen, LMFT, shares about his own childhood experiences with Attention Deficit Hyperactivity Disorder (ADHD) and discusses the condition’s diagnosis, symptoms and treatments.

Being labeled as “hyper” in early childhood, my experience with ADHD was one of feeling stigmatized and different than my peers. I couldn’t sit still, schoolbooks only interested me for two sentences until I was lost and the outside world through the windows seemed infinitely more interesting than what was going on in class. I was always on some sort of detention. Kids would tease me for my constant visits to the principal’s office. You see, the principal’s office was also where the nurse’s office was located. In third grade, our school nurse was a severe, matronly woman in her 70s with white hair and a starched white nurse’s uniform and hat. She resembled Nurse Ratchet from “One Flew over the Cuckoo’s Nest,” except older and with less personality. I never remembered her smiling. Having to meet her at five minutes before my lunch break everyday was terrifying. Inside her medicine closet, next to my midday dose of Ritalin, was a human skeleton. So my daily midday gauntlet consisted of running down the halls with peers poking their heads out of classrooms snickering “you’re in trouble again,” having to meet the white ghost and her skeleton friend and then off to the lunchroom where I had to deal with the rumors and innuendos of being “psycho.”

Attention Deficit Hyperactivity Disorder (ADHD) is a psychological disorder that is frequently diagnosed in early childhood and may last into adulthood. Studies indicate that boys are three times more likely than girls to be diagnosed with ADHD. Diagnostically it is broken down into one of three possible categories: Inattentive type; Hyperactive/Impulsive type or Combined type. The symptoms recognized for each type include:

ADHD – Inattentive type: Often does not pay close attention to details; has difficulty sustaining focus in tasks; does not seem to listen when spoken to directly; does not follow through on instructions; has difficulty organizing tasks and activities; avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort; often loses things needed for tasks and activities; is often easily distracted by extraneous stimuli; and is often forgetful in daily activities.

ADHD – Hyperactive/Impulsive type: Fidgets with hands or feet or squirms in seat; often leaves seat in situations when remaining seated is expected; often runs about or climbs in situations where it is inappropriate; often unable to play or engage in leisure activities quietly; often “on the go” or acts as if “driven by a motor”; talks excessively; often blurts out answers before questions have been completed; has trouble waiting his or her turn; and interrupts or intrudes on others.

ADHD – Combined type: Includes a combination of symptoms from both Inattentive and Hyperactive/Impulsive type diagnoses.

While medication can help reduce symptoms of hyperactivity, inattentiveness, and impulsivity in children and adults with ADHD, a child with ADHD might still struggle with forgetfulness, emotional problems and social awkwardness, or an adult with disorganization, distractibility and relationship difficulties. Widely used stimulants such as Ritalin, Adderall, and Dexedrine are the most common type of medication prescribed for attention deficit disorder. They have been used effectively for over 50 years for treating ADHD and have the most research to back up their effectiveness. Stimulants are believed to work by increasing dopamine levels in the brain, a neurotransmitter associated with motivation, pleasure, attention, and movement. For many people with ADHD, stimulant medications boost concentration and focus while reducing hyperactive and impulsive behaviors. Side effects of stimulants may include: jitteriness, irritability, difficulty sleeping, loss of appetite, depression and dizziness.

Approximately 25% of children diagnosed with ADHD continue to manifest symptoms as adults while the remaining 75% “grow out of” the diagnosis by late adolescence or adulthood. Adults with ADHD may experience an inability to relax or talk excessively in social situations, and may start relationships impulsively, display attention-seeking behavior, and be short-tempered. Addictive behavior such as substance abuse and gambling are also common. Interestingly, ADHD in adults has been known to manifest with traits of extraordinary creativity, high motivation and extreme focus.

Some notable adults with ADHD include business magnate Sir Richard Branson, artist Salvador Dali, Disney founder Walt Disney, General George Patton, Prince Charles of England, genius Albert Einstein, President John Kennedy, photographer Ansel Adams, actors Robin Williams, Whoopi Goldberg and Jack Nicholson, singer Elvis Presley and performer Justin Timberlake.

I survived Miss Miller’s third grade class. According to my year-end report card, “Kim appears to be doing much better with medication. He is able to sit and work at his desk without distraction.” The medication lasted through fourth grade, then I struggled academically through high school. Mastering coping skills as a young adult, a passion for acting and two cups of black coffee in the morning enabled me to complete my education and attain advanced degrees. Various creative outlets through the arts led me to develop skills to manage my “craziness” and have a rich, productive life.