ADHD interview part 1

Updated: Jan 2

(Dr. Sayer with Yoel Adler of Nesher Media)

Hi Dr. can you explain to us in plain words what is ADHD and what are the symptoms in children and adults with ADHD?

ADHD stands for Attention-Deficit Hyperactivity Disorder. ADHD is seen in ~5% of children and children with ADHD have a 25% chance of one of their parents also having the disorder. To meet criteria, a person has to have difficulty staying focused, ignoring distractions, managing impulses, and at times can be hyperactive. Impulse control issues can play out in failure to wait one’s turn, blurting things out, talking over people, rushing through things without good thought/planning, or having quick emotional reactions. Some people are hyper while some are inattentive and space out more easily. You expect to see this as a lifelong problem starting in childhood though it may be more impairing at different parts of life. ADHD is also a neurodevelopmental disorder meaning there are underdeveloped parts of the brain (the prefrontal cortex) that contribute to the symptom presentation. Neurotransmitters (which are natural chemicals in the brain) impact the function of the brain. In ADHD, the neurotransmitters Dopamine and Norepinephrine play a big role in brain functions like focus, attention, and impulse control.

Can the symptoms sometimes be similar to those of anxiety depression etc., or trauma? And if it is similar how one can know what the person is suffering from?

Many mental health issues can impair concentration, focus and attention. In fact, concentration and attention issues are common symptoms of anxiety, depression and trauma. I take into account the time course of symptoms, developmental and family history when gathering a history. If someone is having trouble focusing and also feels sad, down, lethargic, sleep/appetite changes, hopelessness, and lacks interest in things this would likely seem to be a symptom of depression. If the person is excessively worried, has heart racing, trouble sleeping, extreme thinking, and is drained it would seem to fall under a symptom of anxiety. Difficulty with concentration and attention is common after a trauma and if the symptoms seem to have developed after a traumatic experience, or the person has nightmares, flashbacks, and avoidant behavior in addition to focus issues, it would likely be a trauma diagnosis. Additionally, there tends to be less impulsivity (which is a symptoms of ADHD) in depression and anxiety though can have impulsivity in trauma. Also, to meet criteria for ADHD symptoms must be present in multiple settings (at home and at school or for adults at home and at work). If only happening in one environment we would need to investigate what is different about the environment itself and how the person may feel different in each setting to understand what is causing the focus issue.

Is it a must to get a professional diagnosis on ADHD or is an educated guess enough? And what are some of the consequences of diagnosing done unprofessionally?

If someone has respiratory issues, it would make sense to get a professional diagnosis as opposed to making an educated guess that it is allergies, asthma, or bronchitis; the same is true for mental health issues. We see them as medical diagnoses with specific diagnostic criteria and treatment approaches. There are many reasons children and adults can have focus issues as discussed earlier. Children may have a learning disability, speech/language/hearing problem, or some other emotional issue getting in the way of their focus/attention. While it is good to think about what could be going on, diagnosing without a professional expertise from an objective source could prevent the person from getting appropriate help.

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