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ADHD Attention Deficit Hyperactivity Disorder Overview

ADHD Attention Deficit Hyperactivity Disorder Overview

  1. Overview

Attention-Deficit Hyperactivity Disorder (ADHD) or Attention Deficit Disorder (ADD) is an attention deficit disorder. Doctors thus refer to ADHD as hyperkinetic disorder (HKD). About three to five percent of children have ADHD. Boys are significantly more than girls. The symptoms occur from preschool to adulthood. In about 60 percent of those diagnosed with ADHD in children or adolescents, the symptoms persist in adulthood. With the right treatment, sufferers usually get their complaints under control and can lead a normal life.

Scientific research suggests that the cause of ADHD is impaired signalling in the brain. Many ADHD cases are likely genetic. The living environment in which children affected by ADHD can grow or increase; Smoking and alcohol during pregnancy have an influence on the development of the disease.

ADHD and ADD are a particularly strong attention deficit disorder.People with ADHD have a hard time concentrating and are very impulsive. Significant over-activity does not always occur - hence the distinction of attention deficit syndrome with hyperactivity (ADHD) from attention deficit hyperactivity disorder (ADD). Some accompanying symptoms of ADHD or

ADD include:



*Humour or depression,

*Forgetfulness fear

The diagnosis can usually be made by the doctor through the observation and questioning of the person concerned; He obtains certainty through additional information from important confidants such as parents, educators and teachers, through a physical examination and neuropsychological tests. Counseling, behavioral and psychotherapies as well as medications are considered as ADHD treatment. Sometimes a therapy is only needed for a few years, and for some people it is also life-long. The aim is to achieve a normal life with good social contacts, a qualified education and thus a good quality of life.

2. Definition

The abbreviations ADHS or ADS stand for the so-called attention deficit hyperactivity syndrome or the attention deficit syndrome, with which physicians describe a particularly strong attention deficit disorder. Other, sometimes obsolete names for the same clinical picture include "early childhood light brain damage", "hyperkinetic disorder" or "hyperkinetic syndrome (HKS)". ADHD does not only refer to childhood, it also affects adults. Depending on the severity of the disease, physicians classify ADHD into different types: *Predominantly hyperactive-impulsive presentation*Predominantly inattentive presentation*Combined presentation DHD was first literarily portrayed in 1845 by the Frankfurt neurologist Heinrich Hoffmann in the book Der Struwwelpeter. Even today, hyperactive children are proverbially referred to as the Zappelphilipp. But it was only in 1987 that the disease received its still valid medical name Attention-Deficit Hyperactivity Disorder (ADHD). According to today's opinion, ADHD is the result of incorrect information transfer between the nerve cells. An important role is played by the neurotransmitter dopamine. FrequencyResearchers worldwide assume that the rate of ADHD is around five percent in children and adolescents. But many adults also have ADHD: 30 to 50 percent of adults who had childhood ADHD continue to suffer from the disease. Boys are two to four times more likely to be affected by ADHD than girls. For adults, the gender differences are not that serious anymore. If ADHD occurs in identical twins, both children are usually affected. 

3. Causes

The exact causes of ADHD are still unclear. Several factors are probably responsible for the attention deficit disorder. Currently, three main triggers for ADHD are blamed: Genetic predispositionAcquired triggers, such as pregnancy and birth complicationsPsychosocial conditions A genetic predisposition causes the transmission of the nerve signals is disturbed. The signal messenger (neurotransmitter) dopamine is less common in ADHD sufferers in the brain. As a result, the exchange of information between the nerve cells is impaired and stimuli cannot be processed properly. It is therefore difficult for those affected to concentrate. Often siblings, parents or other relatives have ADHD, albeit to varying degrees. Presumably, several genes are involved in the pathogenesis. The acquired triggers - such as smoking or alcohol consumption of the mother during pregnancy - are probably not the sole cause of ADHD. They are likely to favor ADHD when genetically predisposed. The psychosocial factors are not the sole cause of ADHD. The living environment in which children affected by ADHD can grow up or weaken existing genetic material. For example, it is discussed whether the external circumstances and incisive experiences, such as the separation of parents or a traumatic experience, can promote the development of ADHD. Further possible ADHD causes are certain changes in the brain metabolism of those affected: For example, the responsible transmitter substances (neurotransmitters), especially dopamine, do not appear to be optimal in the area of the brain cells (synapses). Researchers using PET (positron emission tomography) imaging showed that these brain areas also consume less glucose than healthy children. In addition, researchers found that people with ADHD have a smaller brain volume, especially the frontal lobe of the brain (frontal brain) is smaller. That food allergies or intolerances affect or are the cause of ADHD symptoms has not been scientifically proven. 

4. Symptoms

The most important ADHD symptoms are inattention, hyperactivity and impulsivity. Attention Deficit Disorder (ADD) causes the same symptoms but without hyperactivity. Typical ADHD symptoms are; Motor difficulties, e.g. in the toddler age while eating with cutlery or in elementary school while writingLack of concentration Easy distractibilityForgetfulnessSlow reactionsStrong impulsivity, e.g. outbursts of anger ADHD symptoms typically occur early, usually before the age of six. In infants, ADHD or ADD can already be manifested by symptoms such as sleep problems, restlessness and difficulty in feeding and digesting. In addition, they often scream and are often irritable. Infants with ADHD are usually hyperactive and unpredictable in their behavior; they find it difficult to build lasting friendships. Some get strong outbursts of anger. Motorically, they often lag behind their peers, for example, they sometimes have a longer time to eat with cutlery. In kindergarten, the ADHD symptoms often get even worse because the children are exposed to even more stimuli. At primary school age, attention deficit disorder becomes very obvious: ADHD children are less receptive than other children, often show a low literacy and numeracy bias, are disruptive to the classroom, are unbalanced, seem awkward, and sometimes aggressive. Due to their unpredictability, other children often avoid ADHD sufferers. Children with ADHD often suffer from low self-esteem. When puberty begins, people with ADHD can become defiant, anxious, depressed or aggressive. Often you are the lack of self-confidence to create. Some seek shelter in alcohol and other drugs. Many are struck by risky behavior, for example while driving, so they are more involved in car accidents. In adulthood, the problems of childhood and adolescence continue for many. ADHD-affected adults often have no school-leaving certificate and no vocational training. In addition, many find it difficult to build lasting relationships. Even as adults, they can keep to bad rules and commit, for example, more frequent traffic violations. The attention and concentration weakness persists in many to old age. But people with ADHD also have many positive qualities: they are often very creative, intelligent and have many ideas. Mostly, they are also enthusiastic and have a strong sense of justice. 

5. Diagnosis

In the case of ADHD, the doctor can make the diagnosis primarily through the life history of the affected child, adolescent or adult. The doctor looks for signs of attention deficit (lack of concentration), for example, if the child is easily distracted. Other important diagnostic criteria are hyperactivity and impulsivity. However, the doctor will only prescribe the ADHD diagnosis if the symptoms are pronounced and persist for a longer period of time (at least six months). Helpful are the statements of important confidants such as the parents To the family situation On social and performance behaviorTo diseases in the family To complications in pregnancy, etc.In order to ensure the diagnosis in ADHD, additional psychological testing procedures have proved useful (eg attention tests, IQ questionnaires). There is no special ADHD test (or ADS test). However, there are several self-assessment sheets that can give an indication of whether ADHD is present. These checklists are sometimes colloquially referred to as an ADHD test or ADS test. In addition to a general physical examination, the doctor will examine the person affected for neurological abnormalities. Certain neurological and mental illnesses can be associated with a similar clinical picture: Exclude: Reading and spelling weaknesses,Epilepsy,Squeal caused by drugs or drugs,Tic disorders,Psychosis Autism. 

6. Therapy

It is not always necessary for ADHD (attention deficit disorder) to be treated immediately and unconditionally. It is important to consult with the attending physicians / paediatricians and psychologists in detail about the severity and extent of the disorder. Treatment should be started at the latest when ADHD leads to pronounced mental and social disabilities. An exact time for the start of therapy does not exist. It always depends on the individual symptoms. The goal of ADHD therapy is to manage symptoms such as inattention, hyperactivity, and impulsivity. Treatment should enable those affected to be socially integrated, to end their education in accordance with their talents and to build up stable self-esteem. Conversely, it should prevent the children and adolescents with ADHD from becoming school failures or outsiders. A cure of the metabolic disorder in the brain is not possible. There are several ways to treat ADHD. It is recommended that multimodal ADHD therapy, ie an individually balanced combination of education about the disease and coping strategies, a behavior therapy and a drug treatment. These include, for example: Education about ADHD and counseling of the person affected, his family and the educator or class teacher Parent training Behavior therapy, in which new behavioral strategies are to be learned and structures and limits are definedPsychotherapy, v.a. when symptoms such as anxiety disorder, addiction or depression occur at the same time Drugs Additional regular sports activities (for example horse riding, climbing, judo or similar)The so-called combination training in ADHD therapy has proved helpful. Parents, teachers and the affected children participate in the therapy activities. The affected learn in the combination training above all, to comply with regular and reliable daily routines. MedicationAn important component of multimodal therapy for ADHD are medications that the doctor prescribes in pronounced cases. They inhibit the hyperactivity of the affected child to the extent that it is more attentive, and the motivation to perform increases. It also makes it easier for children and adolescents to control themselves. The aim of drug therapy for ADHD is to avoid social exclusion and to facilitate further, non-drug therapies (such as speech therapy, occupational therapy). 
The psych stimulants methylphenidate and amphetamine, which are used in many cases, act in the area of the synapses, that is, the nerve endings at which the signals are transmitted. The substances prolong the duration of action of the neurotransmitters dopamine and norepinephrine, thereby restoring the dysfunctional balance of ADHD. About 85 percent of people with ADHD respond to therapy with these psych stimulants. As an alternative to this group of drugs, physicians may prescribe so-called selective norepinephrine reuptake inhibitors (SNRAs) such as atomoxetine for the treatment of ADHD. These substances have a direct influence on the neurotransmitter norepinephrine: They inhibit the reuptake of noradrenaline into the cells, so that the concentration of the messenger substance between the nerve endings (in the so-called synaptic cleft) increases. Possible side effects of the stimulants include lack of appetite, insomnia, tearfulness, headache or abdominal pain. In the case of methylphenidate, the effect starts earlier than with amphetamine, depending on the form of administration (so-called slow-release capsules gradually release the active ingredient), it is also effective for longer. Behaviour therapy an important role in the treatment of ADHD plays the behavioural therapy, a part of psychotherapy. In the process, ADHD sufferers learn to control themselves better and to behave "correctly". In addition, behavioural therapy teaches how to deal with the symptoms in everyday life. The goal is to cope with the attention deficit in the daily routine as well as possible and to allow a largely normal life. Another component of behaviour therapy may be, for example, physiotherapeutic methods for improving motor skills. The behavioural therapy is usually outpatient and takes several months. 

7. History

ADHD can take a very different course. In persons with ADHD (attention deficit disorder) a consistent, regular and long-term appropriate treatment and care is important. Otherwise, many sufferers still have problems in adulthood: in more than half of ADHD children, the disease persists even in adulthood. Sometimes treating ADHD is only a few years, sometimes even life-long for some people. The aim is to achieve a normal life with good social contacts and a qualified education and thus a good quality of life. ADHD is a common and serious condition that can lead to persistent personality problems during treatment without treatment. ADHD in adults About 60 percent of children with ADHD still have symptoms as adults. However, the symptoms usually change.

ADHD in adults is also manifested by the symptoms of inattention, hyperactivity and impulsivity - but these are different from those in children. This can be seen, for example, in hyperactivity: children with ADHD are considered “fidgety child ". ADHD-affected adults, on the other hand, have often learned how to deal with these symptoms, they are more likely to feel inner anxiety or feel driven. If left untreated, adult ADHD can have a major impact on the lives of those affected. They often have difficulty organizing themselves and their everyday lives - with the consequent consequences for their personal and professional lives. Therefore, it is important that ADHD is recognized and treated as early as possible. 

8. Prevent

Genetic ADHD (Attention Deficit hyperactivity Disorder) cannot be prevented. Expectant mothers, however, can avoid several factors during pregnancy that affect the onset of the disease. These include, above all, smoking and alcohol. 


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