Author: Sandhya Basu
“Why fit in when you were born to stand out?”
– Dr. Seuss
Mr. and Mrs. X were anxious about their child Z. As parents, worry comes naturally to them, but this case was different. Z was a quiet kid in the early years of his life. However, when he turned seven, he became increasingly inattentive, would run from one corner of the house to another, and also started withdrawing himself from his social groups. Additionally, his teachers started complaining about his falling grades. Aghast by the situation, Mr. and Mrs. X visited a psychologist who recommended treatment for Attention-Deficit Hyperactivity Disorder (ADHD).
So, what is ADHD?
ADHD is a medical condition that is characterized by impulsivity, increased motor activity, and problems in sustaining attention. Children affected by it tend to be overactive and associated with lower intelligence levels because of poor attention and learning abilities. It originates in childhood and has predominant symptoms of developmentally inappropriate inattention, impulsivity, and hyperactivity. ADHD was first acknowledged 100 years ago and was labeled as a childhood disorder, which was found mainly in boys. It was initially described as “hyperactivity” or “hyperkinetic disorder of childhood.”
There are various labels attached to ADHD. The diversity in the labelling is because of its various underlying causes. Some studies consider the involvement of genes in brain-related (neurobiological) problems, while others consider its similarity with other clinical disorders in terms of risk factors related to genes, and early age of onset. Despite the diversity in the labelling of this disorder, the Diagnostics and Statistical Manual of Disorders (DSM-5) outlines the continuous patterns of inattention and hyperactivity/impulsivity as the symptoms of this disorder.
What are the causes?
ADHD is not a result of a single cause but appears from a complex combination of environmental, neurological, and genetic factors, i.e. heritability is not only about the genes of an individual but is also about the interplay between genes and an individual’s environment. Environmental factors which increase the risk of ADHD include organic pollutants, lead (known to affect the neural system adversely), psychosocial issues (family adversities, decreased income levels, etc.), abuse or maltreatment, deprivation at an early stage in life, loop-holes in the education system, prematurity, issues during pregnancy (for example, infections- viral and bacterial), delivery or labor, complications during the neonatal stage, and children’s consumption of artificial food colors and preservatives. Also, culture plays an inevitable role in moulding the narration of illness and distress, symptoms, and the medical of a particular disorder.
How are they managed or treated?
Several treatment opportunities exist for ADHD diagnosis. Even though studies show an absence of a cure for ADHD, it still affirms the improvement in the ADHD condition through non-medical treatments (parental-behavior training, psychosocial therapy, school-based therapy, etc.) and medicinal treatments (including both stimulants and non-stimulants). Cognitive-behavioral is considered a popular treatment among those who are not comfortable with medicinal treatment. Other non-pharmacological interventions include psychoeducation (educating individuals about ADHD), psychotherapy, self-management skills training (to help incorporate structure and routine in affected individuals’ life), and marital and family counseling (to manage adverse emotions in spousal and family relations). Additionally, research has also established the successful role of yoga in treating the ADHD symptoms.
Is there a role for parents and all of us in general?
We as individuals and as parents can do to help the ones diagnosed with ADHD.
- First and foremost, we need to make sure that we do not encourage any name-calling or discriminatory acts against those affected by ADHD. Stigma, or a strong feeling of disgrace associated with a particular circumstance or a person, is prevalent in the society when it comes to psychological disorders. As educated individuals, we need to make sure that we spread awareness and educate oneself and others in our community. This will help in reducing the stigmatization of mental disorders and will also encourage acceptance of people affected by various psychological issues.
- Secondly, if you are a caregiver to a child diagnosed with ADHD, you can aim at channelizing your child’s natural energy into more productive activities, like sports, dancing, music, etc. This will enable the child to attend to different activities rather than being inattentive to one task. A proper and balanced diet is also one of the things to be taken into utmost consideration for the well-being of your child.
- Lastly, acceptance and love from your side can act as a catalyst to the treatment given by the professionals. If you notice that your child is showing similar symptoms, do not panic and feel free to seek help from a clinical psychologist.
Lets now recap of what we have discussed so far:
- ADHD is a clinical disorder with symptoms of continuous inattention, hyperactivity or impulsivity.
- Causes of ADHD can be either biological, environmental, or in most cases, combination of both.
- There are several treatment options available for us
- Stigma, of any kind, against mental disorders should be strongly discouraged.
- Awareness of mental disorders is the key to educate ourselves and the society.
- Channelizing our child’s natural energy to various extra-curricular activities helps in controlling inattentiveness.
- A balanced diet is of utmost importance. The more nutritious the food, the better it is for the child.
- Acceptance and love are the two key components for the well-being of the child.
- Consultations with a clinical psychologist is a must if you observe these symptoms in your children.
Butcher, J.N., Hooley, J.M., Mineka, S., & Dwivedi, C.B. (2018) Abnormal Psychology. India: Pearson
ICD-10-CM Codes. (n.d.). Retrieved from https://www.icd10data.com/ICD10CM/Codes/F01-F99/F90-F98/F90-/F90.9
Curatolo, P., D’Agati, E., & Moavero, R. (2010). The neurobiological basis of ADHD. Italian journal of pediatrics, 36(1), 79.
Cortese, S. (2012). The neurobiology and genetics of attention-deficit/hyperactivity disorder (ADHD): what every clinician should know. European journal of paediatric neurology, 16(5), 422-433. DOI: https://doi.org/10.1016/j.ejpn.2012.01.009
Thapar, A., Cooper, M., Eyre, O., & Langley, K. (2013). Practitioner review: what have we learnt about the causes of ADHD? Journal of Child Psychology and Psychiatry, 54(1), 3-16. DOI: https://doi.org/10.1111/j.1469-7610.2012.02611.x
te Meerman, S., Batstra, L., Grietens, H., & Frances, A. (2017). ADHD: a critical update for educational professionals. International journal of qualitative studies on health and well-being, 12(sup1), 1298267. DOI: https://doi.org/10.1080/17482631.2017.1298267
Tripp, G., & Wickens, J. R. (2009). Neurobiology of ADHD. Neuropharmacology, 57(7-8), 579-589. DOI: https://doi.org/10.1016/j.neuropharm.2009.07.026
Frank-Briggs, A. I. (2011). Attention deficit hyperactivity disorder (ADHD). Journal of Pediatric Neurology, 9(03), 291-298. DOI: 10.3233/JPN-2011-0494
Steinhausen, H. C. (2009). The heterogeneity of causes and courses of attention‐deficit/hyperactivity disorder. Acta Psychiatrica Scandinavica, 120(5), 392-399. DOI: https://doi.org/10.1111/j.1600-0447.2009.01446.x
Sciberras, E., Mulraney, M., Silva, D., & Coghill, D. (2017). Prenatal risk factors and the etiology of ADHD—review of existing evidence. Current psychiatry reports, 19(1), 1. DOI: https://doi.org/10.1007/s11920-017-0753-2
Cortese, S., & Coghill, D. (2018). Twenty years of research on attention-deficit/hyperactivity disorder (ADHD): looking back, looking forward. Evidence-based mental health, 21(4), 173-176. DOI: http://dx.doi.org/10.1136/ebmental-2018-300050
Lewis-Fernàndez, R. (2016). Culture and psychiatric classification. World Cultural Psychiatry Research Review, 11(1/2), 1-11. Retrieved from: https://www.worldculturalpsychiatry.org/wp-content/uploads/2019/10/2-Lewis-Final-V11S1.pdf
Patil, S. T., Patil, R. A., Dudhgaonkar, T. D., Mohite, S. K., & Magdum, C. S. (2016). Rajarambapu College of Pharmacy, Kasegaon, Walwa, Sangali, Maharashtra, India. Retrieved from: http://ijsrst.com/paper/333.pdf
Murphy, K. (2005). Psychosocial treatments for ADHD in teens and adults: A practice‐friendly review. Journal of clinical psychology, 61(5), 607-619. DOI: https://doi.org/10.1002/jclp.20123
Antshel, K. M., Hargrave, T. M., Simonescu, M., Kaul, P., Hendricks, K., & Faraone, S. V. (2011). Advances in understanding and treating ADHD. BMC medicine, 9(1), 72. Retrieved from: http://www.biomedcentral.com/1741-7015/9/72