The most prevalent mental health disorder diagnosed in kids and a condition affecting 5%, or approximately 11 million, of U.S. adults, ADHD is a typically lifelong condition with no cure that can affect every aspect of a person’s life.
What Is ADHD?
Attention deficit hyperactivity disorder, or ADHD, is a neurodevelopmental disorder most commonly defined by its symptoms of chronic, severe or repetitive inattention and hyperactivity. Other common symptoms of ADHD include:
• Behavioral trouble
• Interrupting and speaking out of turn
• Impulsive and overactive behavior
• Restlessness and trouble remaining seated or in place
• Trouble focusing
Beyond that, ADHD is a medical disorder directly involving the structure and function of the brain. Scientists have discovered a potential link between ADHD and differences in the frontal lobes of the brain. In addition to these brain differences and possible related genetic factors, other factors that may contribute to a person’s ADHD diagnosis include:
• Brain injuries
• Exposure to lead
• Exposure to alcohol or tobacco during pregnancy
• Nutritional factors like sugar consumption although this is still highly controversial among experts, according to the journal Nutrition Research and Practices
Origins and Variations of the Disorder
ADHD has taken decades for experts to understand. The first reports of symptoms relating to what’s now known as ADHD date back to the late 1700s, but the first medical reference to the condition appeared in the American Psychiatric Association’s 1968 Diagnostic and Statistical Manual of Mental Disorders as “hyperkinetic reaction of childhood.” For the 1980 edition of the DSM, the APA changed the term to “attention deficit disorder,” finally giving it the name it bears today in 1987 in response to new research discoveries that symptoms of hyperactivity were endemic to the condition. As of the fifth edition of the DSM, published in 2013, the term ADHD still remains with the addition of three new sub-specifications:
• Predominantly inattentive presentation, presenting more of the attention-related symptoms of the condition
• Predominantly hyperactive impulsive presentation, presenting more of the hyperactivity-related symptoms of the condition
• Combined presentation, presenting both the attention-related and hyperactivity-related symptoms of the condition in relatively equal measure
ADHD in Kids
In a 2016 survey of parents, the Centers for Disease Control and Prevention estimated that 6.1 million children, or 9.5% of kids in the U.S., have received a diagnosis of ADHD, broken down by age as follows:
• 388,000 aged 2 to 5 years
• 4 million aged 6 to 11 years
• 3 million aged 12 to 17 years
Kids with symptoms of ADHD are typically diagnosed with the disorder at around age 7. Approximately three in four of those kids receive treatment for their ADHD, either medication or behavioral treatment or a combination thereof. Approximately 5 in 10 of those children also had a conduct or behavior problem while approximately 3 in 10 of them also suffered from anxiety. Other conditions that kids with ADHD also commonly experience include:
• Autism spectrum disorder
• Tourette syndrome
In a study on children, researchers found smaller frontal lobes by an average of 3% in children with ADHD compared to children without ADHD. This is the area of the brain relating to concentration, motor activity, inhibition and impulse control. Researchers noted that brain size is not an indication of intelligence, however; over the 10-year study using periodic MRI scans, brain development in children with and without ADHD was the same. Moreover, according to the National Institute of Mental Health, the brains of people with ADHD do eventually reach what’s considered a “normal” state, just at a delayed rate of generally about three years for certain regions.
Beyond brain size differences, the researchers in that study also found potentially different neural pathways related to these same functions and activities of the brain in its white and grey matter. This could help explain why learning difficulties and behavior issues are commonly associated with ADHD in kids.
ADHD and Gender
According to a report in the Journal of Attention Disorders, differences in ADHD among genders may also exist. As noted in one study in the report, boys are more than twice as likely as girls to receive an ADHD diagnosis, but whether this indicates a higher prevalence of boys with ADHD than girls or simply a higher prevalence of reporting ADHD among parents of girls than boys is still unknown. Similarly, male adults are more commonly diagnosed with ADHD than female adults although this could also simply be a reflection of more men than women reporting their ADHD diagnoses.
Another study in the JAD report found that boys may be more likely to experience symptoms of impulsivity related to their ADHD while girls may be more likely to experience symptoms of anxiety and depression than boys, especially as they age. Researchers found no gender differences in inattention symptoms, however.
Addiction and ADHD
While no evidence yet exists linking ADHD and addiction in a cause-and-effect relationship in either direction, there is unmistakable evidence that the two conditions can coexist in an individual in what is medically termed a “co-occurring disorder.”
Adult alcoholics are between 5 and 10 times more likely to also have ADHD than their non-alcoholic peers. Moreover, approximately a quarter of adults being treated for alcoholism or drug abuse have a diagnosis of ADHD as well.
In several other studies, researchers found that children with ADHD are more likely to start abusing alcohol as teenagers. One study found that 14% of teens between 15 and 17 years of age with ADHD had alcohol or drug abuse or dependence problems as adults. In another study, almost double the percentage of children with ADHD started using alcohol at a mean age of almost 15 years compared to their peers: 40% vs. 22%. As for young adults, the prevalence of using alcohol was the same among young adults of around 25 years of age with and without ADHD, but those with ADHD used it to greater excess. Researchers additionally discovered links between the prevalence of marijuana use and ADHD.
The prevailing theory among researchers about why people with ADHD are more likely to use and abuse alcohol and other substances is that ADHD is associated with lowered impulse control and greater likelihood of behavioral difficulties, both of which could lead to substance use and abuse.
There is also an apparent genetic relationship in that both alcoholism and ADHD are frequently passed down in families, so if a child has a a parent with both conditions or one parent with one condition and another with the other, the child may be more likely to develop one or both. Researchers have even found genes shared in common among both people with ADHD and people with addiction.
Because ADHD and addiction are so intertwined, when both conditions are present in an individual, both must be treated simultaneously for either to be managed or healed effectively.
Treatment for ADHD
To improve quality of life with ADHD, treatment is recommended. Behavioral therapy is the first treatment the CDC recommends for children under 5 years of age. As a result of early intervention, children with ADHD can experience improvements in school grades and social skills along with a decrease in behavioral difficulties and trouble completing tasks.
By contrast, medication is the most commonly recommended first line of treatment for children 5 years of age and older and adults with ADHD. ADHD medications are typically stimulants, which ironically produce a calming effect in people with ADHD. There are, however, some side effects associated with ADHD medications, including insomnia, fatigue and irritability.
The McGovern Institute for Brain research reports that approximately 60% of people given ADHD medications respond favorably. For those others, non-stimulant ADHD medications are also available. It’s also worth noting that ADHD treatments for men and women are the same.
Lifestyle Changes for ADHD
With or without behavioral therapy or ADHD medication, people with ADHD can help control their symptoms by making certain lifestyle changes, such as:
• Limiting television viewing, particularly during times requiring concentration such as dinnertime or while studying
• Participating in a hobby or sport
• Improving organization and organizational abilities
• Creating a daily routine and adhering to it
• Setting achievable goals with obtainable rewards
These changes are particularly effective in children, for whom habits are still forming.
Addiction to ADHD Medications
One problem commonly facing people with both ADHD and addiction is the propensity to become addicted to the ADHD medication. This is especially prevalent among users of stimulant-based ADHD medications. The ADHD medications most commonly prescribed are:
The first two of these are amphetamine-based stimulants while the third is a central-nervous-system stimulant. When examining the abuse of ADHD medications, it is important to distinguish between those people abusing ADHD medication who have ADHD and those who don’t. Many abusers of ADHD medications don’t have ADHD at all but use them because they may be easier or safer to obtain than other forms of amphetamines or other stimulants. Many students, for example, abuse ADHD medications under the erroneous belief that it will help with their studies.
As a result of this tendency for people to abuse ADHD medications, some people with ADHD are reluctant to use ADHD medications because they fear becoming themselves addicted. Fortunately, a UCLA study found that people with ADHD who use Ritalin or Adderall do not have an increased risk of developing an addiction to those medications or any other drugs. This indicates that the risk factor for people with ADHD to develop substance abuse problems is not ADHD medication but the ADHD itself.
As a result, one simple solution to an addiction to ADHD medication may be to switch to a non-stimulant-based medication or to more lifestyle treatment methods.
Treating ADHD and Addiction Together
The most effective treatments for people who have both ADHD and an issue with substance abuse may be a combination of treatments used in conjunction with ADHD medication, such as:
• Diet management and nutritional counseling
• Exercise programs
• Stress-management tools
• Skills development
• Therapy and lifestyle coaching
• ADHD education and parenting guidance
According to the National Alliance of Mental Illness, effective treatment for ADHD and addiction requires a facility able to accommodate the individual’s dual diagnoses.
Getting Help for Your ADHD and Addiction
If you are suffering from ADHD and you have an addiction or you believe the symptoms you are experiencing in addition to those of your addiction may be due to as-yet undiagnosed ADHD, you can find help at NFA Behavioral Health. Set in 17 acres of wooded New Hampshire countryside, NFA Behavioral Health offers a safe, intimate and private treatment environment where you can get treatment for your addiction and your ADHD at the same time.
Using a range of clinical psychotherapeutic techniques and holistic therapies with and without medication, NFA Behavioral Health recognizes that your addiction and your ADHD are interconnected. For your total treatment and recovery, both elements must be acknowledged and treated in equal measure. At the facility, licensed clinicians and therapists will monitor both of your conditions and provide appropriate treatments for each individual condition.
There is no single treatment program for either ADHD or addiction, let alone both together, that works best for all people. At NFA Behavioral Health, you’ll get a program uniquely suited to you and your ADHD and addiction that adjusts and modifies as necessary.