The Complex Challenges of ADHD

ADHD – A Misleading Label 

Attention Deficit Hyperactivity Disorder is more than just hyperactivity or an attention issue, as its name would suggest.  In fact…it is not necessarily a “deficit,” but would be more accurately described as an inability to regulate attention.  But, as with all brain disorders, the label is merely a list of likely symptoms grouped together to form a means to communicate a complex phenomenon.  While many individuals share the most obvious symptoms, the disorder represents a spectrum of challenges, which may or not be present for a particular individual.  In addition, many symptoms may be masked by coping skills unconsciously developed by an individual in order to compensate for their difficulties.

For the Skeptics…

There is no doubt that everyone struggles with attention and focus from time to time, but there is a difference between what is “typical,” and what is “impairing.”  All students may be reluctant to do homework, chores, or read a book from time to time; but when motivated, they are able to strive for their goals.  When individuals with ADHD, for example, sit down to read an interesting book, play a new game, or follow Lego instructions; they are often unable to focus (especially without treatment), which can cause them to become overwhelmed, anxious, and/or frustrated…even when it is something they REALLY want to do.  The difference being that they cannot always focus on what they enjoy, which is not the case for those who do not have ADHD.  They cannot “regulate” their attention.  In social situations, even when they know better, they may blurt things out; whereas children wihout ADHD are better able to manage their reactions in similar situations, once they have learned that social skill.  This often leads to ridicule, which they internalize, causing shame and damage to their self-esteem.  Without proper treatment, the long term damage can be immeasurable. 

Has ADHD really increased?

It was not until the 1990’s that experts embraced the fact that hyperactivity and distraction might be internal, rather than outwardly observable by others.  And, more recently it has become clear that one does not “outgrow” the disorder, but more likely learns to internalize the symptoms with maturity…in order to “fit in” with external expectations.  DSM-5 reflects the notion that this is one disorder, ADHD, with a variety of presentations, and as a result, “ADD” has become an antiquated term, no longer used by those who are cognizant of the most recent research.  ADHD may present itself as 1. Predominantly Hyperactive-Impulsive, 2. Predominantly Inattentive, or as 3. Combined Presentation.   However, the presentation often changes with time, as illustrated above. 

While DSM-5 provides some examples of the “observable” challenges, or those defined by clinicians; it fails to include many of the less obvious challenges described by self-reflective individuals (children and adults) throughout their lives (discussed under Discover the Hidden Challenges of ADHD).  

It is not clear whether or not ADHD has become a dominant trait (or has increased due to environmental factors, which activate the predispostion); however, more students have likely been diagnosed, since the 1990s, when practitioners began to recognize that the symptoms may not involve “observable” hyperactivity, and that girls present in different ways.  In addition, as society has became faster and noisier, more an more adults have begun to struggle, as the techniques they used to compensate in the past (less competitive society) are no longer sufficient.  The understanding that ADHD runs in families has also revealed that many of the behavioral challenges, which were previously viewed as “personality” traits, are actually a result of the atypical wiring within the brain related to a genetic predisposition. 

ADHD – Diagnostic Criteria – DSM-5 

Do You Recognize these Hidden Challenges of ADHD?

Any questions?…   red-hand

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