Attention deficit hyperactivity disorder (ADHD)

What is ADHD?

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition that is mainly diagnosed in childhood, though sometimes it is not recognised until adulthood.

When diagnosed in childhood, ADHD often persists into adolescence and adulthood and has lifelong impacts.

ADHD is characterised by hyperactivity, impulsivity, and difficulties with attention.
Hyperactivity can include being unable to sit still, fidgeting, or finding it difficult to participate in activities quietly. Sometimes, people with ADHD can appear to be ‘on the go’ or act as if ‘driven by a motor’. Impulsivity can include interrupting (for example, butting into conversations), having difficulty waiting your turn, or talking excessively.

Attention-related symptoms can include finding it difficult to pay close attention to details, being easily distracted, being unable to remain focused on a specific task, or having problems following instructions and organising activities. These characteristics occur among all of us to some extent – we can all be impatient, over-enthusiastic, or find it difficult to focus.

For a health professional to make a diagnosis of ADHD, these symptoms must be severe, be persistent, be present in more than one setting (e.g. home and work) and cause difficulties for the individual across different areas of their lives (at home, university/work and social life).

Everyday environments like work or university can pose challenges for people with ADHD, if the environment is not properly adjusted. A thorough and careful assessment is important, as stress, anxiety, and mental health or physical health conditions can also present with features like ADHD.

Adults with ADHD may have a history of problems at school, frequent job changes, substance abuse, or getting in trouble with the law. They may also find they are more likely to have relationship or financial issues.

Although ADHD is more likely to be diagnosed in boys and men compared to girls and women, ADHD can affect people regardless of their gender. This gender gap is reducing as more women are receiving an ADHD diagnosis in adulthood.

ADHD in childhood and adulthood

ADHD symptoms typically start in early childhood but are not always recognised and diagnosed at this age. For some people, symptoms reduce or are less obvious by adolescence, but for others, the symptoms and impairment continue into adulthood.
It is possible that symptoms can have a greater impact in adolescence and adulthood, when young people are expected to be more independent and demands start to increase.

Alternatively, ADHD might become easier to manage in adulthood, when people are more able to choose roles and environments which suit their strengths and interests. With the right support, people with ADHD can live successful and fulfilling lives.

ADHD is a complex neurodevelopmental condition, which means it impacts on the nervous system as it matures and affects the way people learn, experience, interact with, and interpret the world. It can affect individuals in different ways.
While most people with ADHD will have difficulties with hyperactivity, impulsivity, and attention, some may have problems mostly with attention or mostly with hyperactivity and impulsivity.

ADHD affects some people to a greater extent than others, and other neurodevelopmental problems can occur alongside ADHD such as autism, tics, developmental coordination disorder and learning difficulties such as dyslexia.
Many people with ADHD also have difficulties with regulating their emotions (for example being irritable). They might find everyday environments emotionally challenging in ways that may be hard for others to understand and are likely to be exposed to more emotionally difficult experiences such as bullying and social rejection.

Some people may experience behavioural problems like anti-social behaviours. Others may also experience emotional problems such as anxiety or depression, and other mental health problems like eating disorders, obsessive-compulsive disorder, or substance use.

Getting support

If you believe you have symptoms of ADHD, you should discuss this with your GP, who can offer advice and may be able to refer you to a specialist. Unfortunately, there is no quick and easy test for ADHD.

Getting a diagnosis of ADHD requires a full and detailed assessment by a psychiatrist, including reports from childhood or information about you from someone who has known you for many years.

Different types of help are available depending on your situation:

  • the Student Disability Services team can help
  • if you are at university Access to Work can help If you are looking for work
  • your line manager, occupational health or Access to Work can help If you are in work
  • you can apply for Personal Independence Payment (PIP) to support you If you are unable to work

If parents become concerned about a child or young person, their GP will be able to offer advice and may be able to refer the child or young person to a specialist.

School staff may also raise concerns and may be able to refer to a specialist or suggest visiting the GP.

Getting a diagnosis of ADHD requires a full and detailed assessment usually by either a specialist paediatrician or a child and adolescent psychiatrist. Unfortunately, there is no quick and easy test for ADHD.

Assessments often gather information from several different sources and may include observations and reports of the child or young person’s behaviour at home and school.

Treatments

There are several different approaches to helping people with ADHD, which can be effective in managing the condition.

Management of ADHD symptoms can be implemented before as well as after an official diagnosis is received.

This can include skills training, and small changes in the educational environment or workplace to minimise distraction and aid focus.

There are several strategies that could help with organisation and timing:

  • breaking down tasks into small separate tasks
  • taking regular breaks
  • alarm reminders
  • careful use of diaries and calendars
  • digital software to help with checking spelling
  • reading out text
  • working in a team with people who have different strengths and weaknesses to you

    Healthy lifestyles are also important – these include regular and sufficient sleep, a healthy diet, avoiding illegal drugs and excess alcohol, and getting enough regular exercise.

    Although not a treatment directly aimed at ADHD, some people may benefit from talking therapies, a lifestyle coach, or other forms of external support.
    For example, a manager completing neurodiversity training, or asking a co-worker to assist in particular areas of struggle like proof reading.

    Medication can be prescribed after an ADHD diagnosis. Medication has been shown to alleviate challenges associated with ADHD by reducing hyperactivity and impulsivity, enabling people with ADHD to concentrate and focus more effectively.
    Common medications used to treat ADHD include Methylphenidate (Ritalin, Equasym, Concerta), Lisdexamfetamine, Atomoxetine, (Strattera), and Guanfacine.

    The most used medications generally start to work shortly after each dose, and do not have a long-lasting effect. They can be very effective, but as with all medication, there is a chance of side effects.

    Some research shows that adults with ADHD can be supported by combining talking therapy (such as cognitive behavioural therapy) with ADHD medication.

    Not all adults with ADHD will need medication, and those taking medication may also need educational support or psychological treatment.

If a child or young person is still experiencing significant difficulties related to their ADHD after changes have been made, then medication may be offered.

Common medications used to treat the condition include Methylphenidate (Ritalin, Equasym, Concerta), Lisdexamfetamine, Atomoxetine (Strattera), and Guanfacine.

The most used medications generally start to work shortly after each dose, and do not have a long-lasting effect.

They can be very effective, but as with all medication, there is a chance of side effects. A prescribing doctor will advise you on these issues.

Not all children and young people with ADHD will need medication, whilst those taking medication will also need educational or psychological treatment.

Some children will take medications every day.

Others might, for example, take these only on school days if school is the main environment which continues to be challenging.

Tips for adults with ADHD

  • Remember that having ADHD is not a personality flaw but a different way of being in the world.
  • Educating yourself and those around you can help fight much of the stigma associated with ADHD.
  • Get support and find a community. Building a support network either in person or virtually can be helpful. You can share tips and ask for advice in informal, casual, and non-clinical settings.
  • Don’t get discouraged if one type of management or medication doesn’t work. Try something else until you find what works best for you.
  • If you are at university, speak to the disability team and your supervisor or tutor.
  • If you in the workplace, and you feel comfortable, disclose your diagnosis to your line manager and speak to occupational health to see what adjustments and accommodations could be made.
  • Know your rights. According to the 2010 Equality Act, ADHD is a disability and therefore a protected characteristic against discrimination.
  • Explore which techniques work for you. Some people find a balanced diet, exercise, reducing or cutting out alcohol, or getting enough sleep helps them manage their symptoms better.

ADHD in the workplace and higher education

  • The 2010 Equality Act legally requires employers to make reasonable adjustments in the workplace for employees with a disability or long-term health condition, which ADHD is included in.
  • Reasonable adjustments are changes that can be made in the workplace to help mitigate a disadvantage that someone with ADHD may have, for example, allowing the use of noise cancelling headphones in a noisy office or providing written rather than verbal instructions. More information about this and more suggestions of adjustments, can be found at: adhduk.co.uk/reasonable-adjustments/
  • An Access to Work grant can assist you with starting and staying in work. It includes funding for workplace equipment and adaptation of equipment, travel costs, and other practical assistance such as a job coach. More information can be found at: adhduk.co.uk/access-to-work/
  • Disabled Students Allowance (DSA) covers costs related to studying with a disability, and includes software, mentoring and assistance in purchasing equipment. More information can be found at: gov.uk/disabled-students-allowance-dsa

Tips for children and young people with ADHD

  • Try to treat yourself with kindness; try and think of some of the positive aspects about who you are and write them down so you can refer to them when you need to.
  • Don’t be afraid to ask for help. Try to find a trusted adult at school and/or at home you can reach out to when you need extra support, or if you need an adjustment (for example, if you have a teacher who only gives instructions verbally, you can request that they prepare a written version for you).
  • Remember that there is a lot of misinformation about ADHD among people, even from some adults and teachers. People with ADHD can achieve anything that someone without ADHD can, they might just take a different route than others, so don’t let anyone tell you otherwise!
  • Building friendships with other children and young people with ADHD, or related conditions like autism, can sometimes be easier than building friendships with ‘neurotypical’ people without ADHD or other ‘neurodivergent’ conditions – you may find you are able to understand each other better as your brains may work in a similar way.
  • Remember that ADHD is a condition that you can try to manage, but you might not always be able to control. Doing your best is what counts, and understanding that everyone has bad days, even adults with ADHD.

Tips for parents, carers and staff supporting young people with ADHD

  • Remember that children and young people with ADHD are not being wilful or deliberately difficult. Try to keep in mind that ADHD is a neurodevelopmental condition, and these behaviours are part of it.
  • Learning about ADHD and understanding why a child or young person reacts to things in ways you might not expect, can help you learn to respond to this in ways that minimise conflict.
  • Praise children and young people with ADHD when they do well and look for their strengths – it will boost their self-confidence and make you feel better. Children and young people with ADHD will often receive a lot of criticism from others. Try to make sure that you make positive comments more often than critical or corrective comments.
  • Use rewards and discipline – reward charts for positive behaviour and effective, consistent discipline for difficult behaviour can help support a child or young person.
  • Keep instructions simple and consistent – children and young people with ADHD can find it difficult to process many things at the same time. Try to break up long strings of instructions into one instruction at a time.
  • Write things down and use visual reminders. Stress the importance of writing down homework tasks – and bringing homework books home too. It will make it much easier to keep on top of tasks and what is required.
  • Try to keep things consistent and have a routine. If everything has its place and a child or young person is encouraged to use that place, it will be easier for them to remember where things are and be more organised.
  • Adapt your expectations and family and classroom routines to accommodate a child or young person’s needs.
  • Get support – many parents, children and young people find it helpful to join local or online support groups where you can discuss issues with others. Remember to only follow medical advice from a healthcare professional.
  • ADHD is largely genetic, and many parents find that they recognise traits in themselves after their child receives a diagnosis. If this happens, this doesn’t necessarily mean you have ADHD yourself, but if you are concerned, you can seek advice by speaking to your GP.

Homework tips for young people with ADHD

Tasks that need a lot of concentration, like homework, can be especially difficult for young people with ADHD. Here a few ideas that can help:
  • Keep a homework diary and write down everything you need to do. It might help to ask your teacher to check your diary to make sure you have all the information you need. Remember to take your homework diary home with you.
  • Find a quiet place to do your homework with few distractions.
  • Get everything you need ready before you start. It might help to keep all your stationery and books in one specific place.
  • Take time to read instructions carefully so you know what to do. Check the instructions again as you start to make sure you know exactly what to do.
  • Break long tasks into smaller sections.
  • Take short breaks every 20 minutes or so to give your brain a rest.

Resources

Let’s talk about ADHD animation

The ADHD research team at Cardiff University worked with children with ADHD and their families and carers to create an animation about what it’s like to have ADHD. Read more about the animation.

Piece of Mind podcast: ADHD in women and girls

Dr Joanna Martin and Ellie, a non-binary young person, to discuss how research at Cardiff University is aiming to learn more about ADHD.

Piece of Mind podcast: ADHD

Zoe Piper, founder of ADHD Connections, and Professor Anita Thapar sit down with Piece of Mind host Bozo Lugonja to discuss the latest research in ADHD.

Separating facts from fiction

Professor Anita Thapar discusses some of the myths and misunderstandings around the condition, focusing on what has been learnt from science, and how this might help clinical and educational practice.

Professor Anita Thapar answers questions on ADHD

Claire has a daughter with extreme ADHD and puts her questions to Professor Anita Thapar, one of the principal investigators at NCMH and a clinical professor at Cardiff University. This video was produced as part of the Challenge Cardiff series.

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