Adhd psychiatric disorder
Is ADHD Considered a Mental Illness?
Attention deficit hyperactivity disorder (ADHD) is a common mental health condition. While people may use different terms for ADHD, technically it does fall into the broad category of “mental illness.”
Knowing more about ADHD and the terms used in mental healthcare can provide more context for the usage of various terms.
Language matters
Terms used to describe mental health are important. There can be a stigma surrounding many healthcare terms, especially those used when discussing mental health.
Words like “illness” and “disorder” may help professionals objectively diagnose conditions and provide effective treatment, but individuals may choose to use terms that feel the most comfortable to them when describing their own health.
Mental health is an important part of overall health. Any illness, mental or physical, doesn’t signal personal weakness and is no one’s fault.
According to the American Psychiatric Association, mental illnesses are treatable health conditions that involve significant changes in emotion, thinking, or behavior — or any combination of these. They are often associated with distress and can affect social situations, work, or relationships.
Although ADHD falls into the defined category of mental illness, it’s most often referred to as a disorder, even by the American Psychiatric Association. As these terms are sometimes used interchangeably in clinical settings, ADHD can be described as a mental illness and a disorder.
The category of mental illness is very broad. Some people prefer to use the term “disorder” to avoid or reduce perceived stigma around the term “illness.” There is nothing shameful about a mental illness, a mental disorder, or ADHD.
The National Alliance on Mental Illness (NAMI) uses the terms “mental illness,” “mental disorder,” and “mental health conditions” interchangeably, and provides no separate definition for a mental disorder.
People living with mental illnesses or disorders have the right to use the terminology they choose, but clinically, there’s no difference between the terms.
The 5th edition of the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5, puts forward the language and criteria used by clinicians, researchers, and public health officials to diagnose mental health conditions in the United States. This helps ensure that everyone is using standardized criteria and not random or subjective measures.
Attention deficit hyperactivity disorder (ADHD) is characterized by a persistent pattern of inattention or hyperactivity or impulsivity that interferes with functioning or development.
The DSM-5 criteria for ADHD include:
- Inattention. An individual must have at least six symptoms in children up to age 16, or five or more symptoms for those 17 and older. These must be present for at least 6 months and not developmentally appropriate:
- does not have close attention to detail or makes careless mistakes with work
- trouble with attention to tasks or play activities
- does not seem to listen when spoken to directly
- does not follow through with instructions
- trouble organizing tasks
- avoids tasks requiring sustained attention
- loses necessary items
- easily distracted
- forgetful in daily activities
- Hyperactivity/impulsivity.
An individual must have six or more symptoms up to age 16, five or more age 17 and older. Symptoms must be present at least 6 months and not developmentally appropriate:- often fidgets or squirms in seat
- often leaves seats when sitting is expected
- climbs or runs when not appropriate (children), restlessness (adults)
- talks excessively
- always “on the go”
- cannot play or stay quiet during leisure activities
- often blurts out answers before the question is finished
- interrupts or intrudes often
- trouble waiting their turn
These symptoms also must be present in two or more settings (school, work, home, social settings) and interfere with functioning in some sort of way.
Symptoms of ADHD can vary depending on the type of ADHD, as well as age and sex. Inattention and hyperactivity/impulsivity are main features of ADHD. While people may display hyperactivity, impulsivity, or inattentiveness at times, for people with ADHD these behaviors:
- are more severe
- happen more often
- interfere with functioning at school, work, or social settings
Symptoms can include:
- trouble focusing or concentrating
- forgetfulness with completing tasks
- easily distracted
- trouble sitting still
- interrupting others
Although boys and girls can both have ADHD, boys are about three times more likely to receive an ADHD diagnosis than girls.
ADHD presents differently in girls and boys in several ways, including:
- girls may be more likely to have internalized symptoms like inattentiveness and low self-esteem
- boys may be more likely to be impulsive and have externalized symptoms like interrupting or fidgeting
- girls may display fewer behavioral problems and are thus sometimes overlooked for evaluation or treatment
Finding support for ADHD
Here are some organizations that can help provide resources and information on ADHD:
- Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD)
- ADHD Institute
- ADDitude magazine
- Impact Parents: Helping Parents Help Kids
There is no one definitive test for ADHD. Many factors go into the diagnostic process for ADHD. To make a diagnosis of ADHD, a doctor:
- will assess symptoms that have been present for the last 6 months
- will gather information from teachers, co-workers, family members, or other medical professionals
- may use checklists and rating scales to assess symptoms
- will perform a physical exam to rule out any other medical problems
- can use the DSM-5 to assess symptoms and ADHD criteria
- may refer you to an ADHD specialist, neurologist, or psychologist, who can perform a neuropsychological assessment
There is no cure for ADHD, but there are treatments to help manage symptoms.
While medication alone may be enough, it may be paired with other treatments to help manage symptoms and behaviors.
Treatments can include:
- medications
- stimulant and nonstimulant drugs
- therapeutic treatments
- psychotherapy
- behavior therapy
- social skills training
- support groups
- parenting skills training
- behavioral interventions
- organization
- scheduling
- organizers
- positive reinforcement
ADHD doesn’t go away, and there is no cure. However, it is manageable and symptom severity can decrease with age and treatment.
Treatment can help shape behaviors in such a way that ADHD does not interfere with functioning. It can also help you manage symptoms and lessen their impact on your daily life.
While ADHD is technically considered a mental illness, you may also hear it called a mental disorder, especially in clinical settings.
Those with ADHD may also use different terms to describe this mental health condition.
What’s most important is getting an accurate diagnosis to find appropriate treatment. This will help you manage symptoms and improve overall functioning.
If you think that you or your child has ADHD, talk with your doctor about your concerns. They can do an exam and discuss next steps with you.
Is ADHD Considered a Mental Illness?
Attention deficit hyperactivity disorder (ADHD) is a common mental health condition. While people may use different terms for ADHD, technically it does fall into the broad category of “mental illness.”
Knowing more about ADHD and the terms used in mental healthcare can provide more context for the usage of various terms.
Language matters
Terms used to describe mental health are important. There can be a stigma surrounding many healthcare terms, especially those used when discussing mental health.
Words like “illness” and “disorder” may help professionals objectively diagnose conditions and provide effective treatment, but individuals may choose to use terms that feel the most comfortable to them when describing their own health.
Mental health is an important part of overall health. Any illness, mental or physical, doesn’t signal personal weakness and is no one’s fault.
According to the American Psychiatric Association, mental illnesses are treatable health conditions that involve significant changes in emotion, thinking, or behavior — or any combination of these. They are often associated with distress and can affect social situations, work, or relationships.
Although ADHD falls into the defined category of mental illness, it’s most often referred to as a disorder, even by the American Psychiatric Association. As these terms are sometimes used interchangeably in clinical settings, ADHD can be described as a mental illness and a disorder.
The category of mental illness is very broad. Some people prefer to use the term “disorder” to avoid or reduce perceived stigma around the term “illness.” There is nothing shameful about a mental illness, a mental disorder, or ADHD.
The National Alliance on Mental Illness (NAMI) uses the terms “mental illness,” “mental disorder,” and “mental health conditions” interchangeably, and provides no separate definition for a mental disorder.
People living with mental illnesses or disorders have the right to use the terminology they choose, but clinically, there’s no difference between the terms.
The 5th edition of the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5, puts forward the language and criteria used by clinicians, researchers, and public health officials to diagnose mental health conditions in the United States. This helps ensure that everyone is using standardized criteria and not random or subjective measures.
Attention deficit hyperactivity disorder (ADHD) is characterized by a persistent pattern of inattention or hyperactivity or impulsivity that interferes with functioning or development.
The DSM-5 criteria for ADHD include:
- Inattention. An individual must have at least six symptoms in children up to age 16, or five or more symptoms for those 17 and older. These must be present for at least 6 months and not developmentally appropriate:
- does not have close attention to detail or makes careless mistakes with work
- trouble with attention to tasks or play activities
- does not seem to listen when spoken to directly
- does not follow through with instructions
- trouble organizing tasks
- avoids tasks requiring sustained attention
- loses necessary items
- easily distracted
- forgetful in daily activities
- Hyperactivity/impulsivity.
An individual must have six or more symptoms up to age 16, five or more age 17 and older. Symptoms must be present at least 6 months and not developmentally appropriate:
- often fidgets or squirms in seat
- often leaves seats when sitting is expected
- climbs or runs when not appropriate (children), restlessness (adults)
- talks excessively
- always “on the go”
- cannot play or stay quiet during leisure activities
- often blurts out answers before the question is finished
- interrupts or intrudes often
- trouble waiting their turn
These symptoms also must be present in two or more settings (school, work, home, social settings) and interfere with functioning in some sort of way.
Symptoms of ADHD can vary depending on the type of ADHD, as well as age and sex. Inattention and hyperactivity/impulsivity are main features of ADHD. While people may display hyperactivity, impulsivity, or inattentiveness at times, for people with ADHD these behaviors:
- are more severe
- happen more often
- interfere with functioning at school, work, or social settings
Symptoms can include:
- trouble focusing or concentrating
- forgetfulness with completing tasks
- easily distracted
- trouble sitting still
- interrupting others
Although boys and girls can both have ADHD, boys are about three times more likely to receive an ADHD diagnosis than girls. ADHD presents differently in girls and boys in several ways, including:
- girls may be more likely to have internalized symptoms like inattentiveness and low self-esteem
- boys may be more likely to be impulsive and have externalized symptoms like interrupting or fidgeting
- girls may display fewer behavioral problems and are thus sometimes overlooked for evaluation or treatment
Finding support for ADHD
Here are some organizations that can help provide resources and information on ADHD:
- Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD)
- ADHD Institute
- ADDitude magazine
- Impact Parents: Helping Parents Help Kids
There is no one definitive test for ADHD. Many factors go into the diagnostic process for ADHD. To make a diagnosis of ADHD, a doctor:
- will assess symptoms that have been present for the last 6 months
- will gather information from teachers, co-workers, family members, or other medical professionals
- may use checklists and rating scales to assess symptoms
- will perform a physical exam to rule out any other medical problems
- can use the DSM-5 to assess symptoms and ADHD criteria
- may refer you to an ADHD specialist, neurologist, or psychologist, who can perform a neuropsychological assessment
There is no cure for ADHD, but there are treatments to help manage symptoms.
While medication alone may be enough, it may be paired with other treatments to help manage symptoms and behaviors.
Treatments can include:
- medications
- stimulant and nonstimulant drugs
- therapeutic treatments
- psychotherapy
- behavior therapy
- social skills training
- support groups
- parenting skills training
- behavioral interventions
- organization
- scheduling
- organizers
- positive reinforcement
ADHD doesn’t go away, and there is no cure. However, it is manageable and symptom severity can decrease with age and treatment.
Treatment can help shape behaviors in such a way that ADHD does not interfere with functioning. It can also help you manage symptoms and lessen their impact on your daily life.
While ADHD is technically considered a mental illness, you may also hear it called a mental disorder, especially in clinical settings. Those with ADHD may also use different terms to describe this mental health condition.
What’s most important is getting an accurate diagnosis to find appropriate treatment. This will help you manage symptoms and improve overall functioning.
If you think that you or your child has ADHD, talk with your doctor about your concerns. They can do an exam and discuss next steps with you.
Attention Deficit Hyperactivity Disorder (ADHD)
What if some mental disorders are not disorders at all?
What if mental disorders such as anxiety, depression or post-traumatic stress disorder are not mental disorders at all? In a new paper, biological anthropologists are calling on the scientific community to rethink mental illness. After careful study, they provide information that allows you to think of depression or post-traumatic stress as a reaction to adversity, rather than a chemical imbalance. And ADHD may be a way of functioning that has evolved in a hereditary environment that doesn't fit the way we live today.
Adaptive response to adversity.
Mental disorders are usually treated with drugs within the medical model. So why do the anthropologists who wrote this study argue that these disorders may not be medical at all? They point to several key points. First, medicine has never been able to prove that anxiety, depression, or post-traumatic stress disorder (PTSD) are inherited conditions. Second, the authors of the study note that despite the widespread and growing use of antidepressants, levels of anxiety and depression are not improving. From 1990 to 2010 the global prevalence of depressive disorder and anxiety disorders was 4.4% and 4%. At the same time, data continues to show that antidepressants work no better than placebo. Thirdly, worldwide, the incidence of these disorders remains stable at 1 in 14 people. However, in conflict-affected countries, approximately one in five people suffer from depression, post-traumatic stress disorder, anxiety and other disorders.
Collectively, the authors suggest that anxiety, depression, and post-traumatic stress disorder may be adaptive responses to adversity. Defense systems are devices that are reliably activated in threatening situations to minimize losses. It's not hard to see how this relates to anxiety - it helps us avoid danger. But how does this relate to depression? Scientists claim that the mental pain of depression helps us focus on adverse events in order to mitigate current adversity and avoid similar adversity in the future. If this does not inspire confidence in you, then consider that neuroscientists are increasingly relegating these three disorders to branches of the threat detection system. Anxiety can be caused by chronic activation of the fight or flight system. Post-traumatic stress disorder can occur when an injury triggers a freeze response that helps animals switch off from pain before death, and depression can be a chronic activation of the same freeze response.
Labels matter.
Labels are what help define who we are and what we are capable of. Too often labels limit us. That's why it's important to rethink how we treat anxiety, depression, or ADHD. Does anyone have depression, a brain disease, or a suppressed adaptive response to adversity? Adversity is something we can overcome, while mental illness must be fought. Labels offer a variety of possibilities.
Let's talk a little about ADHD. A generation ago, boys with ADHD were called bad boys and punished or detained. We are now helping children with ADHD understand that they have learning differences. Instead of detention, we try to provide support in a variety of ways. When we do this, behavior problems often disappear. This re-labeling of learning difference is vital because it gives children with ADHD the opportunity to be good and succeed. However, ADHD is still an Attention Deficit Hyperactivity Disorder. In Finland, where a lot of physical activity is part of the school day, rates of ADHD are very low. Meanwhile, in Russia, children are asked to sit quietly for most of the day. Primary school students often only get 15-20 minutes of break per day. And as a result, ADHD rates have risen over the past 15 years.
The authors of the study state that ADHD is not a disorder. Rather, it is an evolutionary mismatch with the modern educational environment that we have created. If ADHD is not a disorder, but a mismatch with the person's environment, then it is not a medical problem. This is a question of education reform. And that's a compelling thought, given the evidence that physical activity improves children's concentration and cognition. However, we must take this study with a grain of salt. There is a large body of research showing other biological factors associated with ADHD. For example, there is evidence that preterm birth further increases levels of ADHD.
Social reform or treatment?
The authors of the study compared the treatment of anxiety, depression or post-traumatic stress disorder with antidepressants with the treatment of a broken bone without fixing the bone itself. They believe that these problems are more like socio-cultural phenomena, so the solution is not necessarily to correct dysfunction in the human brain, but to correct dysfunction in the social world. This is a fair criticism of how we treat mental illness. But the stated goal of the article is not to change treatment, but to explore new ways to get rid of these problems. Research on depression, anxiety, and post-traumatic stress should focus more on mitigating conflict and adversity and less on manipulating brain chemistry.
Based on this, do we need to change the way we view mental health? Yes and no. When it comes to what labels we use, the change is welcome. Mental health recovery depends in part on whether patients believe they will get better. Telling patients that their symptoms may be related to a healthy response to adversity can be very reassuring. It's not news to doctors that adversity affects mental health. But until reform removes the social causes of suffering, physicians should continue to provide patients with standard care. The history of medicine is the story of healers who used the best treatment they had at the time until something better came along.
What is ADHD and why the diagnosis is not a sentence
Attention deficit hyperactivity disorder occurs in every tenth child. However, not all doctors can diagnose it. Without treatment, it progresses, worsening the quality of life. So how can you help ADHD patients?
What is ADHD
Attention deficit and/or hyperactivity disorder (ADHD) is a neurological-behavioral developmental disorder that begins in childhood. Pathology has more than a dozen symptoms. The most common are the inability to concentrate for a long time, absent-mindedness, inattention, restlessness, irascibility, poor memory. From the side it seems that such a person seems to be “flying in the clouds”.
Doctors distinguish three subtypes of mental disorders.
- The first - with a predominance of attention deficit. The person cannot concentrate, is distracted, forgetful.
- The second is hyperactive and impulsive. When it is difficult to stay in one position for a long time and restrain emotional impulses.
- Third - mixed. Combines the features of the first and second. Occurs most often.
The listed symptoms are attributed to character traits, accusing a person or oneself of laziness, procrastination and conflict. In fact, it is not the individual who is “guilty”, but his brain and nervous system. According to the International Classification of Diseases, ADHD is classified as a hyperkinetic disorder.
In Russia, the syndrome is not well understood. Not all specialists are aware of it and know the evaluation criteria. Many do not understand how to diagnose and treat a disease, Olga Demyanenko, a family and child psychologist of the highest category, told RBC. This leads to the fact that sometimes healthy children are given this diagnosis erroneously. And those who really suffer from ADHD do not get the help they need.
How to recognize ADHD in children
Some specialists can diagnose ADHD even in children under one year old. The main symptoms are severe excitability and hyperactivity. Babies often cry, scream, twitch their arms and legs, says Olga Demyanenko. In older children (4-5 years), attention deficit hyperactivity disorder is more pronounced.
“The child is constantly on the move, it is difficult for him to sit still. And this is not connected with some kind of game - he needs movement in itself. He switches very quickly. He took one toy, played, then another. Also, he cannot keep his attention on something for a long time. He needs a switch, he gets tired quickly. Plus, it’s hard to calm down, he can’t fall asleep for a long time, ”says Demyanenko.
A child with ADHD finds it difficult to follow instructions and often does not even hear what is being said to him. Also, a small person cannot behave quietly and with restraint, even when there is no reason for concern. He talks loudly, laughs loudly, screams.
How common is ADHD
The disorder affects approximately 2-10% of children. Research data on this matter vary. In boys, pathology is diagnosed several times more often than in girls.
Some children outgrow this syndrome. That is, mental functions are restored as they grow older. But this is not always the case. In adulthood, the syndrome is present in 2-4% of people, French researchers report in their work. More than half of the people who were diagnosed with ADHD in childhood have symptoms of the disease that persist into adulthood, Anna Portnova, head of the Department of Child and Adolescent Psychiatry at the Moscow Research Institute of Psychiatry, a branch of the National Medical Research Center for Psychiatry and narcology named after V.P. Serbsky" of the Ministry of Health of Russia.
Adults show the same symptoms, including inattention, hyperactivity and impulsivity, and emotional dysregulation. If left untreated, in adulthood ADHD is superimposed in 80% of cases by other psychiatric disorders - anxiety disorders, neurodevelopmental disorders associated with the use of psychoactive substances, sleep disorders, restless legs syndrome. It's hard for people like that. All spheres of life "suffer" from this disease.
The degree of influence of ADHD on a person depends on his personal characteristics. One will be able to adapt and live normally, the other will go downhill. According to a recent study, among youth and adult offenders in police custody, prisons, probation and forensic psychiatric institutions, about 25% suffer from ADHD. They are at a disadvantage in the system because their symptoms are not recognized or misunderstood. Instead of providing psychiatric care, disciplinary sanctions are applied to them, which does not help.
Causes of ADHD
The work of the brain in children with ADHD and in healthy children is different, scientists from the Northern (Arctic) Federal University named after. M.V. Lomonosov. With a mental disorder, the energy metabolism in the frontal sections of the brain changes. They are the key links in the regulation of behavior and emotions, and are also responsible for the function of programming and control. There is a decrease in metabolism and a decrease in the functional connections of the frontal regions with other brain structures. With ADHD, the left and right hemispheres do not “get along” well with each other, the connections between them are broken. “Imbalances in the relations of regulatory subcortical-stem structures” are noted.
Doctors have not yet determined the exact cause of these disorders. It is believed that a significant role is played by hereditary predisposition. Also, ADHD in a child may develop due to the fact that his mother smoked during pregnancy, drank alcohol or drugs. The disorder may occur due to complications in childbirth or chronic illnesses of the mother.
Scientists from the Rostov State Medical University conducted a study and found that the uncontrolled use of digital technologies in childhood increases the symptoms of ADHD. And also leads to increased aggression and irritability, isolation, inability to control emotions, increased feelings of anxiety, anxiety and fear.
How to treat ADHD
Attention Deficit Hyperactivity Disorder needs to be diagnosed by several specialists. This is a neurologist or neuropathologist, as well as a neuropsychologist or clinical psychologist and psychiatrist. Only after making sure that the diagnosis is correct, you need to take action.
Not only drugs are important for a child, but also the right psychological and pedagogical approach, warns Anna Portnova. According to her, a good teacher will put such a student on the first desk and will try to keep his attention. And the bad one will send him to the last one and will constantly make comments, thereby aggravating the child’s condition.
Cognitive behavioral therapy performed by a psychologist or psychiatrist is also effective in the diagnosis of ADHD.
There are drugs that improve brain function and activate attention function. But in Russia there are few registered. We simply do not have many drugs that have proven effectiveness, says Portnova. And this is a big problem.
Therapy with a psychologist is a more affordable option for the correction of ADHD symptoms for Russians. And it is quite effective in most cases.
Still from the TV series The Good Doctor. Caption: The character on the show, Salen Morrison, has ADHD. She uses original methods for concentration: meditation, playing the ukulele, as well as many gadgets - fitness bracelets, tablets, etc.
How to live with ADHD as an adult
Attention deficit and/or hyperactivity disorder persists into adulthood. Experts say it is possible to adapt to this condition, even without the use of medication. A person with ADHD can be successful both in his personal life and in his profession. This can be achieved by controlling your habits, learning to recognize and use your strengths, and controlling your behavior.
Psychologists advise a person with ADHD to properly organize their workspace by removing unnecessary items from the table. For example, a stack of unnecessary papers or books. In order not to forget anything, you can make a to-do list every day. A great help for a person with this disorder can be a day planner, a calendar on a smartphone or computer. People with ADHD like to procrastinate. To avoid this, follow the principle: if a task can be completed in two minutes or less, do it now.
People with ADHD find it difficult to properly manage their time. To avoid this, psychologists advise using a watch. When you start doing work, write down the time and say it out loud. For each task, it is necessary to allocate a certain time period. This is easy to do using a timer or an alarm clock. Let it fire at regular intervals. This makes it harder to lose track of time, a common problem for people with ADHD.
Adults with Attention Deficit and/or Hyperactivity Disorder are often overly impulsive. They jump from one task to another. This may interfere with work. Experts recommend always starting with the most important task. The main mistake is to take on too much work.
