Can adhd make you tired


Fatigue in an adult attention deficit hyperactivity disorder population: A trans-diagnostic approach

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. 2017 Mar;56(1):33-52.

doi: 10.1111/bjc.12119. Epub 2016 Dec 5.

Denise C Rogers  1 , Antonia J Dittner  2 , Katharine A Rimes  3 , Trudie Chalder  4

Affiliations

Affiliations

  • 1 King's College London, King's Health Partners, (formerly Behavioural and Developmental Psychiatry Clinical Academic Group, Maudsley Adult ADHD Service, South London and Maudsley NHS Foundation Trust), London, UK.
  • 2 King's College London, King's Health Partners, Psychological Medicine Clinical Academic Group, Chronic Fatigue Research and Treatment Unit (formerly Behavioural and Developmental Psychiatry Clinical Academic Group, Maudsley Adult ADHD Service), South London and Maudsley NHS Foundation Trust, London, UK.
  • 3 Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's Health Partners, King's College London, UK.
  • 4 Department of Psychological Medicine, King's College London, Weston Education Centre, London, UK.
  • PMID: 27918087
  • DOI: 10.1111/bjc.12119

Denise C Rogers et al. Br J Clin Psychol. 2017 Mar.

. 2017 Mar;56(1):33-52.

doi: 10.1111/bjc.12119. Epub 2016 Dec 5.

Authors

Denise C Rogers  1 , Antonia J Dittner  2 , Katharine A Rimes  3 , Trudie Chalder  4

Affiliations

  • 1 King's College London, King's Health Partners, (formerly Behavioural and Developmental Psychiatry Clinical Academic Group, Maudsley Adult ADHD Service, South London and Maudsley NHS Foundation Trust), London, UK.
  • 2 King's College London, King's Health Partners, Psychological Medicine Clinical Academic Group, Chronic Fatigue Research and Treatment Unit (formerly Behavioural and Developmental Psychiatry Clinical Academic Group, Maudsley Adult ADHD Service), South London and Maudsley NHS Foundation Trust, London, UK.
  • 3 Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's Health Partners, King's College London, UK.
  • 4 Department of Psychological Medicine, King's College London, Weston Education Centre, London, UK.
  • PMID: 27918087
  • DOI: 10.1111/bjc.12119

Abstract

Objectives: Trans-diagnostic approaches suggest that key cognitive and behavioural processes maintain symptoms across a wide range of mental health disorders. Fatigue is a common clinical feature of attention deficit hyperactivity disorder (ADHD) in adulthood; however, empirical data supporting its prevalence are lacking. This study aimed to collate outcomes from outpatient services to (1) investigate the prevalence of fatigue in adults with ADHD, (2) examine symptoms of ADHD in adults with chronic fatigue syndrome (CFS), and (3) consider secondary clinical characteristics common to both disorder groups.

Methods: Measures of self-reported fatigue were compared across groups of adults with ADHD (N = 243), CFS (N = 86), and healthy controls (HC) (N = 211) using a between-subjects cross-sectional design. Groups were also compared on secondary clinical measures of functional impairment, mood, anxiety, sleep, self-efficacy, and their beliefs about the acceptability of expressing emotions.

Results: The ADHD group were significantly more fatigued than HC with 62% meeting criteria for fatigue caseness. ADHD symptoms were significantly greater in the CFS group than in HC. ADHD and CFS groups did not differ significantly on measures of functional impairment, mood, and self-efficacy. No significant differences were detected on measures of anxiety when items relating to physical restlessness were removed from the analysis.

Conclusions: Adults with ADHD experience greater fatigue than HC. Adults with CFS and ADHD share many trans-diagnostic clinical characteristics, including difficulties with low mood, anxiety, and reduced self-efficacy, which impact upon their overall functioning. Further research is required to investigate extraneous factors mediating fatigue severity in these clinical groups.

Practitioner points: Fatigue is a common clinical feature of attention deficit hyperactivity disorder (ADHD) in adulthood. Evidence-based interventions for chronic fatigue syndrome could be adapted to address fatigue in ADHD in adults.

Keywords: attention deficit hyperactivity disorder; chronic fatigue; trans-diagnostic.

© 2016 The British Psychological Society.

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Can ADHD make you tired?

Attention deficit hyperactivity disorder (ADHD) is a condition that affects attention, motivation, and executive functioning. It can also cause hyperactive or impulsive behavior, and some people with the condition say that it can also cause tiredness.

Anecdotal evidence from adults sharing ADHD stories online suggests that many experience brain fog, low motivation, and fatigue.

Tiredness is not part of the official diagnostic criteria for ADHD, but a handful of studies do suggest that some people with ADHD experience fatigue.

Keep reading to learn more about the links between ADHD and tiredness. This article also provides information on other symptoms and treatment options.

Hyperactivity is a hallmark of ADHD. This can cause a person to constantly be moving, talking, or fidgeting. Therefore, it might seem strange that ADHD could cause fatigue. However, for some people with ADHD, fatigue and hyperactivity are two sides of the same coin.

One 2019 study looked at a number of mental health symptoms in 97 nurses and 310 non-nurses. The study found a correlation in nurses who had ADHD and who experienced exhaustion. Exhaustion also correlated with the presence of several other mental health symptoms, including anxiety and depression. A 2017 study supported these general findings.

Researchers have not conclusively shown why ADHD causes fatigue in some people, but one possible explanation is the condition’s effects on dopamine.

ADHD can affect dopamine levels, making it more difficult for the body to respond to this important neurotransmitter. Dopamine plays an important role in motivation, reward, pleasure, emotional regulation, and executive function.

Low motivation or a low sense of reward from completing tasks may cause tasks to feel more exhausting. Also, decreased executive function can make it more difficult for a person to plan and organize their life, contributing to a sense of chaos that may cause feelings of overwhelm and fatigue.

There are several potential explanations for the connection between ADHD and tiredness.

ADHD can affect motivation. A person may find daily tasks overwhelming and struggle to complete them. This low sense of motivation can feel similar to fatigue, especially if a person feels unable to keep up with their responsibilities.

Additionally, the stress that ADHD may cause can feel exhausting, especially if a person’s symptoms are not well controlled. Missing deadlines, forgetting school work, and not meeting household demands may feel overwhelming or exhausting.

People with ADHD are also more likely to have another mental health diagnosis, such as anxiety or depression. Depression can also cause fatigue or excessive sleeping. Therefore, people with ADHD should be sure to seek proper medical advice. A doctor can assess their symptoms and consider the possibility that they may have another condition.

For some people with ADHD, fatigue is a symptom of their treatment rather than ADHD itself. For example, stimulant drugs can cause fatigue if a person stops using them suddenly, especially if they were taking high doses. Severe fatigue may also signal a stimulant overdose.

Brain fog can also be a symptom of ADHD. Researchers sometimes refer to this as sluggish cognitive tempo (SCT). Having SCT means that a person tends to move slowly, daydream often, appear disconnected from activities at school or work, work slowly, not seem very alert, and struggle to stay awake.

One 2020 study looked at 1,436 autistic children, 1,056 children with ADHD and no autism, and 186 neurotypical children.

The researchers asked mothers to rate their children on measures of SCT. The results revealed that SCT was more common in autistic children, 49% of whom scored 1.5 times standard deviations above the norm. Children with ADHD, however, also scored higher on this measure, at 40% for children with inattentive-type ADHD and 31% for those with combined ADHD.

This brain fog and SCT may happen for similar reasons to ADHD-related fatigue, including low motivation, high distractibility, difficulty with executive functioning, and issues with dopamine levels.

A number of other symptoms may look like fatigue or directly contribute to it. These include:

  • Difficulty listening: People with ADHD may constantly feel distracted or get bored easily. They may also frequently interrupt others or “zone out” at school or work.
  • Reward deficiency: Dopamine helps neurotypical people feel a sense of reward or accomplishment after completing a task. People with ADHD may not feel this sense of reward. This can make it hard to persist with challenging tasks and may cause a person to seem sleepy or disinterested even after an important accomplishment.
  • Avoidance of difficult tasks: Because it can be so difficult to focus on challenging tasks, some people with ADHD may avoid them.
  • Daydreaming: Daydreaming and other forms of distraction are common in people with ADHD. The person may appear checked out, disinterested, or chronically sleepy.
  • Feeling overwhelmed: Poor executive function can make it difficult for a person with ADHD to estimate how long a task will take. They may also find it challenging to plan or complete the task and remain focused on it when the time comes. This can make a person with ADHD feel overwhelmed, causing them to distract themselves, including by sleeping and daydreaming.

Although ADHD can present significant challenges, there do seem to be some benefits associated with having the condition, especially in relationships with others. Learn more here.

ADHD is treatable with the right support. Treatment generally works best when a person combines several options, such as classroom support and medication.

Some treatment options include:

  • Medication: Most people with ADHD take stimulant drugs such as methylphenidate. Some other drugs, such as antidepressants, may also help. It can take time to get the right drug dosage, so be sure to tell a doctor about all side effects and try to keep a log of how well the medication is working.
  • Trigeminal nerve stimulation: Trigeminal nerve stimulation is a type of noninvasive brain stimulation. The low electrical signals may reduce hyperactivity. The Food and Drug Administration (FDA) recently approved a trigeminal nerve stimulation device for children with ADHD who are not taking medication.
  • Therapy: Psychotherapy can help a person understand their diagnosis, develop coping skills, and manage their symptoms. It may also help with relationships. For example, couples counseling can help couples in which one partner has ADHD better manage and understand their symptoms.
  • Education and training: Parents and caregivers of children with ADHD need support and training to better manage the condition and understand the diagnosis. Family therapy, ADHD education programs, and parent training programs may help.
  • Accommodations: Having the right accommodations at work or school can greatly improve ADHD symptoms. For example, an adult may need a less distracting environment, while a child might need more time to complete their tasks. A number of federal laws in the United States require employers and schools to make reasonable accommodations.

The American Academy of Pediatrics (AAP) offers additional guidance for treating ADHD in children and teenagers. In children aged 4–6 years, the first line of treatment should be parent training in behavior management and classroom accommodations. Parents and caregivers should only add medication if these interventions do not improve the symptoms.

For older children, the AAP recommends a combination of behavior management, classroom accommodations, and medication.

ADHD manifests differently in each person who has it. Tiredness is just one of many symptoms that a person may experience.

The symptoms can change with time or circumstance, and a person may find that they need to change their treatment regimen as their symptoms shift. Receiving comprehensive care from a doctor and a mental health professional can help.

Parents or caregivers who think that their child may have ADHD should seek a comprehensive workup to rule out other diagnoses. They should then pursue a combination of treatments, including behavioral interventions and parental support.

causes, symptoms, signs, diagnosis, treatment of attention deficit hyperactivity disorder in children and adults

Symptoms of ADHD in children

Causes of pathology

Diagnosis

Treatment methods for ADHD

Prevention


Today, more and more children are being diagnosed with ADHD (Attention Deficit Hyperactivity Disorder). As a rule, it is diagnosed in children aged 6-8 years, when the child goes to school. It is at this time that it becomes obvious that the child has pronounced problems with behavior and perception of information.

ADHD is a neurological-behavioral developmental disorder. Pathology makes itself felt in childhood, but in the absence of timely therapy, it can persist into adulthood. According to statistics, ADHD is most common in boys, but can also occur in girls. If the pathology is not diagnosed and treated in a timely manner, this is fraught with poor school performance, the child may develop serious social problems, which increases the risk of substance abuse in the future.

Symptoms of ADHD in children

Consider some of the signs that may signal ADHD in children:

  • The child is constantly distracted, inattentive, when communicating with him there is a feeling that he is not listening to you.
  • It is difficult for him to keep his attention on the teacher's words for a long time, because of which the understanding of information also suffers.
  • Increased activity is observed - the child literally cannot sit in one place. Even during school hours, he can get up and walk around the classroom.
  • The child is impatient, cannot wait for his turn, constantly interrupts, answers questions without waiting for them to end.
  • Children with ADHD are characterized by emotional instability, which can be manifested by frequent mood swings: a child can suddenly become irritable, tearful, and restless for no reason.
  • Disorder is typical - children with this diagnosis often lose their belongings (for example, school supplies, money, keys).
  • Problems with sleep and appetite, with daily routine.

Additionally, some neurological abnormalities may be observed. For example, a child with ADHD may have poor motor coordination, resulting in some clumsiness. Also, in some cases, twitching of the facial muscles and trembling of the limbs are observed.

The first signs of attention deficit hyperactivity disorder are observed at the age of 2-3 years, but at this age it is difficult to determine whether they are a manifestation of pathology or normal age-related features.

However, if by the age of 6-8 years the child has not become more attentive and collected, this is an alarming sign that makes it possible to assume ADHD with a high degree of probability. That is why, if you have the above symptoms, you should definitely consult a doctor and start treatment.

Causes of pathology

There is no single reason for the development of ADHD. Many experts agree that the most common cause may be genetic mutations that lead to a disruption in the production of dopamine and the work of dopamine receptors.

Also, the causes of the development of attention deficit hyperactivity disorder may be the following factors:

  • Severe pregnancy, complicated delivery, including prolonged or rapid.
  • Use by the expectant mother during pregnancy of potent drugs, alcoholic beverages, toxic substances.
  • Serious pathologies suffered by a child at an early age, including craniocerebral trauma.
  • Psychological trauma in a child.
  • Fetal asphyxia.

It is also worth noting that this pathology has a hereditary predisposition. It was found that the presence of ADHD in parents significantly increases the likelihood of developing this syndrome in a child.

Diagnostics

The diagnosis of ADHD is not established only on the basis of existing complaints. To accurately confirm the diagnosis, it is necessary to conduct some examinations. First of all, you need to visit a neurologist, psychiatrist and psychologist.

During the consultation, the doctor collects an anamnesis, conducts various tests, conversations, and diagnostic surveys.

In order to identify the cause of the development of ADHD, consultations with other specialists may also be required, as well as instrumental and laboratory examination methods, such as: EEG, MRI of the brain, general and biochemical blood tests.

ADHD treatments

It should be noted that attention deficit hyperactivity disorder most often has a favorable prognosis (provided that therapy is started in a timely manner). It is possible to significantly improve the behavior and learning of the child.

Depending on the severity of the pathological process and the causes of its occurrence, the doctor may prescribe such types of treatment as:

  • Medical treatment: the patient may be prescribed sedatives, antidepressants, neurostimulants.
  • Cognitive behavioral therapy.
  • A clear daily routine: a balanced diet, good sleep.
  • Family therapy: if there are conflicts in the family, ADHD often develops against this background.
  • Biofeedback therapy: this method of treatment is aimed at training the child's ability to self-regulate their states with the help of computer game tasks.
  • Physiotherapy techniques, eg massage, exercise, kinesiotherapy.

Additionally, other methods of treatment can be used.

Prevention

Unfortunately, it is not always possible to prevent the development of ADHD. However, there are some factors that significantly reduce the risk of developing pathology. For example, the expectant mother should follow a healthy lifestyle, eat a balanced diet, give up bad habits. Before conception, it is desirable to undergo a complete examination, if necessary, to pre-treat existing pathologies.

Also, as a prevention of ADHD, the following recommendations should be observed:

  • The child should be active, walk outdoors more often.
  • The regimen of the day and meals must be clear.
  • Monitor the child's behavior, immediately stop unacceptable behavior on his part.
  • It is very important to build a trusting relationship between parents and children.
  • Family conflicts should be avoided.

At the first signs of ADHD, it is recommended to contact specialists who will help minimize the risk of developing more serious pathologies in the future.

You can learn more about the treatment of attention deficit hyperactivity disorder at a face-to-face appointment with a doctor. Be healthy!


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Markelov Gleb Vladimirovich

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