Table of Contents

What is ADHD?

ADHD (Attention Deficit Hyperactivity Disorder) is a condition that affects how a person thinks, focuses, and controls their behavior. It is most commonly diagnosed in childhood, though symptoms often continue into adulthood. ADHD can also be diagnosed in adulthood. People with ADHD may have trouble sitting still, paying attention, or following through with tasks. They might act impulsively or get distracted easily.

According to the Centers for Disease Control and Prevention (CDC), as of 2022, about 11.4% of children in the United States have been diagnosed with ADHD (about 7 million children aged 3-17 years old). ADHD is diagnosed more frequently in boys than girls, with boys being about two times more likely to be diagnosed. ADHD in girls is often underdiagnosed or diagnosed later in life. The National Institute of Mental Health (NIMH) also reports that 4.4% of adults in the United States have ADHD, with many adults often going undiagnosed.

Types of ADHD

ADHD is commonly classified into three types, based on the symptoms that are most evident in an individual. These types are:

  1. ADHD, Inattentive Type
    People with this type primarily struggle with inattention. They may have difficulty focusing, staying organized, or completing tasks. Symptoms include being easily distracted, making frequent mistakes due to carelessness, forgetfulness, struggling with executive function tasks, difficulties staying focused on tasks or conversations, difficulties with organization, and trouble remembering and following through with instructions or processes.
  2. ADHD, Hyperactive-Impulsive Type
    In this type, hyperactivity and impulsivity are the dominant features. People may act without thinking, have difficulty sitting still, fidget constantly, have difficulties waiting, and may talk excessively or interrupt others frequently.
  3. ADHD, Combined Type
    This is the most common type of ADHD, where both inattentive and hyperactive-impulsive symptoms are present. People with combined type ADHD show a combination of inattention (difficulty focusing, forgetfulness) and hyperactivity/impulsivity (impulsive actions, fidgeting) symptoms.

ADHD Signs and Symptoms in Children

Attention Deficit Hyperactivity Disorder (ADHD) in children can manifest in a variety of ways, often involving problems with attention, impulse control, and hyperactivity. These behaviors may interfere with a child’s ability to perform well in school, interact with peers, and follow everyday routines. Some signs and symptoms include:

  • Difficulty staying focused on tasks: The child may frequently make careless mistakes due to a lack of attention or seem easily distracted by external stimuli.
  • Forgetfulness: They might forget to complete chores, homework, or other responsibilities.
  • Difficulty organizing tasks: This could include struggles with time management, typical routine/processes, or organizing schoolwork and activities.
  • Avoidance of tasks that require sustained mental effort: Children may try to avoid homework or other tasks that need them to focus for a long time.
  • Fidgeting or squirming: A child may have trouble sitting still, especially in situations where they are expected to be seated, such as in the classroom or at the dinner table.
  • Constant movement: Children may get up and move around when it’s not appropriate, such as during class or meals.
  • Excessive talking: They might talk nonstop, interrupt others, or be unable to wait for their turn in conversations.
  • Interrupting others: Children might interrupt conversations or games, not waiting for their turn.
  • Difficulty waiting: They may find it hard to wait in line or for their turn in games or group activities.
  • Making hasty decisions: This could lead to risky behavior, like running into the street without looking.
  • Difficulty following through on processes or instructions: Children may start tasks but have trouble finishing them.
  • Trouble with relationships: Because of their impulsive and sometimes disruptive behaviors, children with ADHD may struggle to maintain friendships or get along with others.
  • Mood swings or irritability: Children may become easily frustrated or angry, especially when they are unable to complete tasks or meet expectations.

ADHD Signs and Symptoms in Adults

ADHD often continues into adulthood, although the symptoms may look different compared to childhood. While children tend to show hyperactivity and impulsive behaviors, adults with ADHD may experience difficulties with focus, organization, time management, and emotional regulation. Some signs and symptoms include:

  • Difficulty concentrating: Adults may have trouble staying focused during work meetings, conversations, or while reading.
  • Easily distracted: They may get sidetracked by external stimuli or stray thoughts, making it hard to complete tasks.
  • Poor time management: Chronic lateness, missed deadlines, or procrastination are frequent issues.
  • Forgetfulness: Forgetting appointments, commitments, or daily tasks like paying bills or returning phone calls.
  • Disorganization: Problems with keeping track of important documents, tasks, or items, often resulting in a cluttered workspace or home.
  • Feeling restless: A constant need to move, whether it’s fidgeting, tapping, or pacing, especially when expected to sit still for long periods.
  • Difficulty relaxing: Adults may find it hard to unwind or stay calm, often feeling like they need to be doing something constantly.
  • Impulsivity: Making hasty decisions without thinking through the consequences, such as spending money impulsively, acting without considering risks, or interrupting others in conversations.
  • Interrupting conversations: Adults may frequently interrupt others or struggle to wait their turn in discussions.
  • Risk-taking behaviors: Engaging in impulsive behaviors, such as risky driving, substance abuse, or gambling.
  • Difficulty in maintaining relationships: Impulsive or reactive behaviors, such as being quick to anger, can strain personal and professional relationships.
  • Low frustration tolerance: A tendency to get easily frustrated or upset over minor issues.
  • Mood swings: Rapid changes in mood, such as feeling elated one moment and deeply discouraged the next.
  • Chronic stress: Feeling overwhelmed by daily tasks, which can lead to anxiety or depression.
  • Chronic procrastination: Avoiding tasks until the last minute, leading to rushed, incomplete, or poor-quality work.
  • Underachievement: Despite being capable, adults with ADHD may underperform in their careers or personal lives because of difficulties with focus and organization.
  • Frequent job changes or issues with employment: A pattern of switching jobs or struggling to maintain a consistent work routine due to issues with time management or focus.

ADHD Signs and Symptoms in Girls/Women

ADHD can present differently in girls/women compared to boys/men, often leading to underdiagnosis or misdiagnosis. While the core symptoms of inattention, hyperactivity, and impulsivity remain the same, girls/women tend to display more subtle symptoms, which may be overlooked, especially in academic or social settings. Symptoms of ADHD in girls/women often include a combination of inattention, emotional dysregulation, and less overt hyperactivity. Some signs and symptoms include:

  • Easily distracted: Finding it hard to concentrate on tasks like homework or conversations, often becoming easily distracted (girls) and becoming distracted by external stimuli, like children, work, or daily tasks, making it difficult to complete tasks (women).
  • Disorganization: Struggling to keep track of school materials and personal belongings (girls) and appointments, schedules, or even daily tasks (women).
  • Forgetfulness: Forgetting to complete tasks or misplacing items like schoolwork, assignments, or personal items (girls), important dates, tasks, or obligations, which can feel overwhelming, especially in busy family or work environments (women).
  • Heightened sensitivity: Intense feelings of frustration or irritability, especially when faced with tasks requiring sustained effort (girls), sensitive to stress, criticism, or negative feedback, leading to mood swings or emotional outbursts (girls and women).
  • Feelings of inadequacy or low self-esteem: The challenges of living with undiagnosed ADHD might cause girls and women to feel incompetent or overwhelmed by their inability to meet expectations (girls) and the demands of daily life (women).
  • Restlessness and anxiety: Girls may talk a lot or have difficulty sitting still and may feel constantly “on edge” or restless, expressing it through daydreaming or being easily distracted. Women may feel a constant need to be doing something or may experience feelings of anxiety due to internal restlessness.
  • Impulsive decision-making: Women may engage in impulsive behaviors like overspending, poor time management, or even relationship instability.
  • Social Anxiety: Girls may struggle with social cues, leading to problems with peer relationships and may feel anxious about interacting with others, especially when they sense they are different or misunderstood.
  • Masking: Many girls and women with ADHD learn to “mask” their symptoms, meaning they hide their struggles in order to meet social expectations leading to mental health difficulties.
  • Overcompensation: Girls may try to compensate for their struggles by putting extra effort into their work or appearance. Women may overachieve in other areas of life, like work or parenting.
  • Perfectionism: Trying to be perfect to avoid criticism or to meet the expectations of teachers, parents, peers (girls), coworkers, bosses, and family members (women).

Lifestance Health specializes in ADHD (Attention Deficit Hyperactivity Disorder) treatment with multiple locations in 33 states. Services and available treatments vary by location.

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Testing and Diagnosing ADHD

ADHD is diagnosed through a comprehensive process that involves gathering detailed information from multiple sources and using standardized evaluation tools. The process differs slightly between children and adults but generally includes similar steps.

The diagnostic process for children involves a detailed evaluation by a healthcare professional, typically a pediatrician, psychologist, or psychiatrist. The key steps in diagnosing ADHD in children include a clinical interview and medical history, parent and teacher reports and rating scales, behavioral observations, psychological testing, and ruling out other developmental disabilities and mental health conditions.

Diagnosing ADHD in adults can be more challenging because many individuals with ADHD were not diagnosed as children, and symptoms may be more subtle or masked by coping strategies. The process includes clinical interviews, self-report questionnaires, collateral information from family members, psychological testing, and ruling out other mental health conditions.

Causes of ADHD

The exact causes of ADHD are not fully understood, but research suggests that it is likely the result of a combination of genetic, environmental, and neurological factors. ADHD is considered a neurodevelopmental disorder, meaning it affects the brain’s development and functioning, particularly in areas related to attention, impulse control, and executive function. Possible causes include genetic factors, as it tends to run in families; neurological factors such as differences in the size and activity of certain areas of the brain; environmental factors such as prenatal exposures, premature births, and lead exposures; and social and psychological factors such as early childhood traumas, chronic stress, and a chaotic or highly stressful home environment.

Treatment of ADHD

The treatment of ADHD typically involves a combination of behavioral therapies (cognitive behavioral therapy, CBT, parent training), educational interventions (IEP, 504-plan, behavioral classroom management), and, in many cases, medication (stimulant, non-stimulant medications). Treatment is individualized, with the approach depending on the age of the individual, the severity of symptoms, and any co-existing conditions. In addition to medical treatment and therapy, certain lifestyle changes can support the treatment of ADHD such as regular physical exercise, a healthy diet, getting enough sleep, and practices such as meditation and mindfulness may help individuals with ADHD improve focus and reduce stress.

References

Affects focus, attention and behavior and can make learning challenging (n.d.). Learning Disabilities Association of America. Retrieved Dec. 17, 2024 from https://ldaamerica.org/disabilities/adhd/

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Barkley, R.A. (2014). Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment (4th ed.). The Guilford Press.

Barkley, R.A. (2015). Taking charge of ADHD: The complete, authoritative guide for parents (3rd ed.). New York: The Guilford Press.

Centers for Disease Control and Prevention (Nov. 19, 2024). Data and Statistics on ADHD. Centers for Disease Control and Prevention. Retrieved Dec. 17, 2024, from https://www.cdc.gov/adhd/data/?CDC_AAref_Val=https://www.cdc.gov/ncbddd/adhd/data.html

Hallowell, E. M., & Ratey, J. J. (2011). Driven to distraction: Recognizing and coping with attention deficit disorder from childhood through adulthood (rev. ed.). Anchor Books.

Nadeau, K., Littman, E., & Quinn, P. O. (2015). Understanding girls with ADHD: How they feel and why they do what they do. Guilford Press.

National Institute of Mental Health. (n.d.). Attention-deficit/hyperactivity disorder (ADHD). National Institute of Mental Health. Retrieved December 17, 2024, from https://www.nimh.nih.gov/health/statistics/attention-deficit-hyperactivity-disorder-adhd

Smith, T. E. C., Polloway, E. A., Patton, J. R., Dowdy, C. A. (2013). Teaching Students with Special Needs in Inclusive Settings. United Kingdom: Pearson.

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Erica Kalkut, PhD, LP
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Dr. Kalkut is an Executive Clinical Director at LifeStance Health, serving as head of the Psychological and Neuropsychological Testing Services. She is a licensed psychologist who is board certified in Clinical Neuropsychology by the American Board of Professional Psychology (ABPP). Dr. Kalkut’s training includes a doctorate in clinical psychology from Loyola University Chicago with a focus in neuropsychology, a pre-doctoral internship in clinical neuropsychology at Rush University Medical Center in Chicago, and a two-year post-doctoral fellowship in pediatric neuropsychology at the Medical College of Wisconsin in Milwaukee. As a pediatric neuropsychologist, Dr. Kalkut has expertise in evaluating developmental, learning, behavioral, and emotional problems from infancy through college-age. She has specialized training in working with young children and adolescents with various medical, neurological, and genetic disorders. In addition to clinical practice, Dr. Kalkut has focused interest in clinical training, research, and professional advocacy. She has research projects aimed at better understanding the impact of neurologic issues on development, cognition (including executive functioning), and mental health; she has scholarly articles and a book chapter published on these topics. Dr. Kalkut holds interest in professional advocacy and has held several leadership positions within the Society for Clinical Neuropsychology, Division 40 of the American Psychological Association (APA). Dr. Kalkut brings her passion and expertise in working with patients and clinicians to every aspect of her work at LifeStance, helping to provide increased patient access to PNT services and fostering a collaborative approach to behavioral health care.
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Stephanie Bader, PhD, LP
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Dr. Bader is a NY licensed psychologist and behavior analyst, as well as a Board-Certified Behavior Analyst (BCBA). She has over 10 years of experience working with individuals with autism spectrum disorder (ASD), developmental and intellectual disabilities, and other challenging behaviors using evidence-based behavioral interventions. Her clinical and research interests include the development of behavioral interventions and parent-training to increase adaptive behaviors (daily living skills, communication skills, social skills) and reduce maladaptive behaviors (noncompliance, tantrums, aggression) in individuals with and without a developmental disability. Dr. Bader enjoys working with clients and their families to address unique challenging behaviors while building the parent’s skills to continue to manage behaviors that may arise both in the present and in the future. She received her PhD in Clinical Psychology from the University of Southern Mississippi in Hattiesburg, Mississippi. She then attended internship at the University of Arkansas for Medical Sciences (UAMS) and the Arkansas Children’s Hospital (ACH) in Little Rock, Arkansas and went on to complete her postdoctoral fellowship at the Kennedy Krieger Institute (KKI) and John’s Hopkins Hospital in Baltimore, Maryland.
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Mindy Perry, MSW, LICSW
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Mindy Perry is a licensed clinical social worker who has been in practice since 1998. She has a background in inpatient psychiatric, partial hospitalization, intensive outpatient program, and outpatient therapy. Mindy earned her bachelors in psychology from the University of California, Riverside and her master of social work from University of Denver. She has been offering outpatient psychotherapy since 2011 to adult individuals, couples and groups. Mindy comes from a position of partnering with the individual or couple to live according to their own values. When a person connects with their values, it provides clarity in decision-making and behavior. She helps individuals come to a place of acceptance and mindful awareness in their own lives, focusing on what they can control. Mindy specializes in boundaries and communication in relationship issues. A couple of Mindy’s specialties include people in life transitions (such as young adults or parents with children who are becoming independent), ADHD, and couples (Mindy has been trained through Level 3 of the Gottman Method). In her spare time, Mindy enjoys traveling, hiking, spending time with family, and cooking. If the sun is shining, you will find Mindy there.