In the past, ADHD was seen as a problem with hyperactivity and impulsivity. More recently it has become clear that there are additional problems: difficulty with focus, memory and other areas. Both types of ADHD (with and without hyperactivity) are caused primarily by a neurotransmitter (a chemical signal in the brain) called dopamine.
Although these teens have a normal amount of dopamine and other neurotransmitters, they don’t work they are supposed to. This causes symptoms such as difficulty paying attention; not being organized; having trouble finishing school work; or losing completed homework. “Time sense” is also one of the key elements; time for teens with ADHD is usually “now or never.” If they plan to do something later, it is almost impossible for them to remember to do it.
Here are some answers to frequently asked questions about ADHD:
Is it a ‘real diagnosis’?
In 1998 a Scientific Council examined if ADHD is a “real diagnosis” that can be treated effectively with medication, comparing it to other mental health disorders. Their conclusion was that of all of the mental health diagnoses, ADHD is the one that is most accurately diagnosed and most easily treated.
However because no blood test or x ray of the brain can be used to diagnose it, some people believe it is not a medical problem. All the opinions of celebrities, neighbors, and grandparents about this diagnosis create additional barriers. Make sure you’re getting accurate information from health care providers who are up to date on the clinical literature. If you’re looking on the internet, try to use trusted sites such as the CDC, Mayo Clinic, the American Academy of Pediatrics, or the American Psychological Association.
Is ADHD over-diagnosed?
It is also under-diagnosed—more of the latter than the former. The diagnosis was first identified more than 100 years ago, although it is likely that it was present for thousands of years; it occurs in perhaps 8% of teens; and that this is the same all over the world.
Aren’t there ways to treat it without using drugs?
A very large government study found that medication alone was highly effective in treating ADHD while increasing parenting skills alone led to no improvement. The combination of medication and increased parental skills (the parents had 6 weeks of 5-day a week training!) was more effective than medication alone. No “natural” treatments have been scientifically proven to be effective so far.
Isn’t it dangerous to take these drugs?
Teens with untreated ADHD are twice as likely to use street drugs as are other teens; those being properly treated have the same rate as other teens. Teens not on meds often “self-medicate” in order to feel better, taking stimulants such as meth or cocaine. Many teens like being on the meds—they say “I feel like me.” And there are risks of not taking drugs for ADHD. Such teens have 4 times the rate of auto crashes, with girls having 20 times the rate of unplanned pregnancy! Nearly 50% of adolescents with ADHD who are not being treated get into trouble with the law by the time they are 18 years old.
Will kids with ADHD have to take medication for the rest of their lives?
There are 3 possibilities, all about equally likely. One third “outgrow” it; one third manage their lives so they do not need meds (they go into careers that minimize the need to be organized and able to focus at all times—music, art, sports, sales, some computer work—remember that all of us focus better if we are doing something we really enjoy); and one third do need medication their whole lives.
Can we try the medications and see what happens?
The medications for ADHD are effectively very quickly, so you can tell in a matter of weeks if they are helping. Your teen can also stop taking them at any time—there are no withdrawal effects.
Talk to your medical provider if your teen’s grades are slipping and you don’t know why—and if he or she forgets to hand in completed homework. He or she may feel comfortable making this diagnosis, or can refer you to our Adolescent Clinic. Make sure you feel that your child has a good, thorough assessment and you have all your questions answered.