Research Assessment #6

Date: October 25, 2017

Subject: Attention-Deficit Hyperactivity Disorder

MLA Citation:

Harvard Health Publishing. “Attention-Deficit Hyperactivity Disorder (ADHD).” ​Harvard

Health Publishing ​, Apr. 2014,

www.health.harvard.edu/mind-and-mood/attention-deficit-hyperactivity-disorder-adhd​.

In the article from Harvard Health Publishing, the common mental issue of

Attention-Deficit Hyperactivity Disorder (known as ADHD) is discussed. Harvard Medical

School educated readers of what it is, symptoms, the diagnosis process, prevention, and

treatment. By reading this I received a thorough analysis to a mental blockage that is said to be,

incurable. After reading, I have a better understanding of what this dysfunction does to people

and how to aid those diagnosed with it.

This information is relevant to my learning, my topic, my ISM journey, and myself

because learning this is helping me achieve my goals. Not to long ago, my class and I created

goals that would ultimately benefit our development throughout Independent Study and

Mentorship. One of my commitments was to learn every mental illness by the end of this school

year, as well as medications that were used to treat, specifically, common mental disorders;

examples of frequent disorders include Depression, Anxiety, ADHD, and so on. In this case, I

am analyzing the Attention-Deficit Hyperactivity Disorder, to gain background information

regarding an illness I, potentially, will be required to treat.

 This information can be classified into three categories; its definition, early stages, and

treatment. ADHD is defined in its name- Attention-Deficit Hyperactivity Disorder. It is a

disability in which one may be disruptive or impulsive. Hyperactivity and impulsiveness often

improve as a person matures, but attention problems tend follow into adulthood. Harvard Health

Publishing states, “ADHD is the most common problem seen in outpatient child and adolescent

mental health settings;” meaning, this illness is easy to stumble upon for future reference. Early

symptoms of ADHD are difficulty organizing work, impulsiveness, easily distracted, restless

behavior, and the inability to stay focused. The diagnosis after recognizing these symptoms

involve a series of parent/teacher interviews, medical history paperwork, physical examination,

and psychological tests. This is what will determine if one has ADHD or not. Finally, there are

no cures for Attention-Deficit Hyperactivity Disorder; however, many helpful options are

available. Psychiatrists usually utilize medication and psychotherapy as a healthy combination to

achieve successful results in a patient. A common medication used to handle ADHD is,

Atomoxetine. Atomoxetine is a cognitive-enhancing medication that works in the ​brain​ to

increase attention and decrease restlessness in those who are hyperactive. This medication has to

be prescribed by a doctor before indulgence.

With the data I have discovered, I will store this information in my portfolio of psychiatry

to refer to when needed. In addition, I have a passionate desire to help those in need of mental

assistance, therefore this article will be used to further my ability when comprehending what it is

those who are sick have to go through. I will use this information to properly treat clients

diagnosed with Attention-Deficit Hyperactivity Disorder. Currently, I do not have any

prolonging questions regarding this subject; the article was very clear on what the disorder is,

how it affects patients, and how to treat those with it.

As a whole, this article from Harvard Medical School was very helpful to my learning.

Through reading this and deeply analyzing it, I have achieved my goal of learning a common

mental disorder, along with its medicative treatment.

Attention-Deficit Hyperactivity Disorder
(ADHD)
What Is It?
Published: April, 2014

Attention-deficit hyperactivity disorder (ADHD), usually first diagnosed in childhood, can

appear in a variety of forms and has many possible causes. People with ADHD
probably have an underlying genetic vulnerability to developing it, but the severity of the
problem is also influenced by the environment. Conflict and stress tend to make it
worse.

The main features of this disorder are found in its name. Attention problems include
daydreaming, difficulty focusing and being easily distracted. Hyperactivity refers to
fidgeting or restlessness. A person with the disorder may be disruptive or impulsive,
may have trouble in relationships and may be accident-prone. Hyperactivity and
impulsiveness often improve as a person matures, but attention problems tend to last
into adulthood.

ADHD is the most common problem seen in outpatient child and adolescent mental
health settings. It is estimated that ADHD affects between 5% and 10% of school-aged
children. Boys are more often diagnosed with ADHD than girls. Studies suggest that the
number of ADHD diagnoses has risen significantly over the years. But whether more
people have the disorder or whether it is just being diagnosed more often is not clear.
The definition of the disorder has changed over the past several decades and will
continue to develop as the experts explain more about the biology behind it.

The activity component is less apparent in adult ADHD. Adults tend to have problems
with memory and concentration and they may have trouble staying organized and
meeting commitments at work or at home. The consequence of poor functioning may be
anxiety, low self-esteem, or mood problems. Some people turn to substances to
manage these feelings.

Symptoms
The symptoms of ADHD — inattention, hyperactivity or impulsive behavior — often
show up first at school. A teacher may report to parents that their child won't listen, is
"hyper," or causes trouble and is disruptive. A child with ADHD often wants to be a good
student, but the symptoms get in the way. Teachers, parents and friends may be
unsympathetic, because they see the child's behavior as bad or odd.

A high level of activity and occasional impulsiveness or inattentiveness is often normal

in a child. But the hyperactivity of ADHD is typically more haphazard, poorly organized
and has no real purpose. And in children with ADHD, these behaviors are frequent
enough that the child has a harder than average time learning, getting along with others
or staying reasonably safe.

ADHD symptoms can vary widely, but here are common characteristics of the disorder:

● Difficulty organizing work, often giving the impression of not having heard the
teacher's instructions
● Easily distracted
● Excessively restless or fidgety behavior; unable to stay seated
● Impulsive behavior (acts without thinking)
● Carelessness
● Frequently calling out in class (without raising hand, yelling out answer before
question is finished)
● Failing to follow through with teachers' or parents' requests
● Difficulty waiting for his or her turn in group settings
● Unable to stay focused on a game, project or homework assignment; often
moving from one activity to the next without completing any

Many children with ADHD also show symptoms of other behavioral or psychiatric
conditions. In fact, such problems may be different ways that the same underlying
biological or environmental problems come to light. These associated conditions include
learning disabilities and disorders characterized by disruptive behavior.

● Learning disabilities​ — Up to a quarter of children with ADHD may also have

learning disabilities. This rate is much greater than the rate found in the general
population.
● Oppositional, defiant or conduct disorders​ — These behavior disorders,
which involve frequent outbursts of extremely negative, angry or mean behavior,
affect as many as half of all children who have ADHD. Children who have both
ADHD and behavioral disturbances are more likely to have a poor long-term
 outcome, with higher rates of school failure, antisocial behaviors and substance
abuse.

Diagnosis
There is no single test to diagnose ADHD. For a child, a pediatrician may make the
diagnosis, or may make a referral to a specialist. For adults, a mental health
professional generally performs the evaluation.

The clinician will ask about symptoms related to ADHD. Since, in children, many of
these characteristics are more likely to be seen in a school setting, the clinician will also
ask about behavior in school. To help collect this information, the evaluator will often
interview parents, teachers and other caregivers or ask them to fill out special
behavioral checklists.

Since other conditions may cause the symptoms of ADHD, the medical history and
physical examination are important. For example, the doctor may look for trouble
hearing or vision, learning disabilities, speech problems, seizure disorders, anxiety,
depression, or other behavior problems. In some cases, other medical or psychological
testing may be useful to check for one or more of these conditions. These tests can
sometimes help clinicians and teachers develop practical suggestions.

Expected Duration
In most children with ADHD, symptoms begin before age 7 and last through
adolescence. In some cases, symptoms of ADHD continue into adulthood.

Treatment
Although no treatment eliminates ADHD completely, many helpful options are available.
The goal of treatment is to help children improve social relationships, do better in
school, and keep their disruptive or harmful behaviors to a minimum. Medication can be
very helpful, and it is often necessary. Drug treatment by itself is rarely the answer.
Medication and psychotherapy together usually have the best results. For example, a
behavioral program may be put in place where structured, realistic expectations are set.

Stimulants, such as methylphenidate (Ritalin) and forms of amphetamine (Dexedrine),

have been used for many decades. They are relatively safe and effective for most
children to help them focus their thoughts and control their behavior. With the
development of long-acting forms of stimulants, one dose in the morning can provide a
day-long effect.

Despite their name, stimulants do not cause increased hyperactivity or impulsivity. If the
disorder has been properly diagnosed, the medication actually has the opposite effect.
Common mild side effects are decreased appetite, weight loss, stomach aches, sleep
problems, headaches and jitteriness. Adjusting the dose can often help eliminate these
problems. Stimulant drugs are associated with some serious concerns and side effects.

● Tics.​ There is some evidence that tics (uncontrolled movements) are more likely
in patients with a family history of tic disorders, but that is still controversial.
● Substance abuse.​ Although stimulant drugs can be and are abused, newer
research shows that they may actually reduce the risk of substance abuse for
people with ADHD.
● Growth delays.​ Experts disagree about the effects of stimulants on growth.
There is some evidence that children taking stimulants grow at a rate that is less
than expected. Some doctors recommend stopping stimulants periodically during
periods of expected growth.
● Cardiovascular risk.​ Children taking stimulants do show small increases in
blood pressure and heart rate. But major heart complications in children, teens
and adults taking these drugs are extremely rare. Stimulants do not bring an
excessive cardiovascular risk in children and adolescents, except in patients who
already had underlying heart defects or disease.

Since such risks vary widely depending on the individual, it is important to discuss the
potential benefits and risks of each treatment with your doctor.

Another potential problem, which is not strictly speaking a side effect, is that stimulants
can find their way to people other than the person being treated for ADHD. Called
"diversion," it is fairly common among adolescents and young adults. The drugs are
most often taken to improve academic performance. Some individuals do take
stimulants to get high.

Other non-stimulant medications are also available to treat ADHD. Atomoxetine

(Strattera) is as effective as stimulants for treating ADHD. It works by a different
chemical mechanism than stimulants. Atomoxetine is relatively safe, but carries a rare
risk of liver toxicity. The antidepressant, bupropion (Wellbutrin), is helpful in some
cases. It is also generally well-tolerated, but it should not be given to people with a
history of seizures.

Other treatment approaches, used alone or in combination, may include:

● Behavioral therapy​ — This refers to techniques that try to improve behavior,

usually by rewarding and encouraging desirable behaviors and by discouraging
unwanted behaviors and pointing out the consequences.
● Cognitive therapy​ — This is psychotherapy designed to change thinking to build
self-esteem, stop having negative thoughts and improve problem-solving skills.
● Social skill training​ — Developing social skills improves friendships.
● Parent education and support​ — Training classes, support groups and
counselors can help to teach and support parents about ADHD, including
strategies for dealing with ADHD-related behaviors.

Because many children with ADHD also are troubled by poor grades and school
behavior problems, schools may need to provide educational adjustments and
interventions (such as an individualized educational plan) to promote the best possible
learning environment for the child.

When To Call a Professional

Call your doctor if your child shows symptoms of ADHD, or if teachers notify you that
your child is having academic difficulties, behavioral problems or difficulty paying
attention.

Prognosis
ADHD can cause significant emotional, social and educational problems. However,
when ADHD is diagnosed early and treated properly, the condition can be managed
effectively, so children can grow up to have productive, successful and fulfilling lives.
Although some children appear to grow out of their ADHD as they reach their
adolescent years, others have lifelong symptoms.