ADHD

What is ADHD?

Welcome to our comprehensive ADHD resource page.  Here, you’ll find valuable insights into ADHD, including its diagnosis, prevalence, symptoms, common co-occurring conditions, and practical strategies for support and management. 

What is Attention Deficit Hyperactive Disorder (ADHD)?

ADHD is one of the most common neurodevelopmental conditions in school-aged children with the essential features being a persistent pattern of inattention and/or hyperactivity and impulsivity at more severe degree than in typically developing children.

Depending on the primary symptoms and behaviours they exhibit, ADHD is generally classified into 3 different presentations under the DSM-5 diagnosis. These are predominately:

    • Inattentive
    • Hyperactive-Impulsive, or
    • Combined (which meets the criteria for both presentations)

Diagnosis and Prevalence

Diagnosis of ADHD requires severe and persistent difficulties involving either or both of two main dimensions:

    • ‘Hyperactivity-Impulsivity’ e.g. excessive running, climbing, fidgeting, difficulty playing quietly, acting without thinking, interrupting others) and/or
    • ‘Inattention’ (e.g. not seeming to listen, being forgetful, not following through on instructions, ‘daydreaming’, making ‘careless’ mistakes) – so the resulting subgroups include ‘Inattentive-type’ (formerly known as Attention Deficit Disorder or ADD), ‘Hyperactive-Impulsive type’, or ‘Combined-type ADHD.

The difficulties must also be:

    • Age-inappropriate (although in practice, younger children are more likely to be diagnosed)
    • Evident across at least two situations, such as home and school causing ‘functional impairment’ (but judgement of this is subjective, and complicated by co-occurring conditions and/or general ability).

Prevalence rates have increased over time, but vary widely both between and within countries, ranging from 2-5% in the UK and Europe to around 10% in the US and Canada.

ADHD is more common in males than females (although better recognition in females has been reducing this difference) and rates remain higher in children than adults (although the latter have risen steeply following removal of the criterion that difficulties must have been present since early childhood).

ADHD is better recognised amongst children, although more recently concentration has shifted to recognise its presentation in adults as well. Although attentional difficulties remain the most prominently reported feature of adult ADHD, other problems are apparent when tasks being carried out involve other advanced mental processes (known as executive function). For example, compared with other individuals, adults with ADHD have challenges in:

 

    • organising work
    • regulating emotions
    • managing interpersonal relationships
    • show difficulties relating to working memory, switching between tasks and inhibitory control

Learn more about diagnosis, prevalence and ADHD in our blog article, written by the world-renowned Dr Alex Richardson:  Understanding and Managing ADHD

Hyperactivity and Impulsivity

Hyperactivity refers to an elevated degree of activity that is considered inappropriate for a given situation.  For example, an individual with hyperactive ADHD may seem to be constantly in motion – jumping on furniture or not being able to sit still.

Impulsivity can be broadly defined as action without foresight (i.e., acting without thinking ahead).  High levels of impulsivity are associated with ADHD.  For example, suddenly climbing a high unsafe high wall without thinking of the dangers ahead.

Hyperactivity and impulsivity can present differently in each person, but some of the common signs include:

    • Physical restlessness and excessive fidgeting.
      • Engages in constant movement, such as tapping their hands or feet
      • Find it challenging to sit still, often fidgeting, shifting in their seat, or pacing
      • Leaves seat in situations where it is not appropriate.
      • Running or climbing a lot at the wrong times.
    • Excessive talking:
      • Interrupting others – Struggles with waiting their turn in conversation.
      • Blurting out the answers before someone finishes asking the question.
      • Starts conversations at inappropriate times.
    • Mental manifestations:
      •  Racing thoughts and difficulty maintaining focus.
    • Little or no sense of danger
      • Will act without thinking about the consequences of their actions.

Help and Support

Poor quality diets (rich in ultra-processed foods high in sugar and refined carbohydrates, unhealthy fats and artificial additives) are associated with both nutritional deficiencies and imbalances and ADHD-type difficulties.  Learn more about this in our blog articles:

For personalised one to one support to make dietary changes, book an appointment with one of our experienced registered nutritionists:

An occupational therapist (OT) can give guidance and practical strategies to make everyday tasks more manageable.  They can also assist with sensory issues which can create many challenges in everyday situations like classrooms, playgrounds, shops, restaurants, and other community settings.  There are various modifications, strategies and interventions that can be utilised to help support these sensory needs.  Learn more in our blog:  Sensory issues in ASD

We also highly recommend reading the following book:  Sensory Circuits – a sensory motor skills programme for children.  It provides information about setting up sensory circuits to prepare children to engage effectively for the day ahead – promoting physical, social, and emotional development.  Below is a list of behaviours that might suggest challenges with sensory processing and integration, indicating there may be potential benefits from trying sensory occupational therapy or sensory circuits:

    • A child who can’t sit still and constantly figets
    • A child who constantly wants to escape
    • A child who likes to run and run
    • A child who puts their hands over their ears and complains of everyday noises
    • A child who frequently craves danger
    • A child who always has to touch objects and people
    • A child who is constantly anxious

      There is the option to schedule an appointment with a sensory occupational therapist to help you feel more able to recognise and respond to your child’s, or your own, sensory needs, before they reach a state of hyper or hypo arrousal:

      Inattentiveness

      Inattention is characterised by the difficulty in maintaining focus or attention on a task or activity. It can also involve being readily distracted by external stimuli or overlooking crucial details.

      The main signs are:

        • Being disorganised
        • Trouble staying focused
        • Having a hard time paying attention to details
        • Making careless mistakes
        • Having trouble staying on topic while talking
        • Needing to change activity or task constantly
        • Unable to listen or to carry out instructions
        • Being forgetful – e.g., forgetting to bring lunch bag, missing appointments
        • Losing things – e.g., bag, keys, toys

      Help and Support

      Find out how food can affect ADHD type symptoms, including mood, behaviour, and sleep issues in our blog article:  Why Children’s Diets Matter For Their Mood and Behaviour

      Read the following blog article to gain an understanding how play therapy can help with ADHD difficulties:  Therapeutic Play

      Anxiety and ADHD

      For people with ADHD, and their family and friends, understanding the related mental health conditions and emotional challenges can be both important and helpful.

      Although it is not part of the ADHD diagnostic criteria, many individuals with ADHD do experience elevated levels of anxiety. Relatedly, both ADHD and anxiety disorders frequently occur together.

      Reports estimating the extent of this overlap vary, as they are dependant on the specific group being investigated. Some studies report rates of co‐occurrence between anxiety and ADHD as being higher than 25%, whilst other research estimates that almost half of adults with ADHD are living with an anxiety disorder.

      These conditions can simply exist simultaneously, or ADHD symptoms may contribute to the development of anxiety. It can be difficult to differentiate between anxiety disorders and ADHD as the two conditions can appear similar. For example, some signs that are common to both conditions include difficulty socialising, fidgeting, inattentiveness, and working slowly.

      Research also shows that females living with ADHD are more likely to experience a mood disorder, such as anxiety, than males. In fact, because females often present fewer overt symptoms of ADHD than males, professionals can sometimes diagnose a female with anxiety and miss the presentations of ADHD.

      Anxiety symptoms can be particularly taxing for many individuals with ADHD and their loved ones. Experiencing high levels of anxiety can lead to exhaustion, fatigue and burnout which can significantly affect someone’s quality of life, including their physical and mental health, work/school and social life.

      Help and Support

      Learn more about anxiety and depression in our blog article, and gain an understanding of everyday situations which may trigger feelings of stress and anxiety in individuals with ADHD:  ADHD, Anxiety and Depression – and gain an understanding of everyday situations which may trigger feelings of stress and anxiety in individuals with ADHD.

      MBCT (Mindfulness-Based Cognitive Therapy) and MBSR (Mindfulness-Based Stress Reduction) are well-established mindfulness programs that offer valuable support to individuals in managing a range of mental health challenges, including stress, anxiety, and depression. Learn more about these therapies in our blog article:  Mindfulness-Based Cognitive Function

      Food and nutrition are fundamental to mental health.  Learn more about which foods may be making mood disorders worse, and simple switches on how to improve mood in our blog article: The Sugar Rollercoaster

      Or, for personalised support please book an appointment with one of our nutritionists:

      Depression and ADHD

       

       

      A disproportionate number of individuals with ADHD experience depression.

      For some people, depression and ADHD just happen to coexist, but for others, depression is a result of ADHD challenges.

      There are some common symptoms of ADHD which overlap with those presented in a depressive episode, such as:

        • Changes in appetite
        • Disrupted sleep patterns.
        • Social withdrawal, often associated with depression, may also be displayed by individuals with ADHD, who might retreat not only due to emotional distress but also as a coping mechanism for sensory overwhelm.

      The relationship between ADHD and depression can also be cyclical, with each condition feeding into the symptoms of the other.

       

      Help and Support

      To learn more about the connection between anxiety, depression and ADHD, please view our in depth blog article: ADHD, anxiety, and depression

      For further information about how food can affect mental wellbeing, read our blog article: The importance of micronutrients in relation to mental health

      If you require further assistance please schedule an appointment with one of our nutritionists who can advise you on dietary changes that can support your mental wellbeing, and supplements that can help treat micronutrient deficiencies:

      ADHD and Autism

      It is not unusual for ADHD and ASD to be mistaken for the other as both conditions may involve trouble with focus and communication in certain situations. Moreover, the symptoms of ADHD can be masked by more prominent or noticeable ASD symptoms which complicates the diagnostic process further.

      Research suggests that between 30 and 50% of individuals with ASD showed ADHD symptoms, and two-thirds of individuals with ADHD showed features of ASD. Although these conditions have similarities and overlaps, they are still regarded as distinct conditions.

       

      Help and Support

      Gain a deeper insight into ADHD, autism, and frequently co-occurring conditions such as Dyslexia and Dyspraxia, by reading our blog article: Autism and common co-occurring neurodevelopmental conditions

      Learn how omega 3 fatty acids can affect autism and ADHD type symptoms in our blog article: Dietary omega-3s and autism: Can children benefit from consuming more dietary EPA and DHA

      In addition, understand how sensory occupational health can help support behavioural issues: What is sensory occupational therapy?

      If you require one to one support, book an appointment with our experienced occupational therapist:

      Additional Support

      Visit our dedicated ‘What can help’ pages:

      Each page is tailored for parents of neurodivergent children, and neurodivergent individuals, seeking resources to improve their wellbeing.  Here, you’ll find a wealth of information on nutrition and therapeutic support designed to positively impact mood, behaviour, and sleep in neurodivergent individuals.

      Shop supplements

      Get help from a nutritionist

      Important – This information is for insight and educational purposes. Identifying with any symptoms or experiences mentioned should not be taken as a substitute for a formal or clinical diagnosis of these complex conditions, nor the specific support required to support a particular individual. Please talk to a qualified health professional or GP for specific support.  If you are thinking about ending your life, please call 999 (UK) or go to A&E and ask for the contact of the nearest crisis resolution team.