An Introduction to ADD and ADHD

What is ADHD and ADD?

As a teacher, I was aware of these conditions over 25 years ago, and like many at that time recognised the typical stereotypes, including the boy who was always swinging on his chair, twanging his ruler or wandering around the classroom. These particular children were often identified as hyperactive or hyperkinetic and needing extra physical and practical activities. ADD was poorly understood and rarely recognised as a separate condition.

Over time these conditions have been differentiated and better understood, described as ADD - attention deficit disorder and ADHD - attention deficit and hyperactivity disorder. Both conditions are linked, formed in childhood and cause a variety of challenges.

Nowadays we live in a society which celebrates diversity and it is preferable to view these conditions as another way of seeing and interacting with the world. The very term 'deficit' is unhelpful and prejudice. ADHD and ADD are part of a range of neurodiverse ways of being that make up the human population and should be understood from that perspective.

History of the condition

ADHD was identified in 1798 by a Scottish doctor Sir Alexander Crichton and then later by Sir George Frederic Still in 1902, when they observed children of normal intelligence having difficulty with attention and self-control. Boys were observed with the condition three times more than girls. Understanding of the condition 25 years ago was more skewed towards the hyperactive boy swinging on his chair, now we have a greater understanding of ADD and ADHD and particularly of how it is manifested in girls. Subsequently more girls are now being diagnosed with the condition.

In 1932, German doctors Franz Kramer and Hans Pollnow first used the term hyperkinetic to describe children who disturbed their school classes and could not get along with other children. Unfortunately this situation has not changed much, ADD and ADHD can children struggle to manage in some restrictive classroom environments and school structures. Teachers also find it hard to give children who suffer from ADHD and ADD the attention they need.

ADHD and ADD were included in the American Psychiatric Association’s "Diagnostic and Statistical Manual of Mental Disorders" in 1968 but it was still not properly understood and it has only come to the fore along with a variety of other neurodiverse traits as a topic of further research.

Genetic verses Environmental

The origins of these conditions are still unknown, although many psychologists believe ADD and ADHD are hereditary, other mental health experts and most prominently Dr Gabor Maté, a leading physician of ADHD and ADD and suffers from the condition himself, argues in his book ‘Scattered Minds’ that viewing it as a genetic trait is over simplistic. He explains that very few conditions are purely genetic and that a variety of factors including; a personality type with susceptibility (high sensitivity), a fast changing high stress modern world, trauma, inconsistent parenting and generational trauma. may trigger the condition.

Possibly the uncertainty and inconsistency children experience, due to a rapidly changing, fast paced, technology driven world may be responsible for the incidences of ADHD and ADD to be on the rise across the UK and US. A study carried out by UCL research discovered that there has been a 20 percent increase in ADHD diagnoses over the last 20 years and the incidences of ADHD were twice as prevalent in deprived areas.

Symptoms

There is no known brain scan or biological test that can definitively diagnose ADHD or ADD but for those who have this condition, the impact of symptoms can be debilitating. It can also make sufferers more vulnerable to other mental health problems including mood disorder, addiction and anxiety.

People who suffer ADD and ADHD recognise many or all of these key symptoms;

· absent mindedness,

· forgetfulness

· difficulty in concentrating,

· lack of motivation,

· creativity and high interest in specific things

· struggle to maintain interest in a task, leading to starting many things and not finishing anything satisfactorily

· problems with order and tidiness in the home or work environment,

· difficulty being on time,

· not filtering thoughts and speaking out of turn,

· intrusive thoughts

· self-berating

And specifically with ADHD

· difficulties in sitting still

· sleep problems

· the need to keep active in order to regulate mood

· poor impulse control

· mood dysregulation

Children with ADHD and ADD can struggle academically at school and can become socially isolated, either playing up to being the class clown or being ostracised entirely.

Adults can struggle to achieve academically and meet their aspirational targets. Meeting with repeated failure, damages self-esteem and reputation.

Diagnosis and medication

Diagnosis, especially in the initial stages, can offer a revelatory understanding of self and on the outset provide answers to many of the mysteries that have left sufferers baffled. It can lead to heightened self- compassion, self-acceptance and a better understanding of relationships with others. It can also mean that those who suffer from the condition can have access to drug treatment such as atomoxetine, dexaphetamine and methyphenidate. These medications help support higher concentration, increases focussed time and allows for more thinking space to reduce impulsive behaviours.

However, diagnosis should not limit sufferers or box them into a pattern of behaviour that is defined by a poorly understood fixed genetic model.

Gabor Maté, argues that a diagnosis of ADHD and ADD should not be viewed as the end point but as a beginning of personal growth. It can lead to a resolution and improvement in many of the frustrating and overwhelming aspects of the condition.

Those who have developed a fuller understanding of themselves, can begin to harness the many positive aspects of their personality;

· Creativity

· Energy

· Humour

· Sensitivity

· Heightened empathy

· Curiosity

· Originality

· Bravery

And many more.

When therapeutic support is useful

Counselling provides a platform to talk about the unique and personal journey that every individual client who has ADHD or ADD has been on. Discussions could be around coming to terms with a diagnosis, considering medication, recognising and managing symptoms. Therapeutic discussion could include helpful strategies such as Socratic thinking skills to overcome negative thought patterns, mindfulness and meditation to calm the mind and still the body. It could also include talking through traumatic events in a safe space and understanding how these may have a role to play in present behaviours. Life coaching can also be a supportive thinking model for those with ADHD and ADD as it helps to filter and focus actions and also support ADHD sufferers to follow through and complete tasks.

As a person centred therapist I support an understanding of the self.

Each client will come with their own agendas around what they wish to explore. They will recognise their own stressors and coping strategies have to be tailored to the individual. There is no one size fits all model.

Conclusion

We are becoming more aware of the varying ways the human brain works and the role of neurodiversity in creating social structures. We all have strengths and weaknesses and despite modern life throwing us apart and breaking up our social groups, if covid has taught us anything it is that we all need each other. We can continue to choose to see ADHD as a deficit or we can look upon it as another way of being. People who have experienced this condition have an important and unique way of looking at the world and tell us more about what it is to be human and how to live in a more caring and inclusive world.