things we are asked most often

1. What is ADHD?
2. Who is affected by ADHD?
3. Why do people get ADHD?
4. What are the main symptoms of ADHD?
5. How is ADHD diagnosed?
6. How is ADHD treated?
7. What is methylphenidate?
8. What is it like to have ADHD?
9. What is it like to live with someone with ADHD?
10. Is ADHD a life-long condition?

1. What is ADHD?
Attention Deficit Hyperactive Disorder is a condition that affects people of all ages but is most commonly identified as a problem in young people between 5 and 15. It is widely believed to be a neurobiological condition and has a wide-ranging impact on a person's behaviour. Despite big advances in research in the last 20 years, there remains a lot that is unclear about ADHD.

2. Who is affected by ADHD?
It is thought that ADHD has a significant impact on about 5% of young people in the UK. About 2% of the whole population seem to be seriously affected. ADHD affects not only the lives of those who suffer from it but also the people around them, especially family members, teachers and friends.

3. Why do people get ADHD?
It is still uncertain exactly why people get ADHD. Environmental causes have not yet been entirely ruled out but current research strongly indicates that biological factors are responsible. Many people with ADHD seem to have slight differences in the levels of some chemicals in their brains, but experts don't yet know what causes these, or even whether they are directly responsible for ADHD. There seems to be a tendency for ADHD to occur more than once within certain families but no hereditary pattern has been proven.

4. What are the main symptoms of ADHD?
ADHD manifests itself in 3 primary forms of behaviour: Hyperactivity, impulsivity and inattentiveness. Hyperactivity is typified by an excessive amount of movement, talking and fidgeting along with high levels of restlessness. Impulsivity may be observed in a lack of social restraint and a tendency to 'do' without thinking. Highly impulsive youngsters often get in trouble for interrupting and shouting out answers in class. Inattentiveness is characterized by an inability to concentrate and listen carefully. Inattentive people are easily distracted, forgetful, careless and disorganized. If inattentiveness is a problem in the absence of hyperactivity/impulsivity, experts tend to diagnose 'predominantly inattentive ADHD'. In the past this was often referred to as ADD (Attention Deficit Disorder) but the two have increasingly been brought under the single heading of ADHD.

5. How is ADHD diagnosed?
ADHD must be diagnosed by a medical professional and may be done on the basis of a combination of medical, psychiatric, educational, behavioural, personal, family and social histories. It is a difficult condition to diagnose as the main symptoms are found, to some degree, in most young people! It is a question, therefore, of the intensity of the symptoms and the impact they have on the life of the young person. To be diagnosed as having ADHD, someone must experience significant problems with symptoms in at least two different environments (eg. home, school, work, playing). There are no 'medical' ways of testing for ADHD such as blood-tests or scans. The diagnosis is made on the basis of an essentially observational assessment of behaviour. Further complications arise due to the commonality of the main symptoms of ADHD with other conditions and also the high incidence of other conditions co-existing with ADHD.

6. How is ADHD treated?
It is widely accepted the most effective treatment of ADHD involves a combination of strategies rather than any one single course of action. Making people aware of the situation is a good place to start as this gives the maximum possible chance for a young person with ADHD to be understood. Working with supportive parents, teachers and friends, a young person may identify the times of day in which they most struggle with their behaviour. Steps can be taken to aid concentration during these times. Much has been written about the effectiveness of using dietary control as a means of controlling ADHD. It is clear that different treatments work for different people. By far the most well-known and indeed controversial form of treatment for ADHD is the use of methylphenidate and other such CNS stimulants. These have been shown to have a high success rate in helping to manage the behaviour of young people with ADHD. However, there continues to be a sizable body of opinion that holds reservations about these Class B, Schedule 2 drugs and their use in treating young people with ADHD.

7. What is methylphenidate?
Methylphenidate is the active ingredient in Ritalin and other stimulant-based medicines prescribed to help control the behaviour of young people with ADHD. While many experts are still uncertain as to exactly why methylphenidate has the effect it does on ADHD, the fact remains that for over 90% of young people who try it, methylphenidate works. Young people taking Ritalin (or Concerta or Equasym) usually experience a heightened ability to concentrate and an improved capacity to control their behaviour. What makes methylphenidate so controversial is the fact that under the Misuse of Drugs Act it is classed as a Schedule 2 substance for its addictive nature and a Class B drug for its potency. This puts Ritalin in the same category as amphetamines like 'speed'. Unsurprisingly, concerns have been raised regarding the prescribing of such a substance to children as young as five years old. Furthermore, recent studies have highlighted the growing trend of methylphenidate being abused as a recreational drug. Add to this the questions of possible side-effects, and the ethical debate looks set to continue as the use of methylphenidate to control ADHD increases.

8. What is it like to have ADHD?
Having ADHD can be a tough experience. There are few areas of life it doesn't affect. The impact is perhaps felt most severely in relationships, education and self-image. Relationships are made difficult by ADHD because good communication is often impeded. Poor listening/concentrating skills combined with erratic assertiveness do not make interaction easy. This applies most strongly to family relationships where the effects of ADHD are most keenly felt. However, making and keeping friendships can also prove hard work. ADHD impacts education because hyperactivity and impulsivity are not conducive to a classroom environment and inattentiveness can impede learning. As a result of the negative consequences of ADHD on life, it is easy to see why a young person may have a negative self-image. In a culture where popularity and success mean so much, a youngster with ADHD can often feel at a loss of how to behave in a way that people find more acceptable or likable. Feelings of frustration, helplessness and even victimisation can mount and leave him/her down about life. However, while these negatives are very real, we should not forget that there are some definite positives about having ADHD. Youngsters with ADHD are usually energetic and enthusiastic as well as outgoing and creative!

9. What is it like to live with someone with ADHD?
It is also hard work for those who live with ADHD sufferers. Parents, in particular, face major challenges over a sustained period of time and the effects on siblings are significant too. A child with predominantly hyperactive ADHD may leave his/her parents feeling exhausted. For single-parent families the pressure is even greater on the one remaining guardian. The increased demand for parental attention of a child with ADHD can sometime make other siblings feel 'unimportant' and 'unloved'. For friends, too, socialising with a mate with ADHD can be a frustrating experience at times, although rarely a dull one.

10. Is ADHD a life-long condition?
Opinion is divided as to whether people ever truly grow out of ADHD. It is a condition defined by the extent to which the symptoms disrupt life. Therefore it is possible that even if the symptoms remain as strong as ever, a person may learn to better manage them and so reduce the their impact on daily life. By definition, ADHD now becomes an incorrect diagnosis because the symptoms are not ' significantly impairing ' the ability to live, work and relate to people. On the other hand, the discrepancy between figures given for the rates of ADHD in young people and adults may suggest that a sizable proportion of people ' grow out ' of the condition. This could be the effect of the brain developing to correct the earlier chemical irregularities or else the result of a person learning over a period of years to compensate for their behaviour. Opponents of this theory suggest that years of under-diagnosis are responsible for the difference in the figures given for juvenile and adult ADHD.