Understanding ADHD | #FightTheStigma

By Sakuni Weerasinghe

“Malisha jabbers a lot. It’s like she can’t focus on what I’m saying. I think she does it on purpose. Just the other day, I asked her to do something for me and she took ages to do it. She’s always forgetting about deadlines. You know what, it’s just pure laziness. I mean she can try a bit harder. I haven’t even bothered talking to her about her behaviour. No point, ne?”

Have you ever been part of similar conversations? Often, we hear or speak about our friends and family members, both young and old, this way, but we never take the time in trying to understand what is happening. We resort to judgment, and label people as “lazy”, “unmotivated”, or give them unsolicited advice like, “you just need to try harder to get yourself together”. A lot of the complaints made about Malisha in the description above match the signs of ADHD. 

ADHD refers to Attention Deficit Hyperactivity Disorder. It is considered to be one of the most common neurodevelopmental disorders, with both children and adults experiencing its signs. According to the statistics presented by the Centres for Disease Control and Prevention (CDC), a national survey with parents conducted in 2016 found 6.1 million (9.4%) children in the US to be affected by ADHD. It was also found that two out of three children had at least one co-occurring condition, with some experiencing anxiety problems, depression, and/or behavioural or conduct problems. While the worldwide prevalence for ADHD in children is estimated to be 5%, the worldwide adult ADHD prevalence is at 2.8%, according to a study conducted in 2016. 

In children presenting signs of ADHD, you would notice them having considerable difficulty staying still, constantly squirming, or fidgeting. They may also forget things frequently and have trouble staying on task and following instructions, which are particularly highlighted as they start schooling. They may also have trouble taking turns for example, while playing with others. Parents would hear complaints about the child interrupting others in the class and/or about the child’s poor performance in school, especially pertaining to tasks that require them to sit and concentrate for extended periods of time. As they move towards adolescence, they may have trouble reading social cues and experience difficulty getting along with others.

While the signs usually start appearing in childhood and continue to adulthood, in some cases, they may not be as apparent until the person is an adult. If interventions are not done on time, the features presented in adults such as difficulty paying attention, restlessness, and impulsive behaviours, can have a significant impact on the person’s daily functioning. Their occupational functioning can be particularly affected as they may take extra time to complete tasks at work, owing to struggles with time management and being distracted often. Their social life can be affected due to experiencing difficulties focusing on conversations due to distractions and low tolerance of frustration. 

When it comes to making diagnoses, professionals differentiate between three main types: 

• Predominantly inattentive: Mainly characterised by difficulties in sustaining attention and following through on instructions
• Predominantly hyperactive-impulsive: Mainly characterised by constant fidgeting, appearing disinhibited when it comes to social interactions and impatience
• Combined hyperactive-impulsive and inattentive type: Exhibit both inattentive and hyperactive-impulsive signs

Having explored the signs of ADHD, let’s take a look at some common beliefs and misunderstandings about ADHD in order to clarify and correct them.

Misunderstanding: ADHD is not a real condition. You are not allowing kids to be kids.

It is worth stressing that many signs of ADHD can be typical childhood behaviours, and it might be difficult for the average person to discern what a sign of ADHD is and isn’t. While many may have moments of inattentiveness and impulsiveness, for the children experiencing ADHD, these are more than a few random occasions. In fact, they could be pervasive patterns that can cause significant problems in the child’s life, both in school and in interacting with others. It is necessary to consult a mental health professional to make a formal diagnosis which can be conducted through interviews with the child, his/her parents, and teachers, and clinical assessment tools.

Misunderstanding: They just need to be adults and try a little harder

When it comes to adult ADHD, there is a common misconception that people need to try harder and “be an adult”. This statement reflects a lack of understanding of how difficult it can be to manage the signs of ADHD and makes it seem as though people are behaving that way purposely. For example, needing more time to complete assignments, making seemingly careless mistakes, and forgetfulness may be misconstrued as “laziness” and bad behaviour. However, it is vital to remind ourselves that these are signs of a condition. This means that these displayed behaviours are explainable by the condition that occurs due to a complex interplay of biological (genetic, neurological, and structural differences in the brain) and environmental factors (exposure to toxins, poor nutrition, or substance use during pregnancy).

Misunderstanding: ADHD is caused by poor parenting

As a nation that places great value on family, parents, and the relationships we have with our primary caregivers, people are quick to point fingers at parents if they notice any concerns with children. Parents may often be blamed for their “poor parenting”, specifically “not teaching the child some discipline”, which many see as a cause for the signs of ADHD. Any child, with ADHD or without, may struggle to cope in a toxic family environment with parenting characterised by harsh punishment and relentless criticism. However, it is not a direct cause of the ADHD condition. 

There are many treatment modalities available to work with the signs of ADHD including pharmacotherapy, psychotherapy, and specific behavioural interventions. In helping someone manage the signs of ADHD, it is necessary to encourage them to build routines that add more structure to their lives. 

As a parent, you can;

• Give clear instructions to the child
• Reward appropriate behaviour
• Help them keep their belongings in a designated area in the house
• Encourage them to finish their homework by taking short breaks
• Remain a positive role model 
• Pay attention to their strengths
• Discuss with the child’s teachers on how to better help the child with school work

As an adult coping with the signs of ADHD, you may;

• Reduce multi-tasking
• Use reminders
• Keep a planner and record deadlines
• Keep a daily to-do list at your work desk
• Practise mindfulness
• Take care of yourself by making sure your diet is healthy, you get adequate quality sleep, and enough exercise

It is crucial that all of us fight against the stigma and correct any misunderstandinga we or others may have about the condition. This way, we will be of better support to those experiencing its signs by creating a space to understand and accommodate their needs. It’s important to keep in mind that professional support and resources are available to help you manage the signs of the condition, and the start is through an accurate diagnosis by a qualified professional.