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ADHD

ADHD – what you need to know

Attention Deficit Hyperactivity Disorder or more commonly known as ADHD appears to be this label placed upon “naughty” children left, right and centre. Unfortunately this does not help to break the stigma and often garners criticism on those who have been legitimately diagnosed.

To better understand this disorder, Mopani Pharmacy consulted a local clinical psychologist, Nicola Munro.

Disclaimer: This article is not meant to diagnose or indicate treatment of ADHD, but rather as a guideline of what to look out for and relevant questions to ask your doctor, paediatrician or pharmacist, in case a referral is needed. 

How is ADHD diagnosed?

ADHD

“ADHD is predominantly diagnosed by paediatricians, psychologists or psychiatrists. We gather information from extensive testing, screening and a clinical interview with the patient. We also get some input from the patient’s family or perhaps a teacher if the patient is a child,” Nicola explained.

The combination of sources of information should then reveal a pattern of symptoms which will lead to a diagnosis, “However, even then a diagnosis may be clouded as there is significant overlap in symptoms between ADHD and other disorders including anxiety- , behavioural-  and mood disorders in adults and children”, she said.

ADD or ADHD?

“Previously, there was a distinction between the two; however, the DSM-5 has discarded the division and views is as one condition with three possible subtypes. You could be (1) primarily inattentive, (2) primarily hyperactive-impulsive or (3) a combination of the two”, Nicola explained.

To have a diagnosis of ADHD (1), you need to have 6 or more of the following symptoms:

  • Careless mistakes in schoolwork / work / activities and failure to pay attention to detail
  • Difficulty sustaining attention in tasks or play activities
  • Not seeming to listen when spoken to directly
  • Failing to complete schoolwork / chores / duties at work when instructed
  • Difficulty organising tasks / activities
  • Avoids /dislikes /reluctant to engage in tasks that require sustained mental effort
  • Misplacing things needed for task or activity
  • Distracted easily by extraneous stimuli
  • Forgetful in daily activities

To have a diagnosis of ADHD (2) you need to have 6 or more of the following symptoms:

  • Fidgets with hands / feet or squirms in seat
  • Often leaves seat when it is expected to sit still such as work / classroom
  • Runs / climbs even in situations where it is deemed inappropriate (In adults / teens this may present as a feeling of restlessness)
  • Unable to play or engage in leisure activities quietly
  • Is often “on the go” as if “driven by a motor”
  • Talks excessively
  • Blurts out answers before a question or sentence was completed
  • Difficulty waiting their turn
  • Interrupts or intrudes on others

“Those who are diagnosed as ADHD (3) will meet the criteria of both ADHD (1) and (2), and in all three cases, it may be mild, moderate or severe”, Nicola explained.

How would the disorder present in children vs. teens or adults?

“Most of it overlaps, but there are some differences”.

Inattention

“It is normal for those with ADHD to miss important information and to keep track in conversations or follow directions. Children will often avoid asking for guidance as they fear humiliation”, she said.

Impulsivity

“Both children and adults may have difficulty regulating their emotional responses, interrupting others, not waiting their turn or looking for instant gratification. Adults may spend money impulsively.”

Hyperactivity

“In children, hyperactivity may be more obvious as they run, jump and climb constantly, diving off furniture etc. In adults, and sometimes children, this hyperactivity can be subtle; they fidget, bite their nails, twirl their hair, swing or bounce their legs”, she explained.

“Talking fast and excessively is also common. Both children and adults may have difficulty reading social cues or personal boundaries. Children may be seen as the class clown. Adult conversations are often coloured with jokes” Nicola concluded.

An example of ADHD

The following description is summarised from Gabor Mate’s book Scattered Minds, and is typical of the everyday experience of an adult with ADHD:

“You decide to clean your room which, typically, looks like a tornado has just passed through. You pick a book off the floor to replace it on the shelf. As you do so, you notice that two volumes of poetry are not stacked side by side. Forgetting the debris on the floor, you lift one of the volumes to place it beside its sibling. Turning a page, you begin to read a poem. This leads you to your guide to Greek mythology; one reference leads to another. An hour later, you return to your intended task. You are hunting for the missing half of a pair of socks, when another item of clothing on the floor reminds you that you have laundry to do. As you head downstairs, laundry hamper in arm, the telephone rings. Your plan to create order in your room is now doomed.” (p12)

Variants in behaviour

“In both adults and children, ADHD may manifest differently depending on the situation. There may be significant inconsistency from classroom to classroom or from work to other contexts.  If a child is disinterested in a particular subject they may be scattered, distracted, unproductive and possibly disruptive to other students.  On the other hand, if a child is interested in a particular subject, they are able to focus well and perform with excellence.  Motivation and interest are the requirements for what is termed hyper focus in individuals with ADHD.”

“These children are not being wilfully naughty or oppositional but have not yet acquired the developmental ability to function well in an academic setting or regulate their own bodies.”

Can you “outgrow” ADHD?

It is not so much that you outgrow it, but rather, that you are able to learn how to manage it to an extent.

“Adults may underperform or find it to be a challenge to be proactive, accurate, plan ahead or stick to deadlines, unless they have adopted compensatory mechanisms”, Nicola explained.

Is it common to have a learning disability with ADHD?

Children with ADHD can present with a comorbid learning disability. Dyslexia or auditory processing disorder are probably the most common and can be a reason for poorer academic performance”, said Nicola.

What would be the most productive environment for a person with ADHD?

ADHD

The work and academic environment should be free from distractions:

  • Clean and clutter-free
  • Children are best seated in the front of the class, away from windows and doors
  • Use noise cancelling headphones
  • Phones and devices should be on silent / flight mode
  • White or background noise may help to block out distracting external noise

The most important part of leaning to manage the challenges is to become self-aware and compensate for the areas where you have weaknesses:

  • Complete difficult or tedious tasks first thing to avoid procrastination
  • Learning and assignments are to be done in sections with consecutive deadlines
  • Have short term goals instead of long term ones
  • Write things down immediately in your calendar / planner with a weekly or daily to do list
  • Schedule time for rest and breaks while working / studying
  • Make time for your distractions such as social media, but limit this time and set boundaries
  • Many students or adults with ADHD are better able to focus their attention when their bodies are moving. Standing desks, doodling, deep pressure movements, chair push ups and fidget spinners can actually help children and adults attend to the task at hand
  • Positive reinforcement from teachers and positive self-talk in the face of challenges and setbacks is a helpful habit to form

ADHD, food, supplements and medication

“Those with ADHD should avoid foods that are high in sugar or highly refined with artificial colourants and preservatives. If a medication is prescribed, it should be monitored for contraindications to anxiety and other symptoms.  Useful supplements may include omega 3, zinc, iron, magnesium and vitamin b-complex.

Mopani Pharmacy Responsible Pharmacist Corné Cilliers explained why and how supplementing may be helpful.

“There are five essential brain foods you need for optimal function; low-GI foods, essential fats, phospholipids, amino acids and vitamins and minerals”, she said.

  • Low-GI foods allows for a slow, steady release of carbohydrates and avoids blood-sugar dips
  • Essential fats like Omega 3 reduce the risk of allergies, asthma, eczema and promote mental health
  • Phospholipids - phosphatidyl choline and phosphatidyl serine both contribute to better mental performance
  • Amino acids: the body builds new muscle, organ tissue and chemical messengers of the brain from amino acids
  • Vitamins and minerals are essential in building the brain and nervous system – a good multivitamin providing all the B vitamins, magnesium and zinc is recommended

Supplements to ask your doctor or pharmacist about

  • Equazen Eye Q offers a balance of Omega 3’s and Omega 6’s, to support concentration, learning and reading
  • The Real Thing Mega Omega Fish Oil contains ultra-pure and concentrated Omega 3, and is available in a Natural or Lemon flavour
  • ADDvance is a supplement containing Omega 3, vitamins and minerals specially formulated for children with concentration issues
  • NeuroVance contains roseroot extract and inositol, which may aid in regulating your mood and help you focus during times of stress
  • KeenMind contains Bacopa Monnieri, known to support memory, concentration and learning retention, and to help one focus and keep calm
  • Mentat supports short- and long term memory, aiding in enhancing the attention span and reducing the hyper-excitation of neurons which are commonly found in anxiety and stress disorders with natural ingredients
  • Bio-Strath is a 100% natural herbal yeast supplement that contains around 61 of the 100 nutrients your body needs – a supportive therapy supplement often used by those with ADHD
  • Solal Taurine is an amino acid that supports heart, eye and brain health. It has mild anti-anxiety and sleep-enhancing properties, yet is non-sedating.

Routine is healthy

“The following daily habits or rituals are known as protective factors for our brains and have a power cumulative effect (if done every day) on our well-being and resilience” said Nicola.

  • Exercise
  • Mindfulness practices, guided imagery (apps or online tube videos for children are useful) and breathing exercises
  • Positive self-talk
  • Healthy eating habits
  • Following a routine
  • Getting adequate sleep
  • Outdoor time

Can an adult with ADHD thrive career-wise?

ADHD

“Many individuals may be high achievers despite their diagnosis of ADHD. It is best to choose a career in which you are interested and where your strengths lie.  Many great entrepreneurs have ADHD and are highly successful at running their own businesses”, Nicola explained.

“This only works however if they have a strong support team which are able to compensate for the areas of potential weakness such as planning, organising and mundane administrative tasks that are essential in running a business.  This allows the entrepreneur to brain storm and maintain focus on the bigger picture and drive ideas“.

Celebrities with ADHD

Michael Jordan, Michael Phelps, Richard Branson and Jim Carrey are famous people who have reportedly been diagnosed with ADHD.

PS

Gabor Mate’s book Scattered Mind reveals fresh and interesting insights into the nature and treatment of ADHD.  Several chapters of this book are available on his website.

You can book an appointment with Nicola on 072 268 3743. You can find her practice on 31 Melkweg Road, Nelspruit.

Mopani Pharmacy has a variety of supplements that may aid in helping you focus and concentrate better. Ask our knowledgeable pharmacists to assist you in choosing the correct product for your needs.

We can deliver your medications, supplements and other Mopani online shopping, nationwide! More info: mopani.co.za | crossing@mopani.co.za | Tel: 013 755 5500 | WhatsApp: 066-192-1703

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