Attention Deficit Hyperactivity Disorder (ADHD) | Varad Program Integrative Psychiatry Clinic For Mental Health And Holistic Wellness Center Bellevue

Attention Deficit Hyperactivity Disorder (ADHD)


Attention deficit hyperactivity disorder is a neurodevelopmental psychiatric Condition. It is characterized by, difficulty paying attention, excessive activity and inappropriate behavior for their age. According to the DSM V, symptoms must be present for more than 6months and they must cause significant problems functioning in at least two settings (school, work, office, social or home).

Symptoms:

  • Talk excessively
  • Cannot sit at one place for few minutes
  • Forget things or loose items frequently
  • Make careless mistakes
  • Difficult to focus
  • Struggle to follow instructions
  • Easily distracted
  • Frequently switch from one activity to other
  • Trouble understanding minute details
  • Difficulty in organizing things
  • Very impatient
  • Blurt out inappropriate comments
  • Interrupts conversations
  • Difficulty waiting for things

  • Risk Factors:

    1. Temperamental: Reduced behavioral inhibition,
    2. Environmental: Low birth weight increases the risk by 2 to 3 fold, smoking during pregnancy, reactions to diet, child abuse, alcohol exposure in utero, lead exposure
    3. Genetic and Physiological: Elevated in first-degree biological relatives of individuals with ADHD. Visual and hearingimpairments, metabolic abnormalities, sleep disorders, nutritional deficiencies, and epilepsy have possible influence on symptoms.
    4. Course modifiers: Family interaction patterns in early childhood may influence

    Pathophysiology:

    There is a significant decrease in the volume of left prefrontal cortex and posterior parietal cortex. Along with that, there is a functional impairment in brain’s neurotransmitter system. Elevated levels of Dopamine transporters are due to the adoptive response to stimulants. Also found abnormalities in serotoninergic, glutamate, norepinephrine and cholinergic pathways.


    Diagnosis:

    As per DSM V criteria, there are three sub types of ADHD

    1. 1. ADHD, predominantly inattentive: Day dreaming, poor concentration, forgetful,
    2. 2. ADHD, predominantly hyperactive-impulsive type: Restlessness, fidgetiness, destructive behavior
    3. 3. ADHD, combined type: combination of both of the above.

    Management:

  • Behavioral therapy: Cognitive behavioral therapy, counseling
  • Medication management: Methylphenidate, atomoxetine, bupropion, guanfacine and clonidine
  • Alternate therapy: Yoga, Exercise, Reiki, Elimination diet