Attention deficit hyperactivity disorder (ADHD) is a psychiatric condition with strong genetic links. A person with ADHD has differences in brain development and brain activity that affect many areas of daily function.

The area of functioning we think of most as being impacted is attention, but ADHD impacts all areas of executive functioning including impulsivity, memory, forward planning, organisation, time management and mental flexibility. It can also impact social skills and relationships.

There are three types of ADHD:

• Predominantly hyperactive-impulsive subtype

• Predominantly inattentive subtype

• Combined subtype

It is estimated that 1 in 20 Australians have ADHD (5% of the population). By the end of 2022, Australia’s population was 26,268,359, meaning that around 1,313,418 Australians have a diagnosis of ADHD.

There is an historic lack of knowledge around ADHD that has resulted in many people going undiagnosed, particularly those above school age and females of all ages. With greater understanding of ADHD, these numbers are expected to grow.

Treatment for ADHD usually includes:

• Medication: This improves the brain's ability to pay attention, slow down and use more self-control.

• Therapy: Therapists can help people develop the executive functioning, social, and emotional that can be challenging in ADHD.

• Parent training: Equipping parents with the skills to respond to problematic behaviours that are part of ADHD.

• School support: Working with teachers to equip them with the skills to manage behaviour in the classroom and enjoy school more.

The right treatment and management will reduce the impact that symptoms of ADHD have on a person’s life, improving their quality of life.

When ADHD is not treated, it can be hard for people to succeed. This may lead to low self-esteem, depression, oppositional behaviour, school failure, risk-taking behaviour and family conflict.

ADHD is:

• a mental health disorder

• comprised of many symptoms

• often genetically inherited

• disruptive to one’s life

• diagnosed by its symptoms

• manageable

ADHD is not:

• caused by poor parenting

• caused by diet, food additives or refined sugar

• ‘being lazy’

• a ‘made up’ disorder

• strictly a childhood disorder

Myth: if you have ADHD, you also have other conditions. It is common to have coexisting conditions with ADHD, such as anxiety, depression, learning difficulties and autism spectrum disorder. However, having ADHD does not mean you have all or any of these co-existing conditions. Every person’s diagnosis is unique.

Myth: ADHD medication will create drug problems for my child. ADHD medications are not the gateway to drug and alcohol abuse. However, a teenager or young adult with ADHD without a clinical diagnosis and treatment is more likely to self-medicate with substances such as alcohol or illicit drugs.

It's normal for little kids to be distracted, restless, impatient or impulsive – this does not always mean that a child has ADHD. Attention, activity and self-control develop as children grow and learn these skills.

But some kids don't get much better at paying attention, settling down, listening or waiting. When these things continue and begin to cause problems at school, home and with friends, it may be ADHD. Kids with ADHD can show signs in any or all of these areas:

Inattentive

Kids who are inattentive (easily distracted) have trouble focusing, concentrating and staying on task. They may not listen well to directions, may miss important details and may not finish what they start. They may daydream or dawdle too much. They may seem absent-minded or forgetful and lose track of their things.

Hyperactive

Kids who are hyperactive are fidgety, restless and easily bored. They may have trouble sitting still or staying quiet when needed. They may rush through things and make careless mistakes. They may climb, jump or roughhouse when they shouldn't. Without meaning to, they may act in ways that disrupt others.

Impulsive

Kids who are impulsive act too quickly before thinking. They often interrupt, might push or grab, and find it hard to wait. They may do things without asking for permission, take things that aren't theirs or act in ways that are risky. They may have emotional reactions that seem too intense for the situation.

Many kids with ADHD also have learning problems, oppositional and defiant behaviours, or mood and anxiety problems. Health professionals usually treat these alongside ADHD.

ADHD can improve when kids get treatment, eat healthy food, get enough sleep, exercise and have supportive parents who know how to respond to ADHD.

• Be involved. Learn all you can about ADHD. Follow the treatment your child's health care provider recommends. Go to all recommended therapy visits.

• Give medicines safely. If your child is taking ADHD medicine, always give it at the recommended time and dose. Keep medicines in a safe place.

• Work with your child's school. Ask teachers if your child should have an IEP or 504 plan. Meet often with teachers to find out how your child is doing. Work together to help your child do well.

• Parent with purpose and warmth. Learn what parenting approaches are best for a child with ADHD and which can make ADHD worse. Talk openly and supportively about ADHD with your child. Focus on your child's strengths and positive qualities.

• Connect with others for support and awareness. Join a support group like CHADD to get updates on treatment and other information.

For many years we thought that children grew out of ADHD, now we know that is a myth. While many of the symptoms seen in childhood are not present in adulthood, it is not because the ADHD has gone but that symptoms have shifted.

What may have been a child leaving their seat to run around a restaurant, will be the adult remaining seated but bobbing their leg up and down and fidgeting with their fork.

Symptoms of ADHD can continue to impact people even in adulthood, and requires ongoing management. Some adults successfully learn to manage their lives with ADHD, some just get through knowing they are capable of more, too many struggle and fail without the help which will allow them to reach their potential.

There are more than one million people with diagnosable ADHD in Australia, most of whom are adults with no diagnosis or access to treatment that could improve the quality of their lives. We know the cost in economic terms is huge, but the personal cost is immeasurable, not only for the person with ADHD but also for their families and friends.

Women and girls experience the same general symptoms of ADHD as men and boys. However, the way the symptoms are expressed in their behaviours can appear different.

This difference in expression is one of the reasons girls and women are under diagnosed. Clinicians, parents and other adults who work with children look for the male model of ADHD symptoms that focuses on hyperactivity and impulsiveness.

When girls demonstrate symptoms of inattention, overly sociable behaviour, forgetfulness, talkativeness or difficulties with time management, those behaviours are attributed to other causes or cultural expectations.

Women and girls can present with inattentive, hyperactive and combined ADHD just as men and boys do.

ADHD in girls + women

For women and girls, inattentive presentation can appear as:

• Daydreaming quietly in class

• Forgetful in daily activities and easily distracted

• Loses things easily

• Feeling anxious or sad

• Exhibiting silliness or apparent ‘ditziness’

• Acting shy/inattentive

• Difficulty sustaining attention

• Struggling to follow instructions

• Difficulty with organisation

• Trouble maintaining friendships

• Picking at cuticles on the skin

• Being a perfectionist

Hyperactive presentation can appear as:

• Talks excessively

• Fidgets and often needs to get up and walk around

• Acts impulsively or speaks without thinking

• Appears to daydream but says her thoughts are ‘going a million miles a minute’

• Trouble keeping her mind on one topic

• Easily makes friends but has trouble sustaining friendships

• Adopts a compensatory strategy, working three times harder than peers to be equally successful