ADHD 101: What is ADHD?
"There is no way I have ADHD. I don't believe in ADHD. It's just an excuse to be lazy. "
That was my response to my grad school neuropsychology supervisor and mentor when he gently suggested to me that I should consider getting evaluated for ADHD. I was falling behind on my dissertation and missing important deadlines, and he was worried that unless I fixed these issues, I wasn't going to graduate.
I couldn't believe that my supervisor, who is still the smartest neuropsychologist I know, actually thought I had such a ridiculous diagnosis. I mean...I wasn't hyperactive as a kid...I was in gifted and talented from kindergarten through 8th grade for goodness sake! It made me mad that he could suggest such a thing. So I decided to prove him wrong by doing my own research.
And guess what I discovered?
ADHD is a real neurological disability.
I began researching this disorder passionately. What I found is that this diagnosis isn't just "big pharma" making up a diagnosis so they can get people to buy their medications. No. ADHD is an independently confirmed neurological / neurodevelopmental disorder. The science is plain and clear. ADHD is a real thing.
ADHD (and what was formerly called "ADD") is a developmental disorder that begins in childhood and continues into adulthood in most cases. A combination of the right kind of family genetics and environmental factors (e.g., complications while in utero, significant childhood illnesses or injuries/brain injuries, chronic stress/exposure to trauma during childhood, etc.) is what ultimately "causes" ADHD.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5, American Psychiatric Association) outlines that ADHD has three subtypes:
Predominately Inattentive Presentation (formerly ADD);
Predominately Hyperactive and Impulsive Presentation;
Combined Presentation (hyperactive, impulsive, and inattentive)
Individuals with ADHD have a problem with how their frontal lobe develops (in addition to other parts of the brain too) due to how their brain is imbalanced with two chemicals called "neurotransmitters": dopamine and norepinephrine.
ADHD causes a "chemical imbalance" of dopamine and norepinephrine during childhood through early adulthood. This causes the frontal lobes to mature at a slower rate than age-matched peers.
The frontal lobes do not stop developing until the early to mid-20's, and ADHD affects this development in a negative way. The "delay" in frontal lobe development causes the functions of the frontal lobe to be weak and delayed. These functions of the frontal lobe include what is called "executive functions."
Executive functions are what the frontal lobes "do." These functions includes higher-order planning, prioritizing, organizing, impulse control, emotional regulation, judgment, mental flexibility, complex attention, sustaining attention, taking age-appropriate initiative, internal motivation, maintaining motivation, perseverance when things get difficult or boring, self-monitoring, and even self-awareness and empathy.
Looking back, I can now see what I couldn't see then: ADHD is a part of me and has been a part of my story since childhood. I just happen to grow up during a time that it wasn't diagnosed unless you were jumping from the roof of the school or destructively hyperactive. No, I was not hyperactive as a child but I was very much inattentive and perhaps a bit sluggish in my processing speed. Thankfully, I learned to compensate well enough to at least get to graduate school, but I know I would not have completed my coursework at that level had I not been diagnosed with and treated for ADHD.
A lot more can be said about this disorder, and I encourage the reader to check back for updates to our ADHD 101 blog as I plan to add more tips, strategies, and information moving forward. Thanks for reading! At Integra, we are passionate about the therapeutic testing and treatment of ADHD for children, teens, and adults. Please call us to schedule an appointment / consultation with one of our expert clinicians if we can be of any service. Until Next Time, Dr. Levi Armstrong
Clinical Neuropsychologist & Co-Owner
Integra Psychological Services, PLLC