Patient Login     GP / Referrals     NHS

  0345 222 5678       Send Email       TMS Check

Patient Login     GP / Referrals     NHS

  0345 222 5678       Send Email       TMS Check

ADHD in 2024

PREVALENCE

Attention deficit hyperactivity disorder (ADHD) is one of the most common developmental disorders present in children and adolescents with approximately 7.6% of children and 5.6% of adolescents found to be suffering from the disorder (Salari et al., 2023). According to Gehricke et al. (2017) ADHD persists in approximately 2.5% of adults which translates to about 1 in 40 people.

STIGMA

Despite its widespread prevalence, it is a psychological disorder that is often poorly understood by those in the general community with many people holding erroneous preconceptions or even harmful prejudices about ADHD and those who suffer from it. Take a minute to think about what comes to mind when you try to imagine someone with ADHD.

Since those presenting with inattention often struggle to maintain focus when confronted with a task that they find boring but can display hyperfocus when interested, it is easy for people to falsely characterise them as lazy. When someone who has ADHD is hyperactive, people can assume they are being needlessly disruptive or attention-seeking, when in reality they are simply unable to self-regulate with the same ease as neurotypical individuals.

Due to the fact that ADHD is a lifelong condition, symptoms of the disorder are often mistaken for personality traits which means that sufferers are not always treated with the compassion and understanding that they deserve (CDC, 2023).

DIAGNOSIS

ADHD is a complex psychological disorder which can have one of three presentations: predominantly inattentive type, predominantly hyperactive/impulsive type or combined type. Symptoms used to identify inattentive type include struggling to focus and maintain attention and becoming easily distracted while symptoms used to identify hyperactive/impulsive type include persistent restlessness and impulse control deficits (DSM-5).

Below is the exhaustive list of symptoms used as the DSM-5 diagnostic criteria. In order for ADHD to be diagnosed, at least 6 symptoms must be present for at least 6 months in those 17 years or younger, while at least 5 symptoms must be present for at least 6 months in those over the age of 17 years. These symptoms must be present in more than one setting and must have negatively impacted academic, social, and/or occupational functioning.

Inattentive symptoms:

Displays poor listening skills

  • Loses and/or misplaces items needed to complete activities or tasks
  • Sidetracked by external or unimportant stimuli
  • Forgets daily activities
  • Diminished attention span
  • Lacks ability to complete schoolwork and other assignments or to follow instructions
  • Avoids or is disinclined to begin homework or activities requiring concentration
  • Fails to focus on details and/or makes thoughtless mistakes in schoolwork or assignments

Hyperactive Symptoms:

  • Squirms when seated or fidgets with feet/hands
  • Marked restlessness that is difficult to control
  • Appears to be driven by “a motor” or is often “on the go”
  • Lacks ability to play and engage in leisure activities in a quiet manner
  • Incapable of staying seated in class
  • Overly talkative

Impulsive Symptoms:

  • Difficulty waiting turn
  • Interrupts or intrudes into conversations and activities of others
  • Impulsively blurts out answers before questions completed (DSM-5)

CELEBRITIES

While those who suffer from ADHD are guaranteed to face a host of challenges throughout the course of their lives, there are a great many people who have achieved global success despite being diagnosed with the disorder.

  • Fast and Furious star Micelle Rodriguez has noted that she has a hard time focusing due to her ADHD and was expelled from 5 different schools when growing up (Oweis, 2017). Despite these difficulties, she has achieved worldwide celebrity and is the embodiment of female empowerment in modern cinema.
  • Adam Levine, the frontman of Marooned 5, was diagnosed with ADHD as a teenager and took part in an educational campaign designed to raise awareness of the disorder in 2011 (Child Mind).
  • Michael Phelps has stated that the excellence he achieved in swimming was in part due to his ADHD. He noted that, in the water, he felt in control for the first time, and that the pool was the one place that he was able to slow his mind (Understood, 2019).
  • Zooey Deschanel stated that she is an unmedicated adult with ADHD on her HelloGiggles blog where she presented a simple how-to crafting guide for others who struggle to focus their attention.

These celebrities serve as an inspiration to us all but, in particular, their ADHD diagnosed comrades.

SOCIAL MEDIA

Acceptance of and understanding towards ADHD has grown in recent years with a plethora of accounts geared towards spreading awareness springing up across the various social media platforms. The ADHD Chatter Podcast regularly interviews people with ADHD allowing them to communicate how their condition affects their daily functioning, while there is a myriad of memes littered across the internet which focus on ADHD in an attempt to normalise the condition.

Furthermore, ADHD coaches who seek to support ADHD sufferers by giving them specific advice and support have become ubiquitous on Instagram and Facebook. This increased exposure has allowed those with ADHD greater access to helpful information, encouraged those who were undiagnosed to come forward for assessments, and generated communities which seek to empower and support anyone afflicted.

DOCUMENTARIES

A number of documentaries focusing on ADHD have emerged in recent years, many of which were very well received. Some of the most notable of these include:

  • ‘The Disruptors’ takes a look at the harsh reality that those living with ADHD face as well as the link between ADHD and entrepreneurship.
  • ‘Living with ADHD’ is a BBC documentary which examines the difficulties confronted by those with ADHD when attempting to fit into a world built for neurotypicals.
  • ‘Learning Differently’ focusses on how ill equipped the American school system is to educate those with ADHD.

NEUROLOGICAL MECHANISMS

ADHD is a biologically heterogenous condition which means that the development of the disorder follows various distinct pathways, and it is hypothesised to have a variety of root causes including genetics, environmental factors and issues with the central nervous system at key moments during an individual’s development (‌CDC, 2023).

Defining ADHD as a neurological disorder means that the atypical behaviours observed are asserted to be caused by abnormalities in brain structure and/or function. In a recent study it was found that the superior longitudinal fasciculus (SLF) and cortico-limbic areas are dysfunctional in individuals with ADHD (Gehricke et al., 2017). In a meta-analysis conducted by Hart et al. in 2013, it was established that changes in dorsolateral prefrontal cortex (DLPFC) play a vital role in pathophysiology of ADHD as measured by functional magnetic resonance imaging (fMRI) studies.

TMS TREATMENT

While transcranial magnetic stimulation (TMS) is a relatively novel treatment for ADHD, the research has generated some promising results. In a meta-analysis by Madusa et al. (2019) it was found that inattention, hyperactivity, and impulsivity may be targeted by high frequency rTMS applied to the right DLPFC. Alyagon et al (2020) found a statistically significant reduction in ADHD symptoms in participants who had received high frequency TMS to their right DLPFC when compared to both an active control group and a sham treatment group.

Weaver et al (2012) conducted a randomised sham-controlled crossover trial assessing the utility of TMS as a treatment for ADHD and discovered a statistically significant reduction in ADHD symptoms as defined by the ADHD-IV scale. These studies suggest that undergoing treatment which targets the right DLPFC with high frequency TMS could reduce the severity of symptoms associated with ADHD.

Joe, Dublin Practitioner

References

  1. Detrick, J.A., Zink, C., Rosch, K.S., Horn, P.S., Huddleston, D.A., Crocetti, D., Wu, S.W., Pedapati, E.V., Wassermann, E.M., Mostofsky, S.H. and Gilbert, D.L. (2021). Motor cortex modulation and reward in children with attention-deficit/hyperactivity disorder. Brain Communications, [online] 3(2), p.fcab093. doi:https://doi.org/10.1093/braincomms/fcab093.
  2. ‌Salari, N., Ghasemi, H., Nasrin Abdoli, Rahmani, A., Mohammad Hossain Shiri, Amir Hossein Hashemian, Akbari, H. and Mohammadi, M. (2023). The global prevalence of ADHD in children and adolescents: a systematic review and meta-analysis. Italian Journal of Pediatrics, 49(1). doi:https://doi.org/10.1186/s13052-023-01456-1.
  3. Jg, G., F, K., T, T., Sd, A., E, T., J, F. and Lt, M. (2017). The Brain Anatomy of Attention-Deficit/Hyperactivity Disorder in Young Adults – A Magnetic Resonance Imaging Study. [online] PloS one. Available at: https://pubmed.ncbi.nlm.nih.gov/28406942/.
  4. ‌CDC (2023). What is ADHD? [online] Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/ncbddd/adhd/facts.html.
  5. ‌Will you pay #AttentionUK ? (2018). Understanding ADHD Stigma. [online] Available at: https://attentionuk.org/frequently-asked-questions/understanding-adhd-stigma/.’
  6. ‌Team, A.E. (2022). Inside the ADHD Brain: Structure, Function, and Chemistry. [online] ADDA – Attention Deficit Disorder Association. Available at: https://add.org/adhd-brain/.
  7. Child Mind Institute. (n.d.). Adam Levine Speaks Out About His ADHD. [online] Available at: https://childmind.org/blog/adam-levine-speaks-out-about-his-adhd/.
  8. Understood. (2019). Celebrity spotlight: How Michael Phelps’ ADHD helped him make Olympic history. [online] Available at: https://www.understood.org/articles/celebrity-spotlight-how-michael-phelps-adhd-helped-him-make-olympic-history [Accessed 15 Jan. 2024].
  9. Oweis, Z. (2017). Fast and Furious Actress Michelle Rodriguez Cites ADD as Motivation for Success. [online] RespectAbility. Available at: https://www.respectability.org/2017/10/fast-furious-actress-michelle-rodriguez-cites-add-motivation-success/ [Accessed 15 Jan. 2024].
  10. ‌Centre, A. (2022). The Rise of ADHD Awareness On Social Media | Pros And Cons. [online] The ADHD Centre. Available at: https://www.adhdcentre.co.uk/rise-of-adhd-awareness-on-social-media-the-pros-and-cons/.
  11. Pearce, K. (2023). 10 Best Documentaries On ADHD, Entrepreneurship & Creativity. [online] Available at: https://www.diygenius.com/adhd-documentaries/.
  12. ‌Weaver L, Rostain AL, Mace W, et al. Transcranial magnetic stimulation (TMS) in the treatment of attention-de cit/ hyperactivity disorder in adolescents and young adults: a pilot study. J ECT. 2012;28:98–103
  13. Masuda F, Nakajima S, Miyazaki T, et al. Clinical effectiveness of repetitive transcranial magnetic stimulation treatment in children and adolescents with neurodevelopmental disorders: a systematic review. Autism. 2019;23(7):1614–1629.
  14. Hart H, Radua J, Nakao T, et al. Meta-analysis of functional magnetic resonance imaging studies of inhibition and attention in attention-deficit/ hyperactivity disorder: exploring task specific stimulant medication, and age effects. JAMA Psychiatry. 2013;70:185–198