“In the old days they were simply called bad or slow,” said Dr. Rosa C. Gonzalez, a Beaumont psychiatrist, about children with Attention-deficit/Hyperactivity disorder before 1968.
That is when ADHD appeared in the Diagnostic and Statistical Manual of Mental Disorders for the first time.
Some of those children, now adults, have kids with ADHD.
The Centers for Disease Control estimated that approximately 6.4 million Americans were diagnosed with ADHD by 2011.
Even though millions are affected by ADHD, scientists have not pinpointed all of the causes.
“A lot of it is genetics,” Dr. Gonzalez said of one of the causes of ADHD.
Scientists are also studying other possible causes. Environmental issues during pregnancy is one of those.
Dr. Gonzalez has seen this in her Beaumont practice.
Other risk factors being studied are premature delivery, low birth weight, exposure to lead and other toxins at an early age, and brain injury.
Though all of the causes have not yet been discovered, scientists do know how the disease affects people.
ADHD is caused by a lack of the chemical dopamine in the front part of the brain. That is where most of the executive functions are performed.
Dr. Gonzalez explains it in layman’s terms.
“If I hand you a one hundred dollar bill, dopamine levels go up,” Dr. Gonzalez said. Dopamine levels rise when a person is excited.
“When there is not enough excitement, you can’t focus,” Dr. Gonzalez said.
Lack of focus is one of the warning signs that someone may be suffering from ADHD.
“They are fidgety. They can’t sit still to do their homework,” Dr. Gonzalez said of ADHD children.
The CDC reports “A child with ADHD might daydream a lot, forget or lose things a lot, talk too much, make careless mistakes or take unnecessary risks, have a hard time resisting temptation or have a hard time taking turns.”
Even with all of these warning signs, ADHD is not an easy diagnosis to make. Other disorders have to be ruled out first.
“We have to rule out that they are depressed, anxious or have a learning disorder,” Dr. Gonzalez said.
Once the diagnosis has been made, treatment can begin.
Other disorders in children can often be treated with therapy, but ADHD is different.
“Most of the time you have to treat it with medicine,” Dr. Gonzalez said. “The medicines increase dopamine levels.”
Dr. Gonzalez always starts her ADHD patients on Ritalin. If that is ineffective, she tries Dexedrine and then Adderall. These medications are all stimulants.
Dr. Gonzalez has also prescribed a new non-stimulant medication now on the market called Strattera.
ADHD sufferers may need to be on this medication for life.
“About a third of ADHD patients outgrow it as they get into their 20s,” Dr. Gonzalez said. “Two thirds of them will medicate forever.”
The medication can make a big difference.
“The first thing parents notice is their grades go up, sometimes hand writing gets better, they are not as irritable,” Dr. Gonzales said about children receiving ADHD therapy.
This ADHD story is part of a continueing series on good mental health.
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