HYPERACTIVE DISORDER

Attention deficit and hyperactivity disorder (ADHD)'s global prevalence is estimated at 3-5% in people under the age of 19.

The most common symptoms of ADHD are:
• Impulsiveness: acting before thinking of consequences, jumping from one activity to another, disorganization, tendency to interrupt other peoples' conversations.
• Hyperactivity: restlessness, often characterized by an inability to sit still, fidgeting, squirminess, climbing on things, restless sleep.
• Inattention: easily distracted, day-dreaming, not finishing work, difficulty listening.

The symptoms of ADHD can be classified into three clusters, referred to as subtypes:
(1) Inattentive;
(2) Hyperactive/impulsive;
(3) Combined.
Most people exhibit some of these behaviors but not to the point where they significantly interfere with a person's work, relationships, or studies.
Hyperactivity is common among children with ADHD but tends to disappear during adulthood. However, over half of children with ADHD continue to have some symptoms of inattention throughout their lives.
Other Problems with ADHD
• Oppositional defiant disorder (35%) and Conduct disorder (26%). These are both characterized by anti-social behaviors such as stubbornness, aggression, frequent temper tantrums, deceitfulness, lying, or stealing.
• Primary disorder of vigilance. Characterized by poor attention and concentration, as well as difficulties staying awake. These children tend to fidget, yawn and stretch, and appear to be hyperactive in order to remain alert and active.
• Bipolar disorder. As many as 25% of children with ADHD have bipolar disorder. Children with this combination may demonstrate more aggression and behavioral problems than those with ADHD alone.
• Anxiety Disorders. Such disorders commonly accompany ADHD, particularly Obsessive-Compulsive Disorder. Obsessive Compulsive Disorder (OCD) is believed to share a genetic component with ADHD, and shares many of its characteristics

Although the reasons are not clear, it has long been observed that many children seem to "outgrow" ADHD. These individuals include those both treated and untreated. It is also known that many adolescents and adults develop coping skills as they mature, offsetting impairments

How to find out?
No objective test exists to make a diagnosis of ADHD and therefore it remains a clinical diagnosis, which means that only a trained pediatrician or a psychiatrist can make an accurate diagnosis.
However, there are certain guidelines to make a diagnosis and they are outlined below

Either A or B:

A. Six or more of the following symptoms of inattention have been present for at least 6 months to a point that is disruptive and inappropriate for developmental level:
1. Often does not give close attention to details or makes careless mistakes in schoolwork, work, or other activities.
2. Often has trouble keeping attention on tasks or play activities.
3. Often does not seem to listen when spoken to directly.
4. Often does not follow instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions).
5. Often has trouble organizing activities.
6. Often avoids, dislikes, or doesn't want to do things that take a lot of mental effort for a long period of time (such as schoolwork or homework).
7. Often loses things needed for tasks and activities (e.g. toys, school assignments, pencils, books, or tools).
8. Is often easily distracted.
9. Often forgetful in daily activities.

B. Six or more of the following symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for developmental level:

• Hyperactivity:
1. Often fidgets with hands or feet or squirms in seat.
2. Often gets up from seat when remaining in seat is expected.
3. Often runs about or climbs when and where it is not appropriate (adolescents or adults may feel very restless).
4. Often has trouble playing or enjoying leisure activities quietly.
5. Is often "on the go" or often acts as if "driven by a motor".
6. Often talks excessively.

Impulsiveness:
1. Often blurts out answers before questions have been finished.
2. Often has trouble waiting one's turn.
3. Often interrupts or intrudes on others (e.g., butts into conversations or games).

II. Some symptoms that cause impairment were present before age 7 years.

III. Some impairment from the symptoms is present in two or more settings (e.g. at school/work and at home).

IV. There must be clear evidence of significant impairment in social, school, or work functioning.

V. The symptoms do not happen only during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder. The symptoms are not better accounted for by another mental disorder (e.g. Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a Personality Disorder).

1. ADHD, Combined Type: if both criteria 1A and 1B are met for the past 6 months

2. ADHD Predominantly Inattentive Type: if criterion 1A is met but criterion 1B is not met for the past six months

3. ADHD, Predominantly Hyperactive-Impulsive Type: if Criterion 1B is met but Criterion 1A is not met for the past six months.

Can Diet make a difference?
Additives
A meta-analysis has found that dietary elimination of artificial food coloring and preservatives provides a statistically significant benefit in children with ADHD. Other more recent studies agree with these conclusions.

Other similar disorders
Before concluding that a child has ADHD, other problems should be ruled out. Some of the conditions that can present with similar symptoms like ADHD are:

Medical conditions
Medical conditions that must be excluded include: hypothyroidism, anemia, lead poisoning, chronic illness, hearing or vision impairment, substance abuse, medication side effects, sleep impairment, and child abuse, among others.

Sleep Disorders
• Chronic sleep deprivation, that is insufficient sleep for physiologic sleep needs,
• Fragmented or disrupted sleep, caused by, for example, obstructive sleep apnea (OSA) or periodic limb movement disorder (PLMD),
• Primary clinical disorders of excessive daytime sleepiness, such as narcolepsy, and
• Circadian rhythm disorders, such as delayed sleep phase syndrome (DSPS).

All of these are important causes of symptoms which may overlap with the cardinal symptoms of ADHD, and children with ADHD should be regularly and systematically assessed for sleep problems

Your doctor will be able to guide you in ruling out these disorders.
Treatment
Behavioral interventions
Psychological therapies use to treat ADHD include psycho educational input, behavior therapy, cognitive behavioral therapy (CBT), interpersonal psychotherapy (IPT), family therapy, school-based interventions, social skills training and parent management training.
Parent training and education has been found to have short term benefits. Family therapy has shown to be of little use in the treatment of ADHD.

Treatment with medicines is not recommended for pre school children. However your doctor will help you if your child needs to be treated with medicines.

The Future:
ADHD diagnosed in childhood resolves in 40 to 90% of individuals by the time they reach adulthood.[7][8] Those affected are likely to develop coping mechanisms as they mature thus compensating for their previous ADHD.
For those who do not grow out of the disorder, self employment or highly flexible jobs are the best matched. Such people tend to shift jobs very often due to their fleeting interests.