What exactly are ADD and ADHD and what are the symptoms?
“There is one umbrella name: ADHD, Attention Deficit Hyperactivity Disorder,” says professor Marina Danckaerts. There are three groups within it:
• ADHD of the predominantly attention-deficit type: This is often referred to as ADD. This mainly concerns difficulty with concentration, both selective attention and sustained attention and control of attention.
• ADHD of the predominantly hyperactive-impulsive type: those who have this are often restless and have impulsive tendencies. Think of difficulty sitting still, restlessness in the head and body, which causes people with ADHD to fidget a lot, cannot wait well, are impatient, and cannot tolerate delays.
• The combination of both: people who have problems concentrating and are very restless and can react impulsively.
“This is a continuum, just like with blood pressure. Some people have low blood pressure, others have very high blood pressure. The latter are labeled as having high blood pressure. In other words, we all have difficulty concentrating and being calm at times. For people with ADHD, this has such an impact on their lives that they can no longer function properly. We also look at whether these problems occur in all situations: both at school or at work and at home.”
It seems like more and more people have ADHD. Is that the case or is such a label a fashion phenomenon?
“Until 2013 we saw a strong increase in the number of diagnoses, after which the figures remained stable for a number of years and now we are seeing a slight increase again. This does not mean that there are more people with ADHD, that figure is stable in the population. It means that a diagnosis is made more often. This is because there is more knowledge about ADHD and people seek help more often. The diagnosis is then the first step.”
If you suspect that your teenager might have ADHD and he or she doesn’t want to know about it, will you still look for help? Or is it better to leave him or her alone?
“It is very good that someone like actress Pommelien Thijs (known from the Netflix series Knokke off) speaks openly about the fact that she received a diagnosis. Such a role model can be very important for young people because she shows that certain things are difficult in her life, while you can still be successful. Her story helps to put things into perspective: such a label is only a part of your personality, there are many other things that matter. However, there is little point in getting the diagnosis if you are not experiencing any problems yourself. Perhaps your daughter herself is not bothered by it and it is mainly the outside world that has difficulty with it. Then it is up to the outside world to make it clear to her what is going on and why a diagnosis could help. The label has also become way too sticky: it seems like it will stick for the rest of your life. To be clear: that is not the case. Some people only suffer from it for a certain period of their lives, especially when school and studying are very central. In terms of brain growth, we see a maturation delay in the concentration networks and in a large proportion of children this is still improving or they are developing compensation strategies. Moreover, as an adult you have more choice about how you organize your life and you can choose a job that does not require you to concentrate all the time.”
Is medication a good idea for ADD? One says yes, the other says no.
“A lot depends on how much trouble you have and what impact the symptoms have on your life. You can always first try to adjust things in your environment so that you need your attention skills less (e.g. making lists, taking breaks, putting away your phone), but there are limits to the impact of this. What is very clear: at the moment there is only one remedy that can really improve the symptoms and that is medication. If it is necessary for the symptoms to decrease in order to function better, then I would recommend doing so. This is usually necessary during the period when school or studies are the main focus. It is very important to discuss this with the young person or adult themselves. No doctor should force a patient to take medication that he or she does not feel comfortable with. I have helped young people with ADHD for years, often with medication, and I have noticed that the response to medication can vary greatly. For some young people the impact is very positive, they feel much better with the medication. Others really don’t feel good about it. In young children there may be an effect on appetite, so we look for the right balance. So don’t rely too much on the stories of others, the reaction is very different per person.”
Are there other solutions that can help you function better with ADHD?
“The answer is simple: no. Medication is the only proven remedy to really change the symptoms of ADHD. There has been a hype around a hypoallergenic diet for a while, especially in the Netherlands. ADHD is seen as an allergic reaction and patients were given very drastic dietary measures. Very little scientific evidence has been found for this and it does not work at all for most children. Yet another remedy that has attracted attention is neurofeedback. An EEG device was used to attempt to train attention by making the brain waves visible. Although a lot of research has been done, it appears that this only works in the lab. Once you return to normal life, you appear not to apply those training effects. We also find that children can become better at concentration training via the computer during those specific exercises on the computer, but not at concentrating better at other times. Conclusion: all these alternatives do not work. What can help are parent or teacher training, so that those around them know better how to deal with someone with ADHD and how to change the situation so that the young person is less affected by it.”
Are children with ADHD often aggressive?
“We see this more often in practice, but it is not a characteristic of ADHD. On the one hand, there is a genetic link between ADHD and aggression, on the other hand, children with ADHD become aggressive more often because the adults in their environment are so often angry with them. This often starts around preschool age. Parents and teachers often react negatively to them, causing them to grow up in a bath of negativity. That is why it can help to follow parent or teacher training. You will learn how to respond better to your child’s behavior and still build a good bond. You can find information about such training courses in your area from your doctor or online. This will not change the symptoms of ADHD in your child, but it can ensure that you can better help your child and yourself to deal with it.”
Is there an association for people with ADHD or ADD?
“Yes, there are various patient associations (for example Impuls & Woortblind). If you are wondering whether your child might have ADHD, you can start by talking to him CLB. The characteristics of ADHD must be recognizable everywhere, not only at home, but also at school, so they can request information from the teacher in advance. The CLB can then refer you to a diagnosis center nearby. Sometimes this is a rehabilitation center or mental health care, sometimes a university hospital center or a child psychiatric practice. As a young adult you can go to the student centers. ADHD is a problem that often causes many difficulties when studying. Student centers can usually make good referrals. As an adult it is more difficult to get a diagnosis. Few professionals are trained for this. You can make an appointment in most university psychiatric centers, but sometimes you have to wait a long time.”
According to various psychologists, if you want to get a diagnosis for ADHD, it will cost 500 euros. Is that right?
“I fear this may be true. Always check carefully which costs your insurance covers, so you will not be faced with any unpleasant surprises. The reason is that various examinations are carried out for a diagnosis, usually by a psychologist. In the ideal world, psychologists work together with a (child and adolescent) psychiatrist. That also costs money and the waiting lists there are often long.”
This article previously appeared on HLN.be.
No ADD, but still not feeling well? If you have these mental complaints, go to your doctor:
16 september 2023
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2023-09-16 08:00:44
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