What are the core ADHD symptoms?

This condition affects brain development and functioning. It comes in varying degrees of severity, from mild to severe, and impacts nearly three million people in the UK, with 694,000 being children and 1.9 million being adults.

Dr Max Davie is a co-founder of ADHD UK, and a consultant paediatrician with a specialisation in ADHD, and he also has the condition himself.

People with this condition often describe a sense of restlessness and easily-getting-boredness, which can be extremely uncomfortable and even unbearable at times. They report feeling under-stimulated and describe their emotions as being overwhelming and unmanageable.

There's a lot of misconceptions, one of which is that ADHD only applies to children who don't behave well or have been poorly brought up, being rude or aggressive, for example," Dr Davie explains. "That's entirely not true. ADHD behaviour is different from behaviour that's deliberately disobedient or defiant, although they are linked. Moreover, there's a clear genetic element to this condition, which has been extensively researched over the years and has robust scientific backing.

One common misconception is that ADHD is brought about by environmental factors.

"That is utter rubbish.”

What are the primary characteristics of Attention Deficit Hyperactivity Disorder (ADHD)?

The symptoms of ADHD differ from one person to another; however, people with ADHD typically experience difficulties with concentrating, planning and prioritising tasks, managing their time effectively, and maintaining self-restraint.

They may also display excessive levels of hyperactivity and impulsiveness, making it challenging for them to lead normal daily lives. A diagnosis can only be made by a qualified medical practitioner.

For a diagnosis of ADHD, symptoms must occur in at least two out of two areas, including home, school or work, or other pursuits. Symptoms also need to be impacting the individual's social, educational, or work performance.

Other possible causes for these symptoms will be looked into before a diagnosis of ADHD is made. An ADHD assessment will first establish whether someone is consistently showing one of two main types of behaviour: inattention and hyperactivity/impulsivity.

Dr. Davie points out that the diagnosis pathway for ADHD is somewhat fragmented. "As a matter of fact," he says, "ADHD has never really had a defined place within the NHS - it's often seen as both a neurodevelopmental disorder, which falls under the remit of paediatrics, and a mental health condition, which is looked after by child and adolescent mental health services."

Inattention

ADHD is suspected in children up to 16 years old if they exhibit six or more of the following symptoms, and in those aged 17 and above if they exhibit five or more. All of these symptoms must occur frequently and have been present for at least six months.

Hyperactivity and Impulsivity

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The manner in which inattentiveness, hyperactivity, and impulsiveness manifest in adults is often distinct from how they manifest in children. While symptoms of hyperactivity tend to diminish, those of inattentiveness typically persist, albeit in a more discreet form.

Dr Davie goes on to say, "Hyperactivity and impulsive behaviour are much more characteristic of younger patients, whereas as teenagers, hyperactivity tends to become less evident."

“Grown-ups with ADHD might exhibit a certain level of restlessness, but it's more a case of inner turmoil. For these adults, the challenges tend to revolve around emotional struggles, managing their organisation, and finding it hard to focus and come up with plans.”

**Common Symptoms in Women**
Many women know their most common symptoms, which include:
* Pain in the middle to lower abdomen
* Unusual vaginal bleeding or spotting
* Sudden heavy bleeding
* Painful intercourse
* Muscle and/or joint pain and aches
* Weight change
* Mood swings
* Fatigue
* Nausea and vomiting

Research indicates that boys with ADHD often exhibit noticeable symptoms like being overly physically active and impulsive, in contrast, girls with ADHD tend to display more 'internal signs', such as seeming not to pay attention, getting lost in thought, having trouble concentrating, and lower self-confidence.

Boys often exhibit physical aggression, whereas girls display aggression through more verbal means, which can result in them being frequently overlooked and under-referred for assessment.

"These individuals may not exhibit the traditional symptoms, but rather more subtle signs," says Dr Davie.

He thinks that this could be due to the fact that from a young age girls have traditionally been expected to be less vocal.

He suggests that girls with ADHD are not typically the ones causing disruptions in class, but rather those who are switched off, sitting quietly in the back, perhaps chatting with others, and therefore often go under the radar, unlike their male counterparts who tend to attract more attention due to their misbehaviour.

During teenage years and young adulthood, women with ADHD may exhibit more emotional difficulties than their male counterparts.

"With regards to mental health, women truly experience significantly worse issues from their mid-teenage years right through to early adulthood, and this disparity in mental wellbeing is notably more pronounced in individuals with ADHD," Dr Davie states.

This is the day-to-day impact of ADHD symptoms.

As stated by the NHS, "the characteristic impulsiveness, fearlessness and unpredictability of ADHD can often lead to overwhelming and stressful daily routines."

School, especially secondary school, can be a really tough place for someone with ADHD to be, as the school system demands intense periods of focused attention and strict adherence to a set of rules.

There are a variety of possible consequences of the condition for adults and children.

These can include:

Impact on sleep

"Attention Deficit Hyperactivity Disorder has a significant effect on sleep, affecting all age groups," says Dr Davie.

Youths with ADHD frequently experience trouble falling asleep as they find it difficult to calm and unwind. Symptoms typically wane with growing older and tactics can be implemented, such as relaxation methods. Medicines such as melatonin can also bring welcome relief.

ADHD paralysis

According to the Attention Deficit Disorder Association in the Americas, ADHD paralysis refers to a state where an individual with ADHD feels overwhelmed by their surroundings or the sheer volume of information they are presented with, resulting in a significant hindrance to their ability to think and function. Note: this is not a formal clinical term or symptom recognised within a medical context.

“From the outside, it simply appears as trouble getting started on a task," Dr Davie explains. "For those with ADHD, however, it can manifest in a multitude of ways and often involves anxiety. They may feel too anxious to begin a task, creating a self-reinforcing cycle, as the cognitive effort required to plan, initiate, and start a task is significantly greater."

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