For some it is a “superpower”, but for most this neurodiversity is a source of anxiety, depression and low self-esteem.
Attention deficit hyperactivity disorder (ADHD) is one of the most common neurobiological and psychiatric disorders of childhood and in most cases persists into adulthood. It affects millions of people around the world.
It is not a mental illness, but an abnormal neurobehavioral condition that can have a negative impact on the quality of life of those who suffer from it, especially if they are of school age.
ADHD is increasingly recognised as a significant problem in Europe. According to the latest estimates, it affects around 5-7% of children and 2-4% of adults, with some variability depending on the diagnostic criteria used.
In Italy, a recent study indicates an average prevalence of 5.9% in children, while in the adult population it drops to 1.4%. In Spain, estimates suggest that between 3% and 7% of children are affected by ADHD, with a prevalence of 1.2% in the population aged 18-44. No specific studies have yet been carried out in Portugal, but the figures seem to be in line with the European average.
Clinical causes
ADHD is associated with imbalances in neurochemical systems involving dopamine and norepinephrine, two neurotransmitters that are crucial for regulating attention, motivation and behaviour. Dopamine is involved in the brain’s reward system, which affects mood and the ability to concentrate. People with ADHD tend to have lower levels of dopamine in certain areas of the brain, which may explain their difficulties in concentrating and maintaining attention. Noradrenaline, on the other hand, is associated with stress response, cognitive function and impulse control.
Medications used to treat ADHD, such as stimulants (e.g. methylphenidate), work by increasing levels of dopamine and norepinephrine in the brain, improving concentration and reducing hyperactivity and impulsivity.
ADHD in children and teenagers
The symptoms associated with this disorder are more pronounced in children: difficulty concentrating, hyperactivity, impulsivity, debilitating shyness and difficulties in social relationships. Students with ADHD often have difficulty following lessons, doing homework and following classroom rules, which can lead to frustration and academic failure. It is also often associated with mood swings, anxiety and low self-esteem.
During adolescence, difficulties tend to worsen due to increased academic and social demands. Young people with ADHD are more prone to psychotropic drug use and dependence, reckless driving, gambling addiction, obesity, extreme impulsivity and difficulty managing emotions.
Numerous studies have shown that when young people with ADHD manage this neurodiversity optimally, they gradually acquire considerable strengths compared to their peers: marked creativity, the ability to think innovatively and to find original solutions to problems. These abilities are often accompanied by a change in personality, from shyness and reserve to theatricality and exaggeration.
However, these cases are quite rare. It is more common for the disorder to be under-diagnosed or diagnosed late, especially in girls, whose symptoms may be less obvious than in boys. ADHD is often confused with other conditions, such as anxiety or depression, making it even more difficult to identify and treat.
The lack of trained specialists, the differences in diagnostic protocols between European countries and the persistence of stereotypes about ADHD contribute to the fact that this disorder remains unknown, despite the fact that in more difficult social contexts it can develop into a full-blown psychiatric disorder.
ADHD in adulthood
Contrary to what was previously thought, ADHD does not disappear with adulthood but tends to manifest itself in different ways: difficulties with time management, organising daily activities and maintaining concentration at work. Other problems associated with ADHD in adulthood include difficulties maintaining interpersonal relationships, constantly forgetting things and appointments, and an increased risk of developing anxiety and depression.
You may have noticed a proliferation of highly questionable self-diagnosis tests for ADHD on the internet. It can be said that it is a ‘trendy’ condition, especially after it was discovered that, in addition to the problems mentioned above, it can develop skills that are particularly valuable in certain ‘creative’ professions (such as design, art or writing). In addition, the ability to “hyper-focus” on specific interests allows these people to devote themselves with passion and dedication to projects they are passionate about, often with excellent results.
Peter Shaman, a successful American entrepreneur, attributes his ability to innovate to ADHD, describing it as a ‘superpower’ that has allowed him to stand out in his field. In Silicon Valley and elsewhere, ADHD is common at all levels, from senior managers to programmers.
However, ADHD is a condition that increasingly affects the quality of life of both adults and children. Psychiatry has an obligation to increase its expertise in the diagnosis and treatment of ADHD, and to provide psychological support, educational strategies and, in some cases, pharmacological treatment.
