Attention Deficit Disorder (ADD) is the umbrella disorder, encompassing three sub-groups. These three groups are defined as follows:

• ADD Inattentive Type
  Teens and adults with this disorder are not overly active. They do not disrupt the classroom/office, so their symptoms might not be noticed. Their main difficulty is the inability to focus and concentrate. In teen girls, this sub-group of ADD is the most common.
  
  
• ADD Hyperactive/Impulsive Type
  In this sub-group of ADD, rarely adults exhibit only hyperactivity/impulsivity symptoms. This is classified as ADHD, as it includes the element of hyperactivity.
  
  
• ADD Combined Type
  Teens and adults with this type of ADD show hyperactive behavior (starting in childhood), impulsive behavior, and cannot focus or concentrate. Hyperactivity symptoms tend to be less noticeable in adults. This is classified as ADHD as it includes the element of hyperactivity, and is the most common form of ADHD.

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The process of diagnosing attention deficit disorder must be comprehensive. It requires several steps, and involves gathering a multitude of information from various sources. It is important to recognize that under no circumstances should ADD be diagnosed in any adult whose primary diagnosis is an emotional disorder, such as anxiety or depression.

A licensed health care professional or psychologist should:

• Investigate the following areas:
  
  
  • School history and school reports (looking for specific problems beginning as early as possible that may have been encountered during development)
  • Sibling relationships
  • Family history (for any occurrence of ADD)
  • Eating habits
  • Sleep patterns
  • Medical problems (physical problems, particularly allergies)
• Determine how the individual handles different situations through observation activities.
  
  
• Perform a physical examination. A full medical history will be needed to put the behavior in context and screen for other conditions that may affect it. The health care professional will also want to talk to the individual about their feelings and ‘typical’ actions during the course of a routine day.
  
  
• Investigate if other areas are a possible root cause of the behavior. If this is determined to be the case, the diagnosis of ADD must be put on hold until these areas are fully explored. These include:
  • Mental retardation
  • Chronic illness being treated with a medication that may interfere with learning
  • Trouble seeing and/or hearing
  • History of abuse
  • Major anxiety or major depression
  • Severe aggression
  • Possible seizure disorder
  • Alcohol or drug abuse
• Request personal information about the individual’s life at home, behavior in college/work, and in other social settings. The health care professional may inquire about existing symptoms, duration, and the affects of the behavior. Other signs or symptoms may be identified at this time and warrant a blood test, brain imaging study, or an EEG. Blood or other laboratory tests are currently recommended only if the health care professional suspects lead toxicity or other medical problems.

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The main symptom of attention deficit disorder in adults is difficulty with the brain activity responsible for monitoring a person's own behavior. This causes one of the biggest problems adults with ADD face, which is developing a sense of self-regulation.

This lack of self-control affects an adult's ability not just to do tasks, but also in determining when they need to be done. This can be extremely frustrating to the ADD adult.

Adult ADD does not have clear physical signs that can be seen in an X-ray or show up on a lab test. Adult ADD ADHD symptoms can only be identified by looking for certain characteristic behaviors (which vary from person to person) and by examining the individual's history.

The ways in which the following characteristics of adult ADD affect each individual will be different and unique, and may include:

Inattention and Memory Difficulties

• May be forgetful in daily activities
• May consistently begin a task and not complete it
• May have a problem following conversations
• May be difficult to motivate yourself to begin a project
• May have difficulty following a timed schedule
• May be in constant movement
• May get bored easily
• May become restless after a few minutes of inactivity
• May have a great desire for active, risky, and fast-paced activities

School-Related Impairments

• A history of poor educational performance, thus a strong likelihood of underachievement
• Frequent school disciplinary actions
• May have repeated a grade
• May have dropped out of school
  

Work-Related Impairments

• May show a frequent change in employers and perform at less than optimal levels
• May have had fewer occupational achievements, independent of psychiatric status
  

Social-Related Impairments

• Have a lower socioeconomic status
• Have driving violations such as: speeding tickets, suspended license, car accidents, and/or record of poor driving
• Use illegal substances more frequently
• Smoke cigarettes
• Self-report psychological maladjustment more often

Relationship-Related Impairments

• Have more marital problems and multiple marriages
• Have higher incidence of separation and divorce

Remember that every individual is unique, and just because you may have been diagnosed with ADD does not mean you will automatically experience or exhibit these behaviors.

There are several symptoms for ADD that seem to worsen when demands at school, college, work, or home increase. They are:

• Not listening to instructions
• Inability to get organized
• Fidgeting, especially with the hands and feet
• Talking too much
• Failure to finish projects, including work assignments
• Difficulty paying attention to and responding to details

Although adults with ADD (including teens) are more likely to recognize these symptoms than children with ADD, it is still very important to seek a thorough evaluation and professional diagnosis regardless of age.

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Although the following factors may present symptoms similar to those of ADD, research has shown that there is no evidence that ADD is caused by the following:

• Immunizations
• Too much TV
• Poor home life
• Poor schools or colleges
• Bad parenting
• Aspartame (or sugar substitutes)
• Lack of vitamins
• Fluorescent lights
• Video games

However, in some cases, the above factors could certainly cause symptoms similar to those seen in ADD in certain individuals. Iit is worth investigating their impact if a link is suspected.

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The most commonly used stimulants for the treatment of ADD include Ritalin, Adderall and Concerta. The non-stimulant drug Strattera has also been widely prescribed as treatment for ADD.

While there is a place for prescription medication in certain cases of ADD, careful consideration should be taken regarding possible side effects and cautions.

Contact your doctor or pharmacist if you have any questions or concerns about using these medications.

There are some difficulties in using stimulants to treat ADD in teens and adults. Stimulants are controlled substances and it is not uncommon for adults or teens with ADD to have or to have had problems with substance abuse.

Short-acting stimulants may wear off quickly, and since adult patients administer the medication themselves but usually have problems with forgetfulness, consistency can be problematic with multiple-day dosing.

Adults may experience significant difficulty in the evening when they do housework, pay bills, help children with homework, or drive. They may be tempted to use substances 'to relax', which can lead to addiction and drug-dependency. Teens may sell their medication to friends, or combine it with other substances.

Long-Term Complications

Research into the long-term effects of Ritalin and other drugs prescribed for ADD is still in its early stages, and must be continued.

Discuss with your doctor the risks and benefits of using these medications or treating your teen with these medications.

It is strongly advised that the following criteria are fully investigated with regards to any stimulant drugs: common uses, cautions, possible side effects, overdose, additional information, and major drug interactions.

The Food and Drug Administration (FDA) are still investigating certain side effects of certain prescription ADD drugs, and it is advisable that individuals do their own research into these medications so that they are fully aware of the potential risks.

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Alternative solutions for ADD and ADHD including being proactive and taking initiative to find the best possible treatment plan. Be positive. Here are a few tips.

Tips for you as an ADD Adult:

• Set aside a few minutes each night to schedule the following day's events
• Organize needed everyday items so you know where things are
• Use diaries and notebook organizers
• Don’t be too hard on yourself or set unrealistic goals

Activities to Pursue:

While there is no single activity that guarantees teens with ADD instant success, certain types of activities tend to reap more positive results.

• Look for activities with a singular focus, such as sports that center attention
• Consider activities that involve movement, providing an appropriate and controlled physical outlet
• Learn to play a musical instrument
• Seek activities that offer individualized instruction
• Explore activities that result in tangible rewards

Activities to Avoid:

• Those that involve a lot of down time
• Those that require too much divided attention
• Those that require fine motor skills

Special Advice for Managing Teens with ADD

Tips for you as a parent to help your ADD teen:

• Maintain as much routine and consistency as possible
• Try to avoid major or frequent changes
• Ensure that family relationships are stable
• Be very consistent in your discipline and keep all rules the same
• Speak often to your teen's teachers
• Engage in activities that promote concentration and listening skills
• Use frequent eye contact when speaking to your teen or giving instructions
• Keep directions simple and set simple house rules
• Provide a structured outlet for hyperactivity
• Teach using as many of the senses as possible and make learning interactive
• Review your expectations for your teen
• Reward positive behavior immediately
• Anticipate situations
• Make sure your teen is supervised at all times
• Learn and understand the symptoms of ADD
• Schedule tasks and reminders
• Organize needed everyday items
• Use homework and notebook organizers
• Set a homework routine
• Focus on effort, not grades
• Make a special effort to highlight positives in your child

Try not to:

• Use physical punishment
• Put too many expectations on your teen
• Focus too much on the areas your teen is struggling with

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One of the difficulties in diagnosing adults with attention deficit disorder is that it is often accompanied by other problems.

A number of disorders may mimic or accompany ADD. Many experts believe the term ADD should be used to describe a collective group of symptoms and behavioral problems. Many of these problems require other methods of treatment and should be diagnosed separately, even if they accompany ADD.

Because emotional disorders and attention disorders so often go hand-in-hand, every teen exhibiting ADD symptoms should be checked for accompanying anxiety and depression.

Conditions Commonly Coexisting with ADD

ADD may coexist with one or more disorders. The most common disorders to occur in an adult with ADD are:

• Disruptive behavior disorders
• Tics and Tourette's Syndrome
• Learning disabilities

Of course, not all adults with ADD have an additional disorder. Nor do all people with learning disabilities, Tourette's syndrome, oppositional defiant disorder and conduct disorder have ADD. But when they do occur together, the combination of problems can seriously complicate a person's life.

• Learning Disabilities. Many teens with ADD also have a specific learning disability (LD). Reading, writing difficulties, or arithmetic disorders may appear. Dyslexia, a type of reading disorder, is quite widespread.
  
  
• Tourette's Syndrome. A very small proportion of people with ADD have a neurological disorder called Tourette's syndrome. People with Tourette's syndrome have various nervous tics and repetitive mannerisms, such as eye blinks, facial twitches, or grimacing. They may also experience sudden verbal or behavioral outbursts or even problems with anger management. Psycho-stimulant ADD drug treatment may exacerbate the symptoms of Tourette's Syndrome and some believe it may even precipitate the disorder.
  
  
• Oppositional Defiant Disorder (ODD). It is important to note that any teenager, whether or not they are suffering from ADD, will at times feel frustrated and misunderstood. Their behavior could easily be seen as defiant, confrontational, and disrespectful, which may present itself as ODD. Similarly, asserting his or her independence is a normal stage in any teen's transition into young adulthood. Once again, correct evaluation is essential.
  
  
• Conduct Disorder (CD). Conduct disorder (CD) is sometimes seen as a more serious pattern of antisocial behavior. Similarly, as with ODD, it is important to note that most teens will ‘act out’ occasionally. A teenager who has emotional problems may destroy property, steal, and lie – all of which can be misdiagnosed as CD.
  
  
• Anxiety, Mood Disorders, and Depression. Anyone diagnosed with an anxiety disorder, mood disorder, bipolar disorder, depression, or any other emotional disorder as the principal diagnosis may not be diagnosed with ADD. Emotional disorders must be treated separately.
  
  
• Sleep Disorders. Sleep disorders or disturbances are very common in ADD individuals, which can lead to the age old ‘chicken or the egg’ question... “Am I struggling to sleep because of the ADD, or am I suffering with ADD symptoms due to lack of sleep?” Ironically, many stimulant drugs used to treat ADD list sleep problems as a possible side effect to the prescribed medication.

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