Definition of ADD:
The “official” clinical diagnosis is Attention Deficit Hyperactivity Disorder or ADHD. ADHD is then broken down into three different subtypes: Combined Type, Predominantly Inattentive Type, and Predominantly Hyperactive-Impulsive Type. When speaking about ADD or ADHD we are basically talking about the same thing.
ADHD is a diagnosis applied to children and adults who consistently display certain characteristics and behaviors over a period of time. Some of the most common features include:
- Distractibility (poor sustained attention to tasks)
- Impulsivity (impaired impulse control and delay of gratification)
- Hyperactivity (excessive activity and physical restlessness)
In order to be clinically diagnosed with ADHD the behaviors must be excessive, long-term and pervasive. The behaviors must begin to appear before the age of seven and continue for at least six months. These behaviors also must create difficulties in at least two areas of an individual’s life, such as school, home, work or social settings. It is very common to see in many school-aged children some symptoms. To be diagnosed with ADHD all criteria must be met. In children, the symptoms must be more frequent or severe than in other children of the same age.
According to the DSM IV (the Diagnostic and Statistical Manuel of Mental Disorders, Fourth Edition) some specific symptoms include:
- Often fails to give close attention to details or makes careless mistakes
- Often has difficulty sustaining attention to tasks
- Often does not seem to listen when spoken to directly
- Often fails to follow instructions carefully and completely
- Often loses or forgets important things
- Often feels restless
- Often fidgets with hands or feet, or squirms; runs or climbs excessively
- Often talks excessively
- Often blurts out answers before hearing the whole question
- Often has difficulty awaiting turn
Remember the severity and exact nature of the diagnosis varies from person to person.
In treating ADHD in children and teens, a team approach is recommended. This team approach includes educational, psychological and medical interventions. Some examples of these interventions include:
- Parent training in diagnosis, treatment and specific behavior-intervention techniques.
- An appropriate educational program for the child.
- Individual and family counseling when needed.
- Medication when needed.
One of the most important techniques is consistency and positive reinforcement, in which the child is rewarded for desired behavior.
Most children experience the feeling of anxiety before an important event such as the first day of school, before a first date or before an exam. Fear and anxiety are a necessary and normal part of life. According to the National Institute of Mental Health, 19 million Americans with anxiety face much more than just “normal” anxiety. Instead their lives are filled with overwhelming anxiety and fear that can be intense and crippling. If these feelings are left untreated, these disorders can dramatically diminish an individual’s quality of life. In children, anxiety disorders can lead to poor school attendance, low self-cient interpersonal skills, alcohol abuse, and adjustment difficulty.
What are the most common anxiety disorders?
- Panic Disorder: Characterized by panic attacks, panic disorder results in sudden feelings of terror that strike repeatedly and without warning. Children and adolescents with this disorder may experience unrealistic worry, self-consciousness and tension.
- Obsessive-Compulsive Disorder (OCD): Characterized by repeated, intrusive, and unwanted thoughts (obsessions) and/or rituals that seem impossible to control. Adolescents may be aware that their symptoms don’t make sense and are excessive, but younger children may be distressed only when they are prevented from carrying out their compulsive habits. Some examples include: counting, arranging, and excessive hand washing.
- Post-Traumatic Stress Disorder (PTSD): Characterized by persistent symptoms that occur only after the individual experiences a trauma such as abuse, natural disaster, or extreme violence. A recent example of trauma that may cause one to suffer from PTSD is experiencing the events of September 11th. Symptoms include nightmares, flashbacks, the numbing of emotions, depression, feeling anger, irritability, and distractedness.
- Phobias: A phobia is a disabling and irrational fear of something that really poses little or no actual danger. This fear in turn leads to avoidance of objects or situations and can cause extreme feelings of terror, dread, and panic. “Specific phobias” center around particular objects such as certain animals and heights. Common symptoms for children and adolescents with “social” phobia are hypersensitivity to criticism, have difficulty being assertive, and having low self-esteem.
- Generalized Anxiety Disorder: Characterized by chronic, exaggerated worry about everyday activities, which lasts at least six months. Children and adolescents with this disorder usually anticipate the worst and often complain of fatigue, tension, headaches and nausea.
If someone you know has or if you have symptoms of anxiety, a visit to the family physician is usually the best place to start. A physical can help determine whether the symptoms are due to an anxiety disorder, some other medical condition, or both. Following this, the next step is getting a referral to a mental health professional.
Effective treatment for anxiety disorders includes medication, specific forms of psychotherapy (behavioral therapy or cognitive-behavioral therapy), family therapy, or a combination of these.
Babior, S., and Goldman, C. Overcoming Panic, Anxiety, & Phobias: New Strategies to Free Yourself from Worry and Fear. Duluth, MN: Pfeifer-Hamilton, 1996