Teens With ADHD

ADD or ADHD

Attention Deficit (Hyperactivity) Disorder (ADD / ADHD) is a condition characterized by poor self-regulation. The teen with ADD has difficulty inhibiting their spontaneous responses. According to Gabor Mate “The hallmark of ADD is an automatic, unwilled "tuning out," a frustrating non-presence of mind. teens suddenly find that they have heard nothing of what they have been listening to, saw nothing of what they were looking at, remember nothing of what they were trying to concentrate on. One misses information and directions, misplaces things, and struggles to stay abreast of conversations. Tuning out creates practical hardships, and it also interferes with one’s enjoyment of life”

What are the signs and symptoms of ADD or ADHD?

ADD / ADHD varies significantly among individuals; teens with ADD / ADHD don’t all have the same problems. Some may be hyperactive. Others may be under-active. Some may have great problems with attention. Others may be mildly inattentive but overly impulsive. Still others may have significant problems in all three areas (attention, hyperactivity, and impulsivity). The three subtypes of ADD / ADHD are:

Predominantly inattentive type
Predominantly hyperactive-impulsive type
Combined type (inattention, hyperactivity-impulsivity)

From time to time, practically every person can be a bit absent-minded, restless, fidgety, or impulsive. With ADD / ADHD, these behaviors occur far more often and therefore are the rule and not the exception.

Symptoms of inattention

Teens with inattentive symptoms of ADD have difficulty keeping their mind on any one thing. They may get bored easily with a task and bounce to the next task, and the next task after that. Organizing and completing a task is difficult. They may however give undivided and effortless attention to activities and topics they enjoy. teens with ADD often have difficulty learning something new.

Some symptoms of inattention are

ignores details; makes careless mistakes
difficulty sustaining attention or listening when directly addressed
difficulty following instructions or finishing tasks
appears forgetful, disorganized, distracted

Attention is a process. When we pay attention:

we initiate (direct our attention to where it is needed or desired at the moment);
we sustain (pay attention for as long as needed);
we inhibit (avoid focusing on something that removes our attention from where it needs to be); and finally
we shift (move our attention to other things as needed).

Teens with ADD / ADHD can pay attention. Their problems have to do with what they are paying attention to, for how long, and under what circumstances.

Symptoms of hyperactivity/impulsivity

Teens with hyperactive or impulsive symptoms of ADHD seem to be always in motion. Sitting still can be very difficult. They may dash around, squirm in their seats, roam around the room or talk incessantly. They may try to do several things at once, bouncing around from one activity to the next.

Some symptoms of hyperactivity/impulsivity are

fidgety, squirmy
difficulty staying seated
in constant motion, often running or climbing inappropriately
physical restlessness; difficulty with quiet, sedentary activities
excessive talking; blurts out answers before questions are completed
difficulty waiting; interrupts or intrudes on others

Because hyperactivity and inattention are expected behaviors at some ages in childhood, it is the impulsive behaviors that often stand out in very young teens with ADD / ADHD. By age four or five, though, most children have become more selectively attentive and less active, so those with ADD / ADHD stand out in all three behaviors: inattentiveness, hyperactivity, and impulsivity.

How are working memory and executive functioning related to ADD / ADHD?

Those who have ADD / ADHD tend to be low on “working memory”: the ability to hold information in memory that must be used to make decisions and to guide behavior. Working memory and executive functioning are closely tied. Executive functioning includes the abilities to plan, prioritize, organize, persist, multi-task, move toward a goal, delay gratification, and self-monitor. Executive functioning often involves inhibition and waiting.

With ADD / ADHD, the very brain areas responsible for executive function and inhibition are impaired. In addition to symptoms of inattention, impulsivity, and hyperactivity, you may also see these types of executive function problems:

weak problem solving,
poor sense of time and timing,
inconsistency,
difficulty resisting distraction,
difficulty delaying gratification,
problems working toward long-term goals,
low "boiling point" for frustration,
emotional over-reactivity,
changeable mood, and
poor judgment.

It's important to remember that the self-control and self-regulation problems seen in people with ADD / ADHD are not a matter of deliberate choice. These problems are caused by neurological events or conditions. Teens with ADHD know how to behave. They generally know what is expected in a given situation. But they run into trouble at the point of performance -- that moment in time when they must inhibit behavior to meet situational demands. Their troubles may show up in how they act in the outside world, or internally. They characteristically have inconsistent performance. This inconsistency is often mistaken for a lack of regard or respect, or as a lack of effort.

What are symptoms and characteristics of adult ADD?

An adult with ADHD has a different complex of symptoms than a child does. Often the most prominent characteristic in adults with ADHD is difficulty with executive functioning. As a person matures, the childhood symptoms of ADHD may evolve:

Hyperactivity may evolve into

uncontrolled arousal
feeling overwhelmed
talking excessively.

Inattentiveness may evolve into

unwilled tuning-out
the inability to focus on mundane tasks.

Impulsiveness may evolve into

irritability
quick anger
inadequate censorship of rude or insulting thoughts
poor timing in interactions.

Gabor Maté (author of Scattered) and Hallowell and Ratey (authors of Driven to Distraction) also include these characteristics of Adult ADD:

may be perceived as aloof and arrogant or tiresomely talkative and boorish
compulsive joking, often about personal life history and feelings
pressured rapid-fire speech, seemingly random and aimless hopping from one topic to the next
procrastination - difficulty starting tasks
incompletions - tasks or book reading begun but not finished before new projects or new books are started, leaving a never-ending to-do list
insecurity and self-esteem issues because of unmet high personal expectations
often high achiever, even overachiever, but with poor self-image because of beliefs that more could be accomplished if not for disorganization

How does ADD or ADHD look and feel to the person with this condition?

There are several experiences common to teens with ADHD. Gabor Maté, describes these characteristics—he uses the heading ADD—beginning with the main hallmarks:

Poor attention skills

an automatic, unwilled "tuning out," a frustrating non-presence of mind (causes distractibility, short attention spans, and chaos)
lack of a mental model of how order comes about (may be able to visualize a tidy and organized room, but missing the mind-set to create it)
frequent fine motor control coordination difficulties (though some may have well developed mechanical skills)
inability to form three-dimensional mental representations or spatial relationships
inability to track a conversation or verbal directions
inconsistent distractibility (may be able to attend to activities of high interest and motivation)
hyper-focusing (compulsive, hyper-concentrated attention that excludes awareness of the environment)

Impulsiveness in word and deed

poorly-controlled emotional reactivity
difficulty restraining from interrupting others
torturous to wait for a turn
often act or speak impulsively, with no forethought

Hyperactivity

trouble keeping physically still (toes or fingers tapping, thighs pumping, nails being chewed, teeth biting the inside of the mouth)
excessive talking
the mind as a perpetual motion machine
intense aversion to boredom, and a need for constant activity, distraction, or attention
unremitting lack of internal stillness
inertia or procrastination for long periods, with restlessness, and bursts of adrenaline and activity when the threat of failure or the promise of reward is imminent
hyperactivity may occasionally be absent altogether, especially in girls

Overachievement and social disability

high achievers despite ADD (with wide variations)
workaholism and professional success (which can mask serious problems in other areas)
difficulty recognizing interpersonal boundaries
an almost insatiable desire for physical and emotional contact from adults
naive and unrequited openness in approaches to other children (often leading to rebuffs)
impaired ability to read social cues, often leading to ostracism by peers

What are some positive aspects of having ADD / ADHD?

Teens with ADD can be very fun to be with! Some of the positive traits are:

Creativity – Daydreaming and attending to many different thoughts at once can be just the right trait for creative problem-solving. People with ADD are often excellent at brainstorming ideas. Because they do not choose which ideas to focus on too early, they are more open to considering all ideas, to engaging in divergent thinking. Such thinking allows for rare insights in such fields as art, music, and science. Creative thinking is especially useful to inventors, entertainers, comedians, and medical doctors.
Enthusiasm, spontaneity, liveliness, flexibility – Attending to a lot of thoughts at once can provide lively conversation for others who associate with the person with ADD.

Hyperfocus, high energy, tenacity and drive – If something is interesting to a person with ADD, there may be no way to distract them from the task! This is particularly true of interactive or hands-on activities.

Intelligence – Some people with ADD are extremely bright or gifted.