When we talk about attention deficit disorder with or without hyperactivity (ADHD), we often think of hyperactivity, agitation… However, this disorder is much more complex and also manifests itself through less visible symptoms, sometimes difficult to spot on a daily basis.
Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that causes difficulty concentrating, controlling impulses, or regulating activity levels. It appears in childhood and can persist into adulthood, often in more discreet forms. These manifestations can affect school, professional or relational life. Long associated with agitated children, ADHD is now better recognized in adults, and particularly in women, whose symptoms often go unnoticed. The singer Louane had also mentioned this disorder she suffers from, on the set of C à Vous in January 2023: “It’s not visible, but it’s quite debilitating on a daily basis”. A speech that helped raise public awareness and remind people of the importance of knowing how to spot the signs, in children and adults alike.
What are the symptoms of ADHD?
According to the WHO, attention deficit disorder with or without hyperactivity is characterized by a persistent pattern (at least 6 months) of inattention and/or hyperactivity-impulsivity in several situations or settings: at home, at school, at work, with friends or parents.
► These symptoms appear before the age of 12, in early to middle childhood (although some individuals do not present clinical symptoms until later).
► The degree of inattention and hyperactivity-impulsivity is outside the limits of the normal variation expected for age and level of intellectual functioning.
► Inattention refers to significant difficulty maintaining attention on tasks that do not provide a high level of stimulation or frequent rewards, distractibility and organizational problems.
► Hyperactivity refers to excessive motor activity and difficulty remaining still, especially visible in structured situations requiring behavioral control (at school for example).
► Impulsivity is a tendency to act in response to immediate stimuli, without thought or consideration of risks and consequences.
The manifestation of symptoms may vary from one individual to another and change during development. They are not better explained by another mental, behavioral or neurodevelopmental disorder and are not due to the effect of a substance or medication.
What are the symptoms of ADHD in adults?
“Attention disorder is less visible, but still causes many inconveniences. Organizational, planning and management difficulties come to the fore and their consequences worsen with growing responsibilities“, specifies Romane Nicolay. Distraction will manifest itself through missed appointments, loss of documents and frequent forgetting, for example. On the hyperactivity side, we also find the same symptoms as in adolescents, that is to say agitation, discomfort when waiting… The ADHD adult also remains impulsive. “He tends to make decisions too quickly and not to think before speaking. He has difficulty handling frustrations and his mood is often variable“, develops the neuropsychologist. Adult ADHD “is frequently associated with other disorders, such as anxiety disorders, mood disorders, personality disorders, addictive disorders, behavioral disorders linked to substance use and sleep disorders” notes the High Authority of Health. Symptoms in adulthood are strongly influenced by experiences, failures, successes and the personal and professional environment.
What are the symptoms of ADHD in women?
In girls, ADHD can manifest itself differently. “They tend to present a so-called inattentive form, that is to say with more symptoms of inattention than hyperactivity/impulsivity.“, reveals the neuropsychologist. Conversely, boys tend to present a impulsive/hyperactive form predominant. “This different presentation can, unfortunately, delay the diagnosis of ADHD in women and, therefore, without treatment, cause more difficulties. However, this difference tends to disappear in adulthood.“, indicates the specialist. For her, we see a difference in comorbidities which therefore add to the basic disorder. “Women will tend to present internalized disorders (depression, anxiety, eating disorders, etc.) while men will tend to present externalized disorders (addictions, behavioral disorders, etc.).”
What are the symptoms of ADHD in children?
In children with ADHD, schooling will be one of the biggest problems, with symptoms interfering in this area. Romane Nicolay details the demonstrations in this context. “In class, these children experience a uncontrollable need to move, they only manage to stay in their chair by making intense efforts. They are very clumsy and commit many forgetfulness, which leads to repeated reprimands and mockery. As school activities are not adapted to their disorder, they are unable to maintain their attention. These children make themselves noticed in class by shouting their answers and comments, they can quickly become the “class jester”“For the neuropsychologist, despite parental effort and investment at home, the time spent on homework is “a real hell“.”The homework will have a lot of mistakes, they will be disorganized and messy“, describes the specialist. During adolescence, hyperactivity evolves into internal agitation, often interpreted as nervousness, impatience or boredom. “Attention, for its part, does not fluctuate, it remains stable regardless of age while demands in terms of organization and concentration will increase“, describes the professional. Attentional and organizational difficulties may be the cause of poor academic performance. Whether academic or family-related, the failures of the ADHD adolescent can promote poor self-esteem with defensive attitudes (or even withdrawal), demotivation, depression and gratuitous and incessant protests. “Due to his impulsivity, the ADHD adolescent has difficulty controlling the dangers as well as the limits and consequences of his actions. At this age, he is looking for sensations and new things that can increase the risk factor for accidents of all kinds.“.
What are the symptoms of ADHD in babies?
In babies, it is difficult to make a diagnosis, some already presenting warning symptoms and others not. “Some parents will report symptoms present from pregnancy, with a child who is already moving a lot in the belly, or in young childhood with difficulty falling asleep or already increased activity. Others will only notice difficulties when entering primary school“, explains Romane Nicolay. Symptoms of inattention are less easily identifiable than symptoms of hyperactivity and impulsivity, because they are less the subject of complaints and functional discomfort.
What test should you take to diagnose ADHD?
According to international recommendations, ADHD is diagnosed on the basis of a clinical interview carried out by a trained and specialized professional. “It is important to specify that it is not on the basis of questionnaires, imaging methods or neuropsychological tests (attentional test, inhibition test, etc.) that we can attest to ADHD.“, warns Romane Nicolay. There are several options for treatment: therapeutic (cognitive-behavioral therapy, psychoeducation, parental guidance programs, etc.) or medication (ethylphenidate (psychostimulant) and atomoxetine (non-psychostimulant)..). Be careful, however. These do not cure people with ADHD, but relieve symptoms and make daily life easier.
Thanks to Romane Nicolay, neuropsychologist specializing in the assessment and management of ADHD.
