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ADHD:
A teenagers guide
by James J. Crist, Ph.D.
Introduction.
This article is written primarily for teenagers with ADHD. Many ADHD teens get
tired of hearing, "you're just lazy," "I know you can do better," or "if you
would only pay attention in class and do your homework, your grades would be
much better." While many books and articles have been written for children and
adults, very little has been written specifically for teens. This article, which
contains excerpts from my book, ADHD--A Teenagers Guide, is intended to
give teens with ADHD some answers about the disorder and how to cope with it.
What exactly is ADHD? ADHD (or
ADD) stands for Attention Deficit Hyperactivity Disorder. It is thought to be a
brain disorder that makes it difficult to sit still and pay attention. ADHD has
been studied for over 60 years, but has become more well-known only in the last
20 years or so. Estimates vary, but between five and ten percent of children are
thought to have ADHD, and perhaps between one and two percent of teenagers and
adults. Three types of symptoms generally occur in ADHD. You may have only one,
or all three. The first is hyperactivity. This means that you may always be in
motion, tapping your foot or your pencil. Or you may talk too much--people may
call you "motor mouth!" You hate having to sit still, which causes problems at
school. In teenagers and adults, hyperactivity often takes the form of a
subjective feeling of restlessness. The second symptom is inattentiveness. This
means you have trouble paying attention for long periods of time. You are easily
distracted and daydream a lot, which causes problems at school. You make
careless mistakes. Forgetting assignments is common. Reading may be very
difficult. You may get bored easily. Getting yourself organized is likely to be
a problem--you may always be losing or misplacing assignments, notes, your keys,
etc. For girls, daydreaming a lot and not being able to focus are often the only
symptoms present. Impulsivity is the third symptom. People who are impulsive
often do not think before they act. You may skip classes, put off doing
homework, or even break the law without thinking about the consequences. You may
interrupt others or blurt things out and then wish that you had not said them,
because they get you in trouble or hurt someone's feelings. You may also be
accident- prone. In many ways, ADHD is not so much a deficit in attention as it
is an inability to pay attention consistently over a period of time. Some people
with ADHD over focus, meaning that they become so engrossed in what they are
doing (e.g. playing video games) that they completely tune out everything else.
How can you tell if you have ADHD? ADHD must be diagnosed by a qualified mental
health professional who is knowledgeable about the disorder. Such professionals
may include a physician, psychiatrist, psychologist, clinical social worker, or
licensed professional counsellor. The therapist will most likely ask you, your
parents, and your teachers to complete a number of questionnaires that contain
items that are associated with ADHD. A thorough personal, family, and medical
history will be taken. You may also be asked to take a computer test to measure
your ability to pay attention. These tests require you to press a button or
computer key when you see a certain letter or shape on the screen. One of the
problems in diagnosing ADHD is that many of its symptoms can also be symptoms of
other disorders. For instance, people who are depressed often have trouble
concentrating. People who are anxious may appear to be restless or have trouble
sitting still. In addition, many teenagers are disorganized and do not focus
consistently on their schoolwork. Another problem in diagnosis is the
inconsistency of the symptoms. You may be able to focus on some days and on some
activities, especially if they really interest you. Yet with other activities
and at other times, you find it much harder to focus. In larger groups, your
ability to focus is generally less than it is one-on-one. For these reasons, it
is important to have a complete evaluation. What causes ADHD? No one really
knows for sure what causes ADHD. It does seem to run in families, which suggests
that it may be inherited. About three times as many boys have ADHD as compared
to girls. Some research suggests that ADHD is a brain disorder in which the
areas of the brain responsible for maintaining attention and controlling
impulses do not function properly. Studies also suggest that the use of alcohol
or drugs during pregnancy can interfere with the development of brain cells, and
thus may be a cause of ADHD. Others believe that allergies may cause ADHD,
though this belief is generally not accepted by the majority of practitioners.
What are the effects of having ADHD? People with ADHD are at greater risk for
school failure, for having other learning disabilities, and for abusing drugs or
alcohol. You may have more trouble maintaining friendships and getting along
with your family. You might also be more irritable and have a quick temper. Left
untreated, ADHD can also cause problems in college or even on the job. And when
you have had these problems for a number of years, it is hard to feel good about
yourself. If you suffer from low self-esteem, you may also become depressed and
give up trying to succeed. Common symptoms of depression include long-standing
feelings of sadness or irritability, no longer getting pleasure from activities
you used to enjoy, changes in your eating or sleeping habits, avoiding being
around people, being tired a lot, or thinking about death/suicide.
How is ADHD treated? ADHD is usually treated by a combination of medication and
psychotherapy or counselling. Sometimes, only one or the other is needed.
Counselling can help you deal with problems related to ADHD, such as improving
your study skills, getting more organized, coping with depression, and boosting
your self-esteem. It can also help you and your parents learn to get along
better. Medications can help make you less fidgety and more focused. By slowing
you down, the medications can make it easier to think before you act. The most
commonly used medications are the stimulant medications. These include Ritalin
(methylphenidate), Dexedrine (d-amphetamine), and Cylert (pemoline). These
medications are helpful for about 75% of children and adults with ADHD. If these
do not work, or if depression or anxiety is present, an antidepressant
medication may be tried. Examples include Elavil (amitriptyline), Pamelor
(nortriptyline), Tofranil (imipramine), Prozac (fluoxetine), or Wellbutrin
(bupropion). Additional medications which are sometimes used, if neither the
stimulants nor the antidepressants seem to work, include Catapres (clonidine)
and Tegretol (carbamazepine). In some cases, a combination of two or more
medications may be needed. These medications work by altering the levels of
different brain chemical messengers, called neurotransmitters. It is thought
that by doing so, medications correct a chemical imbalance that may be causing
the symptoms of ADHD. Since we cannot know for sure which medication will be
most helpful for a given individual, you may have to try a few different ones
until your doctor finds one that works for you. Many teens dislike the idea of
taking medication. You may worry that this makes you different from everyone
else, that you may become addicted to it, or that it is a way that your parents
are using to control you. None of these worries is true! If anything, medication
can make it easier for you to control yourself. If you do not want people at
school to know you take medication, there are medicines that only need to be
taken once a day, which eliminates the need for a dose at school.
Are there any side effects of medication? Yes. In most cases, the side effects
are mild and may eventually go away. The most common side effects of stimulant
medications are difficulty sleeping, loss of appetite, irritability, and upset
stomach. Common side effects of antidepressant medications include headaches,
dry mouth, blurry vision, drowsiness, and constipation. Make sure you tell your
doctor if you experience these or other side effects. Your doctor may change the
dose or switch you to a different medication.
How long do I have to keep taking medicine? Taking medication does not mean you
need to stay on it forever. Give it a try for at least four to six weeks, to
give the medication a fair chance to work. Take it exactly as prescribed,
without skipping any doses. Give your doctor a chance to adjust the dose or try
different medications. If you honestly think that nothing has helped, then at
least you can say you tried. If you decide that you do not want to keep taking
the medication, it is very important that you tell your doctor first. With
certain medications, it can be dangerous to stop taking them suddenly. You may
need to slowly decrease your dose over a period of days.
What kind of special help is available through my school? Attention Deficit
Hyperactivity Disorder is considered to be a disability under federal law if it
significantly interferes with your ability to learn. As a result, you may be
eligible for special services to help you to do your best. In order to qualify
for this help, you will most likely need to undergo specialized testing. This
will usually include an IQ test, which measures your ability to learn. The
WISC-III is a commonly used example of this test. You will also be given
achievement tests, which measure your level of achievement (what you have
actually learned) in different subject areas, such as mathematics, spelling, and
reading. Once the testing has been completed, school officials will meet with
your parents to review the results and decide whether or not you qualify to
receive special services. An IEP (Individualized Education Program) will be
developed for you which describes your problem areas and specific strategies the
school will use to help you. I recommend that you attend school meetings if at
all possible. This will help you to understand decisions that are being made
about your life. It will also give you the opportunity to voice your opinion.
After all, it is your life!
How can I improve my school performance? You cannot afford to just "wing it" in
school if you have ADHD. Many teens with ADHD were able to get by in earlier
grades, but find that high school is different. You have more assignments, more
deadlines, and are expected to work more independently.
Will I ever outgrow ADHD? Most people do not outgrow ADHD. However, people do
learn to adapt and lead successful lives. Remember also that having ADHD is not
all bad. Many people with ADHD tend to be energetic, outgoing and creative. They
become successful in business, sales, sports, and other careers.
Conclusions: ADHD is a treatable disorder. Counselling, education, and sometimes
medication can all be very helpful. Dealing with ADHD can be a struggle.
However, if you work at it and develop good coping strategies, you will be much
more likely to minimize the negative effects of ADHD. This article contains a
number of suggestions for making your life easier. If you want more information,
there are books that can give you additional suggestions for coping with ADHD.
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James J. Crist, Ph.D., is a clinical psychologist with the Family
Counselling Center in Woodbridge Virginia. He specializes in working with
children, adolescents, and adults with ADHD. You can reach Dr. Crist via
e-mail at
DrJCrist@aol.com
Dr. Crist is the author of ADHD--A Teenagers Guide.
SMSC online are grateful to James Crist for the allowing
the use of this valuable article. |
Coping
with ADHD at school
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