Symptoms, Diagnosis, and Treatment Of ADHD of US Adolescents

ADHD continues to torment the society without discrete solutions to it. Psychopharmacology practitioners keep on juggling from medical solutions to other therapeutic solutions. Explore the symptoms, diagnosis, and treatment of ADHD in US adolescent population and the controversies surrounding the use of Psycho-stimulants in ADHD treatment
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Attention Deficit Hyperactivity Disorder (ADHD) is a chronic condition that is symptomized by inattentiveness, impulsiveness, and hyperactivity. In most cases, ADHD begins in childhood and can be a lifelong condition. Medics and psychologists have partnered over the years to try come up with healing solutions to ADHD, but it still remains almost impossible to cure the condition. There are cases where ADHD is not diagnosed in childhood, and it only happens in teenage around the adolescence years. Teens with this condition usually show extreme behaviors and frequent conflicts with parents. It is also at this age of adolescence that most of the symptoms become more subtle than in childhood. Due to the delicate nature of handling this condition, there have been controversies over the years. At times, experts have failed to agree on the use of psycho-stimulants as the prescription of treatment for adolescents diagnosed with ADHD. This paper first analyzes the causes of ADHD and then diagnosis and treatment of the condition. It is from the treatment that controversies arise, where different experts have voiced different opinions. Experts agree to disagree, and from controversies they create solutions to the challenge; ADHD treatment in adolescents is yet to get that dominant expert solution.

Causes of Attention Deficit Hyperactivity Disorder (ADHD)

ADHD is a brain-based disorder where research has shown it has a genetic component to it. At its hyper stage, it is linked to many parts of the brain area. Most of the other causes are also biologically related. They include; prenatal maternal smoking, low birth weight, prenatal complications. Disagreements remain on whether parenting patterns have a hand on ADHD, but experts maintain strongly that there is no link whatsoever. There are also minor environmental links to ADHD including; food additives, lead exposure and pesticides. There have been scientific prove linking the said environmental issues to the condition.
In this same note that causes of ADHD have been highlighted, it would be important to deconstruct the myths that have been associated with the condition. Some of the highlighted reasons that could cause ADHD that remain mythical include; chaotic family life, lack of discipline and too much TV. All those are unproven, as is bad parenting. The major link of ADHD suggests genetic causes and not anything largely environmental. Therefore, next time someone mentions them as causes of ADHD, dismissal in entirety should meet them. Understanding the causes of ADHD goes a long way on helping the involved persons conduct the right diagnosis and treatment.

Symptoms and Effects of ADHD

Every condition is characterized by its unique symptoms and signs. Before getting into the controversies, it is important to understand what characterizes the condition. In the case of Attention Deficit Hyperactivity Disorder (ADHD), the major symptoms can be split into four categories as follows;
  1. Behavioral – aggression, excitability, impulsivity, hyperactivity, fidgeting, persistent repetition in words and action, lack of restraint and irritability.
  2. Cognitive – difficulties in focusing, absent-mindedness, short attention span, forgetfulness, and problems paying attention.
  3. Mood – anxiety, anger, mood swings and excitement
  4. Other symptoms – learning disability and depression
Those are the major categories, and their examples. When someone exhibits such signs, it is possible for them to be diagnosed with ADHD. In most cases, these symptoms are observed by parents and teachers. This makes it difficult to detect ADHD in an adolescent, because their contact time with parents and teachers are hugely reduced.

Diagnosis of ADHD

ADHD is more than just a mental condition; it is a medical condition that requires proper diagnosis and treatment. If diagnosis is poorly done, so shall be the treatment prescribed done – poor. Therefore, it is only proper to understand the dynamics of youth before going ahead to diagnose the condition. Experts opine that it may be difficult at times to diagnose ADHD within the demographic category of adolescents due to some reasons. Some of the reasons include;
  1. Adolescents show obvious signs of impulsivity and hyperactivity than young children.
  2. Multiple teachers and rare time with parents make it difficult to have good raters of direct observation
  3. Psychiatric comorbidities in adolescents which may ADHD presentation.
  4. Impaired social skills and poor academic performance; which are not captured in causes of the condition.
The above briefly described reasons for difficulties in diagnosing ADHD have made it difficult for professionals to give the best treatments at time. Proper treatment is subject to proper diagnosis. Therefore, when it is compounded with the stated reasons above, then assumptions get introduced and they shall not always be correct.
One has to meet a certain criteria prescribed in DSM-IV and DSM-5 to be declared an ADHD patient. In this case, we are concerned about adolescents. For an adolescent to be diagnosed with ADHD, it must occur that the symptoms discussed in the previous section have been in present for at least six months. Further, the signs must show inconsistencies with the developmental level of the individual – according to the judgment of the person observing. That initial criteria should satisfy one of sufficient impulsive symptoms.

Treatment of ADHD

There are different treatments that have been prescribed to deal with ADHD. Adequate treatment is required for the condition because it impairs quite a number of domains like academic performance, emotional health, social skills and family relations. Most of them revolve around psychopharmacology, using drugs to help subdue the effects of the condition. In this case of adolescents, stimulant agents are the first line consideration for treatment. These stimulants include; amphetamines, methamphetamine, methylphenidate, atomoxetine, and clonidine. The adolescent population, with all their differences from the rest of the people, requires a more informed approach in prescription of these drugs. Treatment of ADHD does not cure the condition entirely, rather reduces its capacity to impair the patient.
ADHD is not only a medically treated condition; rather it has elements of therapeutic treatment too. It should be understood that treatment is brought on board with close consideration of advice from medics and psychologists. It is the role of pharmacologists to ensure that prescription is well hinged on the parameters put in place such as age and the level of prevalence in a patient. Therapeutic relationships should be developed between patients and counselors, or the sake of psychologically managing the condition in the long term. According to CDC, attention deficit requires a combine effort of psychological and medical treatment. When the two are perfectly balanced and commissioned to the patient, then there is a chance of subduing the symptoms of the incurable condition.
Support groups, family therapy, psycho-education, and anger management are some of the therapeutic processes that patients are indulged in. apart from stimulants; there are also antihypertensive drugs and cognition-enhancing medication. Professionals involved in treatment of ADHD include psychiatrists, clinical psychologists, primary care providers, and in the case of children – pediatricians.

Controversies arising from the Use of Psycho-stimulants

The bone to break with ADHD has always come at the treatment stage. The use of psycho-stimulants has always brought across a huge debate. Whenever one is put under medication, there must be convincing evidence that the person bears some sort of illness. With ADHD in adolescents, it has so many ‘maybes' that prescription of stimulants has brought about a prolonged public debate about their effectiveness. Some experts argue in favor of the stimulants, whereas others disagree strongly about the same.
Misuse of stimulants has associated risks unknown to patients who go ahead to abuse their use, as well as unaffected individuals who indulge in their use. In the recent past, there has been a surge in the use of these stimulants among athletes and college folks to maintain focus and enhance performance. This is a misinformed application, brought about by the availability of the stimulants in the market against their real intended use.
It is argued that there are cognitive impacts and adverse effects that arise from the use of stimulants as treatment for ADHD. There are neuropsychological studies that have been conducted to establish the negative impacts of using stimulants for treatment of ADHD. Among the negative cognitive impacts have been established as; selective attention, impairment in memory, poor information procession speed, and working memory loss. All these are negative impacts of cognition resulting from the stimulants.
Application of any kind of treatment should have the capacity to give a net result of improvement. In view of this, some experts feel that the net effect of stimulants is negative. In any case, the impact of stimulants is nothing more than just modest. There is a constant remain from experts and professionals that cognitive advantage of a drug does not qualify it for therapeutic utility. This seems to be the case with the stimulants, taking the assumption that their perceived utility medically can be transferred for therapeutic purposes. In therapy, there is longevity and consistency. Use of the stimulants for an extended period of time is bound to come about with disadvantages.
In principle, ADHD requires a lengthy management process after diagnosis. Therapeutic relationships are usually built on the foundation of psychiatric relations. However, use of stimulants is built on medical provisions. Psychiatrists would not be on the frontline to advice for prolonged use of stimulants, and neither would be medics. Therefore, the principle of long term management of ADHD patients cannot be best executed through use of stimulants as the best option. They are good, but not the best for the interests of long term health.
However, there are those who argue in support of the stimulants for the condition. From a publication on National Library of Medicine, Hamed, Kauer, and Steves argue that stimulants have an avalanche of benefits that should be the guiding point. Among the advantages include; enhanced class setting manageability, increased academic productivity, increased attention, and general quality of output for learning adolescents. These are the desired results out of any ADHD patients. Improved focus brings rise to such kind of results, making an impression that stimulants should be encouraged.
Further, Lakhan and Kirchgessner note that a conversation with an individual who is suffering from ADHD is in a way discouraging and inconsistent. Anything that can be done to improve their focus and concentration is thus welcome. This argument drives the belief among supporters of using the stimulants that it is the best way forward. The supporters are comprised of a section of experts in psychopharmacology, but there is that other section that differs.

Addressing Controversies Surrounding Treatment of ADHD

Increasingly important, addressing the controversies arising from treatment should be a priority. There needs to be better solutions to the prevailing challenge, and professionals should come together and solve the impasse. This is a matter that touches on both the psychology profession, as well as the medical profession. As such, psychiatrists and medics need to come together, have a conference and talk this issue out. They need to arrive at concrete solutions to a challenge on human population. At dire need of a solution are adolescents suffering from ADHD. The argument on whether ADHD is actually a disorder or not is not a consideration here, what matters is treating it as such and seeking a solution.
Misuse of prescriptions is not easy to handle, but attempts can be made to ensure it does not affect patients. The first way to do this is creating awareness. The American Psychological Association (APA) in association with American Medical Association should lead efforts of creating awareness among the people on the risks of misusing subscriptions of stimulants. Some people do misuse subscriptions out of ignorance, whereas others its lack of information. The latter category can be salvaged from the negative effects if information is availed.
The other challenge of longevity of managing the condition can also be addressed. Comprehensive and procedural laydown of a process that combines stimulants prescription and therapeutic relationship should be developed for adolescent patients. The treatment procedures currently available do not provide clinicians with the right mix of things to handle different age groups and demographics. Stakeholders in this sector should this come together in this development and help the course. The future shall remember them for work well done, and a great thing they did for the people.
It is also a high time for researchers in medical field to come in and help with a solution. They have been entrusted with great responsibilities of providing the world with cures, preventions, among others. If they can help come up with prevention, it shall be used on those who are highly likely to contract ADHD biologically. One-off prescriptions may also be a good idea if such a thing can be developed. Instead of being prescription-dependent for a long period, the prescription comes once and ADHD is subdued for good. That would eliminate the debate of the long term effects of continuous use of the prescription.

Why is it Important to deal with ADHD Comprehensively?

Everywhere that there is a struggle, there is a purpose attached to it. The fight against ADHD prevalence among adolescents should not be blind-guided. In contrast, it should be guided by an element of desire to achieve certain objectives. First, ADHD should help achieve clinical stability of patients. The condition comes with it compromised physical and psychological health. A healthy society is related to economic progress and social stability. Therefore, addressers of this mental condition should resolve it to have more people who can contribute to the aforementioned factors of society.
Public health needs to score a plus. In the United States, prevalence of ADHD is quite high. In a 2022 statistical review, CDC estimated the number of children ever diagnosed with ADHD between 2016 and 2019 to be 6 million (9.8%). Therefore, it is the high time that efforts of addressing this condition got a focus to finding its cure. The chances should not only be of depressing the effects of the illness, rather, they should come up with solutions that lead to cure. It is a long call to make, but it would be a massive score for public health.
There is need to understand the discrepancy and difference in prevalence of the condition among boys than girls. From the CDC report, the likelihood of boys having ADHD is 13% while that of girls is 6%. At the same time, psychotropic medicine is more recommended for boys than it is for girls. This kind of discrepancies needs answers. Public health and related agencies need to come up with explanations. They need to explain these patterns and recommendations for changing for the better. Most of the causes of ADHD are biological, but why it is more prevalent among boys than girls is unexplained. Treatment through stimulants is also more prevalent among boys. An explanation of these patterns may help come up with a clear idea on how to go about prevention of ADHD.
From the above discussed aspects; clinical issues, public health progress, and understanding discrepancies, the need to understand and redefine ADHD is very clear. The controversies need solutions so that answers the issues raised herein can be found. One thing lead to another and a solution to the controversies would be a step in the right direction. ADHD someday will get a cure, when other issues preceding that have been addressed through collective efforts.
ADHD continues to torment the society without discrete solutions to it. Psychopharmacology practitioners keep on juggling from medical solutions to other therapeutic solutions. Patients may have no idea what is happening to them, but interested persons on the periphery can tell it all. The need to improve the handling of ADHD patients is there, and an evaluation of the net gains brought about by use of stimulants on adolescents need a clear definition. The successes of the medical and psychiatry fields in the past should be replicated in the search for permanent solutions to ADHD. It would be unfair to claim that nothing has been done, whereas there have been countless innovations medically and psychiatrically in the attempt to help treat ADHD. What is much needed is specificity. The society does not require a youthful generation dependent on stimulants to retain focus and concentration. It shall work in the short run and leave them exposed in the long run.
In this thought-provoking response, the author's perspective is skillfully backed by an extensive body of comprehensive research and readily available information, offering a well-informed and compelling exploration of the subject matter.

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September 20, 2023

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