Attention deficit hyperactivity disorder: a misdiagnosed disorder

Sir,

Attention deficit hyperactivity disorder (ADHD) is a chronic and disabling mental disorder characterized by periods of hyperactivity, inattention, and impulsivity. It affects individuals in their personal, school, and professional lives. While the exact cause of the disorder remains unknown, it often runs in families, and factors like premature birth, low birth weight, alcohol, smoking, and drug abuse during pregnancy may contribute to it. ADHD is typically classified into three main types: hyperactive/impulsive type, which involves excessive movement, restlessness, and impulsive actions; inattentive type, which includes difficulty staying focused on tasks, organizing work, losing things, and being easily distracted; and combined type, which is diagnosed when both hyperactive/impulsive and inattentive symptoms are present.¹

Children are usually diagnosed with ADHD around the age of 7 because at that age they learn to listen, follow rules and sit still when they are asked to do so and don’t say just anything which popped in their mind.² Adults may exhibit symptoms that were previously overlooked, leading to a delayed diagnosis.³ The signs and symptoms of ADHD can vary between children and adults. Child with ADHD may differ in symptoms with another child with ADHD. Some children may have difficulty in paying attention and easily get distracted while others often struggle with staying organized, completing task and remembering things and frequently loses things like books, toys or other items.² Adults if did not receive formal diagnosis and proper treatment of ADHD may have self-esteem and mental well-being issue. They often get involved in substance abuse or drink alcohol to cope up with the symptoms and to have some degree of control over their lives.⁴ Individual with ADHD may have relationship problems as they do and say impulsive things without thinking about consequences which lead to arguments and even breakups. They also have difficulty in staying on jobs and suffer from financial problems. So, it’s very crucial for a person who may suffer from any of the symptoms of ADHD to seek help from psychiatrist.³

ADHD may co-exist with other disorders. One or more additional condition may run parallel with ADHD like anxiety, depression, bipolar disorder and obsessive-compulsive disorder. These disorders may also occur secondary to ADHD like chronic lack of focus may cause anxiety and due to years of disapproval and negative behavior from surrounding may left individual with ADHD depressed.⁵ It present with variety of symptoms which may overlap with other neuropsychiatric disorders which make its diagnosis and treatment complex for physicians. The complexity of ADHD, along with its symptoms overlapping with other disorders and factors such as age and gender, can lead to misdiagnosis. It's important to note that difficulty with attention and hyperactivity can be normal in certain age groups. Girls may show more inattentiveness, while boys may exhibit signs of hyperactivity. Insomnia can also impact attention and focus. Doctors need to consider all these factors and potential co-occurring disorders when diagnosing ADHD to avoid misdiagnosis. Incorrectly prescribing ADHD medications can have serious side effects, including rapid heart rate, hallucinations, increased blood pressure, headaches, disorientation, and even death.⁶

REFERENCES

1. 1. What is ADHD? Available at: https://www.psychiatry.org/patients-families/adhd/what-is-adhd. Accessed on 10 December 2024.
2. 2. Attention-deficit/hyperactivity disorder (ADHD) in children. Available at: https://www.mayoclinic.org/diseases-conditions/adhd/symptoms-causes/syc-20350889. Accessed on 10 December 2024.
3. 3. Adult ADHD: Symptoms, Causes, Treatments. Available at: https://www.webmd.com/add-adhd/adhd-adults. Accessed on 10 December 2024.
4. 4. The Risks of Untreated ADHD in Adults. Available at: https://thephoenixrc.com/blog/mental-health/the-risks-of-untreated-adhd-in-adults/#:~:text=While%20it%20is%20relatively%20common,and%20further%20mental%20health%20problems. Accessed on 10 December 2024.
5. 5. When It's Not Just ADHD: Symptoms of Comorbid Conditions. Available at: https://www.additudemag.com/when-its-not-just-adhd/. Accessed on 10 December 2024.
6. 6. Auditory processing disorder: Symptoms, causes, and more. Available at: https://www.medicalnewstoday.com/articles/325595#auditory-processing-disorder. Accessed on 10 December 2024.