Madeeha Syed

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ADHD And Sleep

Humza Khizer

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ADHD: Unsolicited Opinions Or Facts?

Introduction

Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent neurodevelopmental disorders. It is diagnosed in the early years of life, and continues to exist until adulthood<a href="#accordion">[5]</a>.

&nbsp;

Individuals diagnosed with ADHD have trouble focusing and directing complete attention to one objective. They may submit to urges frequently, exhibiting a lack of discipline. In reality, it&rsquo;s not in their hands to control their impulsive behavior (act without thinking about consequences), or being restless or overactive<a href="#accordion">[5]</a>.

&nbsp;

What is concerning is the negative stigma associated with a disorder. It&rsquo;s mainly why it took a long time to recognise ADHD as a disorder because the symptoms were often attributed to bad behavior, especially in kids who were easy targets for disciplinary action.

&nbsp;

Moreover, earlier studies would characterise and generalize ADHD by specific traits only, such as a short attention span and impulsiveness. This ableist behavior not only hindered the progress of the disorder but also demoralised countless individuals whose struggles were disregarded callously.

&nbsp;

Even now, when ADHD is the most researched neurodevelopmental disorder, it faces countless unwarranted opinions that do not hold any basis; societal taboos and bizarre rumours demoralize and shame individuals diagnosed with the condition. But NOT ANYMORE. This article has been drafted to debunk all the common &lsquo;logo ki baatein&rsquo;, and challenge the stigma that prevents individuals from reaching out.

&nbsp;

Understanding ADHD

This might be a no-brainer (pun intended), but any neurodevelopmental disorder means it is actually in someone&rsquo;s head.

&nbsp;

However, we all know such a statement alludes to how ADHD is not an authentic illness, and should not be dealt with proper treatment options. Statements along similar lines dampen the progress towards a more inclusive world, where pain and discomfort are not only associated with physical factors but also undergo assessment through nonphysical aspects.

&nbsp;

While critics would argue how the new renaissance of political correctness has seen a rise in cases of ADHD, historians would refute this by quoting medical journals and publications of this neurodevelopmental disorder, from as early as 1775. These references are now supported with more advanced and substantial theories<a href="#accordion">[2]</a>. Such profound and elaborate research has proven how ADHD deserves the recognition and status of any other physical ailment, as it causes impactful changes in an individual&rsquo;s life.

&nbsp;

It is easy to distinguish individuals with ADHD from those without, as this disorder causes social anxiety, emotional turmoil, academic struggles, and difficulty in performing occupational tasks<a href="#accordion">[12]</a>.

&nbsp;

The &ldquo;ADHD tag&rdquo; is not an elaborate scheme to garner more attention. Rather, it is a complex, intricate, and sometimes, permanent disorder that brings about a range of symptoms that individuals must learn to manage throughout their lifetime.

&nbsp;

ADHD runs in families. There&rsquo;s a 57% chance that a kid of a parent diagnosed with ADHD also inherits it. And there is a staggering 70-80% probability for a twin to have ADHD, if the other twin has been diagnosed with it<a href="#accordion">[2]</a>.

&nbsp;

Repeated brain scans for numerous cases have been studied to concentrate on the contrasts in the progression of the brain, and how the patterns affect people&rsquo;s functioning. For example, cortical diminishing in the front-facing areas, decreased volume in the inferior frontal gyrus, and decreased grey matter in the parietal, temporal, and occipital cortices<a href="#accordion">[8]</a>.

&nbsp;

One would assume that the high prevalence of a neurodevelopmental disorder, especially in children, would prompt individuals to participate in academic and research-based investigations. But nope. People find more creative ways to blame it on factors that have little to almost no contribution to the development of ADHD. Associating a mental disorder with poor parenting practices is not even a myth, but a shallow attempt to trivialize the severity of ADHD.

&nbsp;

Scientists are now holding hereditary and genetic makeup as probable factors responsible for ADHD.

&nbsp;

Other neurological factors have also been listed. For example complications during birth and gestational periods, visible signs of brain damage, exposure to poisons and harmful substances; and history of infectious contaminations as the primary drivers of ADHD, as opposed to social variables which includes poor nurturing.

&nbsp;

Investigations of twin children with ADHD show that the family conditions of such children contribute extraordinarily little to their singular distinctions in ADHD symptoms<a href="#accordion">[2]</a>.

&nbsp;

However, it should be noted that even though nurturing practices have yet not been deduced to cause ADHD, they can add to the deterioration of coexisting and coinciding issues, like oppositional defiant disorder (ODD) or conduct disorder (CD). And conflicting parental discipline, along with an unequal maternal and paternal contribution, can create a debilitating environment for the improvement of ADHD symptoms<a href="#accordion">[6]</a>.

&nbsp;

To summarise, a child&rsquo;s tendency to be impatient while waiting for their turn in a queue, to answer a question, or a child&rsquo;s inability to remain seated throughout a class are not testaments to their poor upbringing. But they could be an indication of complex chemical activity that compels the brain to react and respond in that manner.&nbsp;

&nbsp;

This is less of a stigmatized myth and more of a disappointing result of institutional sexism in medicine, a field that was previously dominated by men and demonstrated the male body to be the natural form of human life. Such a presumption prevented earlier doctors from witnessing the different symptoms of ADHD in boys and girls. There is such an indubitable disparity that the ratio of boys diagnosed with ADHD to girls is 9:1<a href="#accordion">[13]</a>.

&nbsp;

The symptoms that are typically exhibited, such as inattentiveness or talkativeness, are frequently credited to gendered stereotypes. Therefore, they are often neglected. Consequently, unsatisfactory and sub-par accomplishments and fickle mood swings tend to influence these young girls&#39; performance in school and familial situations<a href="#accordion">[3]</a>.

&nbsp;

Such gender bias in the diagnosis of any disease, including ADHD, could be detrimental to the marginalised group. If any symptoms of ADHD are not managed responsibly and professionally, young girls could transition into women with their untreated symptoms. Not only would they be forced to endure the struggles of an average adult, but they would have to deal with a persistent sense of underachievement and failure, be more at risk to go through substance abuse, have a higher chance of developing eating disorders, or facing financial difficulties due to poor organization and impulsivity<a href="#accordion">[1]</a>. They might struggle as mothers themselves. And, if they have children with ADHD, they&rsquo;d unfortunately not be able to immediately grasp or bring to anyone&rsquo;s notice the same symptoms as something that should be treated professionally.

&nbsp;

It is vital to not only exclusively broaden research tests and work on the existing methods of diagnosis, but to also spread public awareness regarding ADHD.

&nbsp;

Contemporary medicine has suggested how deceiving and falsely titled the name of such a multifaceted neurodevelopmental disorder is. Because it is associated with distinctive and loud traits; any symptom that is not eponymous with the name is not considered a serious factor.

&nbsp;

Doctors have now declared that there are 3 types of ADHD, where one is validated by hyperactivity; the other two, such as the inattentive presentation or the combined presentation are corroborated through different signs and symptoms<a href="#accordion">[9]</a>.

&nbsp;

Those diagnosed with the inattentive presentation type of ADHD exhibit repeated loss of trail of thought, frequent careless or inattentive mistakes, difficulty in remembering key points or important dates, lack of consistency, and being messy and unorganised. But these are not the only symptoms of ADHD<a href="#accordion">[11]</a>.

&nbsp;

Likewise, hyperactive-impulsive ADHD prompts the individual to go through a surge of inexplicable energy, but they may also demonstrate other alarming symptoms such as being frustrated easily, going through unchecked mood swings, being extremely impatient, interrupting people, or not being able to remain quiet for a prolonged time<a href="#accordion">[11]</a>.&nbsp;

&nbsp;

Puberty-induced growth spurts will allow children to grow out of their teenage wardrobes, but the same cannot be said about neurodevelopmental disorders such as ADHD.

&nbsp;

With early diagnosis and regular medications and therapies, symptoms may become manageable. Again, this is not the case for all. Longitudinal studies were carried out to observe different children diagnosed with ADHD at a young age. They found that there is a high probability of ADHD continuing from youth to pre-adulthood in approximately 50% - 80% of all cases, and into adulthood in 35% - 65% of all cases<a href="#accordion">[10]</a>.

&nbsp;

One research, that lasted 16 years, was conducted among groups of young men with ADHD. It concluded that a staggering 77% persisted in having full or sub-threshold DSM-IV ADHD<a href="#accordion">[3]</a>.

&nbsp;

Another notable investigation studied a target population of girls aged 6-12 years diagnosed with childhood ADHD. They discovered after 10 years of follow-up, most members of the sample population kept on having higher rates of ADHD and coexisting disorders, including but not limited to, recurrence of suicidal and intrusive thoughts, as compared to women without ADHD<a href="#accordion">[7]</a>.

&nbsp;

Conclusion

Because ADHD is disguised, it cannot be improved or modified
through physical therapies, such as bandages, stitches, or plasters. It is
easier and more convenient for people to judge and believe misconceptions when
they or a loved one is not the one dealing with it 24/7. But we owe it to our
better judgment, our ability to question, and our will to learn more about a
disorder that ostracises individuals simply because they were diagnosed with a
neurodevelopmental disorder, that too through no fault of their own. If you
suspect someone might have ADHD, it’s best to consult licensed practitioners
and authentic medical journals for facts, rather than indulging in idle talk.

Key Points

<ul><li style="margin-bottom: 0in; border: none;">ADHD is a neurodevelopmental
disorder that affects countless individuals. It can be categorised into the
impulsive-hyperactive presentation, inattentive
presentation, or combined presentation.<o:p></o:p></li><li style="margin-bottom: 0in; border: none;">ADHD is a real disorder and
can have debilitating impacts on an individual’s life, if it’s not treated.<o:p></o:p></li><li style="margin-bottom: 0in; border: none;">Risk factors include
hereditary qualities, neurological factors, pregnancy-related complications, and brain damage. Lack of adequate
parenting does not cause ADHD.<o:p></o:p></li><li style="margin-bottom: 0in; border: none;">Girls are diagnosed less
frequently than boys, but this is because girls are referred to professional
therapists and practitioners less frequently. They also develop different
symptoms.</li><li style="border: none;">Most people do not grow out of
ADHD; only their symptoms are better managed through continuous treatment.&nbsp;</li></ul>

[1] Adelizzi, J. (1998). Shades of trauma. Plymouth, MA: Jones River Press.

[2] Barkley, R. A. (2015). History of ADHD. In R. A. Barkley, Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment, 4th ed (pp. 356-390). New York, NY: Guilford Press.

[3] Biederman, J., Faraone, S., Mick, E., Williamson, S., Wilens, T., Spencer, T., . . . Zallen, B. (1999). Clinical correlates of ADHD in females: findings from a large group of girls ascertained from pediatric and psychiatric referral sources. Journal of the American Academy of Child & Adolescent Psychiatry, 38, 966-975.

[4] Biederman, J., Petty, C. R., Woodworth, K. Y., Lomedico, A., Hyder, L. L., & Faraone, S. V. (2012). Adult outcome of attention-deficit/hyperactivity disorder: a controlled 16-year follow-up study. The Journal of clinical psychiatry, 73(7), 941-950.

[5] Centers for Disease Control and Prevention (CDC). (2021, September 23). What is ADHD?

[6] Ellis, B., & Nigg, J. (2009). Parenting Practices and Attention-Deficit/Hyperactivity Disorder: New Findings Suggest Partial Specificity of Effects. Journal of the American Academy of Child & Adolescent Psychiatry 48(2), 146–154.

[7] Hinshaw, S. P., Owens, E. B., Zalecki, C., Huggins, S. P., Montenegro-Nevado, A. J., Schrodek, E., & Swanson, E. N. (2012). Prospective follow-up of girls with attention-deficit/hyperactivity disorder into early adulthood: continuing impairment includes elevated risk for suicide attempts and self-injury. Journal of consulting and clinical psychology, 80(6), 1041-1051.

[8] Matthews, M., Nigg, J. T., & Fair, D. A. (2014). Attention deficit hyperactivity disorder. Current topics in behavioral neurosciences, 16, 235–266.

[9] Morin, A., & Cunnigham, B. (2014). 8 common myths about ADHD. Understood.

[10] Owens, E. B., Cardoos, S. L., & Hinshaw, S. P. (2015). Developmental Progression and Gender Differences among Individuals with ADHD. In R. A. Barkley, Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment, 4th ed (pp. 223-255). New York, NY: Guilford Press.

[11] Pugle, M. (2022, June 6). 8 Myths About ADHD, Debunked. Everyday Health.

[12] Roberts, W., Milich, R., & Barkley, R. A. (2015). Primary Symptoms, Diagnostic Criteria, Subtyping, and Prevalence of ADHD. In R. A. Barkley, Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment, 4th ed (pp. 51-80). New York, NY: Guilford Press

[13] Skounti, M., Philalithis, A., & Galanakis, E. (2007). Variations in prevalence of attention deficit hyperactivity disorder worldwide. European journal of pediatrics, 166(2), 117–123.

Zarlish Kazmi

Navigating Relationships With ADHD: Embracing The Unique Dynamics

Overview

When it comes to relationships, individuals with <a href="https://merisehat.pk/article/adhd-and-sleep">attention-deficit/hyperactivity disorder (ADHD)</a> often face distinct challenges and strengths that set them apart from neurotypical individuals. While ADHD can present difficulties in various aspects of life, it&#39;s important to recognize that it also brings unique qualities that can enrich relationships. In this article, we will explore the dynamics of relationships with individuals with ADHD, delving into the complexities, potential difficulties, and the strengths that can make these relationships truly special. 
&nbsp;

Challenges

ADHD can impact various aspects of relationships, introducing specific challenges that partners may encounter. Some common difficulties include:

<ul>
	<li>Attention And Focus: Individuals with ADHD may struggle with sustaining attention, becoming easily distracted, or appearing inattentive during conversations or activities. This can create misunderstandings and frustration within the relationship. 
	&nbsp;</li>
	<li>Organization And Time Management: Difficulties in organization and time management can lead to scheduling conflicts, forgetfulness, and an overall sense of inconsistency. These challenges may strain the relationship and require extra effort to maintain structure and reliability. 
	&nbsp;</li>
	<li>Impulsivity And Emotional Regulation: Impulsivity, coupled with difficulties in emotional regulation, can result in impulsive decisions, heightened emotional reactions, and challenges in resolving conflicts effectively. These aspects require understanding and patience from both partners. 
	&nbsp;</li>
	<li>Communication And Active Listening: Difficulties in active listening and following conversations can lead to misunderstandings and misinterpretations. Clear communication strategies and active participation from both partners are essential to overcome these challenges. 
	&nbsp;</li>
</ul>

Strengths

While ADHD can present unique challenges in relationships, it also brings strengths and positive qualities that can enhance the connection between partners. These include: 
&nbsp;

<ul>
	<li>Creativity And Spontaneity: Individuals with ADHD often possess a vibrant imagination and a knack for thinking outside the box. Their creativity and spontaneity can infuse excitement, fun, and a fresh perspective into the relationship. 
	&nbsp;</li>
	<li>Enthusiasm And Energy: People with ADHD tend to exhibit high levels of enthusiasm and energy, which can be infectious and invigorating for their partners. Their passion for activities and new experiences can bring a sense of vitality and adventure to the relationship. 
	&nbsp;</li>
	<li>Hyperfocus: While ADHD is characterized by difficulties in sustained attention, individuals with ADHD can also experience hyperfocus&mdash;an intense concentration on tasks or topics of interest. During these moments, they can display remarkable dedication and productivity, contributing positively to shared endeavors. 
	&nbsp;</li>
	<li>Empathy And Sensitivity: Many individuals with ADHD possess a heightened level of empathy and sensitivity. They may have a deep understanding of emotions and a genuine desire to connect with others, fostering emotional intimacy in relationships. 
	&nbsp;</li>
</ul>

To navigate relationships successfully with individuals with ADHD, both partners can employ strategies that promote understanding, patience, and mutual support:

<ul>
	<li>Education And Awareness: Educate yourself and your partner about ADHD, its symptoms, and how it may impact the relationship. Increased awareness helps in fostering empathy and finding effective coping strategies. 
	&nbsp;</li>
	<li>Open And Honest Communication: Establish open lines of communication, allowing both partners to express their needs, concerns, and frustrations. Encourage active listening and provide a safe space for open dialogue. 
	&nbsp;</li>
	<li>Establish Structure And Routines: Implement structured routines, organization systems, and visual cues to support time management, organization, and consistency within the relationship. 
	&nbsp;</li>
	<li>Seek Professional Support: Consider couples therapy or counseling to work through relationship challenges and develop effective coping strategies tailored to your specific circumstances. 
	&nbsp;</li>
	<li>Embrace Flexibility And Adaptability: Embrace flexibility in the relationship, understanding that unexpected changes and adjustments may be necessary. Adaptability and a willingness to find creative solutions can help overcome challenges. 
	&nbsp;</li>
</ul>

bottom Line

Navigating relationships with ADHD requires understanding, patience, and a willingness to embrace the unique dynamics that ADHD brings. While ADHD can present challenges in areas such as attention, organization, and communication, it also offers strengths such as creativity, enthusiasm, and empathy. By fostering open communication, establishing structure, seeking professional support when needed, and embracing flexibility, relationships with individuals with ADHD can thrive and grow stronger. With empathy, understanding, and a willingness to adapt, partners can build fulfilling and rewarding relationships that celebrate the strengths and navigate the challenges that come with ADHD.

Umna Salah

<a href="https://merisehat.pk/disease/attention-deficit-hyperactivity-disorder-adhd">Attention-deficit/hyperactivity disorder (ADHD)</a> is a neurodevelopmental condition that affects individuals of all ages, causing difficulties in attention, impulsivity, and hyperactivity. While ADHD is commonly associated with challenges in the realm of focus and behavior, its impact on sleep is often overlooked. In this article, we will explore the intricate relationship between ADHD and sleep, examining how ADHD can disrupt sleep patterns and vice versa. Additionally, we will discuss effective strategies for obtaining optimum sleep when living with ADHD, ultimately promoting better overall well-being. 
&nbsp;

ADHD's Influence on Sleep

ADHD can significantly affect sleep patterns and quality, making it challenging for individuals to obtain adequate rest. Common sleep-related difficulties experienced by individuals with ADHD include: 
&nbsp;

<ul>
	<li>Delayed Sleep Phase: Many individuals with ADHD have a natural tendency to have a delayed sleep-wake cycle. They often find it difficult to fall asleep at a conventional bedtime, resulting in insufficient sleep duration.</li>
	<li>Restless Sleep: Hyperactivity and restlessness associated with ADHD can lead to fragmented and restless sleep, causing frequent awakenings throughout the night.</li>
	<li>Sleep Onset <a href="https://merisehat.pk/disease/insomnia">Insomnia</a>: Racing thoughts and an overactive mind can make it difficult for individuals with ADHD to quiet their minds and fall asleep, leading to insomnia.</li>
	<li>Sleep-Disordered Breathing: Some studies have shown a higher prevalence of sleep-disordered breathing, such as <a href="https://merisehat.pk/disease/sleep-apnea-91">sleep apnea</a>, among individuals with ADHD, which further disrupts sleep quality. 
	&nbsp;</li>
</ul>

Bidirectional Impact

The relationship between ADHD and sleep is bidirectional, meaning that poor sleep can worsen ADHD symptoms, and ADHD symptoms can disrupt sleep. Insufficient sleep exacerbates inattention, impulsivity, and hyperactivity, making it more challenging for individuals with ADHD to focus and regulate their behaviors during waking hours. On the other hand, the symptoms of ADHD, such as racing thoughts and restlessness, can disrupt sleep initiation and maintenance, perpetuating the sleep difficulties. 
&nbsp;

Strategies

While managing sleep with ADHD can be challenging, implementing effective strategies can promote better sleep quality and overall well-being. Here are some techniques to optimize sleep:

<ul>
	<li>Consistent Sleep Routine: Establish a consistent sleep schedule, including regular bedtimes and wake-up times, to regulate the body&#39;s internal clock and promote a more restful sleep. 
	&nbsp;</li>
	<li>Create A&nbsp;Sleep-Friendly Environment: Make your bedroom a tranquil and comfortable space for sleep. Minimize noise, light, and distractions that can interfere with sleep. Consider using earplugs, eye masks, or white noise machines, if necessary. 
	&nbsp;</li>
	<li>Stimulus Control: Limit stimulating activities, such as electronic device usage, close to bedtime. Create a relaxing pre-sleep routine, incorporating activities like reading a book, taking a warm bath, or practicing relaxation techniques to prepare the mind and body for sleep. 
	&nbsp;</li>
	<li>Sleep-Friendly Diet And Exercise: Adopt a balanced diet and engage in regular exercise to promote overall health and better sleep. Avoid heavy meals, caffeine, and vigorous exercise close to bedtime, as they can interfere with sleep. 
	&nbsp;</li>
	<li>Sleep Hygiene: Practice good sleep hygiene habits, including keeping a comfortable sleep environment, avoiding daytime napping, and engaging in regular physical activity to support a healthy sleep-wake cycle. 
	&nbsp;</li>
	<li>Seek Professional Help: Consult with a healthcare professional if sleep difficulties persist or significantly impact daily functioning. They can provide further guidance, evaluate potential comorbid conditions, and suggest appropriate interventions or therapies. 
	&nbsp;</li>
</ul>

The interplay between ADHD and sleep is complex, with each impacting the other in a bidirectional manner. Sleep difficulties are common among individuals with ADHD, while inadequate sleep can worsen ADHD symptoms and overall functioning. However, by implementing strategies for optimum sleep with ADHD, individuals can improve their sleep quality and overall well-being.

Remember, prioritizing quality sleep is crucial for individuals with ADHD to manage their symptoms effectively and enhance their overall functioning. By addressing the ADHD-sleep connection and implementing strategies for optimum sleep, individuals can improve their daily focus, attention, and overall quality of life.