Michael Phelps’ Battle With ADHD

Michael Phelps, the most decorated Olympian of all time and holder of 7 world records in swimming, hated getting his face wet as a kid. 

Michael Phelps was diagnosed with ADHD at the age of nine, and it was thanks to his mother he learned swimming, came to love it, and later dominated on the world stage. ADHD is one of the most common neurodevelopmental disorders of childhood. Moreover, the prevalence of ADHD in India is much higher than the global average. 

A study conducted in Coimbatore titled Prevalence of Attention Deficit Hyperactivity Disorder in Primary School Children found that the number of children suffering from ADHD in India stands at 11.32 per cent, much higher than the global average of approximately 2-7 per cent. 

Let’s learn more about this condition in detail. 

What is ADHD?

Attention-deficit/hyperactivity disorder, or ADHD, is one of children's most common and most studied neurodevelopmental disorders. According to research, people with ADHD have differences in their brains, nerve networks and neurotransmitters. 

ADHD is a chronic condition that makes it difficult for people to manage their own emotions, thoughts and behaviours, including the following:

• Managing their behaviour 
• Paying attention 
• Controlling overactivity
• Regulating their mood
• Staying organised
• Concentrating
• Following directions
• Sitting still 

What are the types of ADHD? 

There are four different ways in which ADHD can present itself. 

Predominantly inattentive 

Children who are diagnosed with this primarily display inattentive ADHD only. Earlier, this was referred to as ADD or attention deficit disorder. Children with this type have difficulty focusing, organising and staying on track. They usually have fewer hyperactivity/impulsivity symptoms. 

Predominantly hyperactive-impulsive

Children with this type show issues with hyperactivity and impulsivity. They usually show less than obvious problems with paying attention. They might fidget, find it difficult to sit still, have a lot of excess energy and become extremely talkative. They act on impulse. This is the least common type, and it typically affects younger children. 

Combined 

This is the most common type, and almost 70 per cent of cases fall under this type. Children with this type show at least six other symptoms from both inattentive and hyperactive-impulsive. 

Unspecified

In this type, symptoms might be severe enough to demonstrate dysfunction but fail to meet the official symptom criteria for a diagnosis of ADHD inattentive. When such cases come forward, they are usually diagnosed as “unspecified ADHD.”

What are the symptoms of ADHD?

A diagnosis of ADHD is based on the presence and absence of certain symptoms. The symptoms must have interfered with the child’s functioning in at least two areas (for example, at home or at school) and must have occurred for the past six months. 

According to the symptoms, the types of ADHD are diagnosed as inattentive, hyperactive/impulsive, combined or unspecified. Let’s look at this in detail. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Text Revision (DSM-5-TR) by the American Psychiatric Association provides the guidelines for diagnosis. 

Predominantly inattentive

ADHD symptoms of the inattentive type include difficulty focusing, organising or staying on track. According to the DSM-5-TR, a child with this type must display at least six out of the following behaviours: 

• Making careless mistakes or trouble paying attention to detail.
• Issues with tasks and activities.
• Difficulty in focusing, daydreaming or getting distracted easily.
• Unable to follow instructions or finish tasks. 
• Issues with organising tasks or activities.
• Disliking tasks that require continuous mental effort.
• Losing things often.
• Easily distracted by outside stimuli.
• Regularly forgetful in day-to-day activities.

Predominantly hyperactive/impulsive

According to the DSM-5-TR, a child with this type must display at least 6 out of the following given behaviours: 

• Fidgeting, tapping hands or feet or squirming frequently.
• Leaving their seat when they expected to remain seated.
• Running or climbing when it is inappropriate. 
• Difficulty in engaging in leisure activities quietly. 
• Always ‘on the go’ or seemingly ‘driven by a motor.’
• Talkative. 
• Blurting out answers even before a question is completed. 
• Difficulty in waiting for their turn. 
• Interrupting or intruding in others’ conversations or activities. 

Combined

Children with this type display symptoms from both the inattentive and hyperactive-impulsive types. According to the DSM-5TR, children with the combined type must display at least 12 symptoms (six from the inattentive type and six from the hyperactive-impulsive type). 

Now let’s learn about the causes of ADHD. 

What causes ADHD?

Researchers have discovered major differences in the brain structure between normal people and those with ADHD. However, despite identifying these differences, they have not been able to pinpoint the exact cause behind developing ADHD. 

The brains of people with ADHD tend to reach maturity later than that of neurotypical people, and their frontal lobe works differently. The frontal lobe is responsible for paying attention, among other functions. 

There are two kinds of attention - directed attention and automatic attention. Directed attention is required when we are focussing on low-interest tasks such as studying or concentrating in class. 

Automatic attention is activated when we are doing something interesting or engaging, like playing a game. 

In people with ADHD, the directed attention skill is weaker. In addition, researchers have found major neural networks that work differently in people with ADHD.

Here are other possible causes and risk factors of ADHD:

• Lead exposure.
• Brain anatomy.
• Substance use during pregnancy. 
• Premature birth.
• Low birth weight. 

What are some of the complications of ADHD? 

Here are some of the long-term complications that can arise if ADHD is left untreated:

• Poor self-esteem.
• Depression and anxiety.
• Eating disorders.
• Sleep issues.
• Substance use disorder.
• Risky, impulsive behaviours.
• Frequent driving accidents and injuries.
• Trouble with relationships and other social interactions.
• Academic underachievement.
• Job instability.

How is ADHD diagnosed?

There is no specific ADHD test to diagnose this condition. Usually, a lot of information is collected over several steps, and based on that information, the child’s behaviour is compared with that of other children in the same age group. 

A thorough assessment of behaviour is crucial during the overall assessment. This is because an exceptionally bright child might perform well in studies and at school but might be lacking in other areas. 

How is ADHD treated? 

In most cases, the best line of treatment for ADHD in older children, adolescents and adults includes a combination of behavioural therapy and medication. 

Behavioural Therapy

The goal here is to learn or strengthen positive behaviours while eliminating unwanted behaviours. This is done through social skills training or executive functions training. 

Medications 

ADHD medications include stimulants, non-stimulants and antidepressants. 

And that is everything you need to know about ADHD. 

Before we conclude, did you know that Health and fitness expert Jillian Michaels suffered from Polycystic Ovary Syndrome (PCOS)?  

You can read more about PCOS by clicking on the link. 

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