By Ashley Crisanto, Diana Amador and Albatool Shuhayeb
Xiomara Nayre Martinez, a Chicago mother of two children, is in the process of having her 6-year-old child tested for ADHD.
When describing her child’s symptoms: “My boy never gets tired. He doesn’t sleep he is up all night. He plays rough with others and he is a fast learner and when I told his primary physician he said my boy might have ADHD and that I should get him tested.”
According to American Psychiatric Association Attention-Deficit/Hyperactivity Disorder is a mental health disorder that is commonly found in children, some of the common symptoms include impulsivity, inattention, and hyperactivity. While there is no known cause of ADHD, about six out of ten children diagnosed with ADHD have comorbid of another mental, emotional, or behavioral disorder.
Dr. Amber May, medical director of the comprehensive ADHD clinic at UIC said, “We do a careful assessment examining contributors to ADHD. We rule out substance abuse and medical issues that may masquerade as ADHD. For example, we may test for lead toxicity and thyroid dysfunction when indicated. We examine lifestyle factors that may contribute to ADHD symptoms, such as poor sleep hygiene or dietary indiscretion.”
The Center for Disease Control and Prevention did a survey and found that there has been an increase with youth being diagnosed with ADHD. In 2003, 4.4 million children were diagnosed with ADHD however, in 2016, 6.1 million children were diagnosed with ADHD.there are gender differences when a child is being diagnosed with ADHD. Boys are diagnosed 12.9 % while girls are diagnosed 5.6% with ADHD.
“ADHD is most commonly seen in school-aged children. My clinic predominantly treats patients between 8-18 years old. Problems due to ADHD often manifest during transitional periods, when students are entering junior high and high school. Now with the increased recognition of adult ADHD, college and graduate students are coming to our clinic for treatment. Students get flagged when social and academic demands increase, and they can no longer work around the challenges they face.”- May said.
ADHD cannot be cured but can be treated to reduce the symptoms and prevent the disorder from interfering with everyday life. When ADHD is diagnosed children usually receive behavioral treatment, medication, or a combination of both.
According to the center of disease control and prevention, about 62% of children, ages 2-7 years old diagnosed with ADHD take medication while only 47% receive behavioral treatment. In children ages 6-11-years old about 62% take medication while 51% of children ages 12-17 take medication. Only 18% of children 2-5 years old take medication. Some commonly prescribed medications are Adderall, Vyvanse, and Ritalin.
May said, “About 90% will respond to treatment. Studies show that medications are just as effective for treatment as a combination of meds and therapy. Stimulants are the most effective in treatment for ADHD. There has been an increased interest in alternative treatments like omega 3 fatty acids, zinc, and magnesium. These are not as effective, but when patients ask me about an alternative approach and the risk is low, I am supportive. With the recent popularity of CBD oil, I have been asked by many patients about its usage. We cannot recommend it due to a lack of evidence demonstrating benefit. With the currently unregulated CBD market, there is concern about product purity, potency, and safety.”
According to Child Mind Institute, while stimulant medication can be widely effective in reducing ADHD symptoms it does not come without side effects. Those include, sleeping problems, headaches and stomach aches, delayed growth, moodiness and irritability.
On average about 40% of 12th graders believe trying Adderall is harmful. It is a common misconception that stimulants that treat ADHD are harmful and can lead to addiction.
“Although stimulants have potential for abuse and addiction, their use under the close supervision of a physician is generally safe. Patients treated appropriately for ADHD are less likely to abuse substances than those who remain untreated.” – Amber May, MD
There is a lot of precaution and monitoring done by the psychiatrist to reduce the overuse of ADHD medication. How long medication is prescribed is not the same for everyone. It is a decision made by a professional and client. If it is a minor it would be a decision between the clinician and parent of the client.
Aashwi Bhatt a 21 year old UIC students explains the process of getting her ADHD medication
“I get a prescription up to 3 months, so every month I have to go back because it’s a stimulant they don’t just send people to the pharmacy,” Bhatt said. “You have to get it signed off by a psychiatrist because people abuse Adderall.”
When asked how long she has taken the medication, Bhatt said, “It’s only been two years. Two of my friends who have ADHD, one of them has been taking it for nine years and she just started to get off it.
ADHD has similar symptoms to other mental health disorders, and being misdiagnosed can have negative effects on that individual. For example, ADHD can and has been misdiagnosed for a mood disorder, autism spectrum disorder, and anxiety disorders according to Medical News Today.
Bhatt said, “I moved here to Chicago from Canada. I was already depressed, and I tried to seek help for it, but my primary physician just diagnosed me with depression and put me on antidepressants for a year and made it worse. I was seeing a therapist at the time and she referred me to a psychiatrist maybe she has a different opinion on what’s going on and so I went to see her and she made me do a depression, anxiety test, and she made me take an ADHD test based on what I was describing”
There has been new changes in Diagnostic and Statistical Manual of Mental Health Disorders (DSM5) on ADHD. DSM5 is used by healthcare professionals as a guide to diagnose mental health disorders. According to PsychCenral the onset criterion for ADHD is twelve years old instead of seven. A comorbid diagnosis with autism is now possible. Subtypes have been replaced with presentation specifiers. There is a new awareness in ADHD in adults. In the DSM5 new examples have been added to the criterion items to facilitate application across lifespan. And symptom threshold in adults has been changed. Adults only need to meet five symptoms in the two major domains: inattention and hyperactivity/impulsivity.
Hadeel Arwak, a biology student at IIT, explained it took her a long time to be diagnosed with ADHD. “When I was diagnosed, I was about 22 and to some people, that may seem like it’s really later on. But I think I was confused with just being tired from school and stuff but honestly, I’m not surprised that it was diagnosed so late” For many adults like Arwak, diagnosis during college is very common.
While ADHD has received more recognition and people are more aware that ADHD is a real mental health illness it is not always accepted by families or their own culture.
“It is challenging and heartbreaking to see someone suffering with a mental health disorder while the family attribute symptoms to “just being lazy.” That’s not accurate. We help families to shift their perceptions and understand that symptoms are rooted in brain circuit dysfunction.” – Amber May, MD.
When asked, “ Do you think there are any differences between U.S and Canada regarding ADHD “ I don’t think so I’ve never used mental health services in Canada. I know it was covered so I think that would be one of the biggest differences. Like there is no payment required for it. Here I have to pay to see the psychiatrist every 3 months it’s like a copayment of 40-45 dollars with insurance. You wouldn’t pay those fees in Canada”- Aashwi Bhatt.
We asked Xiomara a similar question and her response was a bit different for her experience with different health care systems, “ It is very different in Mexico it takes two months to see a primary doctor. It is rare that someone receives mental health services” – Xiomara Nayre Martinez.
If you or someone you know are seeking mental health services in Chicago you can find help at these locations above or visit their website at https://findtreatment.samhsa.gov/locator
In September 2016, CHADD conducted a survey about ADHD health insurance coverage in the United States. When discussing the topic of ADHD the struggle of getting a diagnosis and treatment for this particular mental health disorder was at 51% from the survey of 1,500 people with American health insurance seeking.
Timothy F. Page, an economist for the Department of Health Policy and Management, reported that families who have a child diagnosed with ADHD spend an average of $15,036 while families who do not have a child dealing with ADHD spend only $2,848 during the child’s development. It is expensive to treat ADHD.
Despite the stigma around ADHD, it is manageable and many people live functioning and successful lives with proper treatment.