by Dr Bijal Chheda-Varma
According to the NHS, attention deficit hyperactivity disorder (ADHD) is a behavioural disorder that includes symptoms such as inattentiveness, hyperactivity and impulsiveness. The ADHD Institute says that 50-65% of patients with ADHD in childhood will continue with their symptoms into adulthood.
The chapter in the Palgrave Handbook of Male Psychology and Mental Health focuses on the prevalence manifestation of ADHD in men. The neuro-developmental nature of ADHD means that it will occur from birth in men and contribute towards complexities and difficulties in men’s mental wellbeing.
Recognising the symptoms and difficulties early in life and forming a realistic approach to managing these through adapted cognitive behaviour therapy techniques and lifestyle management is the focus of this chapter. The chapter offers insights into the backdrop of ADHD from its early origins with the famous case of “Fidgety Phil,” through to more recent information from neuroscience.
Currently our understanding of ADHD helps us to identify the three main subtypes of ADHD in individuals. First there is the inattentive subtype with difficulties of concentration, focus and organization. Then there is the hyperactive/impulsive subtype with restlessness, fidgeting, disruptive behaviours and impulse management difficulties. Thirdly there is the combined type, where an individual struggles with all of the aforementioned symptoms. Identifying ADHD through more subtle traits when obvious hyperactivity/impulsivity is not present is a challenge in clinical work. Individuals who present with only inattention traits and moderate difficulties often remain in the revolving door of treatments and clinics, until such time as more clarity of traits becomes apparent.
Psychopharmacological interventions are focussed on managing the neurochemical and and brain activation issues. Medication helps in executive functions in individuals by improving focus, attention and overall activation.
Adapted cognitive behaviour therapy based on behavioural interventions – in particular organizational and activity scheduling, problem solving, working on sleep routines and implementation of graded steps – has been the key focus on treatment for ADHD.
Would the world be better off without the existence of ADHD symptoms and traits? Hardly. Strip away ADHD and we may take away our evolutionary pattern of neurodiversity. The hyperactivity and impulsivity when channeled in the right manner offers healthy risk taking, ability to perform high energy and intensity tasks and a mind that can think outside the box when a problem arises.
Hyperfocus aids individuals to attain higher performance and success when channeled into careers, passions, hobbies and inventions. For the deficits of the executive functions in the brain, sociability, emotional quotient and charm is aplenty. ADHD symptoms are part of the rich tapestry of human character and, in measure and in context, can be enriching for the individual and the world they are part of.
About the author
Bijal Chheda-Varma is a CPsychol Chartered Psychologist (BPS), Practitioner Psychologist (HCPC Reg.) and CBT Therapist Founder and Director, Foundation for Clinical Interventions, London. She is the founder and director of the Foundation for Clinical Interventions (FFCI) which specializes in the assessment, diagnosis and treatment/support for autism,Asperger’s syndrome, ADHD and other neurodevelopmental and neurocognitive conditions. Dr. Chheda-Varma’s niche is in offering intensive, but goal-oriented and time-limited treatment and therapy. She uses evidence-based treatment models and CBT is her predominant therapy style in both individual and group therapy. She sees a wide spectrum of clinical and complex psychological conditions but specializes in mood disorders, anxiety disorders, OCD and eating disorders. After beginning her career as a lead Psychologist within a rehabilitation unit for addictions, Dr. Chheda-Varma went on to be the lead clinician for the Nightingale Hospital’s CBT team from June 2013 until June 2014. Currently, she practises at the Nightingale Hospital, The Blue Door Practice alongside her own private clinic.
Dr Chheda-Varma’s chapter Attention Deficit Hyperactivity Disorder (ADHD): A Case Study and Exploration of Causes and Interventions, is in the new The Palgrave Handbook of Male Psychology and Mental Health, edited by Barry JA, Kingerlee R, Seager MJ and Sullivan L (Eds.) (2019). London: Palgrave Macmillan IBSN 978-3-030-04384-1 DOI 10.1007/978-3-030-04384-1