Discussing Attention Deficit Hyperactivity Disorder (ADHD)
First Case, A patient is continuously on their phone, swapping from one app page to another with no specific purpose, and as a result of lack of concentration. The patent is impulsive and very hyperactive and the patient is a young boy whose father suffered from Attention Deficit Hyperactivity Disorder (ADHD). We could say that this patient is suffering from Attention Deficit Hyperactivity Disorder (ADHD) but to be sure, we need to understand what Attention Deficit Hyperactivity Disorder (ADHD), also known as Attention Deficit Disorder (ADD) if the patient is not hyperactive.
it is good that we understand first that it is a neurodevelopmental disorder that follows a disruption in the control of thought processes in the brain that often causes patients to have persistent inattention, hyperactivity, and impulsivity. In children, this impairment is usually through two settings, the Home and School. This doesn't mean that every child who is active in school or naturally playful is suffering from Attention Deficit Hyperactivity Disorder (ADHD), most boys are usually playful and hyperactive as children, my younger brother as a child wasn't a fan of books, he was always repairing and destroying things and loved playing and that didn't mean he suffered from Attention Deficit Hyperactivity Disorder (ADHD) as he grew out of it over time.
That said, patients suffering from Attention Deficit Hyperactivity Disorder (ADHD) can be Inattentive, hyperactive/impulsive, or can have it combined. Just like the name implies these three groups can be explained by a grade 3 student. When the patient has an inattentive type of ADHD, he is basically having issues with paying attention, difficulty following instructions, organizing tasks, and overlooking details. When the patient type is Hyperactive/impulsive, it is expected that they are excessively active and always acting on Impulse, fidgeting, having trouble sitting still, and impatience. For the third type which is Combined ADHD, the patient features both previous types I mentioned. The combined type of ADHD is the most common type based on prevalence, while the inattentive type of ADHD is the second most common type, and the hyperactive/impulsive type is the least common type of ADHD. It is important to state, that when there is a family history of Attention Deficit Hyperactivity Disorder (ADHD), the offspring have a 25% chance of having ADHD. While ADHD is noticed in children just like in the first case I gave, about 30 to 50 percent of patients have the disorder till adulthood.
Children with Attention Deficit Hyperactivity Disorder (ADHD) will have other psychiatric disorders such as anxiety disorder, autism spectrum, sleep disorders, and learning disability. In adulthood, patients with Attention Deficit Hyperactivity Disorder (ADHD) can have difficulty completing education and difficulty at work. You know, there is a cousin of mine who usually have substance abuse and whenever he does this, he often displays symptoms of ADHD whenever he is on those substances. Children who live in foster homes are at high risk of developing ADHD. It is no doubt that a lot of foster homes around the world need to be worked on, well I can speak for foster homes in Nigeria, and I remember a time I went to visit one. The children were basically not treated with respect, and so many children were already displaying signs of ADHD. Another set of children that can suffer from ADHD are children with Acquired Traumatic Brain Injury.
A child suffering from Attention Deficit Hyperactivity Disorder (ADHD) at a very little age can start to display characteristics such as hyperactivity where the child becomes impulsive, and start to become very low at tolerating a change in environment or circumstances which could cause them to be aggressive with their mates. Children who are in school such as basic school, begin to struggle with listening in class, finding it hard to be organized, they find it hard to interact socially as they struggle with social interactions, and can also have issues functioning independently. There was a child who displayed these characteristics when I was growing up in secondary school, actually, his parents thought it was something related to voodoo and black magic. (that is one thing that needs to work on in Africa. A lot of sensitization needs to be done so people can always seek medical and therapeutic attention first when they notice something different rather than thinking the disease or illness is caused diabolically.). In adolescence, they find it difficult to learn new things and perform cognitive activities.
It is important to rule out other possible disorders such as anxiety, Depression, Sleep Apnea, Substance Abuse, and True Learning Disorders such as dyslexia, before coming to a conclusion that a patient has Attention Deficit Hyperactivity Disorder (ADHD). While the exact pathophysiology of Attention Deficit Hyperactivity Disorder (ADHD) is yet to be known, it is believed that a low level of dopamine and noradrenaline can be the cause. Another study shows that the anterior cingulate gyrus and dorsolateral prefrontal cortex are smaller in patients with ADHD which could be the cause for their inability to perform goal-oriented activities.
In Diagnosing Attention Deficit Hyperactivity Disorder (ADHD), history can be the basis, also using the Diagnostic and Statistics Manual 5 (DSM-5) criteria as a standard to confirm the diagnosis. The Diagnostic and Statistics Manual 5 (DSM-5) criteria include the patient must have had 9 long-term symptoms of hyperactivity, impulsivity, or inattention, with 6 or more in children, 5 or more in adolescents, and Adult are needed to be able to diagnose the disorder. Treatments and management of ADHD would be the use of medication and therapy. Therapies such as Cognitive Behavioural Therapy, Psychoeducation, and Interpersonal Therapy. Medications would include Amphetamines, Methylphenidate, and antidepressants such as Atomoxetine and Buproprion. Also, alpha agonists like Guanfacine, and Clonidine can be used.
Conclusion
Back to our first case, if the child possesses any of the symptoms 6 times or more, then the child is suffering from Attention Deficit Hyperactivity Disorder (ADHD). It is important to rule out all other disorders before coming to a conclusion that the patient is suffering from Attention Deficit Hyperactivity Disorder (ADHD).
We are really religious in Nigeria. I recently lost a patient cause she was taken to church h for prayers before she was brought to the hospital. She came in very critical.
There needs to be a line drawn between religion and health in Africa. We need to understand that a religious home is not a medical center, and a medical center isn't a place for religious practice. I guess a lot of medical doctors have learned the latter I discussed, and that is why they do not mix medical diagnoses with religious thoughts.
I agree with you, however, the poor socioeconomic factor is mostly the reason people seek religion first.
So are you a doctor or therapist?