Ella Lee Forest resident Leah Salinas was in middle school when attention-deficit disorder really started impacting her life, though she wouldn’t be diagnosed with it for more than 20 years.
“I could not read (large) amounts of text and absorb it,” she said. “I was in honors classes and had to be moved. I just thought I was not as smart as (other students).”
When her daughter, LilliAnne, was discovered to have dyslexia in elementary school, Salinas wondered if ADHD — which stands for attention-deficit hyperactivity disorder — was also a possibility. However, because misbehavior in the classroom was not an issue, there was no diagnosis.
It was not until Salinas spent a lot of time with LilliAnne this spring and summer during the pandemic that she saw a vision of her “day-dreaming” middle school self.
“I saw an inability to focus, (of) being able to start work,” Salinas said.
Upon reevaluation, LilliAnne was diagnosed with ADHD, too.
October is ADHD Awareness Month. According to the American Psychiatric Association (APA), an estimated 5 percent of children and 2.5 percent of adults in the United States have ADHD. It can run in families, and studies indicate that genes may play a role.
Dr. Cristina Marchesano, a pediatrician with THINK Neurology for Kids Katy and Memorial Hermann The Woodlands Medical Center, said there are three types of ADHD: predominant inattentive, predominant hyperactive/impulsive, and a combined type.
Marchesano said there has been a greater recognition of ADHD, rather than a greater prevalence. She said many people are skilled at developing coping mechanisms over the years that at some point – whether that be in middle school, high school, college or graduate school – become difficult to maintain.
About 50 percent of adults with ADHD also suffer from an anxiety disorder, according to the Anxiety and Depression Association of America. That was certainly the case for Salinas.
“You are working so hard to compensate (for it),” she said. “There are a lot of triggers.”
Once she got on the right medication for her ADD, she no longer felt the same panic.
School psychologist and Oak Forest resident Emily Zihlman was diagnosed with ADHD in high school and said her reliance on structure, a coping mechanism, was also the cause of her stress.
“There was the thought, ‘I have to do this the same way,’ ” she said.
Causes and treatments
Although ADHD is one of the most researched areas in child and adolescent mental health, the exact cause of the disorder is still unknown, according to John Hopkins Medicine. Even so, brain imaging studies show that brain metabolism in children with ADHD is lower in the areas of the brain that control attention, social judgment and movement.
Marchesano said once she makes a diagnosis through detailed behavior histories, observations and testing, she does not necessarily recommend medication right off the bat. For those with severe learning difficulties, she will do an electroencephalogram (EEG) to evaluate the electrical activity in the brain and see if there is an underlying cause, like epilepsy, for the disorder.
For others, she counsels starting with lifestyle changes, such as adequate sleep and a low-sugar, high-protein diet as well as Omega 3 supplementation. If medication is warranted, Marchesano said these days, the choices extend far beyond just Ritalin and Adderall.
“There are a lot of options, 30-plus medications,” she said.
Marchesano said they fall into two main classes — stimulants and non-stimulants. She said in her experience the stimulants are best for the inattentive type of ADHD and the non-stimulants are better for the hyperactive/impulsive type.
Regardless, she recommends pursuing special accommodations for kids through their school district, even for mild cases.
Zihlman was not medicated for her ADHD as a teen, but she and her husband have made the decision to treat their elementary school son, also diagnosed with ADHD, with medication.
“It evens the playing field,” she said. “You just have to find the right balance.”
Anissa Dwiggins said medication was initially a boon to her son, Stephen, when he was diagnosed in fourth grade. But the weight loss that was a side effect as well as what she describes as a heightening of the other senses, causing lack of sleep among other things, made her rethink medication. Right now, in middle school, Stephen is medication free.
“He’s happier but it’s a full-time job for me,” Dwiggins said.
Heights resident Heather Golden has a high school daughter with ADHD, diagnosed in elementary school, and says she often tells parents to try the unmedicated route for a while to see how other adjustments work. She also says they shouldn’t be afraid to medicate.
“The evidence that it is needed may not be just academic performance,” Golden said. “Kids with ADHD are often very smart and many can maintain their grades for several years, particularly in elementary school, without much help. However, they may be struggling behaviorally.”
Zihlman said there is a stigma about the medications for ADHD as well as the disorder itself.
“I tell parents that (ADHD) doesn’t mean that your child is not smart,” she said. “A lot of these kids are highly intelligent. They just have executive function deficits.”
Some, like Heights resident Jenna Taylor, have learned to appreciate their individuality.
“Now, I love the superpowers of hyper-focus, creativity, problem-solving, attention to minor details, the ability to spot things that are out of place in a project and the ability to multi-task easily that come with the diagnosis,” she said. “As a child, ADD was seen as a hindrance, but now I see the gifts that are part of the unique way my brain organizes and processes information. Yes, I still put on music and go to a quiet room to focus, but those are things that can help everyone.”