What is ADHD in practice?

In simple terms, ADHD is not "lack of discipline" or "laziness".
It is a neurological condition in which the brain has difficulty in:

  • maintaining focus for extended periods

  • controlling impulses

  • organising tasks and routines

These difficulties are persistent and interfere with the person's life.

Main symptoms

ADHD symptoms are divided into three groups:

1. Inattention

  • difficulty concentrating

  • forgetting appointments

  • frequently losing objects

  • difficulty completing tasks

2. Hyperactivity

  • constant restlessness

  • difficulty staying still

  • excessive talking

3. Impulsivity

  • acting without thinking

  • interrupting conversations

  • difficulty waiting

There are three main forms of the disorder:

  • Predominantly inattentive

  • Predominantly hyperactive/impulsive

  • Combined type

Important updates (2024–2026)

The most recent guidelines, including the DSM-5-TR and ICD-11, have brought important points:

  • ADHD is confirmed as a neurodevelopmental disorder, with well-established biological basis

  • Diagnostic criteria continue to be based on symptoms of inattention and hyperactivity/impulsivity, with the need for functional impact

  • There has been greater alignment between diagnostic systems (DSM-5-TR and ICD-11), although with minor differences in how symptoms are classified

  • There has been growing recognition that adults can also have ADHD, including late diagnosis

  • Modern approaches emphasise the importance of multidisciplinary treatment, not just medication

How is the diagnosis made?

The diagnosis is clinical, that is, made by specialised medical evaluation.

To confirm ADHD, it is generally necessary to have:

  • symptoms present for at least 6 months

  • onset before age 12

  • impact in more than one setting (e.g. home and work/school)

  • real impairment in life functioning

There is no blood test or imaging that confirms the diagnosis.

ADHD in adults: why is diagnosis increasing so much?

It is now known that ADHD does not disappear in adolescence.

In adults, it can present as:

  • difficulty with organisation

  • procrastination

  • financial or emotional impulsivity

  • difficulty maintaining routines

  • professional or academic instability

Many adults only realise the problem after years of difficulty, which explains the increase in late diagnoses.

Treatment: what really works

ADHD treatment is individualised and can include:

1. Medications

Stimulants (first-line treatment)

These are the most commonly used and have the strongest scientific evidence.

Examples:

  • Methylphenidate (known by trade names such as Ritalin and Concerta)

  • Lisdexamphetamine (e.g. Vyvanse)

How they work:
They increase the availability of neurotransmitters such as dopamine and noradrenaline, improving focus and control.

Non-stimulants

Used when there is contraindication, side effects or specific need.

Examples:

  • Atomoxetine

  • Bupropion (off-label use in some cases)

  • Clonidine

  • Guanfacine

These medications should only be used with medical prescription. Self-medication can pose risks.

2. Therapy

  • cognitive-behavioural therapy

  • organisational and routine strategies

3. Lifestyle changes

  • adequate sleep

  • physical activity

  • reduction of distractions

Treatment does not "cure" ADHD, but greatly improves quality of life.

Impacts of untreated ADHD

Without follow-up, ADHD can lead to:

  • poor academic or professional performance

  • difficulty in relationships

  • low self-esteem

  • increased risk of anxiety, depression and substance use

Conclusion

ADHD is a real, common and treatable condition.
With correct diagnosis and appropriate follow-up, the person can have a completely functional and productive life.

**Important:
**This content is for informational and educational purposes. Reading this material does not replace a medical consultation. For appropriate diagnosis and treatment, seek a qualified healthcare professional.

Dr. Rebeca Soares Andrade CRM-GO 39335