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 long periods

  • controlling impulses

  • organizing 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, brought important points:

  • ADHD is confirmed as a neurodevelopmental disorder, with a 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 increased recognition that adults can also have ADHD, including late diagnosis

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

How is the diagnosis made?

The diagnosis is clinical, that is, made by specialized 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 study that confirms the diagnosis.

ADHD in adults: why is diagnosis increasing so much?

Today it is known that ADHD does not disappear in adolescence.

In adults, it may appear as:

  • difficulty with organization

  • procrastination

  • financial or emotional impulsivity

  • difficulty maintaining routines

  • professional or academic instability

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

Treatment: what really works

ADHD treatment is individualized and may include:

1. Medications

Stimulants (first line of treatment)

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

Examples:

  • Methylphenidate (known by brand 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 bring risks.

2. Therapy

  • cognitive-behavioral therapy

  • organization 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 school or work 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 proper follow-up, the person can have a completely functional and productive life.

Important:
This content is informational and educational in nature. Reading this material does not replace a medical consultation. For proper diagnosis and treatment, consult a qualified healthcare professional.

Dr. Rebeca Soares Andrade CRM-GO 39335