Attention-Deficit/Hyperactivity Disorder (ADHD)

Attention-deficit/hyperactivity disorder (ADHD) is a developmental disorder marked by persistent patterns of inattention, hyperactivity, and impulsivity that can interfere with daily functioning and development.

Overview

ADHD is a developmental disorder that affects a person’s ability to control their behavior and pay attention to tasks. Symptoms begin in childhood and often continue into the teen years and adulthood.

For many people with ADHD, symptoms cause problems in daily life. Symptoms can make it hard to get things done, interfere with school, work, or other activities, and strain social relationships.

Although there is no cure for ADHD, current treatments may help reduce symptoms and improve functioning.

Signs and Symptoms

ADHD is characterized by an ongoing pattern of one or more of the following types of symptoms:

  • Inattention: Difficulty paying attention, staying on task, or staying organized
  • Hyperactivity: Showing too much energy, moving and talking too much, or feeling restless
  • Impulsivity: Acting without thinking or having difficulty with self-control

It is common for people to show these behaviors some of the time. However, for people with ADHD, these behaviors are frequent and persist. And they occur across multiple situations, such as at school, at home, at work, or with family and friends.

Some people mostly have symptoms of inattention. Others mostly have symptoms of hyperactivity and impulsivity. Some people have both types of symptoms. Boys and men tend to display more hyperactive and impulsive symptoms, while girls and women are more likely to be diagnosed with inattentive ADHD.

Signs of inattention can include frequent difficulty with:

  • Paying attention to details, leading to careless mistakes at school, work, or during other activities
  • Concentrating on tasks or activities, for instance, while having conversations, taking tests, completing assignments, or reading papers
  • Listening when spoken to directly
  • Following instructions
  • Organizing tasks and activities, managing time, and meeting deadlines
  • Completing tasks that require sustained attention, such as homework, large projects, and complicated forms
  • Losing things, such as backpacks, books, keys, wallets, and phones
  • Getting easily distracted by unrelated thoughts or stimuli
  • Forgetting about daily activities, such as chores, errands, and events, or other important things like assignments, appointments, and phone calls

Signs of hyperactivity and impulsivity can include often:

  • Fidgeting, tapping hands or feet, or squirming while seated
  • Moving around when expected to remain seated, such as in the classroom or office, or feeling restless in these situations
  • Running, climbing, or moving around at times when it is not appropriate
  • Being constantly “on the go” and acting as if driven by a motor
  • Being unable to quietly play or take part in hobbies and activities
  • Talking excessively
  • Answering questions before they are fully asked or finishing other people’s sentences
  • Struggling to wait or be patient, such as when playing a game or waiting in line
  • Interrupting or intruding on others, for example, in conversations, games, or meetings

How Symptoms Change with Age

ADHD symptoms may change as a person gets older:

  • Children show hyperactivity and impulsivity as the most common symptoms. As academic and social demands increase, symptoms of inattention often become more prominent and begin to interfere with academic performance and peer relationships.
  • Adolescents usually show less hyperactivity and may appear restless or fidgety. Symptoms of inattention and impulsivity typically continue and may cause academic, organizational, or relationship challenges. Teens with ADHD are more likely to engage in impulsive, risky behaviors, such as substance use and unsafe sexual activity.
  • Adults, including older adults, can show inattention, restlessness, and impulsivity, although in some people those symptoms become less severe and less impairing. They may also be irritable, have a low tolerance for frustration and stress, or experience frequent or intense mood changes.

Related Health Effects

  • ADHD often co-occurs with other disorders and conditions, such as behavioral disorders, learning disorders, sleep problems, anxiety, or depression, which can make the conditions harder to diagnose and treat.
  • Children with ADHD are at increased risk for injuries, social problems, family stress, and poor grades.
  • Teens and adults with ADHD are more likely to engage in risky behaviors, such as substance use and unsafe sexual activity.

Causes and Risk Factors

Researchers are not sure what causes ADHD, although many studies suggest that genes play a large role. Like many other disorders, ADHD probably results from a combination of factors.

ADHD has a genetic basis, meaning that a person diagnosed with ADHD is likely to have a close biological relative with similar symptoms. Environmental factors like nutrition and the social environment may also play a role in the development of ADHD.

In addition to genetic and environmental factors, researchers are looking at differences in brain development and neurobiology among people with ADHD compared to those without the disorder.

Diagnosis

To be diagnosed with ADHD, a person’s symptoms must also:

  • Begin before age 12
  • Occur for at least 6 months
  • Be present in two or more settings (for example, at home, at work, in school, or with friends)
  • Interfere with or impair social, school, or work functioning

The number of symptoms required differs by age:

  • Children up to 16 years must show at least 6 symptoms of inattention, hyperactivity and impulsivity, or both.
  • Adults and youth over 16 years must show at least five symptoms of inattention, hyperactivity and impulsivity, or both.

The Evaluation Process

A healthcare provider needs to do a thorough evaluation to determine the cause of symptoms, make an accurate diagnosis, and identify effective treatments. Stress, sleep disorders, anxiety, depression, and other physical conditions or illnesses can cause similar symptoms to those of ADHD.

Primary care providers sometimes diagnose and treat ADHD, or they may refer the person to a mental health professional. Learn about how to talk with a doctor or healthcare practitioner about mental health. During an evaluation, a provider usually:

  • Examines the person’s mental health and medical history, including their mood and past or current health conditions
  • Looks at the person’s current or past childhood behavior and school experiences. The provider may ask for permission to talk with family, friends, partners, teachers, and others who know the person well
  • Uses standardized behavior rating scales or ADHD symptom checklists to determine whether the person meets the criteria for a diagnosis
  • Administers psychological tests that look at cognitive skills, such as working memory, executive functioning (abilities such as planning and decision-making), visual and spatial abilities, or reasoning

Diagnosing ADHD in Adults

Diagnosing ADHD in adulthood is complicated by the need to show symptoms before age 12. For this reason, a diagnosis relies heavily on past reports of behavior.

There are many reasons someone may not be diagnosed with ADHD until adulthood. For instance, teachers and parents may not have recognized the disorder, or they may have provided supportive environments that helped the person thrive despite it. ADHD symptoms among girls and women are especially likely to have been missed in childhood. Sex differences in diagnosis rates begin to even out in adulthood.

It is never too late to seek a diagnosis and treatment for ADHD.

Treatment and Management

Although there is no cure for ADHD, current treatments may help reduce symptoms and improve functioning. Common treatments for ADHD are medicine, psychotherapy, and other behavioral interventions. For many people, treatment involves a combination of elements.

Medicine

Stimulants are the most common type of medicine used to treat ADHD, and research shows them to be highly effective.

Like all medicine, stimulants can have side effects and must be prescribed and monitored by a healthcare provider. Some children may report feeling slightly different or unlike their usual selves while taking the medicine. Most side effects of stimulants are minor and not seen at low doses. However, medicines for common health problems, such as diabetes, anxiety, and depression, can interact with stimulants. Other challenges with stimulant treatment, such as sleep disturbance and slowed growth, can generally be safely managed by a healthcare provider.

Healthcare providers sometimes prescribe nonstimulant medicines, like antidepressants, to treat ADHD. However, the U.S. Food and Drug Administration (FDA) has not approved these medicines specifically for ADHD. Sometimes, a person must try several different medicines or dosages before finding the one that works for them.

You can learn more about specific medicines, including the latest approvals, side effects, warnings, and patient information, on the FDA website.

Psychotherapy and Behavioral Interventions

Adding therapy to an ADHD treatment plan can help some people better cope with daily challenges, gain confidence, or manage impulsive and risky behaviors. Therapy is especially helpful if ADHD co-occurs with other mental disorders, such as anxiety, depression, conduct problems, or substance use disorders.

Several psychosocial interventions have been shown to help manage symptoms and improve functioning:

  • Occupational therapy focuses on building functional daily living skills. It might involve practical assistance, such as organizing tasks or completing schoolwork, learning social skills, or monitoring one’s behavior.
  • Cognitive behavioral therapy (CBT) helps a person become aware of attention and concentration challenges and work on skills to improve focus and organization and complete daily tasks. For instance, by breaking large tasks into smaller, more manageable steps.
  • Family and marital therapy helps family members learn to handle disruptive behaviors, encourage behavior changes, and improve interactions with children and partners.

Parent Education and Support

Therapy for children and teens requires parents to play an active role. Mental health professionals can educate parents about the disorder and how it affects a family. They also can help parents develop new skills, attitudes, and ways of relating to their child. Examples include parenting skills training, stress management techniques for parents, and support groups that help parents and families connect with others who have similar concerns.

School-Based Programs

Many children and teens with ADHD benefit from school-based behavioral interventions and academic accommodations. Interventions include behavior management plans or classroom-taught organizational and study skills. Accommodations include preferential seating in the classroom, reduced classwork, and extended time on tests and exams. Schools may provide accommodations through what is called a 504 Plan or, for children who qualify for special education services, an Individualized Education Plan (IEP).

Learn more about special education services and the Individuals with Disabilities Education Act.

Cognitive Training

Cognitive training approaches involve repeatedly using a program or activity over several weeks to improve specific functions, such as memory or attention. Exercises are tailored to the person’s ongoing performance.

Cognitive training is shown to modestly improve the tasks being practiced. Research shows the training can help memory, attention, inhibition, planning, and cognitive flexibility in people with ADHD.

Neurofeedback

Neurofeedback is a noninvasive technique in which an electronic device monitors and records a person’s brain activity, providing them with immediate feedback to support self-regulation. The device measures brain activity through such means as electroencephalography (EEG) or functional magnetic resonance imaging (fMRI) scans and feeds the information back to the person, usually in the form of a computer screen or visual cue.

Although neurofeedback is shown to help reduce some ADHD symptoms, it may be less effective than those seen from medicine and psychotherapy. Additional research is needed to refine the treatment and determine for whom it works and under what conditions.

Complementary Health Approaches

Unlike psychotherapy and medicine that are scientifically shown to improve ADHD symptoms, complementary health approaches—including natural products, vitamins and supplements, diet changes, and acupuncture—generally have not been found to treat ADHD effectively and do not qualify as evidence-supported interventions.

Dietary supplements may have side effects and interact with some medicines. If you are considering using any complementary health approach for ADHD, discuss this decision with your healthcare provider. Learn more about talking with your doctor about complementary health approaches.

Workplace Accommodations

People whose ADHD symptoms cause impairment at work may qualify for reasonable accommodations under the Americans with Disabilities Act (ADA).

Living With ADHD

Medicine and therapy are the most effective treatments for ADHD, but other strategies may also help manage symptoms.

Strategies for Adults and Teens

The following self-management strategies may help:

  • Get regular exercise, especially when feeling hyperactive or restless
  • Eat regular, healthy meals.
  • Get plenty of sleep. Try to turn off screens at least 1 hour before bedtime and get between 7–9 hours of sleep every night.
  • Stick to a consistent routine.
  • Work on time management and organization. Prioritize time-sensitive tasks and write down assignments, messages, appointments, reminders, and important thoughts.
  • Take short breaks during tasks that require sustained attention to help maintain focus and prevent burnout. Break large tasks into smaller, more manageable steps.
  • Connect with people and maintain relationships. Schedule activities with friends, particularly supportive people who understand your challenges with ADHD.
  • Take medicines as directed. Avoid alcohol, tobacco, and drugs not prescribed for you.

Strategies for Parents and Caregivers

Parents and caregivers can take the following steps to support a child with ADHD:

  • Be patient, flexible, and understanding. ADHD may make it hard for your child to perform certain tasks or behaviors, and some children may need to use different strategies to help them succeed.
  • Use clear, simple, direct language to explain rules and expectations. Reward behaviors that meet these expectations with positive reinforcement and provide consistent praise or rewards for acting in a desired way.
  • Offer practical help, such as on tasks like cleaning and organizing. Or simply be present and engaged while your child works, which can give them a sense of accountability and motivation and help them stay focused and on track.
  • Provide opportunities to explore different activities and interests. Help your child discover their unique talents and build confidence in their abilities.

Find Clinical Trials

Clinical trials uncover better ways to prevent, diagnose, treat, and understand diseases and conditions. To ensure results apply to everyone, volunteers of all ages, sexes, and backgrounds, including both healthy individuals and those with specific medical conditions, are needed. Find clinical trials on attention-deficit/hyperactivity disorder (ADHD).

Find Treatment

If you are unsure of where to get help, a healthcare provider is a good place to start. They can refer you to a qualified mental health professional, such as a psychologist, psychiatrist, or clinical social worker, who can help figure out the next steps.

Find support and locate mental health services in your area on the Substance Abuse and Mental Health Services Administration (SAMHSA) website.

Community Support

The following organizations have more information on ADHD:

If you or someone you know is struggling or having thoughts of suicide, call or text the 988 Suicide & Crisis Lifeline at 988 or chat at 988lifeline.org. In life-threatening situations, call 911.

Note: This resource list is for informational purposes only. It is not comprehensive, and an organization’s inclusion does not constitute an endorsement by NIH.  

Research Information

The National Institutes of Health (NIH) is the largest public funder of biomedical research in the world. NIH invests most of its budget in medical research seeking to enhance life and to reduce illness and disability. NIH-funded research has led to breakthroughs and new treatments helping people live longer, healthier lives, and building the research foundation that drives discovery.  

NIH supports research into the possible causes of ADHD. Researchers are investigating factors such as genes, hormones and other molecules, brain structure and activity, environmental and social factors, and prenatal and early life exposures. NIH-supported research is also exploring the behavioral profiles of children and adults with ADHD to better diagnose and treat the disorder, including identifying symptoms associated with types of ADHD and their presentation at different ages.

Researchers are also studying new treatments for people with ADHD, such as cognitive training and neurofeedback. These options are usually considered only after medication and psychotherapy have already been tried. Additionally, researchers are exploring new technologies, like mobile apps and virtual reality, that can deliver information to people in real time to help them change their behavior.

Find NIH-funded research projects using NIH RePORTER, a searchable database of current and past research projects supported by NIH and other federal agencies.