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ADHD and the classroom: why is sitting still so hard?

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Parent Reading List - Bolton CAMHS ADHD Team

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This padlet is a resource bank for parents and carers of children and young people with ADHD, or on the wait-list for an assessment.

Opinions expressed in these resources are that of the authors, and not necessarily shared by Bolton CAMHS, or Greater Manchester Mental Health Trust. We do not endorse any specific resource however here are some suggestions that you might find helpful.

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Attention-Deficit/Hyperactivity Disorder (ADHD) is a disorder that begins in childhood and encompasses symptoms of inattention, hyperactivity, and impulsivity. These symptoms interfere with functioning at school, at work, and in social situations. ADHD is present in approximately 5% of children, and it is more common in boys. For a majority of people the disorder continues into adulthood, though careful managing can greatly improve quality of life for people with ADHD.

An estimated 25 to 50% of people with ADHD experience sleep problems, ranging from insomnia to secondary sleep conditions. Doctors are starting to realize the importance of treating sleep problems and the impact this can have on both ADHD symptoms and quality of life for ADHD patients and their families.

What's the Connection Between ADHD and Sleep?

Beginning around puberty, people with ADHD are more likely to experience shorter sleep time, problems falling asleep and staying asleep, and a higher risk of developing a sleep disorder. Nightmares are also common in children with ADHD, especially those with insomnia. Sleep problems in ADHD tend to increase with age, though sleep problems in early childhood are a risk factor for future occurrence of ADHD symptoms.

Even those who are rarely hyperactive during the day may experience racing thoughts and a burst of energy at night that interfere with sleeping. For some, nighttime presents the perfect opportunity to "hyperfocus" on a project, as there are less distractions. Unfortunately, this makes it difficult to settle down for sleep and it can lead to a disrupted sleep-wake schedule. Over time, insomnia may worsen as people start to develop feelings of stress related to bedtime.

Many people with ADHD experience daytime sleepiness and difficulty waking up as a result of poor sleep. Others experience restless, non-refreshing sleep with multiple nighttime awakenings.

Sleep problems in ADHD appear to differ depending on the type of ADHD. Individuals with predominantly inattentive symptoms are more likely to have a later bedtime, while those predominantly hyperactive-impulsive symptoms are more likely to suffer from insomnia. Those with combined hyperactive-impulsive and inattentive ADHD experience both poor sleep quality and a later bedtime.

Many ADHD symptoms are similar to symptoms of sleep deprivation. Among others, adult ADHD sleep problems include forgetfulness and difficulty concentrating. In children, fatigue may present as being hyperactive and impulsive. Sometimes it can be difficult to tell whether these issues are brought on by ADHD or by a lack of sleep. This may lead to misdiagnoses or may allow sleep disorders to go undetected. Experts therefore recommend screening patients for sleep problems before prescribing medication for ADHD.

What's the Biology Behind the ADHD-Sleep Connection?

ADHD sleep problems may be a side effect of impaired arousal, alertness, and regulation circuits in the brain. Other researchers believe that ADHD sleep problems can be traced to a delayed circadian rhythm with a later onset of melatonin production. Despite similarities between certain sleep disorders and ADHD symptoms, research has failed to find consistent sleep abnormalities in people with ADHD.

Some individuals find it easier to sleep with the calming effects of stimulant medications that are commonly prescribed for ADHD. However, for many people, stimulant medications cause a number of sleep problems in their own right. Co-existing disorders such as anxiety, depression, or substance abuse, as well as poor sleep hygiene, likely also play a role in sleep difficulties.

How Do ADHD Sleep Problems Affect Daily Life??

Though there is little research on the subject of ADHD with accompanying sleep disorders, children and adults with ADHD plus a sleep disorder often report more severe ADHD symptoms and a lower quality of life. They may also be more likely to suffer from depression, anxiety, hyperactivity, inattention, difficulty processing information, and a higher BMI. Over the long term, chronic sleep deprivation leaves people vulnerable to physical health problems.

Daytime sleepiness can have serious effects on school and work. People may judge a person with ADHD for sleeping at inappropriate times, without realizing that it is part of their condition and very difficult to avoid. Sudden bouts of sleepiness may also be dangerous while driving or performing other activities that require concentration.

Not sleeping well at night can also cause daytime fatigue. Individuals with ADHD-related sleep deprivation may feel grumpy, irritable, restless, or tired, or they may have trouble paying attention at school or at work. Sometimes, these symptoms may be mistaken for a mood disorder. In turn, anxiety and behavioral difficulties have been linked to a higher incidence of sleep problems for children with ADHD.

These problems also take their toll on families and caregivers of people with ADHD. Preliminary research shows that primary caregivers of children with ADHD as well as sleep problems are more likely to be depressed, anxious, stressed, and late to work.

What Sleep Disorders Commonly Occur in People With ADHD?

In addition to generalized insomnia, people with ADHD have higher-than-normal rates of certain sleep disorders. Because ADHD symptoms often resemble the symptoms of these sleep disorders, underlying sleep disorders may go undiagnosed. Children in particular may have difficulty conveying what they are feeling, leading to a misdiagnosis of ADHD when in fact their problems stem from a sleep disorder. Or, they may have ADHD plus a sleep disorder.

Circadian Rhythm Sleep Disorder: Most individuals with ADHD, particularly adolescents, are more alert in the evening. This atypical schedule can make it difficult to honor work or school commitments. A smaller pineal gland, irregularities in clock genes, and later melatonin release may be responsible for circadian rhythm sleep disorders in people with ADHD. Taking melatonin supplements at targeted times or using bright light therapy may help adjust your schedule.

Sleep-Disordered Breathing: Sleep-disordered breathing (SDB), including snoring and sleep apnea, affects up to one-third of patients with ADHD. SDB leads to disturbed sleep and daytime sleepiness, and often causes symptoms typical of ADHD. The encouraging news is that treating SDB may reduce the need for stimulants in children believed to have ADHD. Studies suggest that removing the tonsils may help with ADHD and sleep apnea symptoms in children, while CPAP devices are a better choice for adults.

Restless Legs Syndrome: People with restless legs syndrome (RLS) are plagued by tingling sensations in the legs that make it hard to fall asleep. RLS or other types of periodic limb movement disorders may occur in almost 50% of people with ADHD. Children with both ADHD and RLS appear to spend longer in stage one light sleep, which is not as restorative. Researchers believe RLS is caused by iron and dopamine deficiencies, which are also implicated in ADHD. RLS may be treated with iron supplements or dopaminergic agents.

Narcolepsy: Individuals with narcolepsy tend to fall asleep suddenly during the day and may have difficulty sleeping soundly at night. Adults with narcolepsy are twice as likely to have had ADHD as a child. While the link between the two isn't clear, researchers believe that the sleepiness brought on by narcolepsy might provoke ADHD symptoms. It's also possible that both disorders might stem from a similar cause, such as a faulty gene or a problem with neurotransmitters. Narcolepsy is usually treated with medication.

Treating underlying sleep disorders is an important step toward improving sleep for people with ADHD. Ask your doctor for a sleep study to rule out any secondary sleep disorders that may need to be treated along with your ADHD. A good doctor should monitor potential sleep problems on an ongoing basis, as these tend to develop over time.

Sleep Tips for Children and Adults With ADHD and Sleep Problems

Experts are cautiously optimistic that sleep interventions may be key to improving not only sleep, but also ADHD symptoms and the effects of ADHD medication. Indeed, preliminary studies have found that behavioral sleep interventions improve sleep, ADHD symptoms, quality of life, daily functioning, behavior, and working memory.

For children, adolescents, and adults with ADHD, a consistent bedtime routine and healthy sleep hygiene practices can help reinforce the connection between bed and sleep. Try making gradual changes and note where you see improvements to develop a system that works for you. Some tips include:

Cut out sugar, caffeine, and alcohol within a few hours of bedtime

Avoid screen time for an hour before bed

Avoid doing stimulating activities and projects that require hyperfocusing in the evening

Make the bed a stress-free zone reserved for sleep and sex

Get enough exercise and sunlight during the day

Develop a bedtime routine that you enjoy, such as rereading a favorite book, spending time with pets, or taking a warm bath

Keep the bedroom dark, cool, and quiet, using a white noise machine if necessary to block out intrusive noises

Go to bed and wake up at the same time every day, choosing a time that is realistic and age-appropriate to get the recommended sleep for your age group

Use a weighted ball blanket

People with ADHD also frequently have trouble waking up in the morning. For help getting out of bed, try using light therapy or plan something enjoyable for when you get out of bed, such as exercise or a nice breakfast

The Children and Adults with ADHD organization recommends using a rewards-based system for sleep problems in young children with ADHD. It may also help to offer reassurance by checking frequently on your child. For people of any age with ADHD, talking with a trusted confidant, keeping a worry journal, or using relaxation techniques such as guided imagery may help make bedtime less stressful.

Sleep medication may not be appropriate for people with ADHD, but you can talk to your doctor about adding supplements or tweaking your medication schedule to optimize it for sleep. Some people with ADHD find it helps alertness to take their medication about an hour before waking up. Adolescents and adults with sleep problems may benefit from cognitive behavioral therapy for insomnia (CBT-I).

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ADHD and Sleep Problems: How Are They Related? | Sleep Foundation

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Attention-Deficit/Hyperactivity Disorder (ADHD) is a disorder that begins in childhood and encompasses symptoms of inattention, hyperactivity, and impulsivity. These symptoms interfere with functioning at school, at work, and in social situations. ADHD is present in approximately 5% of children, and it is more common in boys.

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Website

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Attention deficit hyperactivity disorder (ADHD) is a condition that affects people's behaviour. People with ADHD can seem restless, may have trouble concentrating and may act on impulse.

Symptoms of ADHD tend to be noticed at an early age and may become more noticeable when a child's circumstances change, such as when they start school.

Most cases are diagnosed when children are under 12 years old, but sometimes it's diagnosed later in childhood.

Sometimes ADHD was not recognised when someone was a child, and they are diagnosed later as an adult.

The symptoms of ADHD may improve with age, but many adults who were diagnosed with the condition at a young age continue to experience problems.

People with ADHD may also have additional problems, such as sleep and anxiety disorders.

Getting help

Many children go through phases where they're restless or inattentive. This is often completely normal and does not necessarily mean they have ADHD.

But you should discuss your concerns with your child's teacher, their school's special educational needs co-ordinator (SENCO) or a GP if you think their behaviour may be different from most children their age.

It's also a good idea to speak to a GP if you're an adult and think you may have ADHD, but were not diagnosed with the condition as a child.

What causes attention deficit hyperactivity disorder (ADHD)?

The exact cause of ADHD is unknown, but the condition has been shown to run in families.

Research has also identified a number of possible differences in the brains of people with ADHD when compared with those without the condition.

Other factors suggested as potentially having a role in ADHD include:

being born prematurely (before the 37th week of pregnancy)

having a low birthweight

smoking or alcohol or drug abuse during pregnancy

ADHD can occur in people of any intellectual ability, although it's more common in people with learning difficulties.

How attention deficit hyperactivity disorder (ADHD) is treated

For children with ADHD, although there's no cure, it can be managed with appropriate educational support, advice and support for parents and affected children, alongside medicine, if necessary.

For adults with ADHD, medicine is often the first treatment offered, although psychological therapies such as cognitive behavioural therapy (CBT) may also help.

Living with attention deficit hyperactivity disorder (ADHD)

Parents of children with ADHD

Looking after a child with ADHD can be challenging, but it's important to remember that they cannot help their behaviour.

Some day-to-day activities might be more difficult for you and your child, including:

getting your child to sleep at night

getting ready for school on time

listening to and carrying out instructions

being organised

social occasions

shopping

Adults with ADHD

Adults with ADHD may find they have problems with:

organisation and time management

following instructions

focusing and completing tasks

coping with stress

feeling restless or impatient

impulsiveness and risk taking

Some adults may also have issues with relationships or social interaction.

Page last reviewed: 24 December 2021
Next review due: 24 December 2024

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Attention deficit hyperactivity disorder (ADHD)

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Read about attention deficit hyperactivity disorder (ADHD), a condition that affects people's behaviour.

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Website

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This webpage looks at attention-deficit hyperactivity disorder (ADHD) and hyperkinetic disorder, the signs to look for and where to get help.

'Attention deficit (ADD)', 'attention-deficit hyperactivity disorder (ADHD)', 'hyperkinetic disorder' and 'hyperactivity' are various terms used by people and professionals.

These differences in terminology can sometimes cause confusion. All the above terms describe the problems of children who are hyperactive and have difficulty concentrating.

ADHD is a behavioural disorder which often becomes obvious in early childhood. The behaviours are due to underlying problems of poor attention, hyperactivity and impulsivity.

Many children, especially under-fives, are inattentive and restless. This does not necessarily mean they are suffering from ADHD.

The inattention or hyperactivity becomes a problem when they are exaggerated, compared with other children of the same age, and when they affect the child, their school, social and family life.

About 2 to 5% of school age children can suffer from ADHD. Boys are more commonly affected than girls.

We know from research studies that genes play an important role in whether someone has ADHD. There are also lots of other factors involved, including social and environmental factors.

ADHD is the extreme of behavioural traits that are common in the general population. ADHD can occur in different ways:

Common genetic variants combined with environmental factors - In most situations, genetic variants that exist in the general population will interact with environmental factors, resulting in the features of ADHD.

Rare genetic variants - Very occasionally, someone will have ADHD because they have rare genetic variants.

Family studies have found that the risk of being diagnosed with ADHD is nine times higher in siblings of someone with ADHD, when compared to siblings of someone without ADHD.

People who have neurodevelopmental disorders such as autism, are also more likely to have ADHD than people who don't. Studies into twins and siblings have found common genetic risk factors for ADHD and other neuropsychiatric conditions. These include autism and other childhood neurodevelopmental disorders.

Sometimes parents feel blamed for not having controlled their child, but there is no evidence that poor parenting directly causes ADHD. However, it is important to note that parents can play a crucial role in helping and managing a child with ADHD.

ADHD can present with different behaviours depending on the age, setting (i.e. school, home, playground) and even motivation (e.g. when doing an activity or something a child likes).

Not all children have all the symptoms. This means some can just have problems with poor attention, while others are mainly hyperactive.

Children with problems of attention can appear forgetful, distracted, not seeming to listen, disorganised, take ages to start doing things and then when they do they rarely finish it.

Children with hyperactivity seem restless, fidgety, full of energy 'always on the go'. They may seem loud, noisy with a continuous chatter.

Children with symptoms of impulsivity do things without thinking. They have difficulty waiting for their turn in games or in a queue, and interrupt people in conversation.

Children with ADHD can have other problems such as learning difficulties, autism, conduct disorder, anxiety and depression.

Neurological problems like tics, tourette's, and epilepsy can also be present. Children with ADHD can have problems with coordination, social skills and seem to be disorganised.

About 1 in 3 children with diagnosis of ADHD can grow out of their condition and not require any treatment when they are adults. The majority who receive specialist treatment tailored to their needs may benefit considerably. They will have been able to catch up with their learning, improve their school performance and make friends.

Some are able to cope and manage by adapting their careers and home life. However, some can have major problems, even as adults, requiring treatment. They may also struggle with difficulties in relationships, at work, in their mood and using drugs or alcohol.

There is no single, simple, definite test for ADHD. Making a diagnosis requires a specialist assessment, usually done by a child psychiatrist or specialist paediatrician.

The diagnosis is made by recognising patterns of behaviour, observing the child, obtaining reports of their behaviour at home and at school.

Sometimes a computerised test may be done to aid the diagnosis. Some children also need specialised tests by clinical or educational psychologist.

A child suffering from ADHD needs treatment across all situations where the difficulties occur. This means support and help at home, school, with friends and community.

Firstly it is very important for the family, teachers, professionals to understand the child's condition and how it affects them. As they grow up, the young person themselves needs to be aware of their condition and how to manage it.

Teachers and parents may need to use behavioural management strategies like reward charts. Parents/family may find parent training programmes helpful, especially in managing the defiant behaviours which may arise from their hyperactivity.

At school, children may need specific educational support and plans to help with their daily work in classroom and also homework. They may also need help to build their confidence, develop their social skills.

It is important that there is good communication between home, school and the professionals treating the child to ensure that the ADHD symptoms are treated as well as possible, and that the child achieves their best potential.

Medications can play an important role in managing moderate to severe ADHD. Medications can help to reduce hyperactivity and improve concentration. The improved concentration gives the child the opportunity and time to learn and practise new skills.

Children often say that medication helps them to get on with people, to think more clearly, to understand things better and to feel more in control of themselves. Not all children with ADHD will need medication.

A child with ADHD can present with very difficult behaviours at home, school or outside. However, there still needs to be boundaries and discipline. Having ADHD does not mean they will always disobey you or behave inappropriately (e.g. swearing or being violent). A healthy lifestyle, with balanced diet and activity, can help.

Children with ADHD can become easily frustrated because of their poor attention span and high energy levels. Some of the following can help manage these difficulties:

Give simple instructions. Stand near them, look at them and tell them slowly and calmly what you want them to do, rather than shouting across the room.

Praise your child when they have done what is required, however small it is.

If needed, write a list of things to do and put it somewhere where it can be seen clearly (e.g. door of their room, bathroom).

Break any task, like doing homework or sitting on dining table, to smaller time spans such as 15-20 minutes.

Give them time and activities to spend their energy like basketball, swimming.

Change their diet and avoid additives. There is some evidence about the effect of diet on some children. They may be sensitive to certain food additives and colourings. If parents notice that certain foods worsen hyperactivity, these may be avoided. It is best to discuss this with your doctor or specialist dietician.

Many parents find it helpful to attend parenting programmes, irrespective of whether child is being treated for ADHD. Some areas offer parenting programmes and support groups specifically for parents of children with ADHD.

How do I get help?

Your GP, teacher or school nurse can refer you to a specialist to complete an 'assessment' and offer treatment. They may refer you to a paediatrician (Child doctor) or to a child and adolescent mental health service (CAMHS).

What are the medications used in treatment of ADHD?

Medications used to treat ADHD are broadly divided in two groups:

Stimulants like methylphenidate and dexamphetamine

Non stimulants like atomoxetine.

Stimulants have the effect of making people feel more alert, energetic, and awake. In a person suffering ADHD, they can improve attention and reduce hyperactivity. The stimulants used in the treatment of ADHD include methylphenidate (previously commonly known by the name 'ritalin') and dexamphetamine.

Methylphenidate is available as different forms. Immediate release methylphenidate is short-acting. It is used for its flexibility in dosing and can be used to determine the correct level of dose during dose changes. Slow or modified release methylphenidate work for 8 - 12 hours and can be given once a day. They are more convenient, and as the child or young person need not take a dose in school, reduces stigma attached to this disorder.

Non stimulant medications by nature do not make people alert or active. However, in ADHD, they can improve symptoms of inattention and hyperactivity. These include medications like atomoxetine.

Sometimes other medications may be used to help with problems with sleep and challenging behaviours that are associated with ADHD.

How do they work?

Medications act on certain chemicals in the brain called 'noradrenaline'. They seem to affect the parts of the brain that control attention and organise our behaviour.

They do not cure ADHD. They help to control the symptoms of poor attention, overactivity or impulsivity.

Which medication will be used for my child?

Stimulant medication methylphenidate is usually prescribed first. The type of stimulant prescribed will depend on a number of things like the symptoms your child has, your choice of treatment, the ease of giving the medication and even availability/cost of the medication.

If methylphenidate causes unpleasant side-effects or does not work, other stimulant (dexamphetamine) or non stimulant medications may be prescribed. Sometimes a child may respond to a different form of methylphenidate.

How do I know it is working?

You will find that:

your child's concentration is better

their feelings of restlessness or over-activity are less

they control themselves better.

Sometimes school or teachers notice the improvement before you do.

What are the side-effects?

As with most medications, there may be some unwanted effects. However, not everyone gets side effects and most side effects are mild and disappear with continued use. Side effects are less likely if the dose is increased gradually when the tablets are started. Some parents worry about addiction, but there is no good evidence to suggest that this is a problem.

Some of the common side effects of methylphenidate include:

loss of appetite

difficulty falling asleep

light headedness

Less common side effects to look out for include:

being 'over-focused', quiet and staring- this may be a sign that the dose is too high

anxiety, nervousness, irritability or tearfulness

tummy pains or feeling sick

headache, dizziness or drowsiness

tics or twitches.

In the long term, sometimes growth slows down when children are on methylphenidate. Research shows that the total adult height may be reduced by 2.5 cm when on methylphenidate.

This list of side-effects is not exhaustive. I f you notice anything unusual, i t is important to contact your doctor immediately.

Is there anything I need to know before giving the medication?

Before you give any medication do tell your doctor about:

allergies your child might have

any other medicines they take, including vitamins or supplements

for older girls if they are likely to become pregnant

if you or anyone in your family suffers from physical health problems, especially high blood pressure, heart problems and repeated movements (called tics).

Are there any special tests before or while taking the medications?

Before taking the medication, your child should be physically checked up especially for their heart rate, blood pressure, growth and any other medical problems. Sometimes they may need blood test or heart tracing test to measure the electrical activity of the heart called an electrocardiogram (ECG).

While taking the medication, your doctor will monitor your child's heart rate, blood pressure, weight and height on a regular basis along with checking for any side effects.

What do I need to know about giving the medication?

Some helpful things to know:

DO's

Give the medication at the times you were told by your doctor or pharmacist

Keep appointments for regular review of medication

Store the medication safely

Ensure your child swallows the medication, not chew or crush it

Make sure your child drinks enough, especially in hot weather and while exercising.

DON'T 's

Double the dose if they miss a dose of medication

Stop giving the medication without discussing with the doctor

Give the medication to anyone else, even if you feel their difficulties are similar to your child's.

How long do they need to be on the medication?

Most children and young people need the medication at least until they finish their education or schooling. A few might need to take it even when they grow up. Some children need medications only at specific times, like for example while attending school, and do not have to take it on weekends or on school holidays.

Your doctor would regularly check, at least once a year, if they need to continue the medicine.

Taking these medications can affect driving, and even certain careers like joining the army. It is important that the child is aware this and will need to discuss it with their doctor as they grow up.

Young people may need explanations and support as they grow up about taking their medication. Stopping medication can cause symptoms to return, and some young people can put themselves at risk in terms of their education, their work, and socially by being impulsive and taking alcohol or drugs.
Remember: if you have any further questions regarding this medication, do not hesitate to contact your doctor or pharmacist.

"I was always getting into trouble at school. The teacher used to tell me off for not sitting still, I'd try to sit down but it was hard - I would just want to get up and walk around. I was always getting into trouble for talking. The other children in my class would sit still and finish their work but I found this hard.

Mum and dad said I had a lot of energy. Sometimes my friends would tell me I was over the top. Mum says she couldn't take me anywhere when I was younger because I was so noisy and always on the go.

In the end, mum and dad took me to a clinic for children who have problems. They said I have ADHD and talked to my parents and teachers about how to help me. They gave me some medication - Ritalin. My mum and dad think it helps. I don't seem to get told off so much and can do my school work better."

ADD Information and Support Services (ADDISS) - Provides information and resources about ADHD to anyone who needs assistance.

Young Minds -Parents' helpline: 0800 018 2138: for any adult concerned about the emotions and behaviour of a child or young person.

ADD Resources - Website offers free and carefully chosen articles helpful to adults with ADD/ADHD and to parents of children with ADD/ADHD, links to other ADHD-related websites, and more.
Electronic Medicines Compendium (eMC)
Contains information about UK licensed medicines.

Further reading

For parents/professionals

ADD/ADHD Behaviour change resource Kit: Ready-to-Use Strategies & Activities for Helping Children with Attention Deficit Disorder, Grad A Flick, Paperback, 1998,Jossey Bass Publishers, Wiley Print.

ADHD Handbook - For Parents and Professionals. Dr Alison Munden and Dr Jon Arcelis. Jessica Kingsley Publishers.1999

For children

Everything a child needs to know about ADHD (2006), Dr C R Yemula, ADDISS publications, 2007, second edition. For children aged 6-12 years

Putting on the Brakes: Young People's Guide to Understanding Attention Deficit Hyperactivity Disorder. For ages 8 - 12 . Author: Patricia O. Quinn, Judith M. Stern

References

Credits

Revised by the Royal College of Psychiatrists' Child and Family Public Engagement Editorial Board (CAFPEB). This resource reflects the best possible evidence at the time of writing.

With grateful thanks to Dr Viji Janarthanan, Dr Virginia Davies, Dr Vasu Balaguru, and Thomas Kennedy.

About this information

This information reflects the best available evidence at the time of writing. This mental health information for young people was written in 2015.
© 2015 Royal College of Psychiatrists

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ADHD and hyperkinetic disorder for parents | Royal College of Psychiatrists

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This webpage looks at attention-deficit hyperactivity disorder (ADHD) and hyperkinetic disorder, the signs to look for and where to get help. 'Attention deficit (ADD)', 'attention-deficit hyperactivity disorder (ADHD)', 'hyperkinetic disorder' and 'hyperactivity' are various terms used by people and professionals. These differences in terminology can sometimes cause confusion.

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Sometimes, parents feel guilty when ADHD is diagnosed, but it’s important to know that there is nothing you could have done differently to prevent it. ADHD isn’t caused by bad parenting – although you might need above-average parenting skills to deal with its effects.

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We asked ADDitude readers, " What does it feel like to have ADHD?"

Like I need an "off" button for my brain. When I try to explain to others that some of my behavior is due to ADHD, they say I am making an excuse. - Bee, Florida

Everyone thinks I do dumb things on purpose. My friends tell me that everyone has attention deficit. Sometimes I just feel stupid. - Angie, Mexico

Imagine that you crawled on your knees your whole life, but everybody around you walked on two legs. You recognize that you are different, and you know you should be walking like everyone else, but you just can't keep your balance on two legs the way you can when you crawl. - Ashley, Ohio

Crazy, frustrating, and sometimes the funniest thing ever - once you learn to laugh at yourself! And we all need to. - Amy, Ohio

It is like watching a PowerPoint presentation that never stops. I tell someone something and, in the middle of a sentence, I go blank. It is embarrassing to have to ask the other person what you were talking about. People look at me and often think, "The lights are on, but clearly no one is home." - Angela, Indiana
[Self-Test: Could You Have Symptoms of Adult ADHD?]
Having ADHD does not "feel like" anything. Unlike a physical problem - a broken bone, say - ADHD is invisible. People offer sympathy when you are in pain. Trying to explain ADHD without seeming to make excuses is tough. Perhaps if someone were to create a "sling" or "splint" for ADHD, the public might have more sympathy for having the condition. - Ann, Tennessee

Every day is a struggle, but you make the best of it. Meds help, but they aren't a miracle cure. You take things people say literally. - Argelia, Georgia

It is as if you are driving through thick fog, on a dark road, trying to get to where you know you are supposed to be. The problem is, you lost the directions and have no GPS to guide you - and, in the background, the radio is playing loud songs that are changing. - April, Texas

It feels like there is always noise in my head - a constant buzzing that I can't make sense of. It's also paralyzing and frustrating. - An ADDitude Reader
[Free Download: You Know You Have ADHD When... (The Funny Side of ADHD)]
Like I am drowning in a maelstrom of "stuff" that needs to get done, but that I never finish. It's a never-ending feeling of futility. - Linda, Florida

Having ADHD is like having a nonstop conversation with yourself. -Christina, Texas

It's like being off balance, off kilter, similar to when the computer buffers a video, and it takes forever to load and play without doing all that starting and stopping. - Debbie, Arizona

It's not easy having an 18-year-old brain in a 61-year-old body! - Diane, Florida
["To Me, ADHD Feels Like..."]

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Everyone is not "a little bit ADHD." And, no, this isn't a medical fad. To understand what it really feels like to live with symptoms of attention defict, read this honest talk from ADDitude readers.

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(Note: American language described a 'learning disability', which corresponds to what we call a 'learning difficulty' in the UK)

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Is It ADHD? Or a Related Condition with Similar Symptoms?

When an individual has only attention deficit disorder (ADHD or ADD), treatment is often a life changer. Stimulants or nonstimulants - particularly when paired with behavior therapy, dietary changes, and exercise - can spark a dramatic improvement in distractibility, hyperactivity, and impulsivity symptoms for most patients once treatment is fine-tuned.

Some individuals, however, continue to experience significant symptoms - deep sadness, anxiety, defiance, learning and organization problems - long after their most pressing ADHD symptoms are brought under control.

For example: A child is diagnosed with ADHD and his doctor starts him on a stimulant. His parents notice that the symptoms that led to the ADHD diagnosis improve, but other challenges persist. His teacher remarks on his improved attention, yet he continues to struggle with classwork. Or perhaps his hyperactivity decreases, yet he remains defiant. When challenges remain after ADHD is diagnosed and treated, this is often a clue that another undiagnosed condition may accompany the ADHD.

Half of All People with ADHD / ADD Also Have Another Condition

Doctors once considered ADHD a standalone disorder. They were wrong. We now know that at least half of people with ADHD also suffer from one or more additional condition, referred to as a comorbidity. Most commonly, ADHD comorbidities include:
[Free Resource: Is It More Than Just ADHD?]
In some cases, these problems are "secondary" to ADHD - that is, they are triggered by the frustration of coping with symptoms of ADHD.

For example, a boy's chronic lack of focus may trigger anxiety in school. Years of disapproval and negative feedback from family members may likewise cause a woman with undiagnosed ADHD to become depressed. Most of the time, secondary problems fade once the ADHD symptoms are brought under control.

When secondary problems don't resolve with effective ADHD treatment, they are likely symptoms of a "comorbid" condition.

What Is a Comorbid Condition?

Comorbid conditions are distinct diagnoses that exist simultaneously with ADHD or ADD. They do not go away once the primary condition - in this case, ADHD - is treated. Comorbid conditions exist in parallel with ADHD and require their own specific treatment plan.
[Read: ADHD Comorbidity: An Overview of Dual Diagnoses]

A child with comorbid conditions may need school accommodations, psychotherapy, and/or a second medication in addition to his ADHD treatment.

Three Common ADHD Comorbidity Categories

The three categories of comorbid conditions most commonly diagnosed with ADHD all occur along a spectrum of severity - from mild to serious. Their symptoms are as varied as their causes, which range from genes to exposure to environmental toxins to prenatal trauma, and beyond.

ADHD Comorbidity #1: Cortical wiring problems

Cortical writing problems are caused by structural abnormalities in the cerebral cortex, the brain region responsible for high-level brain functions. Cortical wiring problems include:

Learning disabilities

Language disabilities

Fine and gross motor difficulties

Executive function difficulties

Cortical wiring problems are treated with academic accommodations and lifestyle changes. They do not respond to medication.

ADHD Comorbidity #2: Problems regulating emotions

Problems regulating emotions often include:

Note that depression can cause a range of symptoms beyond sadness and thoughts of suicide; these include irritability, reduced interest in activities that used to be pleasurable, sleep disturbances, decreased ability to concentrate, indecisiveness, agitation or slowness of thinking, fatigue or loss of energy, and feelings of worthlessness or inappropriate anger.

Regulatory problems often respond to a group of medications known as selective serotonin reuptake inhibitors, or SSRIs, which generally can be used in conjunction with ADHD medications.

Bipolar disorder is an exceedingly complex condition with many possible treatments. With this disorder especially, it's important to work with a psychiatrist who understands how to administer medications alongside treatment for ADHD.

ADHD Comorbidity #3: Tic disorders

Tic disorders refer to sudden twitches of whole muscle groups. They vary in severity and typically include:

Motor tics (ranging from involuntary eye blinking to head jerking to repeated gestures)

Oral tics (ranging from grunting to random blurting to, in very rare cases, obscene words or phrases)

Tourette's syndrome (multiple motor and vocal tics that have been present for more than a year)

How to Differentiate Symptoms of an ADHD Comorbidity from ADHD

If you or your child continue to struggle after you've begun treatment for ADHD, your next step is to determine whether the symptoms are secondary to ADHD (and likely to dissipate if you fine-tune your treatment plan), or evidence of a fully fledged comorbid disorder that requires additional treatment. signs of a fully fledged comorbid condition. There is no litmus test that can determine this. The best differential diagnosis begins with careful observation of where and when symptoms arise.

1. Secondary problems typically start at a certain time or occur only under certain circumstances. Did your daughter start experiencing anxiety only in the third grade? Is she anxious only in school or at home when doing homework? If so, her anxiety is likely secondary to ADHD and not a true comorbid disorder. Ditto if your son became aggressive only upon starting middle school.

2. In contrast, comorbid disorders are both chronic and pervasive. They are generally apparent from early childhood and occur in every life situation. Rather than occurring just during the school day, for instance, they persist over weekends, holidays, and summer vacation; they are evident in school, at home, at work, and in social situations. For example, ADHD-related mood shifts are usually triggered by life events. Bipolar mood shifts, on the other hand, may appear to come and go without any connection to the outside world, and may be sustained over longer periods of time.As with ADHD, they are often hereditary.

Consult a child and adolescent psychiatrist or psychologist.

If you suspect that your child has more than just ADHD, it's time to request an assessment designed to identify learning, language, motor, or organization/executive function problems. You may also need to pursue a clinical evaluation to determine if your child is living with anxiety, depression, anger control, OCD, or a tic disorder.

Common ADHD Comorbidity Symptoms

Review the list of symptoms associated with each comorbid condition below. If you see similarities to your or your child's behavior, take action. Early recognition of symptoms and prompt intervention are critical. Start with the recommended resources, and seek professional evaluation if it seems warranted.
[The Full Library of ADHD Tests and Assessments for Related Conditions]

Difficulty mastering reading, writing, and/or math skills

Difficulty with memory, mastering new academic concepts, and/or reasoning

Difficulty understanding what is said

Difficulty organizing thoughts and finding the right words when speaking

Persistent moodiness, fatigue, or loss of appetite

Unexplained feelings of guilt

Unexplained agitation or irritability

Reduced interest in activities that used to be pleasurable

Decreased ability to concentrate

Feelings of worthlessness

Sleep disturbances

Inappropriate anger

Uncontrollable anger or rage lasting 5-30 minutes or longer

Irrational during "meltdown"

Often remorseful afterward

Feeling overwhelmed by sensory stimuli, such as bright lights, loud noises, strong odors, tags or seams on clothing

Alternately, an individual with SPD may experience muted sights, sounds, and touch, and crave extra stimulation, as from swinging or spinning

Patterns of simple and complex motor or vocal tics that come and go and may change form

[Read This Now: The Complete ADHD Guide]

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When It's Not Just ADHD: Symptoms of Comorbid Conditions

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At least half of all people with ADHD also have a second condition - like learning disabilities, depression, or anxiety - that requires separate treatment. Learn about the most common conditions that come along with ADHD and how to distinguish symptoms.

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Youtube Video

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https://www.youtube.com/watch?v=dmeE3qTJRUw

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ADHD in Girls: How to Recognize the Symptoms

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ADD/ADHD | What Is Attention Deficit Hyperactivity Disorder?

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ADHD as a Difference in Cognition not  a Disorder (20 Minutes)

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Podcast Episodes

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Listen to the latest episodes of That ADHD Story on BBC Sounds.

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Podcast Episodes

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Parenting a child with ADHD can be a challenge, but it can also be a joy.
Cheryl and Richard are learning to deal with the ups and downs of ADHD since Alexander was diagnosed at the beginning of lockdown. For Tilly and her daughter, Molly, ADHD has been a shared journey that has brought them closer.

Learn more about their stories, and their tips and advice for other parents, here...

Video Transcript Video Transcript

Tilly: Children are no different, what they really need is someone to talk to, someone to understand them and if you have a child with ADHD, they need that even more so

Alexander: Ready?!

Tilly: Hi, I'm Tilly.

Richard, Cheryl and Alexander: and we are... the Jenkinsons!

Tilly: and this is...

Molly: (singing) Molly yeah!

Cheryl: Alexander has masses of energy. He loves running and climbing and jumping. Sit down please!

Tilly: I'm very proud of Molly. She's very kind and caring and loving. She's super creative...

Molly: - Super creative!

Richard: You really like to make people smile; you make them laugh.

Alexander: Yeah!

Tilly: There is never a dull moment (laughs).

Cheryl: We found out that Alexander had ADHD when he was six, just at the start of the pandemic.

Tilly: How old were you when you were diagnosed with ADHD?

Molly: I was seven years old.

Cheryl: He was finding it hard to concentrate on anything for more than a minute. His brain never switches off and he was making quite dangerous and impulsive decisions at times.

Alexander: I've run off.

Richard: And you were running off as well, weren't you?

Tilly: A child, in particular with ADHD, will feel a lot of the time misunderstood, not heard.

Richard: We're finding it pretty hard work, pretty exhausting to be honest and at times it felt almost a bit hopeless.

Molly: I'm the same as everybody else, it's just...

Tilly: Your mind works a bit differently, that's all.

Molly: Yeah. There are certain things that I struggle with but that never makes me stop trying.

Cheryl: The ADHD diagnosis has been life-changing.

Richard: We feel that finally we've been able to get him some help.

Tilly: ADHD is part of her build-up, part of her individuality and without ADHD you wouldn't be you, would you?

Richard: We feel a little bit more equipped to help and support him into the future.

Molly: I think ADHD just makes me be me.

Cheryl: Things that work well for us include really good routines, lots of praise, staying calm and lots of tickles.

Tilly: Show the world yourself...

Molly: Show the world that you are you and nobody in the world can change that.

Tilly: Yeah, a hundred percent.

Molly: Except you.

Tips and advice for parents

1. Allow them to be themselves

ADHD is part of your child's unique makeup and celebrating their individuality builds self-confidence and happiness. Those with ADHD have brains that operate differently, and this might make certain things harder but, as parents have discovered, it can also lead to fun and originality.

2. Listen, talk and understand

Communication is vital. Listen to your child's opinion of their needs and take the time to explain what ADHD is in way that they understand. Being understanding of their perspective on their difficulties helps you to be on the same page as a family.

3. Be patient

For children with ADHD, focussing on one specific task at a time can be challenging. It is important not to take this personally. If you feel like your child isn't listening to instructions, or is quickly distracted, keep in mind that this may be a reflection of their ADHD, rather than their relationship with you. Taking this into account can help you come to the table with a calmer, more accepting mindset.

4. Put routines in place

Routines are helpful for all children, but even more so for those with ADHD. A set structure for family life means that they have less to remember. If they know what they have to do every day, this builds habits that can result in fewer conflicts which will ultimately assist your child in feeling calm and in control.

5. Find the help they need

Your child may need more specialised help to aid them in managing their ADHD. There are evidence-based treatments for ADHD which include both behavioural interventions and, in some children, medication. These can really make a difference in helping your child both at school and at home.

In the first instance, discuss any concerns with your child's teacher at school, or their Special Educational Needs Co-Ordinator (SENCO). You can also talk to your GP who can explain the local process for ADHD assessment.

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If you are concerned that you are developing a mental health problem you should seek the advice and support of your GP as a matter of priority. If you are thinking about ending your life, please call 999 (UK) or go to A&E and ask for the contact of the nearest crisis resolution team. These are teams of mental health care professionals who work with people in severe distress.

The Mental Health Foundation is a charity specialising in research and policy development, with a focus on preventing mental health problems. We are not able to advise people directly on their personal circumstances.

Advice about looking after your mental health during the coronavirus outbreak.

Below are details on services and organisations that offer help and support directly to people with mental health problems:

For support in a crisis, Text Shout to 85258.

If you're experiencing a personal crisis, are unable to cope and need support.

Shout can help with urgent issues such as:

Suicidal thoughts

Abuse or assault

Self-harm

Bullying

Relationship challenges

Anxiety UK was established in 1970 and is run by and for those with anxiety, offering an extensive range of support services designed to help support those affected by anxiety disorders, anxiety and anxiety-based depression.

Services available include:

Helpline services - 03444 775 774, open from 9:30am to 17:30pm Mon to Friday, along with a text service 07537 416905 and 'Ask Anxia' chatbot service, available 24/7 for all anxiety queries at anxietyuk.org.uk. See Helpline services for more information.

Anxiety UK also offer fast access to a range of psychological therapy services, including counselling, Cognitive Behavioural Therapy (CBT), Compassion Focused Therapy (CFT), clinical hypnotherapy and Eye Movement Desensitisation and Reprocessing (EMDR) therapy, with appointments available in person, online and by telephone. See Therapy services for more information.

You can call the Rethink advice and information line Monday to Friday, 10am to 2pm for practical advice on:

different types of therapy and medication

benefits, debt, money issues

police, courts, prison

your rights under the Mental Health Act.

Call Rethink on 0300 5000 927 (calls are charged at your local rate).

The Mind infoline

Mind offer an information line to answer questions about:

types of mental health problem

where to get help

drug and alternative treatments

advocacy.

Call the Mind infoline on 0300 123 3393 (UK landline calls are charged at local rates, and charges from mobile phones will vary considerably). Or email .

The Mind Legal Advice service

If you need legal advice, you can speak to Mind about:

mental health

mental capacity

community care

human rights and discrimination/equality related to mental health issues.

Call the Mind Legal Advice service on 0300 466 6463 (UK landline calls are charged at local rates, and charges from mobile phones will vary considerably). Or email .

The Campaign Against Living Miserably (CALM) is leading a movement against suicide.

You can talk to CALM about anything.

Call the CALM helpline on 0800 58 58 58 or use their webchat here.

The helpline and webchat are both open 5pm to midnight, 365 days a year.

You may find it helpful to talk to your partner, a relative or a friend about your problems. They may be concerned about you and welcome the opportunity to hear what you have to say. If this is not possible, you may prefer to talk to someone else you can trust, like a faith leader or a tutor.

You can find out more about friendships and how to tell your friends on our friendships page.

Your GP may be the first person you talk to about your mental health problems. If you have a good relationship with your doctor, you may find it helpful just to know there is someone you can talk to about the feelings you are having. Your GP may refer you to specialist services if he/she feels they will help you. You can find information about talking to your GP about your mental health in our guide.

If you are unhappy with your own doctor, you can ask to see another doctor at the same practice or make an appointment with a different practice in your area. If you are unsure where to find other doctor's surgeries, look in your local Yellow Pages or try the NHS Choices website.

Specialist Mental Health Services

Most people recover from mental health problems without needing to go into hospital. There are a number of specialist services that provide various treatments, including counselling and other talking treatments. You may also need help with other aspects of your life - for example, claiming benefits or dealing with housing problems. Often these different services are coordinated by a community mental health team (CMHT).

CMHTs are usually based either at a hospital or a local community mental health centre. Some teams provide 24-hour services so that you can contact them in a crisis. If you are already in contact with a CMHT you may find it useful to keep their number by your phone in case you need it. Otherwise you should be able to contact your local CMHT via your local social services or social work team.

Other kinds of community mental health team include Crisis and Home Treatment teams, which provide you with help in your own home and can come out to see you in an emergency or help you get into hospital if you need inpatient treatment.

You may also find it helpful to contact your nearest Citizens Advice Bureau for advice about benefits, debt problems, legal issues and local services. The Citizens Advice Bureau website has a directory listing its local offices.

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Mental health resources for children, students, parents, carers and school/college staff

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This article was updated on 19 March 2024 to reflect the latest information. We have put together some useful links and sources of mental health support so that children and young people, parents, carers, and school and college staff can get …

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This website contains just a fraction of the information that we have on ADHD. If you would like to know more, visit our Bookstore. It has a wide range of resources about all aspects of ADHD and associated conditions, with special sections for parents, children, teenagers and professionals.

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Medication for ADHD (Attention Deficit Hyperactivity Disorder)

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Learn about ADHD medication including the different types, the benefits of taking it, and possible side effects.

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2. Key facts

Methylphenidate is a controlled drug, which means that you may have to prove your identity when collecting your prescription. Collect your prescription within 28 days.

If your child takes slow release methylphenidate, give it to them once a day. If they are taking standard tablets or capsules, your doctor may recommend giving it up to 3 times a day.

It's best to stick to the same brand, particularly if your child has slow release methylphenidate. Different brands work differently in how they release the medicine into the body, and this can affect how they work to manage your child's symptoms.

Methylphenidate makes your child less hyperactive and impulsive, and helps them concentrate.

Methylphenidate for children is also known by the brand names Matoride, Tranquilin, Xaggitin and Xenidate.

5. Side effects

Like all medicines, methylphenidate can cause side effects, although not everyone gets them.

Common side effects

These common side effects may happen in more than 1 in 100 people:

headaches

feeling aggressive, irritable, depressed, anxious or tense

trouble sleeping (insomnia)

loss of appetite - this can lead to weight loss or poor weight gain

stomach ache

dry mouth

feeling or being sick (nausea or vomiting)

Keep giving your child the medicine, but tell your doctor if they bother your child or do not go away:

Serious side effects

Serious side effects are uncommon and happen in less than 1 in 100 people.

Tell your doctor straight away if your child:

has changes in mood or personality

has thoughts about harming themselves

has a fast or irregular heartbeat (palpitations) - your child may feel their heart is beating much faster than normal or may say it is racing

starts seeing, feeling or hearing things that are not real (hallucinations)

has started to get facial tics - these are quick, little movements in the muscles of the face that cannot be controlled and are sudden, if this starts happening, their doctor will stop your treatment

Methylphenidate can also cause a small increase in blood pressure and pulse rate. For this reason, your doctor will usually measure your child's blood pressure and pulse every 6 months.

Growth in children

If your child takes methylphenidate for longer than a year, it can slow down their growth. However this happens in less than 1 in 10 children.

Your doctor will check your child's height, weight and appetite every 6 months to make sure they are growing OK.

Serious allergic reaction

In rare cases, it's possible to have a serious allergic reaction ( anaphylaxis) to methylphenidate.

These are not all the side effects of methylphenidate. For a full list, see the leaflet inside the medicine packet.

You can report any suspected side effect using the Yellow Card safety scheme.

Visit Yellow Card for further information.

7. Cautions with other medicines

There are some medicines that can affect the way methylphenidate works.

If your child is taking any of the following medicines, talk to your doctor or pharmacist before giving them methylphenidate:

medicines to treat depression or other mental health problems

medicines for epilepsy

blood pressure medicines

medicines that treat or prevent blood clots

medicines for coughs and colds

Some cough and cold medicines can affect blood pressure so speak to your pharmacist or doctor if you're buying these for your child. It's important to check whether they are OK for them to have while taking methylphenidate.

Mixing methylphenidate with herbal remedies and supplements

There's very little information about taking herbal remedies and supplements while taking methylphenidate. Check with your doctor or pharmacist before giving any to your child.

Some studies have suggested that omega-3 and omega-6 supplements can help with ADHD. However, the evidence is limited and more research is needed.

Medicine safety

Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements.

8. Common questions about methylphendiate for children

How long does it take to work?

When your child first starts taking methylphenidate they will be on a low dose. Your doctor will usually increase this gradually until they find the dose that works for your child.

This means it might take a few weeks before you see any benefits. When your doctor has found the right dose, methylphenidate should start to work within 30 to 60 minutes of your child taking it.

The medicine makes your child less hyperactive or impulsive, and helps their concentration. How quickly it works depends on whether it's standard or slow release.

Is it safe to take for a long time?

There is no evidence that methylphenidate is harmful as long as it is taken exactly as prescribed and your child is monitored carefully. This is why it's a good idea for them to have regular reviews with their doctor to check whether it's still needed.

What will happen if my child stops taking it?

Only stop giving your child methylphenidate if your doctor tells you to.

If your child suddenly stops taking methylphenidate, you may notice withdrawal symptoms such as depression.

Talk to your doctor if you want to stop giving your child methylphenidate. They may want to slowly reduce the amount that your child takes before stopping completely. This is to help avoid any extra side effects.

Is it addictive?

As long as you follow your doctor's instructions carefully, methylphenidate does not generally cause addiction issues.

Do not stop giving methylphenidate to your child suddenly. Talk to your doctor first, as they may want to reduce the dose gradually. This reduces the risk of your child having extra side effects when they stop taking this medicine.

Addiction problems usually only occur if you give methylphenidate more often than prescribed, or at a higher dose than recommended.

Can my child take it with painkillers?

You can give your child painkillers such as paracetamol or ibuprofen, unless your doctor has told you not to.

Is there any food or drink they need to avoid?

There's no particular food or drink that your child needs to avoid when taking methylphenidate.

Are medicines the first treatment option for children with ADHD?

If a child has ADHD, their doctor will usually only prescribe a medicine if other treatments have not helped. Their symptoms may still be causing problems, even after trying practical things like:

taking regular breaks to move around

reducing distractions, for example by using headphones

having instructions written down clearly

Medicines are usually only used for ADHD as part of a treatment programme. Other treatments can include:

therapies to improve specific skills and behaviours

training for parents to help them manage their child's behaviour

additional support at school

If you have any questions or worries about your child's medicine, speak to your doctor.

Can taking supplements help ADHD?

Some studies have suggested that omega-3 and omega-6 supplements can help with ADHD. Howeve, the evidence is very limited and more research is needed.

Talk to your doctor before giving any supplements to your child. This is because some can react with medicine - causing side effects, or can make the medicine work less well.

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Methylphenidate: a medicine used to treat attention deficit hyperactivity disorder (ADHD).

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Methylphenidate is a controlled drug, which means that you may have to prove your identity when collecting your prescription. Collect your prescription within 28 days. If your child takes slow release methylphenidate, give it to them once a day. If they are taking standard tablets or capsules, your doctor may recommend giving it up to 3 times a day.

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This leaflet is for parents and carers about how to use this medicine in children. Our information may differ from that provided by the manufacturers, because their information usually relates to adults. Read this leaflet carefully. Keep it somewhere safe so that you can read it again.

Name of medicine

Methylphenidate (sometimes known as methylphenidate hydrochloride)

Brand names: Medikinet, Ritalin

Modified-release brands: Concerta XL, Equasym XL, Matoride XL, Xaggitin XL, Medikinet XL, Delmosart prolonged release, Xenidate XL

Why is it important for my child to take Methylphenidate?

This medicine will help to reduce the symptoms of hyperactivity and impulsive behaviour. It will also help to increase attention and concentration span. Methylphenidate is used as part of a comprehensive treatment programme for ADHD that includes behavioural therapy.

What is Methylphenidate available as?

Tablets: 5 mg, 10 mg, 20 mg; these contain small amounts of lactose; Ritalin contains gelatin.

Modified-release tablets: 18 mg, 27 mg , 36 mg, 54 mg; these may contain lactose

Modified-release capsules: 5 mg, 10 mg, 20 mg, 30 mg, 40 mg, 50 mg, 60 mg; these contain gelatin and a small amount of sugar.

When should I give Methylphenidate

Modified-release tablets/capsules are usually given once each day. This is usually in the morning. These gradually release the medicine over the day.

Equasym XL is best given before breakfast.

Medikinet XL is best given with or after breakfast.

Medikinet and Ritalin tablets are usually given two or three times each day. This should be in the morning, then around midday and, where necessary, late afternoon. Ideally, these times are about 4 hours apart. Give the medicine at about the same time each day so that this becomes part of your child's daily routine, which will help you to remember.

How much should I give?

Your doctor will work out the amount of Methylphenidate (the dose) that is right for your child. The dose will be shown on the medicine label.

Your doctor may suggest that your child starts with a low dose. They may then increase the dose as your child gets used to the medicine and depending on how they respond to it. Your doctor will explain what to do. If you are not sure how much to give, check with your doctor, nurse or pharmacist.

How should I give Methylphenidate?

Tablets should be swallowed with a glass of water, squash, or juice. Your child should not chew the tablets.
Medikinet and Ritalin tablets can be crushed and mixed with a small amount of soft food such as yogurt or jam. Make sure your child swallows it all straight away, without chewing.

Do not crush any modified-release (XL) tablets, as they will not work properly.

Capsules should be swallowed with a glass of water, juice, or squash. Your child should not chew the capsule. You can open the capsule and mix the contents with a small amount of soft food such as yogurt, honey or jam. Make sure your child swallows it straight away, without chewing.

When should the medicine start working?

The medicine will start to work within 30 to 60 minutes, depending on which type of tablet or capsule your child has.

What if my child is sick (vomits)?

If your child is sick less than 30 minutes after having a dose of Methylphenidate, give them the same dose again.

If your child is sick more than 30 minutes after having a dose of Methylphenidate, do not give them another dose. Wait until the next normal dose.

If your child is sick again, seek advice from your family doctor, nurse, pharmacist, or hospital. They will decide what to do based on your child's condition and the specific medicine involved.

What if I forget to give it?

If you miss a dose, wait until the next normal dose. Do not give the missed dose.

What if I give too much?

If you think you may have given your child too much Methylphenidate, contact your doctor or local NHS services (details at end of leaflet) or take your child to hospital. Have the medicine container or packaging with you, even if it is empty. This will be useful to the doctor.

Are there any possible side effects?

We use medicines to make our children better, but sometimes they have other effects that we don't want (side effects).

Side effects you must do something about

Other side-effects you need to know about

Your child may get indigestion, stomach ache, feel sick (nausea) or be sick (vomit). Giving the medicine with some food or milk may help. If your child is taking Equasym XL, check with your doctor or pharmacist before giving it with food.

Some children may get a dry mouth when they first start taking methylphenidate. Eating citrus fruits (e.g. oranges) and taking sips of water may help. This effect usually settles down quite quickly

Your child may have a blocked nose more often whilst taking methylphenidate. Usually this does not need treatment and will get better on its own.

Your child may have problems sleeping. This can be helped by taking the last dose of methylphenidate at least 6 hours before bedtime.

They may get a mild headache or pain in their muscles or joints.

Occasionally boys can get a prolonged erection while taking methylphenidate. Contact your doctor if an erection lasts for longer than 2 hours, especially if it is painful

There may sometimes be other side effects that are not listed above. If you notice anything unusual and are concerned, contact your doctor. You can report any suspected side effects to a UK safety scheme at www.mhra.gov.uk/yellowcard

Can other medicines be given at the same time as Methylphenidate?

You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.

Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal and complementary medicines.

Methylphenidate should not be taken with some medicines. Tell your doctor or pharmacist about any other medicines your child is taking, or has taken in the last 2 weeks, before giving Methylphenidate.

Is there anything else I need to know about this medicine?

Your doctor will check your child's blood pressure regularly while they are taking Methylphenidate.

Methylphenidate can affect the ability to do skilled tasks such as riding a bicycle, playing sports or driving. Your child should take care when doing tasks that require co-ordination until they get used to the medicine.

If your daughter thinks she may be pregnant, she should see her doctor as soon as possible but continue taking Methylphenidate in the meantime.

Methylphenidate may affect the growth of some children. Your doctor will monitor your child's growth.

General advice about medicines

Only give this medicine to your child. Never give it to anyone else, even if their condition appears to be the same, as this could do harm.

Make sure that you always have enough medicine. Order a new prescription at least 2 weeks before you will run out.

Make sure that the medicines you have at home have not reached the 'best before' or 'use by' date on the packaging. Give old medicines to your pharmacist to dispose of.

If you are not sure a medicine is working, contact your doctor but continue to give the medicine as usual in the meantime. Do not give extra doses, as you may do harm.

Where should I keep this medicine?

Keep the medicine in a cupboard, away from heat and direct sunlight.

Make sure that children cannot see or reach the medicine.

Keep the medicine in the container it came in.

Your child's doctor, pharmacist or nurse will be able to give you more information about Methylphenidate and about other treatments for ADHD.

Copyright disclaimer

Version [3]. © NPPG, RCPCH and WellChild, all rights reserved. Review by October 2022.

The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk.

We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.

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This leaflet is for parents and carers about how to use this medicine in children. Our information may differ from that provided by the manufacturers, because their information usually relates to adults. Read this leaflet carefully. Keep it somewhere safe so that you can read it again.

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add adhd "attention deficit" focus "jessica mccabe"

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Have ADHD? Know someone with ADHD? Want to learn more? You're in the right place! Most weeks I post a new video with tips, tricks and insights into the ADHD brain. This channel is my ADHD toolbox -- a place to keep all the strategies I've learned about having and living with ADHD.

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What is ADHD?

Attention deficit hyperactivity disorder (ADHD) is a type of condition known as a neurodevelopmental condition.

Neurodevelopmental conditions like ADHD affect the way your brain develops and works, which can impact your behaviour and the way you experience the world around you.

Around one in 20 young people have ADHD. While it is not a mental health condition or a learning disability, some people with ADHD might experience mental health conditions as well.

If you have ADHD your brain might work differently to other people's. It means that the way your brain controls your concentration, activity levels and impulses is a bit different - this is a form of neurodiversity.

For example, you might act without thinking about the consequences or be very easily distracted. However, it's important to remember that people with ADHD can and do live happy and healthy lives.

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Artwork credit: @the_mini_adhd_coach. The artwork depicts a person with a pink bob hairstyle and a peaceful expression. Their head sits on a light blue background. Text placed around the person reads 'it's ok to feel overwhelmed'.

Symptoms tend to start very early in life, before the age of six. Lots of people will get an ADHD diagnosis at this age, but you can be diagnosed at any stage in your life and you might not realise you have ADHD until you're much older.

Symptoms for ADHD can be different for everyone and can depend on your age, sex, gender identity and whether you have any other neurodevelopmental conditions.

ADHD can run in families, but the cause is mostly unknown.

I have ADHD and other people will have it too, so don't think you're alone because you are not. I know it's hard but we can all get through it if we stay strong, be brave and overcome our worries and fears.

How can ADHD affect me?

If you experience any of these symptoms it doesn't mean you definitely have ADHD. But if any of them are affecting your everyday life, you should talk to your GP or a trusted adult for advice.

Symptoms can include:

feeling restless or fidgety (e.g. struggling to sit still in class)

talking a lot and interrupting others

becoming easily distracted or having difficulty concentrating, like finding it hard to watch a film at the cinema

having difficulty making or keeping friends

being forgetful or missing important appointments

feeling very sensitive or overly emotional

saying or doing things without thinking

For a long time, it was thought that women and girls were much less likely to have ADHD than boys and men. This is not true, however women and girls might experience ADHD differently to boys and men.

For example, female-identifying people might be more likely to experience symptoms such as:

struggling to relax or unwind

feeling overwhelmed when making decisions

your mind often drifting when other people are talking

feeling overwhelmed in social situations

For a long time I thought I couldn't have ADHD because I didn't relate to the hyperactivity.

What to do if you think you might have ADHD

If you think you might have ADHD, it's important to remember that you don't have to go through it alone and there is help available.

Tell your GP about your symptoms. We know it can be challenging to talk to your GP, but they may be able to support you, refer you to a specialist for an ADHD assessment, or refer you to Child and Adolescent Mental Health Services (CAMHS) if you need any mental health support before or after your assessment.

To find out if you have ADHD you'll need to talk to an expert, like a specialist child or adult psychiatrist.

They'll ask you some questions and you will fill in some questionnaires about how you're feeling and the symptoms you've experienced - this is called an assessment. They will also ask your permission to speak to your parents and teachers as part of the assessment.

Your family might not be supportive of you being assessed but it's important for you to get the right support for you.

There might be other reasons for your ADHD symptoms such as anxiety or depression. The ADHD specialist will be able to tell you more following your assessment.

Advice on how to manage your ADHD

There are many things you can do to help manage your ADHD. Below are some ideas based on what young people have told us helps them.

It is very comforting and validating to see other people have similar struggles. We talk a lot about the way things are going and give each other tips or help around things.

ADHD and your mental health

ADHD can leave you feeling out of control and overwhelmed.

People might not understand what you're going through and could think you are acting out or being difficult, or criticise and punish you unnecessarily. This can make you feel isolated and depressed, or it can lead to feelings of low self-esteem, especially if you're comparing yourself to your friends who might behave differently to you.

You might also find it hard to sleep, meaning you feel tired, run down and struggle to concentrate. It can help to cut down on caffeine or other stimulants after 4pm as this can also impact your sleeping patterns.

However, having ADHD can also mean that you're really passionate about lots of things. Our brains all work differently and there is no "right way" to be - recognising that is what neurodiversity is all about. If you're struggling with your mental health, these can be positive things to focus on.

It can be really helpful to talk to your friends, family and teachers about how you feel and how they can support you. Let them know what you do and don't find helpful so that they can do their best to help.

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Artwork credit: @authenticallyadhd. The artwork features drawings of stars, moons and planets on a light blue background. One larger planet with arms is giving itself a hug and the text reads: 'don't forget to give yourself the same love you give everyone else'.

Some tips from our Activists that can help with your ADHD symptoms include:

taking time out and finding ways to relax, or taking regular breaks

letting teachers/lecturers know about your ADHD so you can come up with helpful strategies together

registering with the disabilities services at university so you can get the right support in lectures and exams as well as with assignments

regular exercise and eating healthily

making notes or keeping lists to stay on top of things

Tips for managing your mental health if you have ADHD include:

creating a routine for the day

setting clear boundaries in your personal, school or professional life

reflecting on the day and what you achieved - this can be as small as getting to school/work or getting through a lesson

removing yourself from any stressful situations

finding the best ways for you to cope in social situations

looking at local support groups

recognising potential triggers that might make your symptoms worse; these will be unique to each person but could include being over-stimulated

Other common questions people ask about ADHD

ADHD is something that you're born with so you won't 'grow out of it'. However, lots of people do say that their symptoms get a bit better as they get older.

What medicines are used to treat ADHD symptoms?

The below medicines are most frequently prescribed to people with ADHD. These are not a cure, but can help many people to manage some of the symptoms. The medication must be prescribed and checked by a doctor. Click each medication to find out more about what it does and potential side effects.

What support groups are there for people with ADHD?

There are lots of support groups across the UK for children, young people and their families to get help and advice around coping with ADHD. Visit ADHDUK for more information on the groups in your area.

More help and advice

We have information and advice on a range of subjects

Get help now

If you're worried, stressed or struggling to cope you are not alone. Here are some services that can help you.

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ADHD and Mental Health | Signs and Symptoms of ADHD

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What is ADHD? Attention deficit hyperactivity disorder (ADHD) is a type of condition known as a neurodevelopmental condition. Neurodevelopmental conditions like ADHD affect the way your brain develops and works, which can impact your behaviour and the way you experience the world around you. Around one in 20 young people have ADHD.

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Attention-deficit/hyperactivity disorder ( ADHD) is marked by difficulty concentrating, hyperactivity/impulsiveness, disorganization, low frustration tolerance, and other symptoms that impair normal functioning. Treatment and lifestyle changes can help manage the symptoms so you can live well with ADHD.

How People With ADHD May Be Perceived

People with ADHD often lack focus, wander off task, talk excessively, fidget, and act impulsively.

Children often present with hyperactivity most often, and as they age, they may struggle more with attention, leading to academic difficulties.

The disorder is often misunderstood by others. People who don't understand the symptoms may label children with ADHD as unmotivated, lazy, or problem children.﻿﻿ Adults with ADHD may be seen as irresponsible or flighty because they struggle to remember important details or obligations and they have a hard time staying on task.

How It Feels to Be Newly Diagnosed

Many people are surprised by the strong emotions they feel when they are diagnosed with ADHD.

Common emotions include:

Relief: When you first get an ADHD diagnosis, you may feel happy to have a name that describes what you're experiencing. It may feel validating to know that your symptoms stem from a diagnosed condition.

Anger: After the relief has faded, you may feel angry. Perhaps you don't want ADHD or maybe you're feeling frustration toward parents or teachers who blamed you for your symptoms.

Sadness: You may feel sad that you didn't get diagnosed earlier or you may grieve for what your life might have been like if you didn't have ADHD. You may also feel sad for your younger self who struggled with school and life with undiagnosed ADHD.

What You Can Do

Reassure yourself that all these emotions are normal, even if they are painful at the time.

Talk to other people about how you're feeling and be willing to ask for help.

Find an ADHD support group in your area. Meeting other people who have been through a similar experience is very helpful.

Consider working with a therapist who is knowledgeable about ADHD﻿﻿

Deciding Who to Tell

You don't need to tell everyone in your life that you've been diagnosed with ADHD, but sharing your diagnosis with some people could be helpful in moving forward.

It's not always easy to explain ADHD to friends and family members. In fact, those who don't understand the condition may think you're using as an excuse to get out of your day-to-day responsibilities.

People who don't understand may offer unsolicited advice like, "Stop watching so much TV, and you'll feel better." Those things can be tough to hear.

You may also want to consider telling your employer or professor. If your child is diagnosed with ADHD, you'll want to share that information with the school.

Employers and school administration can assist with special accommodations. Placing your desk away from distractions or allowing you to wear noise-canceling headphones, for example, may greatly increase your productivity.

It's important to tell all of your medical providers about your diagnosis. Don't depend on your medical records to speak for themselves.

Managing Your Symptoms

Work closely with medical professionals to find the best treatment options for you. Don't hesitate to speak up when something isn't working and be willing to ask questions about what you can expect to experience with treatment.

It's important to continue managing and monitoring your symptoms even when you feel as though treatment ﻿﻿ is working well. Your symptoms may shift with changes in your environment or your ADHD may change as you grow older.

Continue to communicate with your treatment providers about any changes you experience or any difficulties you notice.

If you're taking medication, there may be times when you need to change your dose or change medications altogether. Or, you may find it's helpful to start therapy when you undergo a change in employment.

You may also experiment with a variety of lifestyle changes. For example, close monitoring of your symptoms might help you recognize that you need more structure in your life so you can spend less time searching for misplaced items. Adding more structure and getting organized, might be key to helping you manage your symptoms best.

A Word From Verywell

Living well with ADHD is about monitoring your symptoms and actively working toward finding what works best for you. With the right support and treatment, you can create a life that allows you to reach your greatest potential.

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How to Live Your Best Life When You Have ADHD

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Attention-deficit/hyperactivity disorder ( ADHD) is marked by difficulty concentrating, hyperactivity/impulsiveness, disorganization, low frustration tolerance, and other symptoms that impair normal functioning. Treatment and lifestyle changes can help manage the symptoms so you can live well with ADHD. People with ADHD often lack focus, wander off task, talk excessively, fidget, and act impulsively.

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Mental Health Support for Children and Young People

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Mental Health Support for Children and Young People

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Mental health support for children and young people

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Find out what help you can get if you're a child or young person who needs support with their mental health - includes information for parents and carers

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Change Mental Health - A future where no one needs to face mental illness alone

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While ADHD (Attention Deficit Hyperactivity Disorder) is often seen as a behavioural issue, it significantly impacts mental health. This disorder contributes to anxiety, depression and emotional dysregulation. Difficulty with focusing, following tasks and controlling impulsive behaviour can lead to frustration and low self-worth, especially when these symptoms interfere with daily life. These emotional struggles often trigger or worsen mental health conditions.
For people with ADHD, the pressure to meet social, or professional expectations can feel intense. Over time, this can erode self-confidence, increasing the risk of . ADHD also affects emotional regulation, making it harder to manage , anger and sadness. Understanding the connection between ADHD and mental health is key to managing both effectively since struggles of living with it can also affect mood, self-esteem and relationships.

Common myths about ADHD

ADHD only affects children

ADHD can persist into adulthood and many adults with ADHD are undiagnosed, struggling with symptoms throughout their lives.

ADHD is just a behavioural problem

ADHD is a neurodevelopmental disorder that affects mental health, emotion regulation and cognitive functioning.

people with ADHD lack intelligence

ADHD has no relation to intelligence. Many people with ADHD are highly intelligent but struggle with attention, focus and impulse control.

impact on mental wellbeing

Attention Deficit Hyperactivity Disorder can have long-term effects on mental health. Some common impacts include:

Emotional dysregulation: ADHD can make it hard to control emotions, leading to extreme reactions to everyday situations and contributing to mood swings or emotional outbursts.

Low self-esteem : The constant struggle with staying organised, meeting deadlines or completing tasks can lead to feelings of failure or inadequacy.

Relationship struggles : Socially, people with ADHD might struggle to maintain friendships or relationships due to impulsive behaviour, leading to or .

: and adults with ADHD are more susceptible to due to prolonged stress from managing time, organising tasks and following through on commitments, which can contribute to chronic stress.

As a result, many people with ADHD experience co-occurring mental health conditions such as:

Those with ADHD often face chronic stress or worry, leading to generalised anxiety disorders.

Depression
The frustration and low self-esteem that accompany ADHD symptoms can lead to feelings of hopelessness, ultimately resulting in .

ADHD often disrupts sleep patterns, and poor can worsen anxiety and depression.

managing ADHD

Managing both Attention Deficit Hyperactivity Disorder and mental health challenges requires a comprehensive approach:

Seek professional support
ADHD and mental health conditions should be managed with the help of healthcare professionals who may recommend therapies, such as Cognitive Behavioural Therapy (CBT), medication or behavioural interventions. Learn more on how to get support from the .

Build a strong support network
Family, friends and support groups can provide much-needed encouragement and understanding.

Structure and routine are key to managing symptoms. Regular schedules can help reduce anxiety and provide a sense of control.

Mindfulness techniques
Practising can help improve focus, reduce impulsivity and promote relaxation.

supporting someone with ADHD

Supporting a loved one with ADHD requires empathy, patience and understanding:

Encourage healthy routines : Help them create and stick to daily routines that help manage their symptoms.

Listen without judgement : without dismissing their concerns, even if the issues seem minor.

Support professional help : Encourage them to seek professional advice or therapy and accompany them if they need support.

Attention Deficit Hyperactivity Disorder can significantly affect mental health. With the right strategies and support, individuals can successfully manage both symptoms and mental wellbeing. By understanding the link between ADHD and mental health, those with ADHD can improve their quality of life to build healthy routines and seek professional advice.

Our Advice and Support Service is open Monday to Friday, 10 am to 4 pm (closed for lunch between 12.30pm and 1.30pm), where advisers can signpost you to local support that most fits your needs, including our services. We offer initial advice on money worries and help to deal with emergencies.

Contact 0808 8010 515, email us at or fill out the enquiry form on the Advice and Support Service page.

Other support

offers various resources/groups for people with ADHD and families who have someone with ADHD within Scotland.

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ADHD and mental health - Change Mental Health

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ADHD (Attention Deficit Hyperactivity Disorder) affects a person's ability to concentrate, control impulses and manage energy levels

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adhdfoundation.org.uk/wp-content/uploads/2023/06/sleep-support.mp3

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Why Stimulant Medication Helps ADHD -- and How Stigma Can Hurt

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Struggling to Sleep with ADHD? Watch This!

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How to Sleep when you have ADHD! (12 minute video)

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How to Sleep when you have ADHD! (12 minute video)

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How to Sleep When You Have ADHD (Fairy Not Included)

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Homework & Study Tips for Children with ADHD

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Discover homework and study tips, apps, and technology that can help children with ADHD stay focused and achieve success.

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It includes information in the following sections:

Booklets

What is ADHD?

Managing ADHD

Medication

ADHD and School

ADHD and Wellbeing

ADHD and Sleep

Signposting

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Each resource has been included as a link, rather than uploading each resource. Therefore, materials have not be reproduced or modified.

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ADHD Awareness Month 2022; Understanding a Shared Experience - ACAMH

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This ADHD Awareness Month, we encourage you to explore the learning opportunities available on our website, and to share with your networks.

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ADHD is widely misunderstood. The goal of this video is to educate children between the ages of 6 to 12 on what ADHD is, the various symptoms of the disorder, and how the symptoms can be inhibited. Illustration and animation by Kwadwo Offei. www.motionworx.co.uk

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Any feedback would be extremely helpful! (Anonymous)

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Resources for Parents Padlet Feedback Form

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Resources for Parents Padlet Feedback Form

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Preparing for Exams Podcast (Click Link)

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Preparing for Exams Podcast (Click Link)

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https://www.adhdfoundation.org.uk/wp-content/uploads/2023/06/Preparing-for-exams-first-edit.mp3

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Padlet for other general mental health and service needs (e.g. anxiety, parent support, bereavement, etc.)

https://padlet.com/hannahdebacker1/ithrive-wider-community-offer-f6p473m6r85hw63h