Understanding ADHD Symptoms and Causes Through Siddha Medicine

Understanding ADHD and Siddha Interventions

In the Western world, ADHD is not uncommon — in fact, it is quite well-known. When we talk about this neurodiverse condition, it is one of the few that is widely acknowledged as a form of neurodivergence. Most people recognize it.

Let us look at the incidence of ADHD, its causes, the etiology, the types and varieties, and then how we intervene, including addressing comorbidities. We all know it is a neurodevelopmental disorder that affects both children and adults. There are many able adults I know who were diagnosed quite late, around the age of 25–30, with adult ADHD.

It is quite common for early diagnosis of this condition to be missed. That is why we need to pay close attention as children are growing up. Children with ADHD may have trouble paying attention — as the name suggests: Attention Deficit and Hyperactivity Disorder. Technically, there are two parts to ADHD, but in fact, there are three. The main features of ADHD are inattention, hyperactivity, and impulsive behavior.

When I say “impulsive,” I mean impatience and acting without thinking about the results — not worrying about the consequences, but instead indulging in things immediately and being overly active. These are specific symptoms that can be observed in some children while they are growing up.

ADHD Symptoms

In adults, however, the ADHD symptoms look different. They may be easily distracted, impatient, forgetful, and prone to postponing things. Procrastination is one of the hallmark features of adult ADHD.

When we talk about ADHD symptoms:

• 1. “AD” stands for Attention Deficit.
• 2. “HD” stands for Hyperactivity Disorder.

Inattention includes forgetfulness, easy distraction, difficulty with organization, chaotic behavior, clumsiness in carrying out tasks, starting many things but rarely finishing them. Many people with ADHD display a sanguine personality type — lively and enthusiastic, but like a will-o’-the-wisp, touching one thing, leaving it unfinished, and quickly jumping onto the next.

The hyperactive side includes fidgeting, difficulty focusing, interrupting conversations, and not being able to wait for another person to finish speaking.

In adults, as mentioned, procrastination is a hallmark symptom, along with impatience, difficulty maintaining relationships in the workplace, at college, or at home. Troubles tend to erupt frequently in personal relationships. They also often struggle with impatience, low self-esteem, and many inhibitions.

As I mentioned earlier, there are three groups of ADHD symptoms: inattention, hyperactivity, and impulsivity. Impulsivity forms a separate group: these individuals have a hard time waiting to talk or react. They want to immediately jump in, blurt out answers before someone has even finished asking a question. I am sure when you read this, you can recall some of your colleagues, classmates, or school memories that fit these descriptions.

By hyperactivity, I also mean difficulty in maintaining hobbies or sticking with them for long. Inattention means they only focus superficially on things and do not dwell deeply, unlike autistic individuals. That is one of the hallmark differences between autism and ADHD.

For example, if a child with autism is given their favorite topic, they can dwell deeply on it for hours. A child with ADHD, however, will not be able to sustain attention for more than a few minutes, even on a favorite subject. Children with ADHD tend to have a lot of energy. In the past, the term “hyperchaotic” was even used to describe them. Many are extroverted, constantly moving, and unable to sit still in a classroom for more than a few minutes.

So the teacher has to constantly remind them: Please sit in your class, please sit in your place, and things like that. At the same time, there is another group of children with ADHD symptoms who are very introverted, quiet, often tired, and with less energy. These are the two extremes of ADHD.

Now, any disorder or disease must have some causes, right? In ADHD, the majority of causes are genetic. That is what we have to keep in mind. But again, when I say “genetic,” it is not something to be used against people or as a limitation on their opportunities. We must always remember that.

ADHD Causes

About one-fourth of the ADHD causes fall into environmental factors, such as brain injury or premature birth. We will see these in detail in the next slide.

So here you can see that the heritable (genetic) causes take the lion’s share. Other causes include brain damage, complications, and some infections. For example, some studies suggest that congenital CMV (Cytomegalovirus) infection can also become ADHD causes in some individuals. Other causes include maternal alcohol exposure during pregnancy, low birth weight (LBW), and prematurity.

Why do we even talk about ADHD? Is it a rare condition, or a very common one? The truth is, it is a very common condition.

For example, in 2016 — about 8 to 9 years ago — around 10% of the population in the U.S. was diagnosed with ADHD. Today, the number has risen to about 12.5%. That means at least 1 in 10 people has ADHD. So we need to acknowledge it and talk about it seriously.

Here is an interesting WHO study: India is among the countries where more than 15% of children show ADHD symptoms. That means India should be talking much more about ADHD and identofy the ADHD causes. In contrast, there are countries where less than 5% or 10% of the population is within the ADHD spectrum.

Now, among the children diagnosed, are they actually receiving treatment? That is the big question. In the U.S., out of the 12.5% diagnosed, only about half — around 6% — are being treated with medication. Others might be receiving non-medical interventions, but medical treatment is available to only about half of those diagnosed.

When it comes to adults, only 1 out of 5 adults with ADHD is actually being treated. We will look into these statistics in more detail.

The three types of ADHD are:

• 1. Inattentive and distractible type (attention deficit).
• 2. Hyperactive/impulsive type.
• 3. Combined type.

ADHD Comorbidities

When we studied Autism Spectrum Disorder earlier, we spent a lot of time discussing comorbidities. The same applies to ADHD as well. Only one in four people with ADHD have pure ADHD without any comorbidities. Three out of four people with ADHD have additional conditions.

So what could these comorbidities be?

• ● The major comorbidity is Oppositional Defiant Disorder (ODD). More than 40% of people with ADHD have this. They tend to do the exact opposite of what they are told, and they feel satisfied only when they resist instructions. This is a hallmark of oppositional defiance, and it is observed in nearly half of the ADHD population.
• ● Another is Conduct Disorder, which is often suspected when a child repeatedly engages in mischief or disruptive behavior at school.
• ● Other comorbidities include anxiety, major depression, and mood swings. Many children with ADHD also show neurological soft signs like tics.
• ● Dyslexia is another common comorbidity — which we will discuss in more detail in our next talk.

So how do we support parents of children with ADHD? Here are some general guidelines (which we will discuss further during the Q&A):

• ● Since children with ADHD usually have excess energy, physical activity should be a part of their everyday routine.
• ● Even if academic progress is limited at school, we should liaise with teachers and encourage the child to engage in physical and social activities.
• ● Activities like cycling, skating, swimming, and jogging not only help to burn energy but also build endurance and physical strength.
• ● Social skills often develop late in ADHD, so encouraging social games is important.
• ● Reducing screen time is also crucial.

We will discuss about the ADHD treatment in the second part of this article.