When the child begins to go to school, the teachers begin to notice that he moves too much, that he does not pay attention and that this leads him to not follow the same rhythm as his classmates ”, explains Fátima Guzmán, director of Active Education, a foundation dedicated to providing resources and training to families and teachers to address this and other learning problems. As if that were not enough, “impulsiveness often leads them to do things without reflecting on the consequences, an attitude that makes it appear that they are conflictive children, that they do not obey,” he adds.
In the same vein, the clinical psychologist Teresa Aguilar, with long experience in schools and children diagnosed with ADHD (the acronym for Attention Deficit Hyperactivity Disorder), tells VERY that “from a young age, they are hung up on the sanbenito of restless children, unruly, useless for studies. So much so that they end up thinking they are stupid and with low self-esteem ”.
And this has immediate and long-lasting consequences throughout your life. “Lack of motivation is one of the things that impacts us the most. We ask the children what they like and the answer is ‘well I don’t know’. There is nothing that excites them ”, explains Dr. Antoni Ramos Quiroga, head of Psychiatry at the Vall d’Ebron hospital in Barcelona. In the opinion of Fátima Guzmán, this is “an almost inevitable consequence when a child grows up mired in school failure caused by a hostile environment, always scolded, punished at home and at school, making an effort to continuously improve without seeing results throughout. of the years”.
Another weak point is the lack of attention, which not only plays tricks at school. It is also responsible for the fact that mortality (among other causes, from traffic accidents caused by distractions) is twice as high in people with ADHD, as shown by a study by the University of Aarhus (Denmark), published in The Lancet in 2015. After analyzing data from nearly two million people, the researchers concluded that the death rate per 10,000 individuals was 5.85 among those with ADHD and 2.21 among those without. In this account, they also excluded those who suffered from behavioral disorders and drug addiction.
So far the bad news, but all is not lost. The first thing is to know what attention deficit and hyperactivity disorder really consists of, which according to the WHO suffers from 7% of the child population and which in adulthood reaches 5 %. In these figures, we must highlight the proportion by gender: four men for every woman with ADHD. As Dr. Ramos points out, “it is a neurological disorder that affects brain development. It begins in childhood and, in 70% of cases, continues into adulthood. When they are older, they are people who have difficulties organizing themselves or assessing the risks and consequences of their actions. As a counterweight, they have a highly developed capacity for improvisation. At work, for example, they are excellent at putting out fires, but they suffer if they are tasked with coordinating or planning tasks ”.
What is not clear is why, in some cases, this disorder remits and in others, it does not. “There are several hypotheses,” adds Ramos. Of all the causes of ADHD, 76% are genetic . When there are adults in the family who suffer from it, it is easier for children to continue to have it when they grow up. Environmental factors also play a relevant role in their appearance and continuity: situations of great socioeconomic stress or abuse in childhood ”.
And what are the risk factors? The main one is having someone with ADHD in the family, according to Ramos, who has taken part in an ambitious study promoted by the Psychiatric Genomics Consortium to detect genetic variants related to this disease.
Among the participants in this study, which was published in the journal Cell last year and analyzed a sample of 230,000 people from around the world, are the Vall d’Hebron Research Institute, the Institute of Biomedicine of the University of Barcelona and the San Juan de Dios Research Institute, all in Catalonia.
Although it is a disease with a marked genetic load, the environment also has a lot to say. “Environmental causes have to do, sometimes, with the moment of birth: if the child is premature or if it is delivered with forceps, there is a greater chance of developing ADHD”, Ramos tells us. Likewise, the risk increases “when there is consumption of alcohol, tobacco or certain medications, such as paracetamol, during pregnancy.” Other factors can be stress and diet. In fact, several studies have shown that malnutrition in the early years is a striking risk factor for ADHD.
Of course, the role of the family is key in this whole process. “When children are not accompanied in a healthy way by their parents, the disorder worsens,” Aguilar warns. To this we must add that the rhythm of life we lead can be harmful. The place of children in the family has changed a lot in recent years. Today they spend a lot of time alone, with the screen of the tablet or television as their most usual company. This is generating a way of being in the world. At the same time, the great drama of our age is that children do not want anything, because before they do they already have it. Desire is the real engine of knowledge, curiosity, and learning. If they have everything, they are left without motivation. They also have no tolerance for frustration or patience ”, concludes this psychologist, who specializes in school-age minors.
In his opinion, ADHD is ” a mixed bag where there can be multiple diagnoses such as learning disorders, behavior, affective, impulsive, anxiety, depression …”. For this reason, accompanying minors with adequate psychotherapeutic support is essential, even when due to its severity it has to be a complement to medication.
María Boixader, mother of a child with ADHD and president of the AFANTDAH association, shares with MUY that “psychotherapy can help them find tools and skills so that, little by little, they do not have to depend on drugs. It is necessary to look for a multidisciplinary team, a good therapist, leisure activities … and train yourself as a father, to have a strategy to help him from home ”. In the words of Fátima Guzmán, ” the role of parents and educators is to treat them with great affection, a lot of positive reinforcement , always bearing in mind that they are not like that because they want to, but because they cannot do things differently”.
Along the same lines, all specialists agree that it is essential to treat the child as soon as possible. “It is a mistake to think that, at five years, the repercussion it can have is not so high. In childhood, you are shaping your own personality : that is why it is so important to prevent these children from growing up with the idea that they are not good students, that things do not go well for them no matter how hard they try. In addition, it is very important to prevent so that it is not complicated by other mental health disorders, such as depression or anxiety ”, warns the psychiatrist.
This is another face of the disorder, comorbidities, that is, other diseases that usually accompany it. For example, “I often share genetic factors with addictions. Throughout their lives, 40% of ADHD patients will have a substance use disorder, ”says Ramos.
So can you lead a normal life with ADHD? According to this psychiatrist, “it can and must be done, if you manage this disorder well.”
