Attention Deficit Hyperactivity Disorder (ADHD)

ADHD — Attention Deficit Hyperactivity Disorder — is a brain-based difficulty with sustained attention, organisation, and impulse control. It is not a personality flaw, not the result of "bad parenting", and not something a person can simply "try harder" to fix. ADHD typically begins in childhood and continues into adulthood in 60-70% of cases. Until recently, ADHD in India was thought of as a childhood condition only — mostly because adult ADHD patients had never been diagnosed in their childhood. That is changing rapidly. Practo and similar platforms report 80%+ year-on-year growth in psychiatric appointments in Tier-2 cities like Gulbarga, with ADHD being one of the leading specific complaints.

What ADHD looks like

There are three presentations:

• Predominantly inattentive — easily distracted, loses things, forgets appointments, struggles to start or finish tasks, daydreams. This is the form most commonly missed in girls and women.
• Predominantly hyperactive-impulsive — fidgets constantly, talks excessively, interrupts others, can't sit still. Most commonly diagnosed in boys because it's visible at school.
• Combined — both.

Adult ADHD often shows up as: chronic disorganisation, missed deadlines, forgotten promises, scattered attention, an inability to manage time, restlessness, mood instability, and a chain of unfinished projects. Many adults arrive at psychiatry not because they suspect ADHD, but because they have anxiety or depression — and the underlying ADHD is found during evaluation.

How we diagnose

ADHD diagnosis is clinical — there is no blood test or scan. It requires:

• A detailed psychiatric interview covering childhood, school history, work history, relationships.
• Standardised questionnaires — Adult ADHD Self-Report Scale (ASRS), Vanderbilt for paediatric cases.
• Collateral information from parents (for paediatric cases) and from a teacher / spouse / sibling.
• Ruling out alternatives — thyroid, anaemia, sleep apnoea, depression, anxiety, bipolar disorder, substance use, learning disability. Many of these mimic ADHD and several often co-exist with it.

We typically need 2 OPD visits to complete the workup — the first to gather history and scales, the second to discuss findings and treatment plan.

Treatment

ADHD treatment is layered, and which layers you use depends on severity:

• Psychoeducation — first step always. Helping the patient (and family) understand that ADHD is a real condition with real treatments transforms how the symptoms are experienced.
• Behavioural strategies — routines, calendars, breaking tasks into small chunks, time-blocking, body doubling. Our psychiatrist explains these at the diagnostic visit.
• Therapy — cognitive-behavioural therapy adapted for ADHD; sometimes coaching for adults.
• Medication — stimulants (methylphenidate, dextroamphetamine; some preparations are scheduled drugs in India and dispensed only on physical prescription) and non-stimulants (atomoxetine, guanfacine). The choice depends on age, co-existing conditions, side-effect profile, and patient preference. Medication often produces a clear within-week improvement in attention and task initiation.

Treatment for children

Paediatric ADHD diagnosis at Asian Hospital involves the psychiatry team working with paediatrics. We talk to parents and ask permission to coordinate with the school. Treatment in children almost always starts with behavioural therapy + parent training + school accommodations, with medication added when impairment is significant. We have seen children whose grades transformed entirely once treatment started — but the goal is not just grades; the goal is for the child to feel less broken inside.

Is medication safe?

ADHD medication is one of the most-studied groups of psychiatric medications. At correct doses, monitored by a psychiatrist, side-effects are limited and reversible. Risks include reduced appetite, sleep disturbance, mild BP rise. They are not addictive at therapeutic doses. We monitor BP, weight, and effectiveness at every follow-up. If you decide medication is not for you, that is your choice — but please don't avoid an ADHD evaluation because of medication fear. Diagnosis itself is the first step.

Confidentiality

Psychiatric records at Asian Hospital are fully confidential. Nothing is shared with family without your written consent. Bookings can be made under initials if you prefer additional privacy. We understand that mental-health visits in Tier-2 India still carry social weight — we treat that with the seriousness it deserves.