El TDAH explicado: comprender los síntomas y su impacto en la vida

Descubra el mundo del TDAH, donde podrá aprender sobre sus síntomas, diagnóstico y estrategias de manejo. Esta página ofrece una guía completa para comprender el TDAH y proporciona información práctica para ayudarle a usted o a un ser querido a sobrellevar la vida con TDAH. Acepte su singularidad y explore los recursos disponibles para prosperar y destacar.
¿Qué es el TDAH?
El trastorno por déficit de atención e hiperactividad (TDAH) es un trastorno del desarrollo neurológico que no solo tiene un nombre horrible, sino que también es difícil de comprender y puede presentar muchos altibajos. Me gusta llamarlo consistente e inconsistente. Muchas personas ni siquiera saben si padecen el trastorno, ya que el TDAH puede manifestarse de forma diferente en cada persona. Los médicos tienen que revisar una larga lista de síntomas y marcarlos. El Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSM) tiene 18 criterios, mientras que algunas listas de síntomas incluyen muchos más rasgos.
Pero ¿qué es lo que hace que los cerebros con TDAH sean tan diferentes y difíciles de diagnosticar?
Un factor que contribuye en gran medida a las dificultades para diagnosticar el TDAH es que frecuentemente se presenta con al menos una comorbilidad , como depresión, ansiedad o dislexia. Esto a veces se denomina TDAH complejo, aunque no es un término clínico.
El TDAH se relaciona con niveles inusualmente bajos de dopamina y noradrenalina , neurotransmisores que se transfieren entre la corteza prefrontal y los ganglios basales . La dopamina interactúa con otros neurotransmisores potentes para regular el estado de ánimo y está estrechamente vinculada a las áreas de recompensa del cerebro. Como resultado de los bajos niveles de dopamina, la persona busca la sensación de recompensa de otras maneras.
Estas diferencias en el cerebro con TDAH pueden causar una serie de síntomas de desarrollo neurológico.
Estos incluyen:
Estos síntomas contribuyen a los criterios utilizados en el Manual Diagnóstico y Estadístico de los Trastornos Mentales ( DSM-5 ) para diagnosticar el TDAH. Sin embargo, no todos estos síntomas se incluyen en los criterios. Algunos síntomas, como la desregulación emocional, han sido difíciles de cuantificar para los científicos y, por lo tanto, no se han podido realizar estudios precisos al respecto.
Puede leer sobre los criterios DSM para el diagnóstico de TDAH aquí .
Los criterios no enumerados en el DSM-5 que pueden ser un indicador clave del TDAH son:
Desregulación emocional: A menudo, incapacidad para regular las emociones. Esto puede causar respuestas emocionales desproporcionadas a eventos o estímulos, como sentirse excesivamente feliz y emocionado por algo que se ve o se oye. Otro ejemplo podría ser frustrarse fácilmente o incluso enojarse explosivamente con alguien porque dijo algo con un tono de voz inadecuado.
Hiperconcentración: Esta no se encuentra directamente en el DSM-5, pero uno de los criterios suele ser causado por la hiperconcentración. "A menudo parece no escuchar cuando se le habla directamente". La hiperconcentración ocurre cuando un cerebro con TDAH se concentra en algo interesante o emocionante. Cuando esto sucede, el cerebro se concentra tanto en esa cosa que el resto del mundo parece desvanecerse y no existir. Imagine estar "en la zona" multiplicado por cien. Puede estar tan intensamente concentrado que puede parecer que la persona no escucha cuando se le habla.
Sensibilidad sensorial: La sensibilidad sensorial se refiere a la respuesta aumentada o reducida a estímulos sensoriales, como sonidos, luces, texturas, olores u otros estímulos ambientales. Las personas con sensibilidad sensorial pueden encontrar ciertas experiencias cotidianas abrumadoras, distractoras o incluso dolorosas. Para otras, estos estímulos pueden resultar atenuados o requerir mayor intensidad para percibirlos.
No estás roto, sólo estás conectado de manera diferente.
El TDAH es un trastorno complejo del neurodesarrollo, pero también una forma única de experimentar el mundo. Si bien los desafíos de la disfunción ejecutiva y la sensibilidad sensorial pueden ser significativos, son solo una cara de la moneda. El TDAH también aporta fortalezas increíbles: creatividad, adaptabilidad, pasión y la capacidad de pensar de forma diferente. Al comprender y aceptar estos rasgos, podemos crear entornos donde las personas con TDAH no solo puedan gestionar sus desafíos, sino también prosperar y destacar.
¿Crees que podrías tener TDAH?
If you suspect that you have adult ADHD, it's important to seek medical advice to confirm the diagnosis. Contrary to popular belief, ADHD in adults does not always involve hyperactivity. Research on this topic has been conducted extensively over the years and includes data from sources such as the University of Massachusetts Medical School, Massachusetts General Hospital, and more than 100,000 scientific articles and books.
One of the challenges of ADHD is that individuals may not fully recognize the impact of their symptoms until their late twenties or early thirties. It's important to remember that ADHD is not a straightforward diagnosis, but rather a complex condition that can affect people in different ways. A helpful way to conceptualize ADHD is to think of it as a dimension, like a person's height or intelligence, where individuals fall at different points. Despite the challenges associated with ADHD, seeking appropriate treatment can help individuals manage their symptoms and improve their quality of life.
Typical adolescent and adult impairments:
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Poor functioning at work
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Frequent job changes
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Risky sexual behavior/increased teen pregnancy and sexually transmitted diseases
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Difficulties managing anger and frustration in intimate relationships
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Unsafe driving (speeding, frequent accidents, numerous parking violations, possible license suspension)
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Difficulties managing finances (impulsive spending, excessive use of credit cards, poor debt repayment, little or no savings, and so on)
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Problems in dating or marital relationships (don’t seem to listen to or appreciate the needs of your partner, talk excessively and interrupt, fail to follow through on promises and commitments)
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Prone to excessive use of substances such as tobacco, alcohol, or marijuana
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Difficulty getting to sleep at a reasonable hour (insomnia), frequent night waking and restlessness, inefficient sleep leading to daytime tiredness
Less common but notable:
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Antisocial activities (lying, stealing, fighting) that lead to frequent police contact, arrests, and even jail time; often associated with a greater risk for illegal drug use and abuse
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Generally less healthy lifestyle (less exercise; more sedentary self-entertainment, such as video games, TV, surfing the Internet; greater use of social media; obesity, binge eating or bulimia, poorer nutrition; greater use of nicotine and alcohol); consequently increased risk for later coronary heart disease
Can you handle the problem on your own?
While it can be a relief to identify ADHD as a potential explanation for the difficulties you've faced, it's important to seek professional help for diagnosis and treatment. There are several compelling reasons for doing so:
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To rule out other conditions that may be causing your symptoms
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To determine whether you have additional conditions in addition to ADHD
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To access medication that has been shown to be effective in managing ADHD symptoms
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To receive psychological therapies that can help improve self-control
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To identify areas of strength and weakness for targeted coping efforts
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To obtain an evaluation that can be used to obtain accommodations under the Americans with Disabilities Act in educational or workplace settings
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To access resources for improving overall health and wellness, such as weight loss support, smoking cessation programs, or sleep improvement techniques.
Many adults with ADHD also have other psychological disorders, including anxiety disorders, oppositional defiant disorder, learning disabilities, depression, bipolar disorder, addiction, and tic disorders.
Medications for ADHD have been shown to be highly effective, with studies indicating that they can normalize behavior in 50-65% of those with ADHD and substantially improve behavior in an additional 20-30%. Seeking professional help can provide you with access to the most effective treatments and resources to help you manage your symptoms and improve your overall quality of life.
Where can you go to get help?
To determine if you might have ADHD, a doctor who knows you well can use screening questionnaires. If you're looking for a professional who is experienced with ADHD, there are several options available.
First, you can call your primary care provider and ask for a referral to a specialist in your area. You can also check with your state psychiatric or psychological association, which usually keep lists of professionals organized by specialty.
Major nonprofit organizations such as CHADD and ADDA may have support groups or chapters in your area that can recommend adult ADHD clinical experts. You can also contact the psychiatry department at a local university or hospital, or the psychology clinic at a local university, to see if they have any practitioners who specialize in adult ADHD evaluations.
Additionally, you can search for psychiatrists and psychologists specializing in adult ADHD online or through directories provided by CHADD and ADDitude Magazine. If you know someone who is being treated for adult ADHD, you can ask for a referral to their practitioner. Websites for CHADD and ADDA can provide additional resources and information.
Questions to Ask before You Make an Appointment
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What percentage of the doctor’s practice is made up of people with ADHD (as opposed to other disorders)?
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If the practitioner sees both adults and children, what percentage are adults?
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How long has the doctor been treating adults with ADHD?
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What is the practitioner’s area of specialization in medicine or psychology? Fields that cover ADHD and related psychiatric disorders include psychiatry, clinical psychology, neuropsychology, and neurology (especially behavioral).
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Is the practitioner board certified in this area of specialization? Board certification is a higher level of certification than a state license to practice medicine or psychology.
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How long will it take to get an appointment? (This may be significant to you if you have a number of professionals to choose from and would like to be seen as soon as possible.)
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Does the doctor treat people after diagnosing them? If not, where are patients referred for treatment?
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Are other potential resources available nearby? Most mental health practitioners will not have coaching, skills training, support groups, and the like on site, but psychologists in private practice often rent space in office parks where related professionals work, and they all refer patients to each other.
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How does the doctor charge, and what insurance plans does he or she accept?
What is needed for an ADHD evaluation?
To conduct a comprehensive ADHD evaluation, the following components are typically included:
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Collection of rating scales and referral information prior to or during the evaluation.
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An interview with the individual being evaluated.
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Review of previous records that may document any impairments.
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Psychological testing to rule out general cognitive delay or learning disabilities.
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Interviews with individuals who know the individual well to corroborate their reports.
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A general medical examination if medication may be part of the treatment or if there are any coexisting medical conditions that need to be evaluated.
To facilitate these steps, individuals should bring any relevant records from schools, physicians, mental health professionals, driving or criminal records, and any other documentation of problems that could be related to ADHD or another disorder. They should also provide the names of a few people who know them well and whom they trust to speak honestly and objectively with the evaluators. Results of a medical exam from a physician and a list of family members with mental disorders should also be shared. Additionally, a description of impairments during childhood and adolescence, as well as recent ones, should be provided.
The initial evaluation appointment can take several hours, so individuals should be prepared for this.
The evaluation may include a brief test of general cognitive ability to rule out limitations in intellectual or learning abilities that may contribute to ADHD-like symptoms. Tests involving reading, math, and spelling may also be given, especially in educational settings. Individuals with ADHD are more likely than others to have specific learning disabilities, and it’s important to know if this is the case. Tests of attention, inhibition, and memory may also be given, but not all psychologists use these tests, and they are not always accurate for diagnosing ADHD.
What Will the ADHD Evaluation Tell You?
The evaluation will provide a comprehensive assessment of your symptoms and overall functioning. The findings from all the information gathered will be discussed, and you will receive an opinion about whether you have ADHD or any other related problems. Additionally, a set of recommendations will be provided on what to do about your ADHD and any other problems uncovered.
To be diagnosed with ADHD, the professional conducting the evaluation must determine that you have high levels of inattention and/or hyperactive and impulsive behavior. These symptoms must occur far more often than in other adults your age and have had adverse consequences for you in many different domains in both childhood and adulthood. Your symptoms must have been present in their current form for at least 6 months and have developed before you were 12-16 years old.
While the DSM criteria for diagnosing ADHD require at least five symptoms from either the inattention or hyperactivity-impulsivity symptom list, many individuals can have ADHD symptoms without having all five symptoms. Recent research has shown that having four symptoms from either list may indicate ADHD to a degree inappropriate for an adult. It's worth noting that these criteria were originally designed to diagnose children, not adults.
Some common ADHD symptoms in adults include a short attention span or lack of persistence on tasks, which can make it challenging to complete tedious or drawn-out activities. Examples of these symptoms may include getting easily bored during repetitive tasks, shifting from one uncompleted activity to another, losing concentration during long tasks, or struggling to submit reports on time without being reminded by your boss.