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Behind the inattention

Attention Deficit Hyperactive Disorder (ADHD) is a condition that is marked by a pattern of inattention or hyperactivity, which interferes with the development and functioning of the brain. There are a lot of children who aren’t diagnosed but have this disorder and are constantly under pressure from their parents to sit still and concentrate on what they are doing. The Week talked to Dr Ravi Raj Timasina, psychiatrist at Institute of Medicine, Maharajgunj, to know more about this disorder and how kids with the disorder should be handled.
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Attention Deficit Hyperactive Disorder (ADHD) is a condition that is marked by a pattern of inattention or hyperactivity, which interferes with the development and functioning of the brain. There are a lot of children who aren’t diagnosed but have this disorder and are constantly under pressure from their parents to sit still and concentrate on what they are doing. The Week talked to Dr Ravi Raj Timasina, psychiatrist at Institute of Medicine, Maharajgunj, to know more about this disorder and how kids with the disorder should be handled. 



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Who is affected by ADHD?

There isn’t a specific age group that is affected by ADHD. In some, the symptoms can be seen as early as when they are three years old, and as the children grow, the disorder grows with them. ADHD is often not seen as a disorder but a problem in the child’s discipline. Some children grow up without realizing they have the disorder in the first place, because they never showed any obvious symptoms. When a child isn’t able to perform well in school, our society calls them lazy and even dumb. They don’t think that it could be due to factors outside the child’s control. Children with ADHD are hyperactive and as they grow they become inattentive. If still left unchecked, people with the condition will go on to feel restless and get bored easily. They will also not be able to maintain relationships. 


How prevalent is the disorder and what causes it?

Studies have shown that ADHD is more common in males than in females, and the prevalence rate is similar in the country too. “In an internal study undertaken in Biratnagar, it was concluded that 11.7% patients were diagnosed with ADHD, out of which and the male: female ratio was 4:1. Similar to Biratnagar, a lot of children in other cities, especially in Kathmandu have ADHD as well. There aren’t a set number of factors that cause ADHD. Like many other mental health issues, it isn’t always in the genes, there are a lot of external factors that come into play as well. Mothers who smoke, drink alcohol, or use drugs may give birth to children with ADHD. Even if they don’t, exposure to environmental toxins such as lead, in the fetal stage or even at a young age, could lead to this disorder as well.


What are the symptoms?

The disorder is identified with two major symptoms, inattention, and hyperactivity with impulsive behavior. People with symptoms of inattention often make very careless mistakes while doing their work, either at school, or at their workplace. They can’t sit still for long periods of time and stop paying attention to the teacher or a lengthy meeting after a few minutes. More often than not, these are the people who claim to not be able to get into a book, and take more than a month to read a book. 

Hyperactive and impulsive children are hard to deal with in classrooms. They tend to fidget a lot, and may occasionally wander around the classroom as well. Especially in our country, where mental health issues aren’t taken seriously, this looks like disobedience and the students are punished.


How can ADHD be treated?

It is very easy to identify with the symptoms you read online or in books, so if you suspect that there is something wrong, you should consult the doctor instead of trying to treat yourself. The treatment for the disorder is two folds, there is therapy as well as medication available to deal with ADHD. Most people with this disorder have to undergo behavioral therapy. The patients are taught to observe their own behavior and find out what they are doing wrong. When they do, they are encouraged to change the pattern of behavior and are rewarded for it. This makes them realize that they are overcoming the disorder and helps them move forward with the therapy. Family members play a huge role in changing the behavioral pattern of a person with ADHD. If they make a routine for them, they will know what is expected of them at what time, and they will start to become more punctual and it will help control their behavior as well. 


What are the medications available? 

There are two types of medicines available for ADHD, stimulants and non-stimulants. The stimulants increase the production of dopamine and nor-epinephrine, both of which are thought to be directly associated with thought processing. The stimulants, however, do have side effects and you should consult the doctor immediately if you have them. Some of the side effects include high blood pressure, and kidney and liver damage, so it is important to not take more than the prescribed dose of the drug. The non-stimulants, on the other hand, affect the body slower than the stimulants do but these don’t have many side effects. 

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