ADHD

What is ADHD?

ADHD stands for attention deficit hyperactivity disorder. It is a condition of brain development that affects attention, activity levels and self-control. People with ADHD are not lazy, careless or badly brought up. Their brain simply finds it harder to stay focused on tasks that are not interesting, to sit still, to wait, and to organise time and work.

ADHD begins in childhood. Doctors diagnose it when a pattern of inattention, hyperactivity and impulsivity has lasted at least six months, started before the age of 12, shows up in more than one setting (such as home and school) and clearly affects daily life. Everyone is distracted or restless at times. In ADHD, it is frequent, persistent and gets in the way.

ADHD is common. A review of Indian studies found it in about 6 in every 100 children surveyed. Symptoms often continue into adulthood: worldwide, about 2.6 in every 100 adults have ADHD that has persisted since childhood. Yet many people, especially adults and girls, are never diagnosed, and ADHD is still often dismissed in India as a discipline problem.

Types of ADHD

ICD-11 describes ADHD by which symptoms are strongest:

• Predominantly inattentive: difficulty concentrating, following through and staying organised. These children and adults are often seen as dreamy or forgetful, and hyperactivity may be mild or absent.
• Predominantly hyperactive-impulsive: restlessness, excess energy, talking a lot, interrupting and acting without thinking.
• Combined: a mix of both.

The picture can change with age. Many hyperactive children become less visibly restless as teenagers or adults, while problems with attention and organisation continue.

Signs in children

• Seems not to listen, even when spoken to directly
• Makes careless mistakes in homework and exams despite knowing the answers
• Loses pencils, water bottles, books and school diaries again and again
• Starts tasks but rarely finishes them; homework drags on for hours
• Is easily distracted by sounds, sights or their own thoughts
• Fidgets, climbs, runs about, or cannot stay seated in class or at meals
• Talks non-stop, blurts out answers or finds it hard to wait for a turn
• Acts without thinking of danger, such as running onto the road
• Brings home frequent notes from teachers about behaviour or not paying attention

Many children with ADHD are bright, creative and affectionate. Constant scolding can badly hurt their self-esteem, which is why early recognition matters.

Signs in adults: often missed until college or work

In adults, ADHD rarely looks like a child running around. It is often first noticed when outside structure disappears: in college, in a first job, after marriage or on becoming a parent. A student who coped at school with parents, tuition teachers and fixed timetables may struggle with hostel life, deadlines and self-study.

Common signs in adults include:

• Chronic lateness, missed deadlines and poor time management
• Putting things off until the last minute, then working in a panic
• Starting many projects and finishing few
• Losing keys, phone, wallet or important documents
• Drifting off in meetings or conversations
• Inner restlessness, difficulty relaxing, or always needing to be busy
• Impulsive decisions, such as quitting jobs, speaking without thinking or sudden purchases
• Becoming absorbed for hours in something interesting while routine tasks pile up

Adults with ADHD often have a history of underperforming in studies, problems at work or strained relationships. Many have spent years being called careless or lazy, and quietly believing it.

Girls and women are often overlooked

Girls with ADHD are less likely to be disruptive in class. Their difficulties more often show as inattention, daydreaming, disorganisation, anxiety and low self-esteem. Because they are quiet, teachers and families may not notice, and their symptoms are especially likely to be missed in childhood.

Many women are first recognised in their twenties or thirties, sometimes after years of being treated only for anxiety or low mood. The demands of managing studies, a career and a household can make symptoms much harder to cope with.

How ADHD affects everyday life

Without support, ADHD can affect far more than concentration:

• Studies: underperforming despite ability, struggling with board exams, coaching classes and entrance preparation, or dropping courses
• Work: missed deadlines, conflict with managers and frequent job changes
• Driving: distraction, speeding and impulsive decisions on the road raise the risk of accidents
• Relationships: forgotten commitments, interrupting and impulsive words can lead to frequent arguments with a partner or family
• Money: impulse spending, forgotten bills and EMIs, and mounting debt
• Self-esteem: years of criticism can leave a person feeling like a failure

With the right treatment and support, these difficulties often improve a great deal.

ADHD and other conditions

ADHD rarely comes alone. It often occurs with learning difficulties, sleep problems, anxiety and depression, which can make each condition harder to recognise and treat. Sleep problems affect up to 70% of adults with ADHD.

Teenagers and adults with ADHD are also more likely to take risks, including using alcohol, cannabis, tobacco or other substances. For some, substances feel like a way to quieten a restless mind. Many also find it especially hard to step away from gaming, social media and other instantly rewarding activities. When ADHD and substance use or gaming problems occur together, treating both at the same time works better than treating either alone.

Why does it happen?

ADHD is a neurodevelopmental condition, meaning it relates to how the brain develops. There is rarely a single cause:

• Genes: ADHD often runs in families. Parents sometimes recognise their own childhood in their child’s difficulties.
• Brain development: differences in the brain systems that manage attention, planning and self-control.
• Before birth and early life: researchers are studying how exposures during pregnancy and early childhood may add to the risk.

ADHD is not caused by poor parenting, sugar or television, although a calm, predictable home helps a child manage it.

Online quizzes can’t diagnose ADHD

Social media is full of short videos and quizzes listing signs of ADHD. They can raise useful awareness, but they cannot diagnose it. Almost everyone recognises some of the signs, because distraction, procrastination and restlessness are part of ordinary life. They can also be caused by stress, poor sleep, anxiety, depression, thyroid problems, substance use or too much time on screens.

Rating scales are helpful tools, but guidelines are clear that ADHD should not be diagnosed on the basis of a questionnaire alone. A proper diagnosis needs a full assessment by a trained specialist. Self-diagnosis can lead to the wrong treatment, while dismissing real ADHD means missing help that works.

When to see a psychiatrist

Consider an assessment if:

• Teachers repeatedly raise concerns about your child’s attention or behaviour
• Studies, work or relationships keep suffering despite genuine effort
• You have always felt disorganised or restless, or as though you are not living up to your ability
• Your child has been diagnosed with ADHD and you recognise the same struggles in yourself
• Alcohol, cannabis, gaming or other habits have become a way of coping
• There have been accidents, risky driving or impulsive decisions with serious consequences

How ADHD is diagnosed

There is no blood test or brain scan for ADHD. Diagnosis rests on a careful, detailed history and often takes more than one appointment. The psychiatrist will look at:

• Childhood onset: whether difficulties were present before age 12, even if nobody named them at the time
• More than one setting: how symptoms show up at home, in school or college, at work and socially
• School reports: old report cards and teachers’ remarks about talking, carelessness or not paying attention are very useful
• Family input: with your permission, parents, a partner or siblings can describe what they have seen, especially in your childhood
• Other explanations: sleep, mood, anxiety, learning difficulties, substance use and physical health

Rating scales for the person, parents or teachers may be used alongside the interview. Before medicines are considered, blood pressure, heart rate, weight and, in children, height are checked. The diagnosis follows international criteria (ICD-11).

Under-18s are seen with a parent or guardian, and with consent the psychiatrist may ask for information from the school.

Treatment

ADHD is a long-term condition, but it can be managed well. Treatment is planned around the person’s age, how severe the symptoms are, any other conditions and their own goals. Guidelines recommend a step-by-step approach.

1. Understanding ADHD

The first step is learning what ADHD is and what it is not. When families understand that a child is not being deliberately naughty, and adults understand why they have struggled for so long, blame and guilt ease. Knowing how your brain works makes it much easier to plan around it.

2. Parenting strategies

For children, especially younger children and those with milder symptoms, parent training is often the first treatment. It teaches practical skills such as:

• Giving short, clear instructions, one at a time
• Keeping predictable routines for mornings, homework and bedtime
• Noticing and praising good behaviour quickly and specifically
• Using calm, consistent consequences instead of shouting or hitting
• Breaking homework into short chunks with planned breaks

3. School, college and workplace adjustments

Small changes can make a big difference:

• Sitting near the teacher and away from doors and windows
• Written instructions and checklists alongside spoken ones
• Short movement breaks, and exam arrangements where the school or institution allows them
• A daily report card shared between teacher and parents
• At work: a quieter desk, noise-cancelling headphones, calendar reminders and large projects broken into smaller deadlines

With your consent, the psychiatrist can guide you on how to talk to a school or employer.

4. Coaching and CBT for adults

Adults benefit from structured help to build systems that work for them. Cognitive behavioural therapy (CBT) adapted for ADHD teaches planning, prioritising, tackling procrastination and managing frustration, and addresses the harsh self-criticism that years of struggle can leave behind. ADHD coaching focuses on practical goals, such as routines, time and money management, and following through. Regular exercise, enough sleep and limiting alcohol also help.

5. Medicines

When symptoms are moderate to severe, or other steps have not been enough, medicines can help a great deal. There are two main groups:

• Stimulant medicines, which act quickly to improve attention and self-control
• Non-stimulant medicines, which take longer to work and are an option when stimulants are unsuitable or not tolerated

These medicines do not change personality or sedate a child. When prescribed after a proper assessment and monitored by a doctor, they are safe for most people. The psychiatrist regularly checks appetite, sleep, weight, blood pressure, heart rate and, in children, growth, and adjusts the plan as needed.

ADHD medicines must only be started, changed or stopped with a doctor. Stimulant medicines in particular must never be shared, sold or taken without a prescription, for example by students trying to study longer before exams. Used that way they can be harmful and can be misused. Keep them stored safely at home.

6. Treating other conditions together

Anxiety, depression, sleep problems and difficulties with alcohol, cannabis or gaming need attention alongside ADHD. Treating them together improves the chances of lasting change.

Outpatient or online care?

• Outpatient care suits almost everyone with ADHD, with regular reviews while continuing school, college or work.
• Online consultations are convenient for follow-up, parent guidance, therapy and families living outside Delhi NCR.
• Inpatient rehabilitation is only needed when a serious alcohol or drug problem accompanies ADHD.

Dr. Tarwani sees patients at Sukoon Health in Gurugram and South Delhi, where inpatient rehabilitation is also available, and online.

Living well with ADHD

ADHD does not have to limit a person’s future. Many people with ADHD bring energy, creativity, curiosity and quick thinking to their studies, work and families. Treatment aims to build on these strengths and reduce the difficulties. Needs often change at new stages of life, such as a new school, college, a job, marriage or parenthood, so staying in touch with your doctor helps.

For families

Parenting or living with someone with ADHD can be tiring and frustrating. A few things help:

• See ADHD as a reason for the difficulties, not a character flaw or an excuse
• Avoid comparing a child with siblings, cousins or classmates
• Keep routines steady, and keep screens away at homework time and before bed
• Praise effort and small wins, not just marks
• Work with the school as a team rather than against it
• Share accurate information with grandparents and relatives who may advise more strictness
• If you recognise ADHD in yourself, consider an assessment too
• Look after your own health and patience

You are welcome to consult Dr. Tarwani first, on your own, to understand the next steps.

Common myths

• “ADHD is just an excuse for bad behaviour.” It is a recognised medical condition with a clear pattern, listed in ICD-11.
• “Only naughty boys get ADHD.” Girls and women have ADHD too, often with quieter, inattentive symptoms that go unnoticed.
• “Children grow out of it.” Symptoms often continue into adulthood, even if they look different.
• “She can play games for hours, so she can’t have ADHD.” People with ADHD can focus intensely on things they find interesting. The difficulty is with tasks they don’t.
• “ADHD medicines turn children into zombies.” Prescribed and monitored properly, they are safe for most people and do not change personality.
• “Strict discipline will fix it.” Harsh punishment usually makes things worse. Structure, warmth and treatment help.