ADHD and Covid-19: A toxic mix

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"It is clear to see that the toxic mix of ADHD, poor executive functioning and the COVID-19 pandemic needs attention."
"It is clear to see that the toxic mix of ADHD, poor executive functioning and the COVID-19 pandemic needs attention."

Dayne Williams is a South African Educational Psychologist. Here he shares his thoughts on how the pandemic has affected those with ADHD.

Attention-Deficit Hyperactivity Disorder (ADHD) is one of the most common learning barriers, with research suggesting that anywhere between 2 and 16% of school-going learners are struggling with either inattentive, hyperactive/impulsive or a combination of both types of this neurological disorder.

Alarmingly, these numbers appear to be on the rise with research showing significant increases in ADHD diagnoses between 1997 and 2016. There are many reasons to explain this increase but it helps to understand some of the basics.

A closer inspection

There are three presentations of ADHD – inattentive, hyperactive/impulsive and a combination of the two. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), many aspects need to be considered before a diagnosis is made.

Some of the most common symptoms of inattentive ADHD (previously referred to as Attention Deficit Disorder or ADD) include difficulty: sustaining attention, paying close attention to detail, following through with instructions, organizing tasks and activities, avoiding tasks such as homework and a tendency to become distracted by external stimuli and/or one's thoughts.

You would be forgiven for thinking that these symptoms fit your teenager to a tee. However, many teens can relate to these in a world where novelty and instant gratification are just a swipe away on their phones; but it is important to differentiate between normal inattentive-like behaviour and behaviour causing distress and poor academic functioning.

On the other side of the coin is the hyperactive/impulsive presentation which tends to see individuals fidgeting, moving their body frequently (often unaware that they are doing it), needing to move around even when inappropriate to do so, often being in an almost manic state as if driven by a motor and/or struggling to moderate emotions and/or behaviours.

The latter of these symptoms is often overlooked but can be a strong indicator of difficulties with ADHD. In my experience, it is all too often this emotional challenge that causes the most conflict in the home between parents and their children.

Covid-19 and the rise of home-based learning

As we find ourselves amid an international pandemic I have seen a sharp increase in referrals from parents concerned about their child's challenges with time management, procrastination, addictive-like behaviours (often involving screens), and low frustration tolerance to name a few.

Read: Nine tips to make reading fun for children with ADHD

Parents, now able to observe their children first hand in a working environment, are often overwhelmed. At the heart of this, it seems, is the extent to which their children find self-management skills inaccessible. Assistant clinical professor of psychiatry at Yale, Thomas E Brown describes these skills as executive functions or the skills we use daily to learn, work and manage our lives.

The correlation between deficits in these skills and ADHD is well documented and, to add fuel to the fire, we have also known for decades that stress, anxiety, depression and trauma contribute significantly to how our brains work.

If we consider the significant loss children and adolescents have endured in the form of lost learning time, fewer social gatherings, sports events and celebrations; it is clear to see that the toxic mix of ADHD, poor executive functioning and the Covid-19 pandemic needs attention.

Where to from here?

Treatment options can be a challenging discussion for parents. Particularly as opinions are often polarized when it comes to the use of stimulants such as Ritalin.

However, the research is overwhelmingly clear that drug therapy is highly effective for the treatment of ADHD symptoms. In effect, they aim to minimize the symptoms and therefore make it easier for the individual to lead a healthy and functional life.

One can, in some ways liken this to the medical approach used to treat depression. Generally, healthcare practitioners may suggest a trial of medication, such as anti-depressants to treat the symptoms, while suggesting psychotherapy as a means to address the underlying cause and/or gain tools to better manage future episodes.

In the case of ADHD, a similar approach is gaining momentum as practitioners are, in addition to medication, encouraging executive functioning training to strengthen and equip children and teens with the tools needed to manage these areas more effectively.

The truth is that the vast majority of Adolescent ADHD cases report symptoms that last into adulthood. Therefore, learning practical skills in adolescence, that can be used long-term, is in the best interest of your child.


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