Attention-Deficit/Hyperactivity Disorder

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition that affects the brain's ability to regulate attention, impulse control, and activity level. It typically begins in childhood, though its presentation changes with age, and a growing number of adults are now being diagnosed after living for years with unrecognised symptoms, often after a child's diagnosis prompts a parent to recognise the same traits in themselves. ADHD is not a result of poor discipline, laziness, or low intelligence; it is a well-documented difference in brain development and neurotransmitter function that responds well to appropriate support and, where needed, treatment. In Nigeria, awareness remains limited and ADHD symptoms in children are frequently misattributed to poor behaviour or lack of discipline, delaying diagnosis and support.

Symptoms fall into two main clusters, and people may show predominantly one, or a combination of both: Inattention: • Difficulty sustaining attention on tasks, easily distracted • Frequent careless mistakes, forgetfulness in daily activities • Difficulty organising tasks and managing time • Avoidance of tasks requiring sustained mental effort • Frequently losing items needed for tasks (keys, documents, phone) Hyperactivity and impulsivity: • Restlessness, fidgeting, or difficulty remaining seated • Talking excessively, interrupting others, or blurting out answers • Difficulty waiting one's turn • Acting without considering consequences In adults, hyperactivity is often less visible and instead presents as inner restlessness, chronic disorganisation, poor time management, difficulty completing tasks, and a pattern of underachievement relative to ability, which is frequently mistaken for a personality trait rather than a treatable condition.

ADHD arises from differences in brain structure and function, particularly in regions and neurotransmitter systems (dopamine and norepinephrine) involved in attention, impulse control, and executive function. It has a strong genetic component, with heritability estimates among the highest of any psychiatric condition, meaning it runs strongly in families. It is not caused by parenting style, excessive screen time, or sugar intake, though these factors can sometimes worsen symptom expression.

• Family history of ADHD, the strongest known risk factor • Premature birth or low birth weight • Maternal exposure to alcohol, tobacco, or certain toxins during pregnancy • Significant early childhood adversity

• Academic underachievement relative to ability, and higher rates of school dropout if unsupported • Occupational difficulties, including underperformance, frequent job changes, and workplace conflict • Relationship strain from impulsivity, forgetfulness, or difficulty listening • Low self-esteem, often from years of being labelled as "lazy" or "careless" • Increased risk of anxiety, depression, and substance use disorders, particularly when ADHD goes unrecognised and unsupported into adulthood

ADHD cannot be prevented, as it is a neurodevelopmental condition with a strong genetic basis. However, early diagnosis and appropriate management significantly improve long-term outcomes and reduce the risk of secondary complications such as academic failure, low self-esteem, and substance misuse. Management combines behavioural strategies (structure, routines, organisational tools), educational or workplace accommodations, and, where appropriate, stimulant or non-stimulant medication, which is highly effective for most people with ADHD when properly prescribed and monitored.