Attention-Deficit/Hyperactivity Disorder (ADHD) is a well-recognised neurodevelopmental condition characterised by inattention, hyperactivity, and impulsivity. Although inattention is known to be the most prevalent subtype, it is equally important to shed light on the lesser-known subtype, i.e. Hyperactive-Impulsive Presentation (ADHD-HI). Understanding this unique subtype is pivotal for an accurate diagnosis, effective treatment, and ultimately improving the quality of life for those grappling with its challenges.

Delving into the Unique Traits of ADHD-HI

ADHD-HI, as the name implies, primarily features hyperactivity and impulsivity, with inattention playing a lesser role. Individuals with this subtype often exhibit heightened levels of physical restlessness, an inability to stay still, and a pronounced inclination toward impulsive actions.

Understanding Hyperactivity

Hyperactivity is a hallmark of ADHD-HI. Individuals display excessive restlessness and a constant need for movement. They may fidget, tap their feet, or find it difficult to sit still for extended periods. This surplus energy often seeks physical outlets, such as sports or other high-energy activities.

ADHD behaviour demonstrated as hyperactivity & impulsiveness

Office Environment:

• Hyperactivity: Constantly shifting in the chair, tapping feet, difficulty in staying seated during meetings.
• Impulsivity: Interrupting colleagues during discussions, impulsively expressing opinions without fully considering the topic.

Relationships:

• Hyperactivity: Restlessness during conversations, frequently changing topics, inability to sit calmly.
• Impulsivity: Making impulsive decisions without consulting the partner, sudden plans or changes in plans.

Hyperactivity and impulsivity might lead to a partner feeling overwhelmed or neglected, as the individual with ADHD-HI can struggle to give undivided attention or engage in balanced conversations.

Children:

• Hyperactivity: Running around excessively, unable to sit still during class, fidgeting and squirming.
• Impulsivity: Blurting out answers in class without raising a hand, difficulty waiting for their turn during games or activities.

On the Road:

• Hyperactivity: Excessive speeding, frequent lane changes, impatience in traffic.
• Impulsivity: Aggressive driving, impulsive overtaking, disregarding traffic rules.

Exploring Impulsivity

Impulsivity refers to acting without careful consideration of consequences. In ADHD-HI, impulsivity is notably significant. Individuals may interrupt conversations, act on immediate urges without assessing potential outcomes, and grapple with impulse control in various situations.

Unveiling the Multifaceted Challenges Faced by Individuals with ADHD-HI

Living with ADHD-HI presents distinctive challenges that affect various aspects of an individual's life, including education, work, relationships, and self-esteem.

Impact on Academic and Professional Life

In educational settings, hyperactivity and impulsivity can manifest as difficulty remaining seated, frequent interruptions of teachers or classmates, and struggles to follow instructions. These challenges can significantly hinder academic performance and social interactions.

Similarly, in the professional realm, individuals with ADHD-HI might encounter challenges in maintaining focus during meetings, meeting deadlines, and adhering to structured work hours. The constant need for movement and impulsive tendencies can impact productivity and job satisfaction.

Strain on Relationships

Hyperactivity and impulsivity can strain personal relationships. The constant movement and difficulty in remaining attentive during conversations make it challenging to maintain meaningful connections. Impulsivity may lead to abrupt or inappropriate comments, inadvertently causing tension or misunderstandings.

Impact on Self-Esteem

The conspicuous hyperactivity and impulsive behaviour experienced by individuals with ADHD-HI can lead to feelings of self-consciousness and lowered self-esteem. Social challenges and the potential for negative feedback can significantly impact an individual's perception of themselves.

Diagnosis and Treatment

Accurate diagnosis of ADHD-HI necessitates a comprehensive assessment, considering observed behaviours, medical history, and standardised ADHD-specific rating scales. Individuals need to meet the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to obtain a precise diagnosis.

Tailored Treatment Approaches

• Behavioural Therapy: Behaviour modification therapies, notably cognitive-behavioural therapy (CBT), prove instrumental in managing impulsivity and hyperactivity. CBT helps individuals develop coping strategies and techniques for impulse control.
• Medication Management: While stimulant medications are commonly prescribed for ADHD, careful calibration is necessary for individuals with ADHD-HI. The objective is to effectively manage hyperactivity and impulsivity while minimising potential side effects.
• Lifestyle Adjustments: Implementing lifestyle changes such as regular exercise, adhering to a structured routine, maintaining a balanced diet, ensuring adequate sleep, and practising stress management techniques can significantly aid in managing the symptoms of ADHD-HI.

The Crucial Role of Support and Understanding

A strong network of support from family, friends, educators, and mental health professionals is vital for individuals with ADHD-HI. Creating an understanding and accommodating environment that acknowledges the challenges associated with this subtype can be immensely beneficial.

Understanding the Hyperactive-Impulsive presentation of ADHD is not only essential for an accurate diagnosis but also for the effective management of this rare subtype. Additionally, impulsive actions and decisions could lead to misunderstandings and conflicts. It's crucial to approach these situations with empathy and understanding. Individuals with ADHD-HI face unique challenges in managing their impulses and energy levels, which necessitates tailored treatment approaches. By raising awareness and fostering understanding, we can ensure that individuals with ADHD-HI receive the appropriate support and resources to lead fulfilling lives, leveraging their unique strengths and abilities. 

Reference link

https://www.wionews.com/entertainment/lifestyle/news-hyperactive-impulsive-presentation-of-adhd-understanding-the-rare-subtype--adhd-awareness-month-2023-647397