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Causes of ADHD

Bad parenting? Genes? Something else? Find out what really causes attention deficit hyperactivity disorder.

Medically reviewed in August 2021

How do you get attention deficit hyperactivity disorder (ADHD) or attention deficit disorder (ADD)? Some assign blame to poor parenting, incompetent teachers or watching too much TV, but none of these things are the cause of ADHD or ADD.

Another theory that has been floating around over the years is that refined sugar and food additives make children hyperactive, but scientists at the National Institutes of Health found that this may only apply to about 5% of children with ADHD -- either very young children or those with food allergies. Others have thought that injuries to the brain are behind the attention disorder, but the vast majority of people with ADHD have no history of a brain injury or evidence of brain damage.

The underlying causes of ADHD have yet to be fully understood, says Andrew Gilbert, a psychiatrist at the Hallowell Center in New York City. Dr. Gilbert specializes in the diagnosis and treatment of ADHD in children and adults. "There are clearly genetic factors, but genes don't explain it all," he says. "It appears that environmental factors, such as perinatal stress, low birth weight and maternal smoking during pregnancy, can contribute. Recent studies have recognized differences in brain development/maturation in children and adolescents with ADHD compared to those without the disorder."

According to Mayo Clinic, you're at risk of ADHD if any of the following apply:

  • Your blood relatives, such as a parent or sibling, have ADHD or another mental health disorder. (According to the Attention Deficit Disorder Association, if one person in a family is diagnosed with ADHD, there is a 25% to 35% probability that another family member will have it, compared to a 4% to 6% probability for someone in the general population.)
  • Your mother smoked, drank alcohol or used drugs during pregnancy.
  • Your mother was exposed to toxins, such as polychlorinated biphenyls (PCBs) during pregnancy.
  • You were exposed to environmental toxins as a child. (Lead found mainly in paint and pipes in older buildings has been linked to a short attention span, among other behavioral problems.
  • You were born prematurely.

"Effective treatments, such as stimulants, target neurotransmitters, including dopamine and norepinephrine, which are involved in attention-regulating brain circuits," Gilbert says. "These and other treatments may be helping to rewire dysfunctional circuitry, but more studies are needed to confirm this and better understand the mechanisms."

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