The Other ADHD

It looks like inattentive ADHD, but it isn't. It's called Concentration Deficit Disorder (CDD), and here's what you should know about it.

Fatigued Student

Here is what the research community knows — and doesn't know — about CDD. There are more questions than answers.

   
 

CDD Symptoms at a Glance

> Daydreaming excessively

> Trouble staying alert or awake in boring situations

> Easily confused

> Spacey or "in a fog"; seems to be elsewhere

> Stares a lot

> Lethargic, more tired than others

> Underactive or has less energy than others

> Slow moving or sluggish

> Doesn't seem to understand or process information as quickly or as accurately as others

> Apathetic or withdrawn; less engaged in activities

> Slow to complete tasks; needs more time than others

 
   

As more parents and adults get educated about the symptoms of ADHD and its subtypes, discover treatments that work, and put a game plan together to help their child move forward in school and life, along comes a news flash from the research front that there may be another type of ADHD to contend with. It is called Concentration Deficit Disorder (CDD). You probably want to throw up your hands and shout, "Just what we need! Another type of ADHD to learn about and manage."

What does Concentration Deficit Disorder look like in a child? He has persistent difficulty concentrating, and he stares or looks blank when he is asked a question. He is slow-moving, lethargic, drowsy, or sleepy during the day; uninterested in playing with friends; withdrawn.

A Scottish physician first described a pattern of behavior similar to CDD back in 1798. However, no one has been able to determine whether this pattern of behavior is a type of ADHD or a different disorder that often co-occurs with ADHD.

In the research literature, this cluster of symptoms is still called Sluggish Cognitive Tempo (SCT). However, for many people, the word "sluggish" is derogatory, because it suggests mental slowness, slow-wittedness, or outright laziness. Russell Barkley, Ph.D., recently made a plea to change the name to Concentration Deficit Disorder, which is less offensive and does not suggest that we understand the nature of the cognitive difficulties. The name change is a good suggestion. It focuses on the functional impairments of being drowsy, lacking energy, and being readily fatigued. Anyone who has had the flu knows that lack of energy and fatigue make it hard to concentrate on a task for more than a minute or so, or to engage in conversation or other social interaction.

Here is what the research community knows — and doesn't know — about CDD. There are more questions than answers.

What Do We Know About CDD? There is no agreement on the number or type of symptoms of CDD. Some research has been based on just two or three symptoms, while other studies have included as many as 14 symptoms. Some of the suggested symptoms of CDD are similar to symptoms of inattentive ADHD or depression. This makes it difficult to find out whether CDD differs from those conditions.

Is CDD a Form of Inattentive ADHD? Some researchers found that a set of five symptoms was unique to CDD: "loses train of thought," "easily confused," "seems drowsy," "is slow-thinking and slow-moving." This set (or similar sets) of symptoms can be found in children, adolescents, and adults. Studies show that CDD symptoms are different from ADHD and depression, although CDD often co-occurs with ADHD, particularly with the inattentive form. Parents, teachers, and clinicians shouldn't assume that all problems with concentration or inattention mean that the individual has ADHD. However, a child or adult who has both CDD and ADHD is likely to be more severely impaired than those with either condition alone.

Does CDD Occur With Disorders Other Than ADHD? CDD often occurs with ADHD — up to 50 percent of children or adults with ADHD or CDD may have the other. However, even though children with ADHD often meet diagnostic criteria for Oppositional Defiant Disorder (ODD), children with CDD rarely have ODD or aggression. Moreover, many children, adolescents, and adults with CDD symptoms also have symptoms of depression, but those with ADHD do not.

Since There Is No Known Way to Manage or Treat CDD, What Can I Do?

  • Make sure that the person with CDD symptoms gets enough sleep. Night-time sleep problems (difficulty falling asleep and staying asleep) are a major culprit in causing daytime sleepiness, lethargy, and difficulties in concentrating. Ask your doctor for advice about sleep hygiene.
  • Make sure that the person with CDD eats a nutritious breakfast. Skipping breakfast brings lower energy levels, tiredness, and a less positive mood. Eating a nutritious breakfast improves energy levels, mood, and cognitive function throughout the morning.
  • Take stock of how much exercise the person with CDD symptoms does daily. Regular exercise is beneficial for us all, but it may be particularly important for those with CDD.

NEXT: The Effects of CDD

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