The second primary component of ADHD is the "hyperactivity" portion. Hyperactivity includes behavior that is restless, agitated, and difficult to control. Hyperactivity can refer to a physical or mental restlessness. Physical symptoms can include an irresistible need to move, requiring the person to be physically active or in constant motion. This need can be experienced as a compulsion; i.e., a powerful and compelling urge to act. This powerful urge creates enormous distraction that can only be relieved by acting upon it.
Physical hyperactivity is more common in children than in teens or adults. It may seem as though the child is motorized with batteries that rarely need recharging. As the child ages, this intense need to move evolves into more of a mental restlessness. Even so, teens and adults with ADHD may still have more energy than their non-ADHD peers. It is usually helpful to include frequent physical activity as part of an ADHD self-care routine. However, planned physical activity may not be enough. For some, they experience more of mental restlessness, an internal fidgety agitation. They may appear twitchy and easily irritated. This internal, mental restlessness is different than an outward physical compulsion to move about. Nonetheless, the need it produces is no less compelling. Teens and adults with ADHD must learn to manage mental restlessness with skills similar to those needed to manage physical hyperactivity.
Hyperactivity (and impulsivity) are generally associated with higher accident rates; greater problems with social interaction; and, regular displays of angry outbursts. Children are noticeably more active than their peers. This is particularly true during unstructured physical activities. They frequently become so engaged in unstructured activities that they do not recognize their own bodily signals regarding thirst, hunger, or fatigue. Hyperactive children tend to dash around, touch whatever they come across, interrupt others, and talk constantly. They are often humming, singing, talking, or making other types of noises, and they are often quite loud. They tend to feel restless if they sit too long and have great difficulty slowing down enough to fall asleep. Once they fall asleep, they may sleep quite heavily, but also move actively throughout the night.
Symptoms of Hyperactivity during infancy can include:
- An aversion to being cuddled or held;
- Strained/negative mother/child relationship;
- More frequent crying; and,
- More likely to be comforted by movement (walking, swinging, throwing in the air) than when sitting together quietly.
Symptoms of Hyperactivity during the preschool years can include:
- Higher activity levels than peers;
- Noticeable problems in structured play;
- Aggressive behavior;
- Difficulty going to sleep;
- Motor restlessness during sleep;
- Strong will; and,
- Family disorganization where caregivers feel overwhelmed.
Symptoms of Hyperactivity during the elementary school years can include:
- Diminished need for sleep;
- Fidgeting with hands or feet, or squirming in their seat;
- Leaving their seat often, even when asked not to do so;
- Running or climbing at inappropriate times;
- Difficulty with quiet play;
- Frequent feelings of restlessness; and,
- Excessive speech.
Symptoms of Hyperactivity during adolescence can include:
- Decreased hyperactivity;
- Pronounced feelings of restlessness;
- Low self-esteem;
- Intense need to stay busy and/or to do several things at once;
- Discipline problems; and
- High-risk behavior.