Attention-deficit hyperactivity disorder (ADHD) is a disorder characterized by inattention and/or hyperactivity and impulsivity that impairs an individuals ability to function socially, academically, and/or occupationally.
ADHD is a neurodevelopmental disorder that affects executive functioning. Individuals with ADHD do not have an adequate amount of norepinephrine and/or dopamine available for use in the prefrontal cortex of the brain. Medication is usually necessary to replace these neurotransmitters or slow their natural elimination so more will naturally be available for use.
Often misunderstood as only being a childhood disorder, it persists into adult life in nearly half of individuals who have it. Approximately 1 in 5 adults who seek psychiatric treatment for other conditions may have undiagnosed ADHD. Untreated ADHD is not only correlated with significant social and occupational impairment, but also higher substance abuse and incarceration rates.
Someone may experience just inattentive symptoms, just hyperactive symptoms or a combination of both. Common inattentive symptoms include inability to concentrate and focus, misplacing or losing things, forgetting appointments, difficulty organizing tasks or environments, lack of follow-through, easily distracted, frequently makes careless mistakes, trouble paying attention to someone even when they are speaking to them directly, and others.
Common hyperactivity symptoms include fidgeting or squirming, difficult sitting still or seated even when expected to, difficulty with waiting ones turn, interrupting others even when they are busy, finishing the sentences of others or answering questions prematurely, feeling driven by a motor, inability to relax and unwind, and others.
ADHD is one of the more difficult disorders to diagnose accurately and takes a significant amount of evaluation time. Many ADHD symptoms are subjective and nearly every symptom of ADHD can be caused or exacerbated by other psychiatric disorders, medical disorders, lifestyle factors, or substance use. Likewise, ADHD can be overlooked or misdiagnosed as one of those other disorders. Further complicating the matter is there are unfortunately individuals who attempt to obtain stimulant medication for illicit recreational abuse by pretending to have ADHD. Therefore, making a proper diagnosis is an important first step so that we can pursue the proper treatment type. Once a diagnosis is confirmed there are several medications available for ADHD treatment and medication is typically highly effective.
Many of the medications used to treat ADHD are schedule 2 controlled substances (stimulants). This is the most strictly regulated group of prescription medications due to their high abuse potential. Therefore, after confirmation of an ADHD diagnosis, our blanket policy is to always require at least one full-length trial of an FDA approved non-controlled substance before considering any controlled substance use to treat ADHD. If someone is currently already taking a controlled substance to treat their ADHD, or has already completed a trial of a non-controlled medication for ADHD, we simply ask for a records transfer (or a signed note from the previous provider). If we agree that the diagnosis is accurate and the medication had been used appropriately in the past, we will likely be willing to continue the medication. We require a CDS contract (proper medication use agreement) and may request a drug screen prior to beginning any controlled substance.
ADHD usually requires the use of medication to manage well. In some cases therapy may also help individuals learn to better organize their environments or manage particular symptoms, behaviors, or self-esteem issues that have arisen a result of their ADHD symptoms.