Treatment for ADHD in Adults

What Does ADHD Look Like In Adults?

Attention-Deficit/Hyperactivity Disorder (ADHD) is typically diagnosed in children and teens (Froehlich, Lanphear, Epstein, Barbaresi, Katusic, & Kahn, 2007; DSM-5).  As the research on ADHD did not gain momentum in the field until approximately 20 years ago, many people with ADHD have grown up undiagnosed.  Many adults struggle with undiagnosed ADHD or symptoms of attention deficit who could benefit from diagnosis and treatment. 

ADHD is rooted in differences in brain function.  Research has identified possible neurological explanations for symptoms of ADHD (see Rubia, Smith, Brammer, Toone, & Taylor, 2005; Yu-Feng, 2007), particularly related to activity in the prefrontal and temporal cortices in the brain. Symptoms of ADHD begin to emerge early in childhood as social expectations are increased, such as simple household chores or interacting with other children. 

ADHD is a diagnostic category used to describe consistent inattention and/or hyperactivity-impulsivity that prevents people from everyday functioning.  If you struggle with any of the following, you may struggle with treatable symptoms of ADHD:

  • Staying organized
  • Interrupting others in conversation
  • Keeping track of thoughts
  • Motivation to finish tasks
  • Sitting still during meetings
  • Impulse control

Although we commonly refer to ADHD as one disorder, three subtypes of ADHD have been identified. 

The three main types of ADHD include:

1)    Predominantly inattentive type

  • Difficulty maintaining attention or focus to one task
  • Often makes careless mistakes
  • Difficulty organizing or keeping track of schedule
  • Frequently loses things
  • Easily distracted

2)    Predominantly hyperactive or impulsive type

  • Constant squirming, fidgeting, bouncing
  • Difficulty being quiet or waiting
  • Interrupts others frequently
  • Agitated, unable to sit still

3)    Combined inattentive and hyperactive/impulsive

  • A combination of inattentive and hyperactive/impulsive symptoms
  • Typically, this is the most severe type

Many of these symptoms are common in childhood and are overlooked as “bratty” or “typical” behaviors.  In determining a diagnosis, the severity and duration of the symptoms are the determining factor between the normal and the dysfunctional.  Left untreated, ADHD can impact the life trajectory of a child. This means that many adults may have missed opportunities in life due to untreated symptoms.

So, how can we help?

 

Treatment for ADHD

Treatment for ADHD in adults is similar to treatment for kids, as the first step involves accurate assessment of symptoms and diagnosis.  Many other disorders can manifest in similar ways, and the treatment is different for each disorder.

Here are a few examples of other concerns that look like ADHD:

1)    Depression

  • Inability to focus or concentrate
  • Irritability and aggression
  • Slower processing speed

2)    Anxiety

  • Difficulty staying on task
  • Fidgeting and squirming
  • Racing thoughts
  • Lack of focus

3)    Learning Disability

  • Difficulty with certain work or school related tasks
  • Specific areas of learning deficits

 

Of course, ADHD can also be present with other disorders.  Psychologists call this comorbidity, which identifies multiple disorders that feed into and worsen the others.  For example, difficulty focusing would likely make us feel depressed, angry or anxious.   

Accurate diagnosis might also include specific testing for ADHD using neuropsychological tests.  If you would like to learn more about testing for ADHD, check out the page on Diagnostic Assessment under ADHD. 

Once we have a clear diagnosis, I design a treatment plan to help manage symptoms and improve functioning in the affected areas.  For example, if you struggle to keep tasks organized at work, we would begin by identifying coping strategies for that deficit.

Treatment objectives for ADHD might include:

  • Improving organizational skills
  • Down-regulating or calming the body
  • Developing insight regarding attention difficulties
  • Increased awareness of self and others
  • Learning to express attachment needs

Over the course of treatment, I carefully monitor progress and identify any additional areas for improvement. 

Part of the treatment plan may also involve meeting with your primary care provider (PCP), psychiatrist, or other prescribers to consult regarding the use of medication. 

Medication can be an effective way to moderate hyperactive behaviors (Nair, Ehimare, Beitman, Nair, & Lavin, 2006).  However, stimulants tend to be overprescribed in the United States (Jensen, Kettle, Roper, Sloan, Dulcan, Hoven, & Payne, 1999). Adults are at lower risk than children for the negative effects of taking stimulant medication, collaboration with your prescriber is necessary.  We will work as a team to determine the most effective strategy for treatment. 

If your child struggles with inattention or hyperactive behaviors, take a look at the Treatment of ADHD page to learn more. 

If you believe you or a loved one struggles with symptoms of ADHD, please contact me today.  Let’s begin the process of improving your life and getting you on track to being your best self. 

 

Interested?  Let’s Connect!

If you are interested in therapy services, please contact me as soon as possible. I would love to hear from you and answer any questions you may have about my practice. 

It is never too late to receive treatment.  I believe I can help make a difference in your life. 

I help people and their families in the Newport Beach area, but I also work with folks from Irvine, Newport Beach, Costa Mesa, Laguna Beach, Rancho Santa Margarita, Aliso Viejo, Laguna Hills, Mission Viejo, Anaheim, Orange, Tustin, Huntington Beach, Seal Beach, Dana Point, Fountain Valley and more.

 

Read About Dr. Montgomery

Dr. Aaron Montgomery, Child, Adolescent and Adult Psychologist. Newport Beach Psychologist | Irvine Psychologist

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References

Froehlich, T. E., Lanphear, B. P., Epstein, J. N., Barbaresi, W. J., Katusic, S. K., & Kahn, R. S. (2007). Prevalence, recognition, and treatment of attention-deficit/hyperactivity disorder in a national sample of US children. Archives of pediatrics & adolescent medicine161(9), 857-864.

Greenhill, L. L., Pliszka, S., & Dulcan, M. K. (2002). Practice parameter for the use of stimulant medications in the treatment of children, adolescents, and adults. Journal of the American Academy of Child & Adolescent Psychiatry41(2), 26S-49S.

Harpin, V. A. (2005). The effect of ADHD on the life of an individual, their family, and community from preschool to adult life. Archives of disease in childhood, 90(1), i2-i7.

Jensen, P. S., Kettle, L., Roper, M. T., Sloan, M. T., Dulcan, M. K., Hoven, C., ... & Payne, J. D. (1999). Are stimulants overprescribed? Treatment of ADHD in four US communities. Journal of the American Academy of Child & Adolescent Psychiatry38(7), 797-804.

McGoey, K. E., Eckert, T. L., & Dupaul, G. J. (2002). Early intervention for preschool-age children with ADHD: A literature review. Journal of Emotional and Behavioral Disorders10(1), 14-28.

Nair, J., Ehimare, U., Beitman, B. D., Nair, S. S., & Lavin, A. (2006). Clinical review: evidence-based diagnosis and treatment of ADHD in children. Missouri medicine103(6), 617-621.

Rubia, K., Smith, A. B., Brammer, M. J., Toone, B., & Taylor, E. (2005). Abnormal brain activation during inhibition and error detection in medication-naive adolescents with ADHD. American Journal of Psychiatry162(6), 1067-1075.

Yu-Feng, Z., Yong, H., Chao-Zhe, Z., Qing-Jiu, C., Man-Qiu, S., Meng, L., ... & Yu-Feng, W. (2007). Altered baseline brain activity in children with ADHD revealed by resting-state functional MRI. Brain and Development29(2), 83-91.