ADHD Treatment

Attention-deficit hyperactivity disorder (ADHD) is prevalent, and diagnoses of this condition are multiplying fast.

Consider these statistics: 11 percent of all U.S. children have ADHD, three to five percent of teenagers, or an estimated two million, have it, and 4.4 percent of U.S. adults also have the condition. 

Plus, children diagnosed with ADHD have significantly increased over the past 20 years, according to a study published by the JAMA Network. 

ADHD can impact your brain and behavior, where you exhibit symptoms such as hyperactivity, impulsiveness, and inattention. The condition can harm someone’s life whereas children experience problems with academics, issues with social skills, and strained relationships with parents.

An estimated 30 to 60 percent of impacted people will continue to show significant symptoms of the disorder when they become adults. 

There is no cure for ADHD, but that does not mean that treatment does not exist. The best treatment for adults who have the condition is a multimodal, multidisciplinary approach that includes medication and psychotherapy. 

Read on to learn more about ADHD treatment. 

What is ADHD?

ADHD is a common mental disorder that affects children. Adults can also have this condition. When people have ADHD, they exhibit symptoms of inattention, where they are unable to focus. They will also display hyperactivity, where they show increased movement and act impulsively.  

There are no specific causes for ADHD, but three out of four children with ADHD have a relative that has it. 

The symptoms that mark ADHD — the fidgeting, high activity, and short attention span — are behaviors that many children display. However, children with ADHD exhibit a higher degree of hyperactivity and inattention for their age. 

In turn, their behavior can cause distress and/or interfere with how they function at home, school, or with their friends, according to the American Psychiatric Association (APA). 

There are three types of ADHD diagnoses: the inattentive type, hyperactive/impulsive type, or a combined type. Diagnosis is based on whether the symptoms have occurred over the past six months. 

No lab test exists to diagnose ADHD. When a diagnosis is considered, therapists gather information from parents, teachers, and other parties. Also, a diagnosis involves checklists and medical evaluations, including a vision and hearing screening, to rule out other medical problems. 

According to the APA, these are the criteria for ADHD diagnoses: 

Inattentive – six (or five for people over 17 years) of the following symptoms occur frequently:

• Doesn’t pay close attention to details, or makes careless mistakes in school or job tasks.
• Has problems staying focused on tasks or activities, such as during lectures, conversations or long reading.
• Does not seem to listen when spoken to (i.e., seems to be elsewhere).
• Does not follow through on instructions and doesn’t complete schoolwork, chores or job duties (may start tasks but quickly loses focus).
• Has problems organizing tasks and work (for instance, does not manage time well; has messy, disorganized work; misses deadlines).
• Avoids or dislikes tasks that require sustained mental effort, such as preparing reports and completing forms.
• Often loses things needed for tasks or daily life, such as school papers, books, keys, wallet, cell phone, and eyeglasses.
• Is easily distracted.
• Forgets daily tasks, such as doing chores and running errands. Older teens and adults may forget to return phone calls, pay bills, and keep appointments.

Hyperactive/impulsive type – six (or five for people over 17 years) of the following symptoms occur frequently:

• Fidgets with or taps hands or feet, or squirms in seat
• Not able to stay seated (in the classroom, workplace)
• Runs about or climbs where it is inappropriate
• Unable to play or do leisure activities quietly
• Always “on the go,” as if driven by a motor
• Talks too much
• Blurts out an answer before a question has been finished (for instance may finish people’s sentences, can’t wait to speak in conversations)
• Has difficulty waiting for his or her turn, such as while waiting in line
• Interrupts or intrudes on others (for instance, cuts into conversations, games or activities, or starts using other people’s things without permission). Older teens and adults may take over what others are doing.

ADHD Dangers 

ADHD, when undiagnosed, can cause people to engage in risky behavior.

The reason, according to this WebMD report, is that people with ADHD have lower levels of certain brain chemicals, especially dopamine, the neurotransmitter that governs motivation, reward, memory, attention, and body movements.  

According to mental health counselor Stephanie Sarkis, “Risky behaviors can increase dopamine levels, which may be part of the reason some individuals with ADHD are drawn to them.”

Thus, engaging in risky behavior can give them that dose of dopamine that they need. 

By engaging in risky behaviors, people with ADHD can compromise their wellbeing, work or school life, or their relationships.  

According to WebMD, the following are examples of risky behaviors or tendencies exhibited by people with ADHD:

• They may have trouble getting motivated or finishing tasks at work or at home.
• They may frequently be late or unable to follow through on commitments, appointments, or responsibilities.
• They may engage in impulsive spending or overspending.
• They may start fights or argue.
• They may have trouble maintaining friendships and romantic relationships.
• They may speed and engage in dangerous driving.
• They may take part in risky sexual behaviors, like having unprotected sex.

ADHD and Substance Abuse

The same WebMD report states that ADHD, especially in adults, makes them up to six times more likely to abuse drugs and alcohol.

ADDitude Magazine, a specialty publication focused on ADHD-related matters, cites a survey that found that more than 15 percent of adults with the condition had abused or were dependent on alcohol or drugs at one point, which is triple the rate for adults without ADHD. 

The most commonly abused substances were alcohol and marijuana, states the report. In addition to seeking the rush that dopamine provides, people with ADHD can abuse intoxicants to find symptom relief.

For example, a special education teacher from Fort Wayne, Indiana resorted to drinking in college because, she said, “My mind was so out of control, and drinking would make that go away. I didn’t drink to get smashed, but to concentrate and get my homework done.”

Life Outcomes

Another factor that can lead people with ADHD to abuse substances is life outcome. People with ADHD tend to be less academically successful. Fewer graduate from high school and college, and thus, earn less money.

According to the Archives of Disease in Childhood, adults with ADHD are more likely to be dismissed from employment, have difficulties with employers and colleagues, experience relationship problems, and be at a higher risk for developing issues with substance abuse.   

Biology 

Biology can influence why people with ADHD abuse drugs or alcohol. Family members with ADHD who engage in this behavior can predispose a relative toward developing a substance use disorder, the clinical term that encompasses dependence and addiction. 

ADHD Treatment

There is no cure for ADHD, but there are treatments that have been shown to address its symptoms effectively. The known treatments for this condition can be classified as either medicinal and therapeutic.

For children and adults with ADHD, stimulant medications like Adderall, Ritalin, and Focalin work to increase dopamine levels, thereby improving concentration and focus. The central nervous system (CNS) stimulants, however, are prone to abuse.

According to Drug Abuse Warning Network (DAWN) data, from 2005 to 2010, there was a nearly 450 percent increase in emergency department visits for the non-medical use of ADHD stimulants among young adults ages 18 to 25. Over the same period, there was a 420 percent increase among adults 26 and older. 

The recommended treatment approach for adults with ADHD is one that combines complementary approaches that work to reduce symptoms. What that means is that someone with ADHD can tackle symptoms by taking medication, engaging in behavioral therapy, and taking up exercise. 

According to ADDitude Magazine,  “If you use medication, speak with the prescribing professional about his or her expertise with complementary treatment options. If you do not use medication, find a professional who specializes in the types of treatments you want to use — for example, a nutritionist or psychologist specializing in behavior therapy.”

Stimulant Medications

Healthline cites these CNS stimulant medications as helpful in treating ADHD symptoms:

• Amphetamine-based stimulants (Adderall, Dexedrine, Dextrostat)
• Dextromethamphetamine (Desoxyn)
• Dexmethylphenidate (Focalin)
• Methylphenidate (Concerta, Daytrana, Metadate, Ritalin)

Non-stimulant medications can treat ADHD in children when they have not worked, or their side effects prove to be too much, according to Healthline. 

Non-stimulant treatments include:

• Atomoxetine (Strattera)
• Antidepressants like nortriptyline (Pamelor)

Healthline also says that other non-stimulants can help to treat ADHD. How they address ADHD are not fully known. Medications in this category include guanfacine (Intuniv) and clonidine (Kapvay).

Behavioral Therapy Treatment   

Primarily, behavioral therapy works to change negative habits and behaviors in adults. Cognitive behavioral therapy (CBT) is used most in with medication to tackle symptoms of ADHD. CBT is a form of psychotherapy that helps patients change negative thought patterns and the way they feel about themselves, abilities, and life.  

Alternative Treatments

Exercise, food choices, and specific, time-tested alternative therapies help to improve your overall wellbeing. ADHD friendly nutrients include zinc, iron, magnesium, and fish oil. 

According to ADDitude Magazine, those alternative treatments can include the following:

Exercise

A 30-minute walk, four times a week can help you realize some noticeable benefits.

Nature therapy

A walk in a park or the woods, or even spending time in a greenhouse may reduce ADHD symptoms.

Yoga and Mindful Meditation

With mindfulness or mindful meditation, you develop a greater awareness of your internal state from moment to moment. How? Because this traditional practice allows you to focus in on your thoughts, feelings, and bodily sensations. It can also help you to experience psychological wellbeing. Practicing yoga can help you reduce anxiety and increase energy, while also endowing you with similar benefits that mindfulness proffers.

Neurofeedback

ADDitude Magazine states that neurofeedback utilizes brain exercises that help to reduce impulsivity and increase attentiveness.

ADHD Coaching

An ADHD coach is that cheerleader, taskmaster, teacher, and a personal assistant who can help you create structures to order your life, make plans and set goals, get and stay motivated and develop money and time-management skills.

Sources

Drug Abuse Warning Network, 2011: National Estimates of Drug-Related Emergency Department Visits [PDF File]. (n.d.). Rockville, MD: Substance Abuse and Mental Health Services Administration. Date accessed: July 2, 2019. from https://www.samhsa.gov/data/sites/default/files/DAWN2k11ED/DAWN2k11ED/DAWN2k11ED.pdf

ADHD Editorial Board. (2019, January 18). ADHD Statistics. Retrieved from https://www.additudemag.com/statistics-of-adhd/

American Psychiatric Association. (n.d.). Retrieved from https://www.psychiatry.org/patients-families/adhd/what-is-adhd

Harpin, V. A. (2005, February 01). The effect of ADHD on the life of an individual, their family, and community from preschool to adult life. Retrieved from https://adc.bmj.com/content/90/suppl_1/i2.full

Healthline. (n.d.). ADHD Treatment: What Are the Options? Retrieved from https://www.healthline.com/health/adhd/treatment-overview

Pagán, C. N. (n.d.). The Link Between Adult ADHD and Risky Behavior. Retrieved from https://www.webmd.com/add-adhd/guide/adhd-dangerous-risky-behavior#1

Sherman, C., Ph.D. (2019, March 01). The Truth About ADHD and Addiction. Retrieved from https://www.additudemag.com/the-truth-about-adhd-and-addiction/

Williams, P., & Williams, P. (2018, November 13). Adult ADHD Treatment Options – An Overview. Retrieved from from https://www.additudemag.com/adhd-treatment-options-adult/

Xu, G., MD, Strathearn, L., Ph.D., & Liu, B., MD. (2018, August 31). Twenty-Year Trends in Diagnosed ADHD Among US Children and Adolescents. Retrieved from https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2698633