Attention deficit hyperactivity disorder (ADHD) affects roughly 8% of the US population. While historically it has been diagnosed in childhood or adolescence, a growing number of adults are pursuing diagnosis and treatment. It’s never too late to find out whether or not ADHD explains your difficulty focusing, being organized, struggling to remember things, running late, or losing things. Adults with ADHD can receive treatment just as successfully as children and teens, and the relief that comes with knowing why you struggle can be transformative. But it’s important to know which treatments are most effective because there are differences in how therapy works best when someone struggles with attention.
[Are you considering whether or not getting evaluated for adult ADHD is right for you? Check out “The Reality of Adult ADHD” for more information.]
First, make sure that you are properly evaluated for ADHD. Do not assume that problems with attention, focus, and lack of organization are attributed to ADHD. Rather than asking your primary care doctor to prescribe medication first, schedule an appointment with a psychologist who conducts ADHD evaluations with adults. The evaluation should consist of a thorough clinical interview, cognitive testing to assess performance on tasks that require attention, and collateral data collected from spouses, friends, or other trusted individuals who observe you in every day life. Failure to include any of these variables in an evaluation for adult ADHD means that it’s not complete. There are many reasons why people struggle to focus, including anxiety, depression, the side effects of other medications, a chronic medical condition, or the impact of trauma. Narrowly evaluating attention as though it’s only affected by ADHD neglects the possibility of important contributing factors that may need to be addressed in treatment. Comprehensive adult ADHD evaluations are conducted only by clinical psychologists with training and assessment. You cannot get the same level of assessment done by a primary care doctor or even a psychiatrist.
[Learn more about the value of psychological evaluations here.]
Once the evaluation has been completed and you receive a diagnosis of ADHD, or ADHD with depression or anxiety, obtain referrals for a physician with experience managing medications for ADHD. Psychologists usually have a list of trusted providers to whom they can refer clients. The options for ADHD medications are more complicated than the Ritalin prescriptions of the past. Your ADHD symptoms may not be effectively addressed with one of the more common medications. You also want to make sure that your dose is adjusted for what your body and brain can handle, so you’re maximizing the positive benefits while minimizing potential side effects.
Once you’ve received the official diagnosis of ADHD, therapy is an integral part of getting the results that you want. Although medication is incredibly helpful in improving attention and focus, behavior change is a critical part of living a more organized life and accomplishing personal and professional goals. Cognitive behavior therapy (CBT) is a type of therapy validated by empirical research that works well in managing ADHD symptoms. Talk therapy, as it is known, is usually not enough to help clients become more efficient and self-confident as they learn how to navigate life with ADHD. Most clients tell me that merely talking about their struggles with a compassionate listener falls short of making necessary changes to modify their behavior. They also say that once they leave the session, they struggle to remember what was discussed, and it’s hard for them to assess tangible progress in therapy.
In contrast, cognitive behavior therapy provides more structure to therapy sessions. The therapist and client set short term goals and there are homework assignments, so the client has tangible achievements in therapy. This helps clients feel empowered, and it gives therapy a purpose. Since one of the symptoms of ADHD is talking a lot and getting off topic more easily, traditional talk therapy does not provide a platform for tangible outcomes. While talking with a therapist to process feelings of grief over time that was lost before the diagnosis of ADHD is important, it’s equally important to come up with a plan so that clients can feel hopeful with their new knowledge of the reason behind their struggles.
Interventions to help adults who is suspect they have ADHD must be comprehensive, to include a psychological evaluation, effective medication management from a competent provider, and therapy that is goal directed. It’s never too late to find out if ADHD has been holding you back. As an adult, you can still develop the tools and strategies to improve your daily functioning and live the life you want.
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