How to get treatment for adhd

Adult attention-deficit/hyperactivity disorder (ADHD) - Diagnosis and treatment

Diagnosis

Signs and symptoms of ADHD in adults can be hard to spot. However, core symptoms start early in life — before age 12 — and continue into adulthood, creating major problems.

No single test can confirm the diagnosis. Making the diagnosis will likely include:

Physical exam, to help rule out other possible causes for your symptoms
Information gathering, such as asking you questions about any current medical issues, personal and family medical history, and the history of your symptoms
ADHD rating scales or psychological tests to help collect and evaluate information about your symptoms

Other conditions that resemble

ADHD

Some medical conditions or treatments may cause signs and symptoms similar to those of ADHD. Examples include:

Mental health disorders, such as depression, anxiety, conduct disorders, learning and language deficits, or other psychiatric disorders
Medical problems that can affect thinking or behavior, such as a developmental disorder, seizure disorder, thyroid problems, sleep disorders, brain injury or low blood sugar (hypoglycemia)
Drugs and medications, such as alcohol or other substance misuse and certain medications

ADHD Treatment

Standard treatments for ADHD in adults typically involve medication, education, skills training and psychological counseling. A combination of these is often the most effective treatment. These treatments can help manage many symptoms of ADHD, but they don't cure it. It may take some time to determine what works best for you.

Medications

Talk with your doctor about the benefits and risks of any medications.

Stimulants, such as products that include methylphenidate or amphetamine, are typically the most commonly prescribed medications for ADHD, but other medications may be prescribed. Stimulants appear to boost and balance levels of brain chemicals called neurotransmitters.
Other medications used to treat ADHD include the nonstimulant atomoxetine and certain antidepressants such as bupropion. Atomoxetine and antidepressants work slower than stimulants do, but these may be good options if you can't take stimulants because of health problems or if stimulants cause severe side effects.

The right medication and the right dose vary among individuals, so it may take time to find out what's right for you. Tell your doctor about any side effects.

Psychological counseling

Counseling for adult ADHD generally includes psychological counseling (psychotherapy), education about the disorder and learning skills to help you be successful.

Psychotherapy may help you:

Improve your time management and organizational skills
Learn how to reduce your impulsive behavior
Develop better problem-solving skills
Cope with past academic, work or social failures
Improve your self-esteem
Learn ways to improve relationships with your family, co-workers and friends
Develop strategies for controlling your temper

Common types of psychotherapy for ADHD include:

Cognitive behavioral therapy. This structured type of counseling teaches specific skills to manage your behavior and change negative thinking patterns into positive ones. It can help you deal with life challenges, such as school, work or relationship problems, and help address other mental health conditions, such as depression or substance misuse.
Marital counseling and family therapy. This type of therapy can help loved ones cope with the stress of living with someone who has ADHD and learn what they can do to help. Such counseling can improve communication and problem-solving skills.

Working on relationships

If you're like many adults with ADHD, you may be unpredictable and forget appointments, miss deadlines, and make impulsive or irrational decisions. These behaviors can strain the patience of the most forgiving co-worker, friend or partner.

Therapy that focuses on these issues and ways to better monitor your behavior can be very helpful. So can classes to improve communication and develop conflict resolution and problem-solving skills. Couples therapy and classes in which family members learn more about ADHD may significantly improve your relationships.

More Information

Cognitive behavioral therapy
Family therapy

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Lifestyle and home remedies

Because ADHD is a complex disorder and each person is unique, it's hard to make recommendations for all adults who have ADHD. But some of these suggestions may help:

Make a list of tasks to accomplish each day. Prioritize the items. Make sure you're not trying to do too much.
Break down tasks into smaller, more manageable steps. Consider using checklists.
Use sticky pads to write notes to yourself. Put them on the fridge, on the bathroom mirror, in the car or in other places where you'll see the reminders.
Keep an appointment book or electronic calendar to track appointments and deadlines.
Carry a notebook or electronic device with you so that you can note ideas or things you'll need to remember.
Take time to set up systems to file and organize information, both on your electronic devices and for paper documents. Get in the habit of using these systems consistently.
Follow a routine that's consistent from day to day and keep items, such as your keys and your wallet, in the same place.
Ask for help from family members or other loved ones.

Alternative medicine

There's little research to indicate that alternative medicine treatments can reduce ADHD symptoms. However, studies indicate that mindfulness meditation may help improve mood and attention in adults who have ADHD, as well as those who don't have ADHD.

Before using alternative interventions for ADHD, talk with your doctor about risks and possible benefits.

Coping and support

While treatment can make a big difference with ADHD, taking other steps can help you understand ADHD and learn to manage it. Some resources that may help you are listed below. Ask your health care team for more advice on resources.

Support groups. Support groups allow you to meet other people with ADHD so that you can share experiences, information and coping strategies. These groups are available in person in many communities and also online.
Social support. Involve your spouse, close relatives and friends in your ADHD treatment. You may feel reluctant to let people know you have ADHD, but letting others know what's going on can help them understand you better and improve your relationships.
Co-workers, supervisors and teachers. ADHD can make work and school a challenge. You may feel embarrassed telling your boss or professor that you have ADHD, but most likely he or she will be willing to make small accommodations to help you succeed. Ask for what you need to improve your performance, such as more in-depth explanations or more time on certain tasks.

Preparing for your appointment

You're likely to start by first talking to your primary care provider. Depending on the results of the initial evaluation, he or she may refer you to a specialist, such as a psychologist, psychiatrist or other mental health professional.

What you can do

To prepare for your appointment, make a list of:

Any symptoms you've had and problems they've caused, such as trouble at work, at school or in relationships.
Key personal information, including any major stresses or recent life changes you've had.
All medications you take, including any vitamins, herbs or supplements, and the dosages. Also include the amount of caffeine and alcohol you use, and whether you use recreational drugs.
Questions to ask your doctor.

Bring any past evaluations and results of formal testing with you, if you have them.

Basic questions to ask your doctor include:

What are the possible causes of my symptoms?
What kinds of tests do I need?
What treatments are available and which do you recommend?
What are the alternatives to the primary approach that you're suggesting?
I have these other health problems. How can I best manage these conditions together?
Should I see a specialist such as a psychiatrist or psychologist?
Is there a generic alternative to the medicine you're prescribing?
What types of side effects can I expect from the medication?
Are there any printed materials that I can have? What websites do you recommend?

Don't hesitate to ask questions anytime you don't understand something.

What to expect from your doctor

Be ready to answer questions your doctor may ask, such as:

When do you first remember having problems focusing, paying attention or sitting still?
Have your symptoms been continuous or occasional?
Which symptoms bother you most, and what problems do they seem to cause?
How severe are your symptoms?
In what settings have you noticed the symptoms: at home, at work or in other situations?
What was your childhood like? Did you have social problems or trouble in school?
How is your current and past academic and work performance?
What are your sleep hours and patterns?
What, if anything, appears to worsen your symptoms?
What, if anything, seems to improve your symptoms?
What medications do you take?
Do you consume caffeine?
Do you drink alcohol or use recreational drugs?

Your doctor or mental health professional will ask additional questions based on your responses, symptoms and needs. Preparing and anticipating questions will help you make the most of your time with the doctor.

By Mayo Clinic Staff

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Where Can Adults with ADHD Find the Best Treatment?

Attention Magazine October 2019

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Alberto was working with an ADHD coach who suggested that medication would add to the progress he was making.

Gabrielle was diagnosed with ADHD by a psychologist. Her primary care doctor dismissed the report, because “if you have a law degree, you can’t have ADHD.”

Micah took an online quiz that urged him to talk to his doctor about ADHD, but he hasn’t picked a provider since his insurance changed.

WHERE SHOULD THESE PEOPLE TURN for the best expertise in treatment for their ADHD, including medications? It’s not as simple as finding a cardiologist for a heart problem or an obstetrician to deliver a baby. What kind of practitioner specializes in ADHD? The variety of specialists who treat ADHD can be dizzying.

Psychiatrists

Psychiatrists are traditionally the specialists we should assume will specialize in ADHD. Many, but not all, adult psychiatrists are trained to treat ADHD. Adult ADHD was not widely recognized by psychiatrists until the 1990s, and it took many years for psychiatry residencies to develop and train faculty to teach adult ADHD care to residents. Recent psychiatric residency graduates are thoroughly trained in ADHD care, and most prior graduates have learned about it through professional accreditation and continuing education programs.

Most psychiatrists treat a significant number of patients with ADHD, although this cannot be assumed. Psychiatrists have extensive training in differential diagnosis and are usually the best specialists to seek when ADHD is comorbid with depression, severe anxiety, bipolar disorder, aggressive disorders, or other serious psychiatric conditions.

Child and adolescent psychiatrists are extensively trained in ADHD care of children. Some have extended their scope of practice to include adults in locations where adult ADHD specialists are not available.

In the field of psychiatry, HIPAA regulations are often interpreted to limit a psychiatrist from caring for more than one member of a family. HIPAA regulations do not spell this out specifically, but this is a common interpretation of the law in psychiatry.

Primary care providers

Family practitioners, pediatricians, internists, some ob-gyns, nurse practitioners, and physician assistants in primary care practices are typically the first point of contact for when adults with ADHD need care. Some will determine and monitor treatment, some will continue treatment after a specialist determines it, and some refer all ADHD care.

Many group practices have one caregiver who acts as an internal consultant, managing ADHD patients for all the other providers. Pediatric practices are increasingly employing nurse specialists who coordinate care for all ADHD patients in their practices, and the concept is spreading to large primary care groups as well.

The advantage of obtaining ADHD care at a setting in which you are already known is obvious. Because ADHD in one person affects everyone in the home, family-oriented medical practices are sometimes more attuned to family dynamics than specialty offices. Family care providers have different methods for providing privacy under HIPAA guidelines, and they are often willing to provide mental health care for all members of a family as needed.

Primary care doctors can prescribe all psychiatric medications. Some will not initiate care, but will provide continuing care once a specialist has determined the correct dosage. They will often consult a psychiatrist if ADHD is accompanied by bipolar disorder, severe depression, and/or anxiety disorders, or if treatment response is not typical.

Nurse practitioners (NPs) and physician assistants (PAs)

NPs and PAs may work within a larger physician group, but increasingly more are working in independent practice settings. Some specialize in mental health broadly, while others specialize in ADHD or depression and anxiety specifically. Their practices may be especially suited to mental health care. Studies have shown, for example, that nurse practitioners spend more time with their patients, give patients more information, and follow-up more frequently than physicians do. NPs and PAs prescribe medications including controlled substances in every state.

Psychologists

Psychologists can prescribe mental health-related medications in Idaho, Illinois, Iowa, Louisiana, New Mexico, and the Territory of Guam, as well as in the Public Health Service, the Indian Health Service, and throughout the US Armed Services. In other states, psychologists typically consult with a patient’s primary care physician, who writes the recommended prescriptions.

Neurologists and physiatrists (rehab specialists)

Doctors who treat injuries to the brain are often knowledgeable regarding ADHD. The majority of these specialists in diseases and injuries of the brain don’t treat developmental disorders such as ADHD, but their background is sufficient if they develop an interest.

Network to find a specialist

If you are lucky enough to know an ADHD specialist already, your next step is a phone call to schedule a first visit. If you don’t know one, finding one will require some sleuthing. Here are some suggestions.

If you are seeing a coach or therapist for ADHD, ask for recommendations.
If you know someone with ADHD, ask them who they have seen.
The director of your local CHADD chapter (https://chadd.org/affiliate-locator/) often knows providers in your area who have worked with chapter members.
Your primary care provider might prescribe ADHD medications. If not, he or she will often refer you to someone who does.
University medical centers have health centers that provide mental health services. Many have specialized ADHD clinics or behavioral health clinics. If not, there will be a be an outpatient mental health clinic where ADHD patients are seen.
Consider asking your pastor, the principal of your child’s school, the president of your PTA, or other community leaders who know who’s who in your locale.
Search provider databases at chadd.org, www.add.org or www.additudemag.com. All providers in these databases specialize in ADHD.
The provider referral service at psychologytoday.com has a robust database. Narrow the search with the selections on the left of the page: select ‘ADHD’ in the Issues category and ‘Psychiatrists’ in the ‘See Nearest’ selector at the bottom. Your search results will include psychiatrists, NPs, and PAs.
And last, but not least, there’s Google. Try “ADHD doctor near me” or “ADHD specialist.”

Check out potential practices

After you locate a candidate or two, you will want to dig a little deeper.

Check the practice website. Most doctors who concentrate in ADHD will let you know that quite prominently on their personal page.
Don’t assume that all mental health specialists are experienced at treating ADHD or that primary care providers are not. Some adult psychiatrists finished residency without any training in ADHD, while some family doctors and internists find a special interest and become very experienced at diagnosing and treating ADHD.
In many large practices, nurse practitioners and physician assistants do the bulk of the mental health patient visits and prescriptions. Some of the best listening and smartest prescribing happens in their offices.

The most revealing questions you can ask

You probably cannot call and interview a physician, but you can often speak to a nurse at a prospective practice. The top two questions I would ask are:

How many patients with ADHD do you currently treat?
Do you (or does your doctor or your practice) like treating ADHD?

The first question is a good indicator of expertise. It’s hard to have up-to-date expertise without actively managing a panel of at least 50-100 patients. This is not a precise number, as it is entirely possible to churn through a high number of patients using rote treatment formulas.

The second question is odd, and not all answers are helpful. If the person stammers or asks what you mean, that is not a deal-breaker, but an answer such as, “Dr. Goodheart has family members with ADHD and considers it a special part of her mission,” suggests that you may have found the right place.

ADHD specialty clinics

A growing number of medical practices specialize in ADHD, and they are often a good choice if you can find one in your locality. When everyone in a practice focuses on ADHD, office personnel can offer rich advice and support. You can be assured that a practice named “ADHD Clinic” has expertise and “likes” treating ADHD.

In my personal practice, my staff and I manage over a thousand ADHD patients. We have diagnosed more than five thousand individuals since we began in 2001. When my office nurse is asked whether we like treating ADHD, she has been heard to say, “Why people with ADHD are literally the reason we open our doors in the morning!”

Practical questions

There are other questions that may help you evaluate a practice. Check the practice website first, particularly the FAQ section if there is one. It is usually quicker to do this than to sit on hold waiting to talk to office staff, since their time is often overwhelmed by the needs of patients already sitting in the office. Look for answers to the following suggested questions.

What is the cost of an evaluation?
What is the wait time for a new evaluation?
What are the costs of follow-up visits?
What is the standard follow up for typical patients after treatment is established? This typically varies from two to twelve visits per year.
What insurance does this practice accept?
Are televisits available (if you live a considerable distance from the practice)?
Does this practice offer ancillary services—psychotherapists, social workers, coaches, educational specialists, nutritionists, care coordinators, etc. ? If not, are referrals available?

Selecting a practice

ADHD specialists are unfortunately uncommon relative to the number of people with ADHD needing treatment. You are fortunate if you have more than one or two practices from which to choose.

All the research in the world cannot help you find the perfect practice, since there is no such thing. In the end, the best practice is not the one with the prettiest office or the nicest doctor. It is the one under whose care the person with ADHD finds symptom relief and successful life progress. That result will develop over time, but careful research now improves your chance of that success.

Oren W. Mason, MD, is a family physician and an assistant professor at Michigan State University College of Human Medicine. Since 2000, he has specialized exclusively in the diagnosis and treatment of children and adults with attention disorders. In 2008, he founded Attention MD and currently treats over 1000 patients with ADD/ADHD, executive function impairments, and accompanying comorbid conditions. He has published research on combination therapy for ADHD, ADHD management in a primary care setting, and stimulant prescription abuse. He has also authored educational programs for physicians who treat ADHD. Dr. Mason speaks internationally to professional and lay audiences about ADHD, and he is the author of Reaching for A New Potential: A Life Guide for Adults with ADD from a Fellow Traveler. Dr. Mason lives in Grand Rapids, Michigan, with his wife, Christine, who is also a family physician. Two sons were born in 1992 and 1995, and in 2001 they expanded their family to include five Sudanese teenagers orphaned by the civil war in South Sudan. They maintain a personal interest in the education and medical care of the poor in the developing world.

ADHD in adults - treatment, symptoms, diagnosis

Make an appointment

Treatment of ADHD in adults

Rehabilitation clinic "A NEW DAY" specializes in the treatment of adults with ADHD. We have developed and effectively applied a set of rehabilitation measures for ADHD.

Individual approach

Each patient has his own doctor - a neurologist. He knows everything about the patient and his disease, if necessary, he can make adjustments to the course of treatment at any stage. The main thing is the result. At the end of the course of treatment, individually developed recommendations are issued. nine0006

Treatment is always a complex

Taking into account the variant of the course, the age of the patient, the severity of manifestations, the most appropriate methods and their combinations are selected: (BOS).

In everyday life, ADHD patients are not recommended to engage in those sports that involve a competitive nature and have a pronounced emotional component, for example, martial arts, team games. Useful jogging, swimming (non-competitive), cycling, skiing. nine0003

To improve the psychological and emotional state, reduce anxiety, overcome depression, sleep disorders, various methods of psychotherapy are used. The choice of a technique suitable for a particular patient is carried out by a psychologist or psychotherapist.

Relaxation techniques: special relaxation massages, relaxation sessions, medical treatment.
Cognitive training is used for attention deficit. Acupuncture (IRT) is traditionally used to restore the regulation of many organs, including the brain. nine0006

Innovative techniques

Translingual neurostimulation (TLNS) is an effect on the brain through the stimulation of tongue receptors. This is an advanced innovative technique, most effectively used in the treatment of diseases of the central nervous system, and as we know, ADHD belongs to such diseases. The use of TLNS allows you to restore the regulation of excitation-inhibition processes in a short time, which ultimately leads to an improvement in the course of ADHD, the best psychological and motor correction. In addition, TLNS has a positive effect on cognitive functions, such as concentration and memory, improves sleep, allowing the body to restore its neurotransmitter stores and have a good rest. nine0006

Continuity and recurrence

ADHD has a favorable course when properly treated. It is important to maintain the results achieved. To do this, at discharge, we give detailed individually developed recommendations. As long as there is any residual symptomatology, courses of treatment should be repeated, as a rule, 2-3 times a year.

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Attention deficit disorder in adults

ADHD is a childhood-onset neurological behavioral disorder characterized by difficulty concentrating and maintaining attention, excessive motor activity (hyperactivity) and incontinence (impulsivity).

In recent years, the frequency of ADHD has increased, including among adults. It used to be thought that by adolescence, the symptoms of ADHD would significantly lessen or go away. However, now these ideas have changed: in 30-70% of cases, ADHD persists into adulthood. Most often this is due to insufficiently effective treatment in childhood. nine0006

More about ADHD

All processes occurring in the nervous system are based on two oppositely directed mechanisms: excitation and inhibition. Normally they are balanced. However, the formation of the nervous system does not occur immediately after birth. The brain is mainly formed before the age of 8 years, but finally only by the age of 25. Therefore, in children, arousal and inhibition often get out of control, in some cases leading to ADHD. Over time, the brain matures and the symptoms of ADHD improve or go away on their own. But even in an adult, cognitive, behavioral, and motor
disorders resulting from ADHD. That is why the prevalence of ADHD in adults, although it has increased in recent years, still remains much less than in children.

In general, the manifestations in children and adults do not differ, but there are features.

First, if a child does not have ADHD, then an adult will not develop this disease. Therefore, ADHD in adults is not a separate disease, but disorders that have persisted since childhood.

Secondly, in adults, attention disorders prevail over manifestations of hyperactivity. It is difficult for such people to concentrate and maintain attention, so many activities that require concentration may not be available to them. Hyperactivity can be manifested by restlessness, so sedentary sedentary work is not suitable for them. nine0006 Impulsivity can be manifested by conflicts in the family and at work.

And thirdly, the presence of ADHD in adulthood requires careful examination to exclude other disorders, incl. mental illness.

Manifestations of ADHD depend on the course of the disease.

Types of ADHD in adults

With a predominance of attention deficit (deficit)
With a predominance of hyperactivity
Mixed version of the ADHD

Symptoms of ADHD in adults

Symptoms of inattention (in at least 5 symptoms for at least 6 months):

Inability to concentrate on details, errors of incorrect
Inability to hold attention for a long time
Often one gets the impression that he does not listen to spoken speech
Inability to follow instructions, algorithms, for example, to fulfill conditions tasks
Resistance to getting involved in tasks, avoiding or active resistance
Frequent loss of things, especially those necessary to complete tasks
Easy distractibility to extraneous stimuli or thoughts (“hovering” in thoughts)
Routine forgetfulness (errands, chores, being late)

Symptoms of hyperactivity (in adults, at least 5 symptoms for at least 6 months):

Constant movements in the hands, feet, fidgeting in a chair
Getting up from a place
Inability to sit still
Inability to pass time calmly
Constantly in motion, as if “wound9”, as if “attached a motor” 908088
Answers a question without listening to the question itself
Difficulty waiting in line
permissions. nine0088

These symptoms must reach a degree of severity that interferes with learning, communication, work. They should be observed both at home and in other places (at work, at a party, etc.). They should be noticed not only by relatives, but also by those around them.

An additional examination may be required to clarify the diagnosis and exclude other diseases that have similar symptoms:

EEG (electroencephalography)
Doppler ultrasonography0088
Evoked potential (EP) method
Psychotherapist's consultation
Brain MRI
Psychiatrist's consultation (if indicated)

)
– ADHD CR (expanded complex)
– Cognition CS (standard complex)
– Cognition CR (expanded complex)

– Psychotherapy ind. COP (complex standard)
– Psychotherapy ind. CR (advanced complex)

Comparative table of all programs

ADHD in adults - treatment, symptoms, diagnosis

Make an appointment

Treatment of ADHD in adults

with ADHD. We have developed and effectively applied a set of rehabilitation measures for ADHD.

Individual approach

Treatment is always a complex

Taking into account the variant of the course, the age of the patient, the severity of manifestations, the most appropriate methods and their combinations are selected: (BOS). nine0003

In everyday life, ADHD patients are not recommended to engage in sports that involve a competitive nature and have a pronounced emotional component, for example, martial arts, team games. Useful jogging, swimming (non-competitive), cycling, skiing.

Innovative techniques

Continuity and recurrence

Fill out the form

+7 (812) 603-70-10

Attention deficit disorder in adults

More about ADHD

In general, the manifestations in children and adults do not differ, but there are features.

First, if a child does not have ADHD, then an adult will not develop this disease. Therefore, ADHD in adults is not a separate disease, but disorders that have persisted since childhood.

And thirdly, the presence of ADHD in adulthood requires careful examination to exclude other disorders, incl. mental illness.

Manifestations of ADHD depend on the course of the disease.

Types of ADHD in adults

With a predominance of attention deficit (deficit)
With a predominance of hyperactivity
Mixed version of the ADHD

Symptoms of ADHD in adults

Symptoms of inattention (in at least 5 symptoms for at least 6 months):

Inability to concentrate on details, errors of incorrect
Inability to hold attention for a long time
Often one gets the impression that he does not listen to spoken speech
Inability to follow instructions, algorithms, for example, to fulfill conditions tasks
Resistance to getting involved in tasks, avoiding or active resistance
Frequent loss of things, especially those necessary to complete tasks
Easy distractibility to extraneous stimuli or thoughts (“hovering” in thoughts)
Routine forgetfulness (errands, chores, being late)

Symptoms of hyperactivity (in adults, at least 5 symptoms for at least 6 months):

Constant movements in the hands, feet, fidgeting in a chair
Getting up from a place
Inability to sit still
Inability to pass time calmly
Constantly in motion, as if “wound9”, as if “attached a motor” 908088
Answers a question without listening to the question itself
Difficulty waiting in line
permissions.
Learn more

How to get treatment for adhd

Adult attention-deficit/hyperactivity disorder (ADHD) - Diagnosis and treatment

Diagnosis

Other conditions that resemble

ADHD Treatment

Medications

Psychological counseling

Working on relationships

More Information

From Mayo Clinic to your inbox

Lifestyle and home remedies

Alternative medicine

Coping and support

Preparing for your appointment

What you can do

What to expect from your doctor

Related

Associated Procedures

Products & Services

Where Can Adults with ADHD Find the Best Treatment?

ADHD in adults - treatment, symptoms, diagnosis

ADHD in adults - treatment, symptoms, diagnosis