Therapy for ADHD
ADHD at a Glance
For as long as you can remember, you’ve struggled to pay attention to tasks or you’ve found it difficult to sit still for extended periods of time. Perhaps you relate to both - you feel easily distracted and hyperactive. If paying attention is hard for you, you might notice that you get bored easily, switch tasks often, lose track of things, and have difficulty planning ahead. If you’re hyperactive, it may be difficult to relax, and it may feel like you’re driven by a motor.
Over the years, these symptoms have negatively impacted important areas of your life - your studies, your relationships, and your career have all suffered. Since these areas are regarded as markers of success, you may have developed painful, inaccurate, and unhelpful thoughts about yourself along with habits that exacerbate your symptoms. For example, you may have developed ideas that you’re lazy or incompetent, and you may avoid organizing and planning, believing yourself incapable of these activities. You want things to be different, but you’re not sure where to start.
Life, In Focus
Imagine waking in the morning knowing what you want to accomplish and feeling like your goals are attainable. As new tasks and projects arise, you have a system in place to organize them. You’ve learned to prioritize tasks and say no to some of them altogether. You’re able to focus on bigger picture goals. You no longer avoid tasks you once put off, and they feel easier to complete than you imagined. You don’t misplace things as often; you know where to find things when you need them. As much as you enjoy being more organized and productive, you're also able to slow down and relax. You feel calm, capable, and connected with yourself and others.
Reasons to Be Hopeful
ADHD is present in approximately 5% of children and 2.5% of adults. Patients who seek treatment in the form of medication, therapy, or a combination of the two typically improve.
Studies have shown that gains from cognitive behavioral therapy are maintained at 6 and 12 month follow up assessments. This makes sense given that CBT helps clients challenge maladaptive thoughts and behaviors that maintain symptoms of ADHD while also teaching practical skills that can be used well after therapy ends.
Drs. Casey and Christopher each have years of experience helping clients with ADHD. Clients often initiate treatment with concerns about depression, anxiety, or a substance use disorder. In fact, clients with ADHD have an increased risk for these and other mental health concerns. Drs. Casey and Christopher talk with clients about the pros and cons of addressing symptoms of ADHD prior to, in conjunction with, or following treatment for other mental health concerns.
Frequently Asked Questions
Isn’t everyone easily distracted or hyperactive sometimes? What makes ADHD a psychiatric disorder?
While symptoms of inattention, hyperactivity, and impulsivity impact everyone occasionally, a person with Attention Deficit Hyperactivity Disorder has experienced these symptoms since early childhood, and they are the norm rather than the exception. Because of their chronic nature, these symptoms manifest in a variety of settings and cause serious impairment in important areas of a person’s life.
How is ADHD diagnosed by a psychologist?
ADHD is most commonly diagnosed by conducting a thorough clinical interview with the patient based on criterion from the Diagnostic and Statistical Manual of Mental Disorders (DSM-V-TR) . During the clinical interview, not only do psychologists assess for ADHD, they assess for other mental health concerns that may mimic or otherwise account for symptoms of ADHD. For example, symptoms of impulsivity might indicate ADHD, bipolar disorder, or cyclothymic disorder. Meanwhile, difficulty sustaining attention may be more accurately attributable to a substance use disorder, major depressive disorder, or an anxiety disorder.
In addition to conducting a clinical interview, psychologists obtain collateral information from caregivers, parents, friends, and significant others as warranted. They might also review objective data from academic progress reports and/or performance evaluations from a person’s work setting. Psychologists gather this information because symptoms of ADHD need to have been present prior to age 12 and manifest in a variety of settings. Psychologists often use rating scales such as the Conners Adult ADHD Rating Scales to help gather and interpret collateral information.
Finally, psychologists can use objective measures to assess symptoms of ADHD. Examples include the Conners Continuous Performance Test, Third Edition (Conners CPT-3) and the Test of Variables of Attention-9 (TOVA-9). Objective measures of ADHD are often conducted alongside other forms of assessment such as the Wechsler Adult Intelligence Scale and the Personality Assessment Inventory to rule out other diagnostic considerations.
Is medication helpful for ADHD?
There are stimulant and non-stimulant FDA approved medications for the treatment of ADHD. Stimulants include Adderall, Vyvanse, Concerta, and Ritalin. Non-stimulants include Strattera and Intuniv. In lieu of these medications, a psychiatrist might prescribe certain antidepressants for the treatment of ADHD, Wellbutrin and Effexor being two examples. The patient and/or the provider may prefer an antidepressant medication if the patient has a comorbid depressive, anxiety, or substance use disorder. For individuals who respond well to medication, there is typically a 50% reduction in symptoms. Medication is often more effective when combined with behavioral treatments.
Is therapy helpful for ADHD?
Psychotherapy, cognitive-behavioral therapy in particular, has been researched and shown to be effective for the treatment of ADHD. Medications can relieve many symptoms of ADHD but they cannot help a person alter maladaptive thoughts, behaviors, and emotions that typically coincide with this diagnosis. Cognitive-behavioral therapy for the treatment of ADHD tends to be action-oriented and structured. Clients are often taught a series of skills that build upon one another. Skills might include: planning, organizing, problem solving strategies, reducing distractions, making changes to one’s environment, addressing procrastination, and learning to identify and challenge cognitive distortions that impede progress.