This is not intended as medical advice. Please see a doctor if you think you have ADHD
You’re a twenty-something in college (perhaps older, perhaps younger), you want to get good grades and succeed, but it’s a struggle. Growing up you were always told you were a bright, gifted child ー that changed. You saw your friends succeeding, and it didn’t make sense. “What am I doing wrong?” They weren’t any smarter than you were. You’d ask yourself: “Am I lazy? Am I unmotivated?” You have goals, you have dreams, you have hobbies you enjoy. But you just… can’t… You enjoy your classes, and yet your grades are slipping. You became depressed and even less motivated. Luckily, you stumbled across a blog by some gentleman talking about ADHD, and he may as well have read your life story. It all makes sense. You’re not lazy, you’re not unmotivated, you have ADHD.
You want to get better. No more entering a room and wondering why you walked in. No more playing on your phone for hours when you should be getting ready for bed. Now is the time for action. But how do you begin? What do you do? That depends on what you are looking for in terms of treatment. What follows are three routes of treatment I’ve observed taken by friends of mine who have been diagnosed with ADHD, as well as by patients from my time working in a hospital.
DIY route: This is arguably the most difficult of the options and revolves around learning new behaviors and skills to combat ADHD without the help of a professional. Habits and behaviors that have been shown to improve ADHD include: exercise1, meditation2, getting a full nights rest3 and dietary modifications4.
Medication route: Step one is to set up an appointment with your General Practitioner. Tell them what’s going on. Tell them about how you think you may have ADHD, what symptoms and struggles you have. The most important note here is to be honest, don’t underplay or overplay your symptoms. At that point, some GPs may feel comfortable or knowledgeable enough to prescribe you medication right there. However, most GPs will give you a referral to a psychiatrist.
When you go see your psychiatrist, you are going to have a similar interview. You tell them what symptoms you have, how it affects your life, etc. They are asking these questions to see if it is indeed ADHD you have, and not something like anxiety that can mimic the symptoms of ADHD. After the interview, some psychiatrists will prescribe you medication, but other psychiatrists may ask you to have some blood work done, as well as some tests for ADHD. The blood work is to rule out other medical issues that can be causing ADHD-like symptoms, such as thyroid dysfunction. The ADHD tests administered vary: some of them involve sustaining attention and clicking responses; others are more comprehensive, including puzzles and word games designed to measure your response time and attention capacity. If the psychiatrist deems the test results consistent with ADHD, they will prescribe medication and schedule a follow-up date. Some doctors prefer to start with a non-stimulant medication like Strattera or Wellbutrin because they are less likely to be abused. Other doctors will go straight to stimulant medication like Ritalin or Adderall. In the latter case, they may ask you to take an EKG (a heart test) beforehand; while stimulant medications are safe at therapeutic doses, they may be harmful for people with underlying heart issues. Regardless of what medication your doctor prescribes, the main thing to do is follow their instructions. Take the medication as instructed, and if you have any serious side effects, make sure you call your doctor. Be impartial, try the medication in good faith to see if it is a good fit. Just because someone you know has had a good experience with a medication, that does not mean you will – everyone’s body is different. When you first start taking it, keep note of any benefits and side effects you have, and monitor if they improve or worsen as you keep taking them. When you follow up with your doctor, be sure to tell them how you feel about the medication, and depending on that, they may adjust your dosage or change your medication altogether.
Behavioral therapy route: This one is much more straightforward. Do some research online (psychologytoday.com has a good tool for finding therapists) and find a therapist that specializes in behavioral therapy and or ADHD and schedule an appointment. Your therapy will be focused around teaching you new behaviors to combat ADHD, as well as unlearning the old behaviors that contribute to or worsen ADHD5. The therapy will vary based on your specific needs and what you struggle with. How long you go to therapy is up to you. If after a couple weeks or months you feel as if you’ve learned some new behaviors to help you manage your ADHD, then you can choose to stop. If, however, you feel as if there’s more to learn, and that you are indeed getting something out of the sessions, then feel free to continue. The biggest downside here is that some insurances may not be as willing to cover the therapy route as they are to cover the medication route.
With all that in mind, I wish you good luck on your journey! I hope that with therapy and or medication you can learn to live with ADHD and improve your abilities and capacity to function. Good luck!
References
1. Christiansen, L., Beck, M. M., Bilenberg, N., Wienecke, J., Astrup, A., & Lundbye-Jensen, J. (2019). Effects of Exercise on Cognitive Performance in Children and Adolescents with ADHD: Potential Mechanisms and Evidence-based Recommendations. Journal of Clinical Medicine,8(6), 841. https://doi.org/10.3390/jcm8060841
2. Modesto-Lowe, V. (2015). Does mindfulness meditation improve attention in attention deficit hyperactivity disorder? World Journal of Psychiatry,5(4), 397. https://doi.org/10.5498/wjp.v5.i4.397
3. Um, Y. H., Hong, S.-C., & Jeong, J.-H. (2017). Sleep Problems as Predictors in Attention- Deficit Hyperactivity Disorder: Causal Mechanisms, Consequences and Treatment. Clinical Psychopharmacology and Neuroscience,15(1), 9–18. https://doi.org/10.9758/cpn.2017.15.1.9
4. Kiliaan, A., & Königs, A. (2016). Critical appraisal of omega-3 fatty acids in attention-deficit/ hyperactivity disorder treatment. Neuropsychiatric Disease and Treatment, Volume 12, 1869–1882. https://doi.org/10.2147/ndt.s68652
5. Evans, S. W., Owens, J. S., & Bunford, N. (2013). Evidence-Based Psychosocial Treatments for Children and Adolescents with Attention-Deficit/Hyperactivity Disorder. Journal of Clinical Child & Adolescent Psychology, 43(4), 527–551. https://doi.org/10.1080/15374416.2013.850700
