Table of Contents
- What is Adult ADHD?
- Why have rates of ADHD increased?
- Why do we treat ADHD?
- How is ADHD diagnosed in adults?
- How is ADHD treated in adults?
- Tips for finding a mental health professional who can treat Adult ADHD
- How Integrative Psych treats Adults with ADHD
- Frequently Asked Questions
What is Adult ADHD?
Adult ADHD (attention deficit hyperactivity disorder) is a normal variant in how one’s brain is organized. It is a common condition, and at its core, presents as difficulty maintaining focus and managing one’s impulses. ADHD usually begins during childhood; however, many people are not diagnosed until adulthood. For most people, ADHD is a lifelong condition.
ADHD is highly heritable and ADHD brains are different from non-ADHD brains. While brain scans show differences between ADHD and non-ADHD brains, ADHD is diagnosed by well-trained experienced experts.
Note: ADHD was historically referred to as attention deficit disorder (ADD) with and without hyperactivity.
Things that people with ADHD say and do:
“I tend to fidget or get up from my seat in situations when others can remain still”
“I depend on others to keep track of details and keep my life in order”
“Even when I have time to myself, I find it hard to unwind and relax”
Types of ADHD:
Patients with ADHD struggle with one or both types of symptoms, inattentive and hyperactive.
Officially, ADHD is divided into inattentive type (formerly ADD, attention deficit disorder), hyperactive type, and combined type. However, in reality, most individuals with ADHD move between different subgroups throughout their life.
ADHD Inattentive Type
A person with ADHD may struggle with inattention and make careless mistakes. They may have difficulty following instructions, get easily distracted and sidetracked, and be disorganized. Additionally, they may struggle with time management, have a tendency to daydream, and easily misplace important belongings.
ADHD Hyperactive Type
Someone with ADHD may also have hyperactivity, which may involve frequently fidgeting, interrupting others in conversations, talking excessively, or being impatient. As people with ADHD get older, related issues may arise that affect self-esteem, trouble with controlling anger and problems in relationships. Such individuals frequently struggle with depression and anxiety, as well. People with ADHD may also be at greater risk of abusing substances.
Regardless of type, symptoms of ADHD in adults are pervasive and have effects at work or school, at home and in social relationships. In some ways, ADHD may be even more destructive for adults as the stakes may be much higher - a lost job, a damaged relationship, or injury in a car accident.
“I always felt like I had to work harder than others to do as well. Getting my diagnosis helped me realize how to overcome my ADHD. Treatment opened my eyes to what I could really do with my life.”
Why have rates of ADHD increased?
The rates of ADHD have nearly doubled since the late 1990s.
Structurally, as our society continues to expect greater amounts of organization, time management, and focus, both in school and work environments, individuals who historically had a less severe form of ADHD (and may not have received a diagnosis) are now being diagnosed in this higher expectation environment.
Additionally, there is less stigma associated with ADHD now than in the past, which may lead to more individuals and professionals being comfortable with seeking and providing treatment for ADHD.
Still, environmental factors that are associated with ADHD should not be discounted. For example, poor nutrition, blue light-emitting devices, sleep deprivation, maternal smoking or drinking during pregnancy, and environmental chemicals, are all more recent factors.
These factors are particularly relevant in a fast-paced lifestyle in a major metro area such as New York City (NYC). With so much happening around us, it is quite easy to get side-tracked—while our jobs still require the best of ourselves. In such an environment, having untreated ADHD can be highly debilitating towards occupational and social success.
“School wasn't that hard for me. I was always smart. But I would lose interest in things easily. I assumed I didn't have ADHD. After getting diagnosed and treated–I realized how to overcome limits I didn't know that I had. I now run a growing venture capital start up”
Why do we treat ADHD?
Adult ADHD has many advantages. ADHD brains are well-documented as using creative ‘outside the box’ thinking and being able to channel their passions to hyper-focus. Unfortunately, untreated ADHD brains are at a high risk for social, educational, career, and mental health challenges (link to more specific article on untreated ADHD and negative outcomes)
Untreated ADHD increases the risk for:
- Addiction and addictive behaviors
- High risk behaviors (unsafe sex, car accidents, speeding tickets, accidental death).
- Relationship problems (more likely to get divorced and increased conflict with friends)
- Reduced education achievement (Not doing as well in school and not going as far in their schooling)
- Poor work performance and being fired from your job or quitting jobs
Treating ADHD can reduce the risks of all of the above while maintaining creativity and hyper-focus.
“When I was in my teens and early 20s, I would tailgate and speed often. I drove safer after I started ADHD treatment.”
How is ADHD diagnosed in adults?
ADHD should be diagnosed comprehensively holistically: there is no single medical, physical, or genetic test that can completely diagnose ADHD. A careful examination of childhood history and adult development, while examining other day-to-day symptoms, is necessary for a mental health professional to determine whether or not an individual has ADHD.
Certain scientifically validated ADHD screening tools, such as the ASRS-5 (which stands for the Adult ADHD Self-Report Screening Scale for DSM-5) can assist the therapist in evaluating ADHD symptoms. Such a screening tool will determine the range and frequency of symptoms.
Additionally, information from people who know the individual well, such as family members or significant others, can assist in the diagnosis process by providing relevant information.
How is ADHD treated in adults?
Adult ADHD treatment consists of three components, often done together:
Adults with ADHD often struggle with poor self-esteem and negative self-talk as a result of struggling with ADHD for a lifetime. Process-based talk therapy is often necessary to improve self-perception and confidence. For example, people with ADHD may have thoughts like “I always keep messing up” or “it has to be perfect or it’s no good”, which can be overcome with psychotherapy.
Medication is also a highly effective therapy for adult ADHD. Scientific studies have shown that when on the right medication and dose, nearly 9 out of 10 people with ADHD will have the majority of all of their symptoms disappear. Using medications to complement therapy improves the lives of people with ADHD and moves them further than medication alone.
- Organizational coaching and executive function skills
ADHD coaches use a combination of relationship building, encouragement, and cognitive behavioral techniques to improve many of the residual symptoms of ADHD. Specifically, meeting regularly with a coach can improve time management, planning skills, and interpersonal relationships. For example, someone who is constantly late, disorganized, and losing things will benefit from an ADHD coach. ADHD coaching allows you to build the skills you need in our busy hyper-organized lives.
Non-Medication Tips and Techniques for ADHD Folks
1. Organize yourself with to-do-lists
First, you can make a to-do list and prioritize tasks. It's also important to accurately estimate how long each task will take and break them down into smaller, more manageable steps. This can help prevent feeling overwhelmed and make it easier to stay focused and on track.
2. Commit to small, attainable tasks
If you're feeling overwhelmed with tasks, it can be helpful to commit to just one or two small, attainable tasks. It's important to set the bar low, so that you can lower the initial activation energy required to get started. Once you start a task, it becomes easier to keep moving forward with it. By breaking larger tasks into smaller, more manageable ones, you can reduce stress and feel more productive overall.
3. Take breaks
It's important to take frequent breaks to avoid feeling overwhelmed or burnt out. Research shows that people with ADHD have an upper limit of concentration of around 30 minutes, so taking breaks is necessary to maintain productivity. Make sure to get up from your seat and do something during your breaks—such as going for a quick walk or engaging in physical activity to increase dopamine levels (which is important, since ADHD folk have lower dopamine than everyone else!). This can help you feel refreshed and more focused when you return to your task.
4. Rely on others for help
Sometimes, if available, lean on friends/family who are good at tasks to help organize you. This can also take the form of an ADHD or executive functioning coach!
Tips for finding a mental health professional who can treat Adult ADHD
ADHD is a complex condition that generally appears in early childhood and can affect individuals throughout their lifetime, if untreated.
Given that complete ADHD treatment usually requires psychotherapy, coaching and nuanced medication plans—ADHD usually requires treatment from a specialist.
Tip #1: Adult ADHD was not recognized as a condition until the past decade and until recently was not taught to most mental health practitioners. Therefore, a good starting point in finding your expert is individuals with recent training—who are more likely to have a stronger expertise in ADHD.
Tip #2: Only some professionals, including psychiatrists (medical doctors with an MD or DO degree), psychiatric nurse practitioners, and some psychologists, are experts in ADHD. A professional or practice who can provide you with comprehensive treatment, including psychotherapy, medication, and coaching, is ideal as splitting up between practices reduces cooperation among your treatment team.
If you are unable to find an expert in ADHD, your primary care provider or neurologist may also be able to provide some treatment; usually primarily medication. However, they are unlikely to be able to provide coaching, nor may they feel comfortable providing all the different medications that may be helpful in treating ADHD.
Tip #3: Another tip is to find a mental health professional who has a background in child psychiatry (even if you are an adult looking for treatment). Child psychiatrists are the sub-specialists in medicine who originally described the diagnoses of ADHD and have led the fight in improving the lives of those with ADHD. Additionally, since ADHD typically begins during childhood, a mental health provider with a child psychiatry background will be able to better assess your current ADHD symptoms in the context of your childhood.
How do I locate an Adult ADHD professional?
Finding a specialist in your area that can treat adult ADHD may not be easy.
- We recommend using google to look for small private practices that discuss the specialty in ADHD.
Other resources are available, including provider search websites such as Zocdoc or Zencare, and Psychology Today—looking for people who mention ADHD in their profiles. Finally, Google Maps can be useful to search for providers in your area.
- When looking at different potential experts in ADHD, you may wish to narrow your search to people who have a similar identity (gender, race/ethnicity, religion) to you as studies show patients feel best with people who they have commonality with.
What questions do I ask to determine if a provider is an expert in ADHD?
- How many patients with ADHD do you currently treat?
- Do you (or does your doctor or your practice) like treating ADHD?
- What do you know about different types of ADHD treatments?
- Have you received any special training in diagnosing and treating adult ADHD?
- What is the assessment process like? Are there written tests or interviews? Psychological testing? Is family history assessed?
- What is your approach to treatment? Psychotherapy? Medication? Coaching?
How Integrative Psych treats adult ADHD
Integrative Psych is an NYC-based private practice specializing in the treatment of Adult ADHD and related conditions. Many of our clients are based in Brooklyn, Queens, Manhattan (Chelsea, Village, Lower East Side, Upper East Side, Upper West Side, Tribeca, SoHo), Westchester, and New Jersey, Connecticut, and Florida.
Our experts have extensive training and experience in the treatment of ADHD, coaching, therapy, and medication. For example, Dr. Ryan Sultan and Dr. Justin Mohatt have published numerous articles in the field, are sought after speakers, and are regularly featured on the news and in magazines discussing ADHD. Many of our clinical staff have ADHD and believe in the same treatments that gave them success.
Integrative Psych takes a compassionate, comprehensive and holistic approach to the diagnosis and treatment of ADHD. We will carefully explore your childhood history and adult development, examining for other conditions or factors that could be causing your symptoms.
Further, we will evaluate how your symptoms affect your day-to-day life, including work and relationships. When making recommendations, treatment may involve tailored medication and likely include a blend of therapy including cognitive-behavioral therapy, or coaching, depending on what works best for you.
Decisions about what treatment or treatments to pursue are made as a team, between you and your clinician. Once you have begun care with us, we will see you regularly to monitor your progress and make any adjustments necessary to ensure that you benefit fully from your treatment at Integrative Psych.
If you’re interested in working with us, book an appointment here.
At Integrative Psych, we are your premier destination for integrative and evidence-based therapy in New York City. Our team of experienced and compassionate therapists specializes in a wide range of mental health services, tailored to meet your unique needs. Whether you are seeking assistance with psychodynamic therapy nyc, bipolar disorder nyc, high-functioning anxiety nyc, complex PTSD nyc, or any other mental health concerns, we are here to support you on your healing journey.
We offer specialized therapies such as light therapy nyc, anger management therapy nyc and OCD therapy in NYC. Our dedicated therapists work collaboratively with you to tailor treatment plans that suit your specific needs and goals. Additionally, we have ADHD doctors who provide comprehensive assessments and evidence-based interventions for individuals with ADHD, helping them manage their symptoms and improve their daily functioning.
Frequently Asked Questions
How quickly do you notice a difference after treatment with medications?
Patients who begin stimulant treatment for ADHD frequently notice benefits soon after starting the medication. Other medications, such as Strattera or Qelbree, may take several weeks before they become fully effective.
What percentage of people improve with ADHD treatment?
On average, 80-90% of patients improve from ADHD treatment. The success rate is higher for combined treatment than single treatment alone.
Can I treat my ADHD without medication?
The short answer is, maybe. The long answer is, you probably will want to take medication.
There are many effective non-medication treatments for managing the symptoms of ADHD. However, supplementation with medication, even at low doses, drastically improves functionality and skill building, and reduces ADHD symptoms.
Do I need to be on treatment for ADHD forever?
ADHD, for most people, is a lifelong condition. As the brain matures, many of the symptoms of ADHD improve. Further, treatment becomes less important and necessary as adult lives tend to be more settled, structured, and consistent.
Will I become dependent on my ADHD medication?
ADHD medications are potentially addictive, but only at extremely high quantities. There is no evidence for addiction when using ADHD medications at a dose prescribed by a practitioner. Rather, the right medication dose actually reduces the likelihood of other substance use disorders, such as alcohol or cannabis.
“I was referred to Dr. Sultan and Jenn Ray by a friend of mine who had been treated by them. I didn't think I would ever be able to manage my ADHD…With the treatment of my ADHD and a combination of CBT, my self esteem has improved as well as my organization, productivity skills and interpersonal relationships. Thank you Jenn and Integrative Psych.”
“I left [ADHD] untreated when I went to college and managed to get by, however I’ve found that it’s affecting my professional life…I’m falling behind on my work and not meeting my deadlines…[At Integrative Psych], I’m on a medication that is treating my symptoms without any side effects and am attending a monthly therapy session. So far I’m happy with the results!”
“My biggest challenge is that I can't get things done. I'm falling behind in my work and feel overwhelmed by everything that I have to do. It's not that I procrastinate, it's just that I start a lot of things but have trouble finishing them. I did an assessment with Dr Sultan and discovered that I have ADHD. I've started a combination of medication and therapy, which is helping me focus and manage my stress. I'm starting to get through things a lot quicker now, it's been very helpful.”
- Completing school assignments on time and feeling prepared for exams because you’ve studied without cramming
- Excelling in your career and getting promotions because you’ve been able to manage your workload with ease
- No longer feeling like you are at the mercy of the constant distractions surrounding you
- Having the support of an ADHD expert who can develop a customized treatment approach