ADHD diagnosis 

1. Inattentive type

2. Hyperactive type

3. Combined type

ADD is considered an outdated term and the diagnostic manual we use, known as the DSM-5 refers to this condition as ADHD, which is then differentiated into types.  Depending upons the symptoms presented some will have ADHD, Inattentive type, while others are diagnosed with ADHD, Combined type. ADHD, Hyperactive type is a diagnosis seen mostly in children, as adults typically outgrow many of the symptoms of hyperactivity.

Diagnosis of ADD or ADHD is made when reported symptoms have been occurring for longer than 6 months and are found to cause significant distress. DSM-5 (Diagnostic Statistical Manual) has criteria for diagnosing ADD/ADHD, which are a set of guidelines all psychiatric providers follow for establishing this diagnosis. An individual with ADHD must have 5 out of 9 symptoms of inattention and or hyperactivity to meet criteria  for the diagnosis. Some symptoms must have been present in childhood or prior to age 12.  Another important criteria is that symptoms are reported to be causing distress in 2 areas of function, such as in relationships and work, or relationships and school or work and school. 

Adults with ADHD

In adults with ADHD hyperactivity looks differently than in kids.  They  tend to feel fidgety, they are often seen tapping their feet or hands.  They report an internal feeling of hyperarousal which is not being able to relax, constant tension and difficulties with turning off the mind and body prior to sleep.  Racing thoughts are commonly reported. Thoughts and emotions are more intense in the ADHD population.

Inattention

Inattention in ADHD can be explained as attention being paid to many things at once and one cannot select where to focus his or her attention.  ADHD can also be seen as an intention disorder.  You know what needs to be done, but are frozen with procrastination and simply don't do what needs to be done.  It is often talked about as a disorder of performance. 

Impulsivity

Impulsivity in ADHD manifests as hasty decision making, acting without thinking, reward seeking and inability to delay gratification. It can be seen as interrupting others excessively, or not being able to wait your turn to speak.

Learning

ADHD is not a learning disability and in many cases individuals graduate from high school and college, but often suffer greatly as they take much longer to complete their programs. They are often frustrated with their workload, feel disorganized and impatient.

Self-Esteem

Low self-esteem is developed due to repetitive failure to complete projects, harsh internal dialogue and criticism from others. Many experience guilt and shame. Many experience anxiety, irritability and mood swings.

Medication Management

Stimulant medication ( Adderall, Ritalin, Concerta, Vyvanse, Focalin, Modafinil)  and non-stimulants like Wellbutrin and Strattera are the first line treatment for ADHD. ADHD is a neurodevelopmental disorder with potentially low levels of Dopamine & Norepinephrine.  While the condition is more complicated than neurotransmission alone, it has been the experience of most patients with ADHD that their symptoms dramatically improve when they begin to take stimulant medication. Stimulant and non-stimulant medication does require fine-tuning and adjustment, so it is important to see an experienced psychiatric provider to help you manage this medication.  Often patients with ADHD will find advice about medication on the web or on Reddit and will bring up questions and areas of concern.  Talking to your psychiatrist or psychiatric nurse practioner about these concerns is much safer than relying on Reddit, Facebook, or other forms of internet information channels.

ADHD Coaching

ADHD coaching is a type of counseling which focuses on symptoms of impairment in  ADHD: planning, time management, organization, problem solving and goal setting. An ADHD coach can help you set academic and vocational goals and address emotional, and interpersonal life difficulties. A coach will partner with you to develop practical life skills and begin to make changes in your daily life.  Coaches provide support, encouragement and feedback.  Most importantly a coach will hold you accountable to follow through on the goal you set. You will meet regularly and check in. If you are interested in setting up an appointment for ADHD coaching, let your psychiatric provider know and we will arrange a referral. Focused Mind Psychiatry has licensed and experienced ADHD therapists who can provide valuable counseling to help you manage your symptoms.

Nutrition & Lifestyle

ADHD can be easier to manage when your diet is free from additives and preservatives.  There are certain food dyes that have been implicated to result in increased symptoms, but the research is not definitive.  Fish oil supplements have a few studies showing a small effect in improving ADHD symptoms, but this benefit from fish oil supplementation is relatively modest compared to treatment with FDA approved medication such as stimulants ( Adderall, Ritalin). Another important tool is exercise! The brain releases chemicals called neurotransmitters during exercise, including dopamine, which helps with attention and thought processing. It is a theory that people with ADHD often have less dopamine than those without ADHD.  The stimulant medicine works by increasing the availability of dopamine in the brain. That is why exercise is highly recommended as an alternative treatment option.

"Having ADHD, and taking medicine for it is nothing to be ashamed of nothing that I'm afraid to let people know." — Simone Biles