Everyone, at times, has difficulty sitting still, paying attention and controlling impulsive behavior. For some, however, these problems are so pervasive and persistent that they interfere with their ability to function at home, at school/work and with friends. Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder affecting 11 percent of school-age children. Symptoms continue into adulthood in more than three-quarters of cases. Read on regarding symptoms, behaviors, co-occuring disorders, and strategies and tools for managing symptoms and seeking resources.
Symptoms and Behaviors
While anecdotal reports about focus and attention difficulties due to the ongoing pandemic are very real and rising, quarantine is not “giving you” ADHD. Other things that cannot give you ADHD: studying for the LSAT; ending a relationship; your children; your phone; watching tv; work in general; stress. Some of these are certainly major life events and in no way should be minimized. However, nothing can “give you” ADHD. As a neurodevelopment disorder, ADHD is something you’re born with. It’s just how the brain works. All the events mentioned above would certainly exacerbate ADHD symptoms, particularly untreated ADHD, but they are not causing you to suddenly develop ADHD. Think of ADHD as the umbrella term (ADD is no longer used). Under that umbrella are three types of ADHD: Inattentive; Hyperactive/impulsive; Combined.
Symptoms include:
(6 or more symptoms must be present in each category for diagnosis)
Inattentive: difficulty paying attention; makes careless mistakes; difficulty listening; difficulty following directions; difficulty organizing; avoids/dislikes tasks that require sustained concentration; often loses things; easily distracted; forgetful
Hyperactive/impulsive: fidgets with hands or feet; difficulty remaining seated; feeling restless; difficulty remaining quiet; “on the go”; talks excessively; blurts out answers; difficulty waiting for a turn; often interrupts or intrudes on others
Combined: if both criteria for above categories are met
Diagnosis
For an accurate ADHD diagnosis, comprehensive testing must be done. Testing for ADHD is a series of different tests, not just one ADHD test. Essentially what’s happening during testing is, we’re ruling out the possibility for other disorders. We want to know if the attention and/or focus issues are a result of ADHD rather than a product of depression, anxiety (in both adults and children) or Oppositional Defiant Disorder (ODD) (in children). Often there will be co-occuring disorders, meaning both ADHD and another disorder (anxiety, depression, OCD) will be indicated and therefore treatment of both would be suggested. Throughout my years of clinical practice many adults would seek treatment concerned that they had suddenly developed ADHD when in fact what they were dealing with was anxiety. Anxiety is often mistaken as ADHD because it can have such a profound impact on our ability to focus. ADHD is quickly taken out of the equation should an adult patient report that symptoms are recent rather than historical. Testing should be done by an experienced psychologist who will administer the various tests (ranging from 3-5 hours), review the results and write the report. If you have ADHD concerns regarding your child, start by speaking to their pediatrician or school. Both should be able to provide referrals. Diagnosis should be taken seriously and though the testing process can take time, it is important to get a full clinical picture of what’s happening and to develop a treatment plan.
Treatment
Medication is strongly indicated for ADHD treatment. Remember, ADHD is not a commentary on will power or intellectual ability, it is neurodevelopment, it’s just the way the brain is wired. There is a wide range of medication available these days and a skilled psychiatrist will help you and your family find the right fit. Therapy can be helpful for processing thoughts and feelings around the diagnosis and coming to terms with the treatment plan. Individuals and families often feel overwhelmed by the thought of “taking medication forever.” Therapy is also very helpful for dealing with byproducts of ADHD such as relationship issues, anxiety, helplessness, powerlessness, uncertainty and disappointment.
Tricks & Tools
In addition to medication, knowing what works for you can be extremely helpful. ADHD groups are available and provide support around diagnosis as well as tools to help with organization, focus and time management. Some tools include:
Time Management:
Schedule time for distracting habits, don’t deprive yourself.
Break down to-do’s into small components. Steps belong on to-do’s NOT entire projects.
Schedule tasks in small increments (10-15 minutes) and then take breaks between.
Structure:
Set aside time to review your calendar (5 minutes before you start work)
Use visuals to get a sense of your day (color coded calendars, schedules, to-do lists)
Mindfulness:
Do one thing at a time. Multitasking does not work.
Increase Attention/Motivation.
Listen to music with no lyrics and that does not end but loops around.
Create accountability via a friend/family member.
Set a goal to do something for 15 minutes. Research shows that we tend to keep going once we hit the 15 minute mark.
Start to-do lists by completing the easiest, shortest task.
I am a Licensed Clinical Social Worker (LCSW) at a group practice in Beverly Hills and maintain a private practice in the Los Feliz/Silver Lake area. I provide individual, couples and group psychotherapy to both teens and adults. My practice approaches include, but are not limited to, CBT, EMDR, psychodynamic and mindfulness therapy. I started my career at psychiatric hospital working on both the inpatient units as well as developing and running the hospital’s long-term outpatient Partial Program. I then spent five years at Kaiser Permanente’s LA Medical Center providing individual and group psychotherapy in their outpatient psychiatry department. Women’s health, in particular perinatal health, has always been a passion of mine. While at Kaiser I started their Post Partum Depression/Anxiety Group. As an alum of the Kaiser MSW Training Program, I was excited to join the training team as a clinical educator when I returned as an LCSW. I love collaborating with my patients as they identify patterns, achieve their goals, cope with change and improve their well-being.