Treating ADD and ADHD
Attention deficit disorder, with or without hyperactivity, affects more than our ability to concentrate in school. Lacking focus results in decreased motivation, interest, energy and self-esteem. Our lives feel disorganized, without meaning, coherence and contentment. When we ʻspace outʼ and are not fully present, our schoolmates, family, friends and co-workers all experience us as not really caring about them. We care but just canʼt sustain our focus. We then may react by withdrawing, feeling depressed, ashamed, angry or just plain lost.
Typical symptoms include inability to sustain concentration, being easily distracted, and misplacing personal objects like our keys, wallet or purse. Students report they are unable to both take good notes and carefully listen to lectures at the same time. What often makes people believe they canʼt possibly have AD(H)D is that when they are reallyinterested in something, they can be highly focused. But as in all psychiatric conditions, we only sometimes are symptomatic. Another confusing factor for patients is that ADHD usually co-occurs if patients have an underlying mood disorder. When this happens, treatment with a stimulant causes a worsening of symptoms, particularly increased anger or even mania. For these patients, initiating treatment with a mood stabilizer like lithium or depakote than allows stimulant medications to work.
Hyperactivity makes us feel like we sometimes have a motor driving us. We may feel ʻwiredʼ and easily get irritated. Kids often have ʻmeltdownsʼ. Rapid pressured speech and talking out of turn are common. We start 10 projects, but donʼt finish one. Itʼs hard to relax and feel calm. We sometimes act impulsively and then wonder why in the world we did something so dumb!
Treatment for either ADD or ADHD utilizes once daily stimulant medications like Adderall-XR, Concerta or Vyvanse. Sometimes non-stimulants like Strattera or Intuniv are effective. I often see both children and adults completely start turning their lives around after just a single dose of a stimulant. It is counter-intuitive and paradoxical that amphetamines calm patients, but I see amazing transformation when I treat ADHD. Patients then report that ʻthe weight of the world is off my shoulders. Why didnʼt I do this
years ago. That is why early treatment in very young children is so effective.