Living with Attention Deficit Hyperactivity Disorder

If you’re a parent of a child who’s recently been diagnosed with attention deficit hyperactivity disorder (ADHD), you may be devastated and overwhelmed. If you’re an adult who’s recently been diagnosed, you may be going through “various stages of grief” after learning that your “lifelong difficulties can now be explained by a medical condition,” said Terry Matlen, MSW, ACSW, licensed psychotherapist and founder of ADD Consults. Fortunately, ADHD is highly treatable and whether one is diagnosed at 30 or 80, “your quality of life will change for the better,” Matlen said.

But knowing what treatments are effective and how to find them can seem just as overwhelming as the diagnosis. Here’s a clear-cut look at managing ADHD, from evaluation to treatment.

Common Misconceptions

• ADHD is over-diagnosed. “It really depends on the community; ADHD can be over-diagnosed in some communities and under-diagnosed in others,” said Arthur L. Robin, Ph.D, licensed psychologist and chief of psychology at the Children’s Hospital of Michigan. For instance, ADHD may be under-diagnosed in an inner city where no one talks about it, but over-diagnosed in an affluent suburban area, where parents are more aware of ADHD and may think their child has the condition if he or she isn’t doing well in school.
• Inattention, distractibility, and impulsivity are character flaws. ADHD is a neurobiological disorder, and these “character flaws” are symptoms.
• You can will yourself out of ADHD. “The fact is, and research backs this, that the harder one tries, the worse the symptoms seem to get,” Matlen said.
• Children outgrow ADHD. “What people typically outgrow is the hyperactive part of ADHD. What remains is the inattentive and impulsive parts of the disorder which can cause impairments in academic, personal, and occupational arenas,” said Adelaide Robb, M.D., associate professor of psychiatry and pediatrics at the Children’s National Medical Center in Washington, DC.

Diagnosis

“The best antidote to under-diagnosis and over-diagnosis is an appropriate evaluation,” Robin said. Pediatricians, who are at the front line, don’t have the time necessary to conduct a comprehensive evaluation, so they may jump to conclusions and prescribe medication, he said. To avoid this, ask your pediatrician to help you find a mental health professional. Also, note that ADHD symptoms must occur across settings, including at school and home. Adults can ask their primary care physicians for a referral.

According to Robin, an appropriate evaluation entails: systematically reviewing ADHD symptoms from the DSM-IV with parents; getting input from teachers, who complete standardized rating scales; conducting a thorough interview with parents and children; and ruling out alternative explanations. To rule out learning disabilities or low cognitive ability, the practitioner administers an IQ and achievement test.

More about ADHD diagnosis in adults.

Steps to Successful Treatment

1. “Be thankful. ADHD is a condition that can be managed effectively when it is recognized and understood,” said Peter Jaksa, clinical psychologist and director of ADHD Centers in Chicago.
2. Educate yourself about ADHD. Whether it’s you or your child, become an authority on ADHD. Read online resources (e.g., LifeHelper, Attention Deficit Disorder Association, Children and Adults with Attention Deficit/Hyperactivity Disorder); attend conferences ; and seek support groups. For parents, learn about how ADHD affects your child “in school, socially, and at home”; what parenting techniques work for kids with ADHD; and your child’s educational rights, Matlen said. For adults, understand your ADHD brain by cataloguing how ADHD impacts your daily functioning, Robin said. For some, the biggest impact is on organization, ability to follow through, short-term memory, and attention to details, he said. Does ADHD interfere with work, intimate relationships, or parenting your kids?
3. Talk to professionals about treatment options. Choose professionals who regularly see people with ADHD. Look at your treatment options as “tools in a tool chest to be used as needed across your life,” Robin said. These tools typically include medication, cognitive-behavioral therapy (CBT) and organizational strategies—an effective combination for treating ADHD.
4. Become an advocate. “Parents are the most important and strongest advocates” for their kids, Jaksa said. Help kids “understand that they aren’t ‘dumb’—that their brains are simply wired differently,” Matlen said. “Meet with your child’s teachers before school starts to inform them about your child’s history and “discuss strategies that would be helpful for your child,” Jaksa said. If your child doesn’t have an Individualized Education Plan (IEP), talk to the principal and school psychologist about doing the evaluation, he said. Don’t be afraid to ask how therapy is going, Robin said. If it doesn’t seem successful, seek another therapist.

At work, Sandy Maynard, M.S., an ADHD coach who operates Catalyst Coaching, advises against disclosing your diagnosis. Instead, identify “what you need to perform better” and ask for it, she said. A boss will rarely refuse a reasonable accommodation.

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