1. How can medication help me manage my ADHD?
One of the first steps in treating your ADHD is knowing both your objectives in seeking treatment and which treatment will meet those objectives.
Unfortunately, there is often a lot of confusion around how medication can help treat ADHD.
In short, while the medication is active in your system it may help minimize the impact of your ADHD symptoms, even though the symptoms remain. Specifically, it can help you attend better and control your impulsivity, which in turn can help you follow through on your intentions.
As Dr. Thomas Brown, author of Attention Deficit Disorder: The Unfocused Mind in Children and Adults, explains:
“…increased dopamine in the synapse can act almost as a kind of ‘Viagra’ to encourage the brain’s response to the task. Thus [stimulants] may counter the chronic problem with motivating oneself to do necessary, but not intrinsically interesting tasks.”
2. What is the best medication for treating my ADHD?
Ultimately this question can only be answered in collaboration with your prescriber. But, as Dr. Russell Barkley notes,
“…among the treatment that results in the greatest degree of improvement in the symptoms of the disorder, research overwhelmingly supports the use of stimulant medication for the disorder.”
The main benefit is that, by providing adequate amounts of the necessary neurotransmitters, particularly dopamine and norepinephrine, it serves to correct a biochemical condition in the brain that interferes with attention and impulse control.
At the same time, we know stimulants do not work for 20 % -30% of Adults with ADHD. And, in addition, you may not be able to take stimulants because of other mental health or physical conditions.
So, the bottom line is you need to make sure you work closely with a prescriber, who has expertise in ADHD medication, to find the right medication.
3. What if I tried medication and it did not “make things better?”
In my conversations with clients who ask this question we often uncover that, while they know there are limits to medication, they were, well, hoping for more.
If you were also hoping your medication would do more, it is important to remember how it can help you. In addition, so you can see whether there are improvements in these areas — attention and impulse control — and know whether your medication is working or not, it is essential to use a tracking log.
Also, it is necessary to remember the limits of medication — what it can not do for you. For example, most adults with ADHD have deficits in certain skill areas having to do with executive functioning, such as planning, organizing and decision-making. As the saying goes, “pills can’t treat skills.”
But, while medication won’t teach you these skills, you may be better able to follow through in using the new skills and strategies you learn when you take medication to treat your ADHD.
4. Is medication the best way to treat my ADHD?
Though medication can form the cornerstone of an effective treatment plan, it actually may not be very effective in managing your ADHD, if it is the only intervention.
Think of the two examples below:
- The correct medication should be able to help you attend better. But, if you have difficulty making decisions about what is essential to do and then creating a plan to execute, you still won’t know where to focus your attention. You need to learn these skills.
- And, if you are not sleeping or eating well, medication can’t make up for this. You still need proper nutrition and enough sleep.
You get it. Medication is usually most effective when it is part of a holistic treatment plan that may include:
- proper nutrition
- enough sleep
- ADHD Coaching
- a mindfulness practice
- other forms of treatment
Whether you decide to take medication or not, you will need to incorporate other forms of treatment to effectively manage your ADHD.
5. But what if I don’t trust I really have ADHD? Maybe I shouldn’t be taking medication.
I have had clients ask me this question even after working together for months. They wonder, “What if I don’t have ADHD?”
If you have not yet received a diagnosis from a psychologist, psychiatrist or psychiatric nurse practitioner, I would suggest going back one step before considering taking ADHD medication. The aforementioned professionals are trained in the field and are the most qualified to make a diagnosis.
The advantage of seeing a psychiatrist or psychiatric nurse practitioner for evaluation is that they can also prescribe medication if a need is indicated by the evaluation.
I know some of you may be tempted to consult with your family doctor, as the process can seem easier and quicker. And some family doctors may be willing to diagnose and prescribe medication for mental health issues.
But I strongly caution against seeing your family doctor for advice or evaluation for any suspected mental health issue, including ADHD, as they likely do not have the necessary specialized knowledge and also do not keep current in the field.
This lack of expertise can result in delays in receiving the correct diagnosis and treatment plan for ADHD or any other mental health issue. Consequently, the process may be longer and your ability to move effectively and efficiently toward your goals may be severely compromised.
However, your family doctor may be able to help you by making an appropriate referral.
The bottom line is you want to trust your diagnosis before considering medication.
6. Isn’t ADHD medication overprescribed? I don’t want to be drugged!
Yes, just as ADHD is overdiagnosed, ADHD medication in some cases is overprescribed. It is also undiagnosed and medication is underprescribed, even when a diagnosis and prescription is warranted.
The key to getting it right is making sure you do so under the guidance of a prescriber, who has expertise in ADHD medication, such as a psychiatrist or psychiatric nurse practitioner.
Just as with an evaluation, you may be tempted to see your family doctor to prescribe medication to treat your ADHD. But, as is true with an evaluation, the understanding needed to prescribe the right medication is also far too complex for a generalist, like your family doctor.
You will save time and effort in the long run if you see a psychiatrist or psychiatric nurse practitioner.
Yet, finding a prescriber you trust and work well with may still take some time. And once you find the right prescriber, determining the right medication may entail some degree of trial and error. And you may even find yourself questioning whether it is worth the time and effort.
The key to persisting in your efforts to get the right medication is to know up front it may take time, and decide whether you have the patience to get it right.
7. What if I tried medication and did not like the side effects?
It is often the case when attempting to figure out the right medication to treat your ADHD that you will need to adjust the dosage and possibly the type of medication before you get it right.
So, when you first get your prescription it is important to have a specific plan in place for follow-up with your prescriber in order to monitor the effectiveness and possible side effects of the medicine.
But you will only be able to do this if you can remember the information in order to communicate it effectively to your prescriber. Not easy to do, right?
Luckily, you don’t have to keep the information in your head. If your prescriber does not give you one, try this Weekly Medication Log to track how your medication is working.
8. What if I don’t want to take medication?
Many people commonly think only of medication as a way to treat ADHD. And, on occasion people have even said to me, “I don’t see any point in getting evaluated for ADHD because I know I don’t want to take medication.”
Yet, medication is only one piece of the treatment puzzle, and you get to decide how to treat your ADHD. You can choose to use the many other pieces available to you and put them together in a way that both honors your preferences and helps you manage your ADHD symptoms.
It’s your choice.
9. Can I treat my ADHD without using medication?
Ideally, you can work with a professional to create a holistic treatment plan that may or may not include medication.
For more on treatment options, you can check out this 43 page interactive PDF workbook I wrote, Treatment Options for ADHD Workbook: A Guide to Exploring and Making Decisions About Treating Your ADHD.
10. Can I still work with an ADHD Coach if I decide not to take medication?
On occasion, a prospective client will ask, “Would you work with me if I don’t take medication?” Plenty of my clients do not take medication. So, the answer is, “Yes, of course.”
As psychologist and ADHD expert Keith Conners notes, “You must be a savvy consumer of your healthcare to get a proper diagnosis and treatment.” So, be sure to ask prospective coaches about their take on medication to make sure it jibes with your’s before deciding to work with them.
I hope you will be a savvy consumer, as you consider all your various treatment options.