As many of you may recall, one of the newsletter articles from last month discussed unmasking ADHD. This article also provided information regarding unrecognized symptoms as well as effective management of ADHD symptoms. This month we will discuss ways in which ADHD can impact everyday life and ways to positively manage to improve overall functioning and quality of life.

ADHD manifests itself differently in each individual and no two people will have the same experience with ADHD. There is also no right or wrong approach to treatment, the most important approach is one that is tailored to individual needs and feels right to the person seeking treatment. Treatment approaches for ADHD can vary and be one or a combination of approaches to best suit the individual. In this article we will explore a few approaches for treatment which will give you the opportunity to explore which one resonates with you, if desired.

One of the most common treatment approaches for ADHD is medication management. Individuals can obtain prescriptions for psychotropic medications through psychiatrists, psychiatric nurse practitioners (PNP) and sometimes a primary care physician (PCP). Psychiatrists and PNPs vary in terms of treatment approaches and educational backgrounds. PNPs tend to take a less pharmalogical approach and typically focus on more holistic and counseling approaches. There are a variety of medications that can be prescribed to treat ADHD. They can include stimulants, non-stimulants, mood stabilizers or medications that aim to tackle symptoms of anxiety and depression that can co-occur in individuals with ADHD.

Stimulants vs. non-stimulants

When looking into medication management through the use of psychotropics there are stimulants, non-stimulants and mood stabilizers that can be prescribed. Stimulants work by increasing the levels of neurotransmitters in the brain, such as dopamine and norepinephrine, which can improve focus, attention, and reduce hyperactivity. Stimulants have several benefits which include improved focus, attention, reduced hyperactivity and impulsivity, enhanced academic and social performance. Stimulants fall into two categories which are extended release and immediate release. Extended release is short acting while immediate release is immediate and long acting. When considering a stimulant, it’s also important to consider the side effects. Some of the side effects can include decreased appetite, insomnia, headache, rebound hyperactivity, and in some cases increased risk of substance abuse.

When stimulants are not effective or cause negative side effects a provider may prescribe non-stimulants. Anti-depressants can also be effective for treatment of ADHD. The antidepressants providers typically prescribe for ADHD work on the dopamine and norepinephrine levels in your brain. Different classes of antidepressants that target serotonin levels may also be prescribed along with a stimulant if there are symptoms present of anxiety and depression.

Types of Therapy for ADHD

Each therapist subscribes to their own modalities that they draw from in practice. When choosing a therapist, it’s a good idea to research the following approaches beforehand. Every person will have their own preference and styles that resonates with them. Therapy is not a one size fits all model and it can take time to find the right therapist. It can be helpful to try more than one therapist when first looking into therapy. There are also plenty of resources available to help learn more about the differing therapeutic approaches.

  • Cognitive Behavioral Therapy
  • Dialectical Behavioral Therapy
  • Narrative Therapy
  • Play Therapy
  • Mindfulness
  • Mindfulness Based Cognitive Therapy
  • Art Therapy
  • Interpersonal Psychotherapy

Hormonal imbalances can occur in individuals with ADHD that can impact neurological functioning and mental health. Individuals with ADHD often produce lower amounts of dopamine. Dopamine is the hormone and neurotransmitter that is responsible for sending messages between nerve cells. These messages are also exchanged between the brain and the rest of the body. Dopamine also plays a role in our emotional state and how we feel pleasure and rewards. Another role of dopamine is its impact on our ability to think and plan. This can assist with focus, working towards goals and what we find interest in.

There are several ways to increase dopamine. Dopamine can be increased through prescription psychotropic medications. If this a route you are interested in, your PCP can make a referral or you can research a psychiatrist or PCP on your own. More ways to increase dopamine include sun exposure, getting the right amount of sleep, exercising regularly, listening to music, meditation and finding healthy ways to manage stress.

Another hormonal imbalance that can occur in men with ADHD is low testosterone levels. Testosterone is important for the development and maintenance of the prefrontal cortex, which controls executive functioning. Testosterone can improve attention and mood, which are areas of difficulty for people with ADHD. There are several options for men diagnosed with ADHD to balance their levels of testosterone. Some of them include antidepressants, exercise, changes in diet and hormone replacement therapy.

Hormonal fluctuations also impacts symptoms of ADHD in women. The main hormones that impact symptoms are estrogen and progesterone. When estrogen is low symptoms of ADHD can increase and cause a plummet in executive functioning. On the other hand when progesterone levels increase, ADHD symptoms also increase. Both of these hormones can fluctuate around the time of ovulation. Levels of progesterone tend to be higher during puberty, which can reduce the effectiveness of certain ADHD medications such as Adderall and Ritalin.

Holistic approaches can also be helpful in managing symptoms of ADHD. Holistic approaches can look like changes in diet, exercise and taking supplements. Nutritional changes such as adding foods with fish oil, probiotics and protein can be beneficial. Other vitamins and minerals that can be supplemented include vitamin D, vitamin B and magnesium.

Life coaching is also another way to approach the treatment of ADHD. Life coaches draw on their specialized education, unique life experiences, and targeted training to help people identify and work toward key personal development goals. Life coaching can help improve self-confidence, healthier decision making, achieve clarity on personal and professional goals and help people maximize their potential. This can be beneficial for individuals with ADHD as the life coach can help clients learn practical skills and initiate change in their daily lives.

If you are an adult who is struggling with some of the symptoms listed above, Capital EAP can help you with exploring effective tools for management in tandem to seeing your healthcare provider or until you are able to connect with your healthcare provider for an assessment. You can reach us at 518-465-3813 to talk to our intake team who will connect you to an EAP Counselor, we are happy to help.

By: Meryl Tremblay, LMSW, EAP Counselor