What is ADHD?
Attention deficit hyperactivity disorder (ADHD) is a behavioral disorder that most often occurs in children, affecting approximately 6.4 million U.S. children each year. That said, it also occurs in adults, with about 4% of Americans over 18 living with the condition. The main symptoms of ADHD are inattentiveness, hyperactivity, and impulsiveness. Fortunately, effective treatment options are available, including medication and psychological therapy.
How is ADHD diagnosed?
The majority of ADHD cases are diagnosed in children between the ages of six and 12. This is partly because their symptoms may become more noticeable once they start attending school.Although the exact cause of ADHD is unknown, it tends to run in families. Other factors that some studies have shown may contribute to a person developing ADHD include:
- Low birth weight
- A mother that smoked, consumed alcohol, or abused drugs during pregnancy
- Premature birth
- Epilepsy
- Brain damage
A common myth is that ADHD only occurs in people with learning disabilities. Although it is more common in children with learning difficulties, ADHD can affect people of any intellectual level.ADHD symptoms that can first be seen are inattentiveness, hyperactivity, and impulsiveness. Some people diagnosed with ADHD will only display one of these symptoms, while others will show all three warning signs.
Most symptoms occur before the age of six and in various situations, both at home and school. Here are some examples of ADHD symptoms:
- Having a short attention span
- Constantly changing activities or tasks
- Seeming forgetful
- Unable to complete tasks that are tedious or time-consuming
- Excessive talking
- Constant fidgeting
- Inability to sit still, even in calm and quiet environments
- Interrupting conversations
- Poor sense of danger
- Unable to concentrate
- Inability to wait their turn
Given the lack of research in adult ADHD, symptoms are more challenging to define than in children. Adults with ADHD usually experience symptoms that have persisted from childhood, although they can become more subtle with age.If you think you or your child has ADHD, it’s best to start by speaking with your primary care provider. When it comes to children, it’s often recommended to speak with their teachers and other adults that care for them, such as sports coaches or daycare supervisors, to ask if they’ve noticed any symptoms or concerning behavior.
Primary care providers or pediatricians should be able to diagnose ADHD. However, they may also refer you to the most appropriate specialist. A specialist could be a psychologist or psychiatrist.
Some questions your doctor may ask include:
- What symptoms have you observed?
- When did these symptoms begin?
- Do you have a family history of ADHD?
- Where do the symptoms occur?
- Have there been any particularly stressful events recently, like death or divorce?
- Does your child have any other health conditions?
In the United States, your healthcare provider will use the American Psychiatric Association’s Diagnostic and Statistical Manual, Fifth Edition (DSM-5) to form a diagnosis. Children must have six or more of the symptoms that fall under either inattentiveness or hyperactivity and impulsivity. These symptoms must have been present for at least six months and be developmentally inappropriate. For adult diagnosis, only five symptoms must be present. There are some additional conditions that must be met, including several symptoms being present before 12 years of age, several symptoms occurring in two or more settings, symptoms not being caused by other mental health conditions, and the symptoms interfering with social functioning at work or school.
ADHD treatment options
Although it cannot be cured, there are many ADHD treatments available to help manage the disorder and minimize its effect on everyday life. The most common and effective treatment methods are medications and behavioral therapy, which are often used together. The best ADHD treatment plans often include support from family members, teachers, coaches, therapists, and friends.
Behavioral therapy
Behavioral therapy is an important part of ADHD treatment. For children with ADHD, their parents and teachers are also included in the therapy and given tools to help manage the condition.Simply put, the aim of behavioral therapy is to strengthen and reward positive behaviors, whilst reducing or eliminating unwanted behavior. For example, parents will work with a therapist to identify the behavior they’d like to encourage in their child, such as sitting at the table during meals. When children show good behavior, they’re given a small reward. When they behave poorly, a privilege is removed. In this training, parents and teachers are educated on how to praise and reward even the smallest signs of progress.
In this therapy, the person with ADHD may also learn how to express their feelings in ways that are not disruptive to others around them. This is achieved specifically through cognitive behavioral therapy (CBT).
ADHD medications
Medication is also an effective way to help manage ADHD symptoms, especially when used in conjunction with behavioral therapies. The US Food and Drug Administration (FDA) has approved two types of medications to treat ADHD: stimulants and non-stimulants.Treatment plans can vary between adults and children, with both patient groups benefiting from a treatment plan tailored to their individual needs. Your specialist will help design the best treatment plan based on your own medical history, symptoms, and lifestyle.
There are two classes of medications used to treat ADHD in children, young adults, and adults alike. None are a permanent cure for the condition, but they can alleviate symptoms to help those with ADHD be calmer, more focused, and less impulsive.
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Stimulant medications
Stimulants are the first-line prescription medication for people with ADHD. They increase the amount of the neurotransmitters dopamine and norepinephrine in the brain, which have the effect of increasing concentration and focus. Stimulants should not be taken if you have uncontrollable body movements like tic disorders, glaucoma, or a history of mental health problems, including psychosis, severe anxiety, or depression.The most common stimulant medication brands are:
Adderall (amphetamine/dextroamphetamine)
Adderall is usually taken orally two to three times a day. Because it is short-acting, it has the benefit of giving the patient control over when the medication is in their system. However, this also means you have to remember to take the drug.Adderall XR is also available, which usually only needs to be taken once a day.
There are indications that this ADHD drug can lead to addiction and have negative side effects, such as depression, if stopped suddenly. Always speak to your doctor if you decide to stop taking prescribed medication.
Side effects include weight loss, dry mouth, nausea, insomnia, increased heart rate,and increased blood pressure. This isn’t a full list of side effects, so always ask your doctor for more information.
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Dexedrine (dextroamphetamine)
Like Adderall, Dexedrine is a stimulant that changes the amount of hormones in the brain, which helps to control behaviors and increase concentration. It’s usually taken orally two to three times a day as a tablet. To get the best results from this medication, it needs to be taken regularly. Like Adderall, dextroamphetamine can induce withdrawal symptoms if stopped suddenly.Side effects include loss of appetite, nausea, cramps, dry mouth, insomnia, increased heart rate, and increased blood pressure.
Focalin (dexmethylphenidate)
Another short-acting stimulant, Focalin, acts the same way as Dexedrine and Adderall and has similar side effects.
Ritalin, Concerta, Daytrana (methylphenidate)
Popular medications for ADHD, Ritalin and Concerta, can be prescribed to adults and children. The FDA approves both of these medications to be given to children ages six years and older, but some providers will prescribe Ritalin to children younger than six.Although Ritalin and Concerta have the same active ingredient, they are prescribed differently. Ritalin is a short-acting stimulant, whereas Concerta is a long-acting stimulant.
Daytrana is another brand-name stimulant that contains methylphenidate, but it is administered in the form of a transdermal patch, which may be an option for children who have difficulty swallowing oral medications.
Methylphenidate is not to be confused with dexmethylphenidate, as they cannot be interchanged or used as substitutes. This is largely because they often have varying strengths and doses.
Methylphenidate can cause severe withdrawal symptoms if stopped suddenly, including suicidal thoughts and depression. Always speak with your doctor before stopping or changing any medication.
Side effects are not limited to, but can include, nervousness, insomnia, dizziness, weight loss, increased heart rate, and increased blood pressure.
Vyvanse (lisdexamfetamine)
Vyvanse works in the same way as amphetamine. It is sometimes prescribed as a first-line choice for adults. It’s typically only prescribed for children if methylphenidate was not effective or caused adverse effects. Vyvanse is taken once a day as a capsule.Side effects include weight loss, decreased appetite, dizziness, headaches, and diarrhea.
Non-stimulant medications
While non-stimulants are effective drugs to treat ADHD, they affect the brain differently than stimulants in that they do not release dopamine. Because of how they work differently, they are generally slower to show results than stimulants.Non-stimulants are often prescribed because stimulants either have not worked for the patient, or they aren’t suitable given their medical history.
Common non-stimulant brands include:
Strattera (atomoxetine)
Atomoxetine is a drug that allows norepinephrine to stay in the brain for longer periods of time. As a long-acting drug, it only needs to be taken once a day.A rare side effect when using Strattera is liver damage, so contact your doctor immediately if you notice a swollen abdomen, fatigue, or yellowing of the skin or whites of your eyes when taking the medication.
Some other potential side effects include dry mouth, insomnia, upset stomach, and decreased appetite.
Kapvay (clonidine ER) and Intuniv (guanfacine ER)
Both of these effective ADHD drugs are also prescribed to adults to treat high blood pressure. This means they can lead to low blood pressure for some patients with ADHD. Tell your doctor if you notice any lightheadedness while taking either of these medications.
Qelbree (viloxazine ER)
Approved by the FDA in April of 2021, Qelbree is the most recent non-stimulant ADHD treatment to become available. It is approved to treat children ages six years and older. It is a long-acting drug with a quick onset. Similar to Strattera, Qelbree works as a selective norepinephrine reuptake inhibitor, reducing the amount of norepinephrine that leaves the brain. Potential side effects include insomnia, fatigue, headache, dry mouth, upset stomach, nausea, and decreased appetite.
RELATED: FDA approves Qelbree, a new non-stimulant ADHD medication
What is the best medication for ADHD?
ADHD is a very complex, nuanced condition. Given it can affect both children and adults, there is no one-size-fits-all ideal treatment. Your doctor will be able to determine if therapy, medication, or a combination of the two are the best for you based on your symptoms, medical history, and lifestyle.Best medications for ADHD
Only take ADHD medication as prescribed by your doctor. The dosages above represent standard starting measurements, but your doctor may recommend different prescribing instructions. Other side effects are possible.
What are common side effects of ADHD medication?
As with most medications, there are a number of side effects associated with ADHD drugs. This is a list of some possible side effects for the different drug classes commonly prescribed for people with ADHD, but it is not exhaustive. Speak with your doctor or pharmacist for a full list of side effects and to see how these drugs may interact with any preexisting conditions or medications.
Side effects of stimulants:
- Sleep issues, like insomnia
- Decreased appetite
- Weight loss
- Increased blood pressure
- Headaches
- Upset stomach and nausea
- Dizziness
- Irritability
- Risk of addiction
- Possible withdrawal when stopped suddenly
Side effects of non-stimulants:
- Upset stomach
- Nausea
- Dizziness
- Fatigue
- Irritability and mood swings
- Headache
- Liver problems
- Suicidal thoughts
How can I treat ADHD naturally?
Although medication is generally the first line of treatment for patients with ADHD, especially in combination with cognitive behavioral therapy, there are things people can do at home to help minimize their symptoms.Here are some natural treatments that may be helpful in coping with ADHD, and even help prevent episodes of the disorder:
- Cut out food colorings and preservatives. There is some evidence that certain food colorings and preservatives can increase hyperactive behavior in children, exacerbating any symptoms of ADHD. Discuss lifestyle changes that may be necessary to cope with ADHD or prevent episodes of ADHD from occurring.
- Electroencephalographic (EEG) biofeedback. Recent studies indicate promising results in using EEG to treat ADHD. It helps track brain waves during exercises in concentration, so therapists can help patients focus better over time. However, it's in its early days and more research is required.
- Vitamins and supplements. Research is mixed on how viable these are as effective treatments, but some naturopaths recommend zinc, L-carnitine, magnesium, ginkgo, ginseng, and vitamin B-6.
- Behavioral therapy for patients and parents of children with ADHD. With the guidance of a behavioral therapist, parents can learn skills to help minimize the disruption that their child's ADHD has on their day-to-day lives. This can include creating routines, reinforcing positive behavior, and managing distractions and screen time.
Treatment for adults with ADHD
Adults can work with their healthcare providers to find a tailored treatment plan to fit their personal needs. Treatment plans usually use a combination of medication and counseling, such as cognitive behavioral therapy and marital or family therapy. This can ease ADHD symptoms and lead to a productive life.
Finding the right ADHD treatment and support
Each person is different and there is not a fool-proof treatment plan for ADHD that applies to everyone. Medication can help treat ADHD symptoms. Combining medication with behavioral therapy will help patients overcome daily issues they may encounter. A healthcare provider will work closely with you to help improve symptoms of ADHD, assess what’s working, and change what is not working. Cognitive behavioral therapy can help those with ADHD learn specific skills to manage their behavior and change thinking patterns. Marital or family counseling can help loved ones understand ADHD and learn how they can help aid in treatment. These types of behavioral therapy can help improve time management and organizational skills, reduce impulsive behaviors, improve relationships, cope with past failures, improve communication skills, and improve self-esteem.
Here are some resources that can help with ADHD:
There are many treatment options available for ADHD, and working with a supportive healthcare provider, family, and friends can lead to positive outcomes. It is best to remember that treatment is not a linear path and there may be twists and turns along the way. However, it is important to keep monitoring treatment effectiveness and adjusting ADHD treatment as needed.
Frequently asked questions about ADHD
What are the most common ADHD medications?
The most popular type of ADHD medication is called stimulants. Stimulants work by increasing the amount of dopamine in the brain. When this is increased, it helps people with ADHD focus.
What is the most common treatment for ADHD?
The most common treatment for ADHD is a combination of stimulant medication and behavioral therapy. That being said, everyone is different and your doctor will determine the best ADHD treatment plan that’s personalized for you.
Can people with ADHD lead a normal life?
People with ADHD can often lead normal, fulfilling lives. Getting appropriate treatment and putting work into behavioral therapy can lead to great outcomes with significant improvement in symptoms. It may not always be easy, and there may be potential challenges along the way, but treatment can help those with ADHD overcome obstacles, such as distractibility, impulsivity, and hyperactivity. It can also help improve relationships.
What is the best therapy for ADHD?
The best therapy for ADHD depends on the individual and will be determined with the help of your doctor. Effective therapy includes cognitive-behavioral therapy , which helps people control and change the way they think, behavioral therapy, and support groups.
Can ADHD be cured or grown out of?
ADHD cannot be cured or outgrown, but it is common for the disorder to change over time. For some adults, their symptoms reduce to the point that the disorder no longer creates any significant impairment.
Is ADHD medication safe?
Drugs prescribed for ADHD are considered among the safest psychiatric medications. Like all medications, there are risks involved and potential side effects, so we strongly encourage you to speak with your doctor. A long term study, beginning in the 1970s, showed no indication of long-term negative effects when taking ADHD medication. Another study, however, indicates ADHD medications affect brain development differently in adults than when compared to children.
Can ADHD medication get you high?
If not taken strictly as prescribed, some ADHD medications can induce a high and lead to addiction if abused. Medication should always be taken as prescribed and it should never be obtained without a valid prescription.
Is there a natural supplement for ADHD?
There is little evidence to support the effectiveness of natural supplements for the treatment of ADHD. Always speak to your doctor before taking any natural supplements because they can cause dangerous interactions with other drugs and medical conditions.
How can I help my ADHD without medication?
It’s always best to speak with your doctor to determine the best treatment options for you. Some people find behavioral therapy alone to be effective in managing their ADHD.
Related resources for ADHD:
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