How will you know when you have the right ADHD medication and dosage?
TRACK YOUR OWN or your CHILD’S RESPONSE to TREATMENT!
“You can’t notice small improvements or side effects without a monitoring sheet.” The goal is to find the best results with the fewest side effects. Finding the right medication and dosage is seldom a straightforward process. It usually involves medication trials and may require many adjustments to dial in just the right combination. The better you keep track of improvements or problems, the more likely to best the best results from treatment. Don’t waste time or suffer needlessly on the incorrect type and/or dosage of medication.
Prescribers may slowly increase the dosage, then back off when side effects begin to interfere. Other times, they will switch to a different type of medication altogether. It will depend on what you have to report. Even if you use supplements like Omega 3 Fatty Acids, how will you know whether they are helping if you don’t record what changes, if any, occur? For more on the alchemy of prescribing ADHD medication, see ADDitude Magazine’s 10 Medication Fallacies even Doctors Believe.
Stage I: “The Journey Begins” (Discovery and Diagnosis)
Relief: “Finally, an explanation!”
For many adults, discovering they have ADD, usually by reading an article, a book or seeing something on television, is a very emotional moment. People at this point in time are usually very excited. They want to talk. They want to tell their story. They want to be understood now that they are starting to understand themselves. Most want to immediately seek a professional diagnosis so they can move forward with treatment.
Stage II: “Wandering in the Wilderness” (Increasing Awareness)
This stage is marked by a variety of feelings and questions.
Denial: “How do I know this is a valid disorder?”
Flickering Optimism: “Maybe there is hope.”
Fear, anxiety, and more anxiety: “What if I follow through with treatment, but nothing changes? All that effort and for what?” Another failure?” “Is medication safe? If I use it, will I have to take it for the rest of my life?”
Grief, Anger, and Resentment: “Why wasn’t this diagnosed and treated sooner?”
Stage III: “Up and Over the Mountain Top” (Restructuring)
At this stage, the ADDult no longer puts his energy into “What might have been ….” She moves forward with her life, focusing on what works and minimizing the impact of what does not. Some ADDults go to bed in Stage II and wake up in Stage III. It is hard to predict when or why the transition occurs, but it does, and it feels good! In Stage III, ADDults feel less shame about their disorder. They feel more empowered and more comfortable with telling others about their condition. Stage III involves:
Accepting: “I’m ready to let go of the past. I want to get on with my life.”
Delegating; Using Strategies and Accommodations: “Could some else more easily do this task?” “What strategies can I use, what accommodations can I request to accomplish my goals?”
Stage IV: “Enjoying the Peaceful Valley”(Self-Acceptance)
Along your journey you have enjoyed the occasional oasis…the moments when you recognize and praise yourself for new behaviors, small accomplishments, and completed tasks. You note where you started and how far you have come. The journey has been difficult, (and often you wanted to quit or turn back), but you realized you were making progress toward your destination. By noting the oases along the way, you confirm for yourself that you are traveling in the right direction, on the right road and keep you nourished for continued travel.
Eventually, you reach a point in your journey when you are traveling light. You no longer carry baggage from your past. You are a seasoned traveler, good at figuring out how to pass through this rough landscape. You are confident in your abilities and strong in your knowledge of having survived. You know your journey will get easier–that you will even start to enjoy it. You continue to journey, but now you travel without needing guides and fellow travelers. You journey down the open road of life, sometimes skipping, sometimes trudging, sometimes limping, but now there is usually a song in your heart, a twinkle in your eye, and a smile on your face. It is good to notice another oasis just ahead. Your journey of life has become the adventure you have always looked for.
Everyone on an ADD JOURNEY needs guides and fellow travelers to show the way and provide support when we weaken and falter. Our guides and fellow travelers provide the six essentials of multi-modal ADD treatment.
Just as the wise backpacker carries the ten essentials (1) when out trekking, the journeying ADDult needs to have the ADD treatment essentials at hand. Whether or not all treatments get used during the journey depends on the traveler. Some need to employ all treatments; others, only a few. Below is a chart showing which Guide or Fellow Traveler is most suitable for each stage of the journey
Psychologist, Psychiatrist, Counselor or Primary Care Physician
Education and Support
Education and Support Groups Self-education Self-Help Groups Friends and Family
I and II,
I and II,
II and III
Medication (and/or Alternative Treatments)
Psychiatrist, Primary Care Physician (and/or Alternative Health Care Providers)
II, III, and IV
Counseling (and Therapy Groups)
Counselor, Psychologist or
II and III
Professional Coach or Coaching Partner
WHO ARE YOUR GUIDES FOR STAGES I AND II?
Psychiatrists are medical doctors who specialize in helping people with mental health problems. Their training includes medical school and usually a three-year postgraduate residency. One advantage of their training is that it enables them to understand, use, and prescribe medications. With respect to ADHD, this is a definite advantage, since ADD treatment usually includes medication. In addition to psychiatrists, other medical doctors along with physician assistants and some nurse practitioners have prescriptive authority. However, none of them do psychological testing.
Sometimes psychological testing is recommended–not to make the ADD diagnosis–but to gain other information on the person’s functioning. Only psychologists do this kind of testing. So, at times, an adult seeking an ADD diagnosis may see several different professionals. Some adults see several experts for another reason. They cannot find a knowledgeable helper. Sadly, many mental health professionals are not knowledgeable about adult ADD. They may look at it as either a “made up” or an over-diagnosed problem. Since mental health professionals are not used to working with adult ADD patients, it is likely that they may believe another problem is dominant.
Professionals in any field tend to “see” only what they know. If they don’t know or understand something, they can’t see or treat it. For example, the psychologist may see your problem mainly as depression or anxiety (especially if you are a woman), not recognizing the ADD as the underlying concern. How you feel about your life because of your untreated ADD may cause you to be depressed or anxious. ADD may be your primary problem, but other problems may need treatment as well.
In evaluating a mental health professional’s knowledge about ADD in adults, many of the following questions could be asked. Most of these questions could also be asked of ADD counselors and ADD coaches.
Do you accept my insurance? Do you diagnose ADD/ADHD?
How long have you been diagnosing this disorder in adults?
How many ADD/ADHD adults have you diagnosed in the past five years. What percent of your practice has a primary diagnosis of ADD/ ADHD?
How familiar are you with the day to day tribulations of having ADD? (You’re trying to learn if they or someone they are close to has this condition. How intimate is their understanding of ADD on a daily basis?)
What is your treatment philosophy? (Will the clinician work with you and be open to suggestions or will he/she call all the shots. Is their treatment of ADD the same for everyone or is it individually tailored?)
In a subtle way, learn what they do to keep current in their knowledge about adult ADD and its treatment protocols.
How do you make a diagnosis? How many visits will it take and how much will it cost?
How long will I have to wait for an appointment?
Ask psychologists how they handle the medication part of treatment.
Ask physicians (and other medical personnel with prescriptive authority) what medicines they use to treat ADD/ADHD.
YOUR GUIDES FOR STAGES II AND III – Therapists and Coaches
Counselors/Therapists: Often, after being diagnosed with ADD, it is a good idea to find a therapist with you whom you can work. Many times adults with ADD have become so mired in negative feelings about themselves that the first thing they need to do is to face these feelings directly and learn how to let them go. Besides dealing with the ADD symptoms themselves, there may be depression, anxiety, or other problems that need to be addressed.
A good therapist can help you develop practical ways to deal with your daily life based on your own problems and circumstances. You will develop insights into how your ADD symptoms have interacted throughout your life, which is likely to help you understand why your life has taken a certain direction. It is our belief that a good therapist will educate you thoroughly about ADD.
Individual therapy is the most likely choice because most people prefer the privacy of a one-to-one relationship with a mental health professional. In individual therapy you and your therapist talk about your particular problems and develop ways in which you can deal with them more effectively. You will probably see your therapist once each week, although the schedule may later change. Visits usually last about forty-five to fifty minutes. After the initial screening is completed, you and the therapist will spend your visits talking about specific challenges, developing coping strategies, sharing new insights, and whatever concerns are on your mind.
The therapy will vary according to the therapist’s orientation. For example, one therapist may help you listen to your negative thoughts and get you to actively challenge them. This method is central to cognitive therapy. Another therapist may help you develop strategies for actively confronting and, hopefully, overcoming the ADD symptoms that make your life less than optimal. Often you will gain insight as therapy proceeds. You may have misunderstood your ADD and thought that you were just “lazy, crazy, and stupid.” You may have many misconceptions that you built up over the years that you can now interpret in the light of your new understanding of ADD.
This does not in any way release you from doing the necessary work to get your life in order. Yes, you will develop insights. But you will also need to work at developing skills you have never had before.
A good therapist will teach the ADD adult to acknowledge the importance of small steps in making progress. Often people don’t continue along the road of self-improvement because they don’t acknowledge their small steps of Progress. The person with ADD often expects a difficult problem to be solved rapidly. “I want it yesterday.” If it can’t be solved soon, the person gets frustrated and gives up. The adult with ADD who learns the value of taking small but positive steps toward a goal learns a very valuable lesson. The good therapist keeps the client on track and helps the client maintain a positive perspective.
Coaches can be therapists, although coaching is not therapy. Coaches can also be another ADD adult, a friend or someone in your family. ADD coaching focuses on practical issues confronting the ADD adult, such as organization, managing time and setting and reaching goals. Coaching could help ADD adults to develop routines and daily habits which will simplify and make their lives more manageable. Some coaches are very forceful and offer lots of suggestions while others prefer coaches who mostly listen and then offer ideas.
A coaching relationship could last any length of time, but a typical relationship lasts at least six months. Sometimes coaching is done in person, one hour a week. It can be done over the phone, 10-15 minutes a day, or even done through e-mail. Hiring a trained person to be your coach is called professional coaching while getting someone else to work with you is called peer or partner coaching.
A coach works with you to improve your results and your successes. A coach will:
help you set better goals and then reach those goals
ask you to do more than you would have done on your own
get you to focus your efforts better to produce results more quickly
provide you with the tools, support, and structure to accomplish more
How does coaching differfrom consulting? …therapy? ….sports coaching? …Having a best friend?
Coaching is a form of consulting as coaches provide advice and expertise in achieving personal change and excellence. However, unlike the consultant who offers advice and leaves, a coach stays to help implement the recommended changes, making sure they really happen and ensuring that the client reaches his goals in a lasting way.
In most therapies, patients or clients work on “issues,” reflect on their past experiences and try to understand the psychodynamic causes of their behaviors. Coaching focuses only on the here and now, looking at the problems in the present needing solutions. In this way, it is like solution-focuses therapy. Coaches work with their clients to gain something, such as new skills, not to lose something, such as unhealthy thought patterns. The focus is on achieving personal and professional goals that give clients the lives they want.
Professional coaching includes several principles from sports coaching, like teamwork, going for the goal, and being your best. Unlike sports coaching, professional coaching is non-competitive. You develop your own way to achieve your goals. There is not one best way to do it. It is not focused on outdoing someone else. It is focused on strengthening the client’s skills, such as a trainer might do.
Having a best friend is always wonderful, but you might not trust your best friend to advise you on the most important aspects of your life and/or business. A best friend might not be able or willing to provide the consistency in monitoring and feedback that coaching demands. The relationship with your coach has some elements of a good friendship in that a close relationship evolves. The coach knows when to be tender or tough with you, is willing to tell you the truth, and keeps your best interests foremost in the relationship.
“A coach is your partner in achieving professional goals, your champion during a turnaround, your trainer in communication and life skills, your sounding board when making choices, your motivator when strong actions are called for, your unconditional support when you take a hit, your mentor in personal development, your co-designer when developing an extraordinary project, your beacon during stormy times, your wake-up call if you don’t hear your own, and most importantly: Your coach is your partner in living the life you know you’re ready for, personally and professionally.” —Thomas Leonard, President of Coach University
People hire coaches because they want more to their life; they want to grow as individuals, and they want to make achieving their goals easier. When using a coach, people take themselves and their goals more seriously. They immediately start taking more effective and focused actions. They stop focusing on thoughts and behaviors that drag them down. They create a forward momentum to their lives and they set better goals for themselves than they would have without a coach.
COACH SELECTION RECOMMENDATIONS
Rapport is very important. Your relationship with your coach is important to your professional and personal growth. The effective coaching relationship is an effective model for all your other relationships: inspiring, supporting, challenging and productive. Choose someone you will be able to relate to very well.
Experience in your field is less important, although knowledge of A.D.D. is important. Coaching technology works for a wide variety of people, professions, and situations. A coach with experience in your personal or professional situation may understand you more quickly. However, much of your work with a coach will involve encouraging you to use and develop your personal skills and your expanding network. Therefore, the specific business experience of your coach is not as important as you might think. Coaching technology works independently of the business or professional environment.
Location is normally not important. While some coaches do offer on-site coaching, it is normally not necessary nor efficient. You will get the same or better results with telephone coaching at a fraction of your investment with on-site coaching.
Interview more than one coach before you decide. Most coaches are happy to speak with you for several minutes in order to get to know you and your situation. You can use this time as an opportunity to gather information and an impression about the coach’s style. Compare two or three coaches and select the one who seems most helpful to you. Trust yourself to know what you need.
Ask the prospective coach good questions. Great coaches are willing to answer your questions directly and forthrightly. Consider asking questions about their depth of experience, qualifications, skills, and practice. For example:
“How many clients have you coached, and how many are presently active clients?”
“What is your specialty and how long have you been practicing in that specialty?”
“What is your knowledge of Attention Deficit Disorder? (expand this to be lots of questions–modify those suggested earlier for evaluating a mental health professional’s knowledge of ADD)”
“How many clients have you had with A.D.D.?” What percentage of your clientele has this diagnosis?”
“What qualifies you to coach people in my situation and how many people with my concerns have you coached?”
“How do you typically work with a client?”
“What are the names and numbers of some of your clients so that I may ask about your coaching?”
The inspiration for this article and some of the information on the journey, its stages, (stage IV is my addition), guides and fellow travelers came from a self-published booklet, “Coaching Partners,” by Lisa F. Poast
Material on therapy and therapists was adapted from Do You Have Attention Deficit Disorder? by Lawrence Thomas, Ph.D. It is published by Dell Books
Information on coaching was obtained from the International Coaching Federation.
Cynthia Hammer, MSW, ACSW, an adult with ADHD and the parent of three sons, two with ADHD. At age 49, she learned that she had ADHD and realized she knew very little about the disorder. Cynthia founded ADD Resources in 1994 and went on to become a nationally recognized advocate for the understanding of ADHD among both those who have it and those who treated it. Cynthia is now retired and lives in Tacoma with her husband.
About 4.4 percent of American adults — 10 million people — have ADHD. And roughly 8 million children have been diagnosed with the disease, making it one the most commonly occurring mental health disorders in the United States.
The rate of co-occurring substance use disorders is high among those with ADHD. Individuals with this diagnosis are 2.5 times more likely to develop a substance use disorder. A study by researchers at Massachusetts General Hospital found that 15 to 25 percent of adults who have a substance use disorder also have ADHD.
For co-occurring ADHD and substance abuse disorders, the best treatment programs combine medical treatment for ADHD, drug detox and therapy that address both disorders. Additionally, proper ADHD treatment during childhood can prevent further development of the disorder that may lead to a substance use disorder during adulthood.
The risk for substance abuse is often higher for people with ADHD. Compared to the general population, people with ADHD are:
Three times more likely to develop a nicotine use disorder
Two times more likely to develop an alcohol use disorder
Two times more likely to develop a cocaine use disorder
5 times more likely to develop a marijuana use disorder
Research shows that those with ADHD may have lower levels of dopamine — the brain chemical responsible for reward-seeking behavior — and turn to substance abuse or other dopamine-releasing behaviors as a result.
Despite the increased risks, those with co-occurring ADHD and substance use disorders are not doomed to struggle with addiction their entire lives. Many rehab centers offer specialized programs for co-occurring disorders that focus on treating the separate disorders concurrently, giving patients a realistic chance of reaching recovery and living a healthy life.
Treatment for Co-Occurring ADHD and Substance Use Disorder
Treatment for co-occurring mental health and substance use disorders is most effective when the disorders are treated simultaneously. Addressing them at the same time is preferred to treating them one at a time, which was the generally held practice in the past.
Medication is the most common form of treatment for ADHD, and with proper use, it can greatly benefit those with co-occurring ADHD and substance use disorders. Stimulant and nonstimulant medications can be effective in treating individuals with ADHD with or without a co-occurring substance use disorder. The most common types of medications used to treat ADHD are stimulants.
A study by researchers at Massachusetts General Hospital examining the results of six long-term studies found that stimulant treatment for ADHD during youth leads to reduced risk of developing a substance use disorder during adolescence and adulthood.
The two most common stimulants used to treat ADHD are methylphenidate and analogs of amphetamine.
Amphetamine medications activate the reward pathway and trigger the release of dopamine in the brain, bringing balance to dopamine levels among those with ADHD. This can help alleviate drug cravings.
According to researchers at Columbia University, clinical trials of Ritalin (methylphenidate) have also been effective in reducing symptoms of ADHD and substance use disorder when combined with relapse prevention therapy. The drug has a relatively low risk of abuse under proper medical supervision.
Methylphenidate has been used for decades to treat ADHD and has shown to be effective for children and adults. Uncontrolled trials of methylphenidate have shown to have a positive impact in reducing symptoms of ADHD and cocaine use disorders, according to researchers at Columbia University.
Some nonstimulant medications can be used to treat ADHD and may present an alternative to stimulants. While stimulants have a higher abuse potential, nonstimulants are often seen as a less effective treatment option.
Atomoxetine is a selective norepinephrine reuptake inhibitor that can be used to treat ADHD. It affects those with ADHD similarly to stimulants, but in a more gradual manner. With no known abuse potential, atomoxetine is an attractive alternative to stimulant medications.
Tricyclic antidepressants have also been used to treat ADHD. However, they are generally less effective than stimulants in treating ADHD.
Problems with Medication Treatment
Research from Massachusetts General Hospital shows medications that are effective in treating adult ADHD may be effective for adults with ADHD and co-occurring substance use disorders, but the medical benefits of the medications are hindered if an individual is actively abusing substances.
Patients may require higher doses in order for a medication to be effective.
The presence of other substances in a patient’s system may make the therapeutic effects of a medication less effective.
Individuals actively engaging in substance abuse are more difficult to treat with medication, with or without a co-occurring disorder.
Alcohol and ADHD Medications
ADHD medications are associated with high risks when used concurrently with alcohol. Adderall is a medication of particular concern because it is commonly abused by college students who participate in binge drinking culture at parties, bars and nightclubs.
Individuals who abuse Adderall and alcohol together find that the depressant alcohol effects are lessened by the stimulant properties of Adderall, allowing them to drink more for longer periods of time.
Abuse of Adderall or other ADHD medications while drinking may cause people to consume hazardous amounts of alcohol. ADHD medications that block the depressant effects of alcohol may cause individuals to ignore signals from their bodies that they have had enough to drink, which can lead to dangerous health concerns such as alcohol poisoning.
It is crucial for people to consult their doctor about alcohol use while taking any type of ADHD medication.
About the Author: Trey Dyer is a writer for DrugRehab.com. Trey is passionate about breaking the stigma associated with drug addiction in the United States. When Trey is not writing, he can be found fly fishing, playing soccer or cooking BBQ.
Adler, L. et al. (2005, March). Long-term, open-label study of the safety and efficacy of atomoxetine in adults with attention-deficit/hyperactivity disorder: an interim analysis. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/15766294
Somoza, E. (2004). An open-label pilot study of methylphenidate in the treatment of cocaine dependent patients with adult attention deficit/hyperactivity disorder. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/15077842
Wilens, T. et al. (2003, January). Does stimulant therapy of attention-deficit/hyperactivity disorder beget later substance abuse? A meta-analytic review of the literature. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12509574
“Image courtesy of stock photos/FreeDigtalPhoto.net” Modified on Canva
Disclaimer: ADD freeSources does not endorse or recommend any of the providers or services listed. Nor should not being included on the list affect your choice of provider. We have not investigated those listed and do not have the ability to evaluate their competence in providing services to families and individuals living with ADHD.
Psychiatrists can diagnose and prescribe medications. Other MDs may or may not diagnose, but all can prescribe. Psychologists can diagnose and refer to a prescribing provider. Many Nurse Practitioners have experience adjusting ADHD medications but may not feel comfortable diagnosing.
Treatment combines medication, supplements and lifestyle changes. SPECT Scans are expensive and may not be covered by insurance. Will diagnose and treat without using a SPECT scan- but hourly rates are quite high and they do not accept insurance. However, if it’s a case that has been difficult to diagnose or treat, it may be worth the price.
Independent Practitioners – Eastside and greater Seattle area. Offices in Issaquah Snoqualmie, and Woodinville. Everett Clinic – Search under behavioral health brought up over 25 providers north of Seattle. Referral line is 425-458-5048. email@example.com
George F. Jackson III, MD –
James Dale Howard, MD
(Fletcher Taylor, MD is very experienced, but seldom has an opening)
Steve Parkinson, PhD also does ADHD Assessments
Trust the front desk, but be clear about what you need.
5909 Orchard St W
University Place, WA 98467
Robert Sands, MD (& Associates)
Child Psychiatrists- will work with adults)
3609 S 19th St
Tacoma, WA 98408
Dr. Stephen Schilt, MD- (Child Psychiatrist)
7609 6th Ave
Tacoma, WA 98405
Union Ave. Neurobehavioral Clinic–
Child Psychiatrists- Will also diagnose and treat parents of the children they treat)
Carl Plonsky and Associates
Dr. Heather Daniels and others
1530 S. Union Suite 13
Tacoma, WA 98405
Lance A. Harris, PhD – Neuropsychologist
3001 East J Street
Tacoma, WA 98404
Phone: 253) 274-9733
Edwin Lawrence Hill, PhD – Neuropsychologist
2013 South 19th Street
Tacoma, WA 98405
Phone: (253) 383-3355
Daniel Wanwig, MD – Adult psychiatrist
1901 South Union Avenue Suite A305
Tacoma, WA 98405
Phone: (253) 272-3031
Patrick Joseph Donnely. MD – Adult psychiatrist
3609 South 19th Street
Tacoma, WA 98405
Phone: (253) 381-3071
Robert Grumer, DO, Ann Marie Branchard, MD and Todd Clemens, MD
Individual and family counseling, Case management, Group Therapy, Psychiatric services and medication management. Partners with Tacoma schools to offer counseling at schools, Services also available in Gig Harbor. http://comprehensiveliferesources.org/Counseling.html
Must call for information 253-396-5800
1305 Tacoma Ave S Ste 305
Tacoma, WA 98402
Tutor, researcher, and teacher of teachers. She advocates for children and parents in and out of the school system. She teaches all ages all aspects of literacy and specializes in Dyslexia and ADD. http://www.readingwritingthinking.net/
The Learning Disability Association of Washington online directory helps those affected by learning disabilities find resources within the greater Puget Sound region. The directory lists over 800 resources organized into categories ranging from diagnostic testing, consultants, therapists and support groups to optometrists, ADHD resources, physicians, and psychiatrists.
Washington State ADHD Treatment Providers – Note: ADD freeSources does not endorse or recommend any provider or services listed. Nor should exclusion from the listing affect your choice of provider. Many of these were chosen because they were associated with ADD Resources or local CHADD groups at some time.
The core symptoms of ADHD are hyperactivity, impulsiveness, distractibility and inattention as evidenced by problems organizing, planning, procrastinating, and time management. But doesn’t everybody have these problems? Yes, but for the diagnosis to be applicable, the doctor will consider the severity and duration and the extent to which your problems interfere with the quality of your life. For a diagnosis, you must see a doctor who is knowledgeable in ADHD and related problems. The principle tool for diagnosis is the interview.
Before seeing your doctor, take some quiet time to think about what is really bothering you and write it down. (People with AD/HD often forget the key things to say). If your office looks like the aftermath of a hurricane and you feel depressed, be sure to tell the doctor both facts. You may be depressed because you can’t deal with the office, or your office may be a disaster because you are depressed. Which came first?
“Pills? I don’t take pills!”
Well, you aren’t alone. Many people feel that way. Consider for a moment. Do the pills make you a different person? Is it not you, if you take a pill? Who is the real you?
That person who loses his temper at the slightest excuse,
the nerd who walks past his best friend without saying “Hello”,
the wife who is too tired to clean up the mess and greet hubby with a smile and kiss when he comes home?
Or are you the smiling affable, competent person you know is inside trying to get out?
Let’s go back to our car. Do you expect your car to run without oil or gasoline? Would you drive a car that worked on two or three of its four cylinders? Your brain needs fuel.
Ideally, every brain would produce just the right amount of all the ingredients it needs, but there is no such thing as an ideal brain. Some brains are chronically undersupplied with the chemicals they need to function properly. Clinical trials have shown that medication is the most effective method of dealing with an under functioning brain
There are a number of medications available. Your doctor may need to try more than one, to find the right one for you. He will probably start with a low dose to see if you tolerate it and then increase the dose to find the most effective dosage and timing. So don’t be discouraged if you don’t get a positive result immediately.
When you start taking the medication it would be a good idea to keep a record of the time you take it and any sensations you may feel and the time when they occur. Be sure to tell your doctor about all the effects. Some unpleasant effects like a headache or dizziness may, in fact, be what are called rebound effects which occur when the medication wears off. The problem can often be resolved by changing the timing of the next dose or even by increasing the dosage. Help your doctor to know what’s happening and he can help you to find the best solution for you.
For information about medication, you must see a doctor who has experience with ADHD.
For treatment guidelines and which medications are available, see
A PHYSICIAN’S PERSPECTIVE on ADHD Medications by Theodore Mandelkorn, MD
Editor’s note: Not everyone wants to take medication or is helped by traditional ADHD medications. Nor is medication alone enough. Some type of outside intervention, however, is usually helpful. You may prefer to try cognitive behavior therapy, coaching, diet changes, supplements, mindfulness meditation or any number of holistic or alternative treatments. Many treat their ADHD with a combination of these, searching for the right mix. Please see the Pinterest boards listed below for examples.
Can’t attend an ADHD conference? You can still learn about ADHD from experts in the field. Best of all, you can view them on your own time and for no charge.
*Best of the Web –CADDAC 2009 ADHD Conference videos – A wonderful gift from – The Centre for ADD/ADHD Advocacy of Canada- (CADDAC) Choose from a number of presentations filmed over both days. You’ll find the list at this link.
The 30 Essential Ideas Every Parent Needs to Know (about ADHD), by Dr. Russell Barkley
This is the 3-hour video presentation from the CADDAC conference (found above), broken up into 27 manageable parts with an average length of 6 to 7 minutes. It’s far easier to watch. To take a saying from Barkley, “Small Chunks, Frequent Breaks.”
ADHD: Undiagnosed in Millions, Do You Have it? (4 minutes) Alan Brown gives us a call to action to be advocates to bring awareness and attention to ADHD so individuals do not fall through the cracks and have the safety net they need to succeed.
ADD coaching focuses on practical issues confronting the ADD adult, such as organization, managing time and setting and reaching goals. ADHD Coaches can be therapists, although coaching is not therapy. SeeThe ADD Journey: Help for the Road Ahead or ADHD Coaching Strategies to learn more about ADHD Coaches and how their services differ from those offered by other treatment providers.
If you cannot afford a personal coach, see ADHD Coaching Optionswhich lists group coaching, self-coaching, and other options.
Search Tips – Most ADD coaches work over the phone. It’s possible that you won’t find one nearby. It may be more important to find one who deals with your specific needs rather than one close to you. With any site, just choose Coach as the Service Provider Type and the Age Group looking for help. To narrow the search further, make a selection from Coaching Focus. If you prefer someone nearby, your choices will be much more restricted.
You’ll find other listings through AD/HD Coach Certification or Training Programs.
You can also find a few referrals for Specialty Coaching for Teens and Parent below. AD/HD Coach Certification
The specialized field of ADD Coaching is still largely unregulated. No certification past that granted by the following organizations is required to call yourself an ADD Coach. Most of the Associations seeking to establish standards for ADD Coaching require applicants to have met the training requirements for Life Coaching set up by the International Coach Federation (ICF), International Association of Coaching (IAC), or the ADD Coach Academy (ADDCA) with David Giwerc.
On the other hand, there are now ADHD Coaching Associations and specific ADHD Coach Training that credit specialized training in working with clients with ADHD.
Reduce ADHD Costs with Patient Assistant Programs by Kimberly Holland
Find retail prices for the brand name and generic versions of Adderall and other popular ADHD medications. (Be sure to compare costs with your local pharmacies.) Try other cost-saving techniques, such as mail-order prescriptions and coupons.
Comprehensive collection of sources for help with medication costs – Post on Psych Central Forums. – Repeats some of the sources listed below but provides additional ideas especially about generic medications.
Help from Pharmaceutical Companies – Patient Assistance Programs
Eligibility varies program by program. Generally, individuals must have incomes under 200% of the Federal Poverty Level, cannot have prescription coverage from any public or private source and must be a U.S. resident or citizen. Some companies also require that the patient has no health insurance (including Medicare).
Note: These are non-profit sites and do not charge you for their help.
RX Hope has program descriptions and downloadable applications for prescription assistance programs for specific medications including psychotropic medications
Needy Meds – Just enter the name of your medication in the Drug Search box in the upper right corner.
RxAssist – Offers access to PHARMA programs for both doctors and consumers (877) 844-8442
Note: IF you need Vyvanse or Intuniv, Shire Care’s income criteria is significantly higher than the less than the 2x the poverty level required by most Pharma programs. You still need to provide proof of hardship however. Each application will be considered on a case by case basis. See Shire Care for more information and to apply.
Monthly paperwork for stimulant medications too much for you to deal with?
For a small fee, The Medicine Program.com will help you with applying for PHARMA programs and enlisting your physician’s help. – P.O. Box 520 – Doniphan, MO 63935-0520 – (573) 996-7300
The Cost of Not Treating ADHD by Steven Kurtz – “We’re already paying the cost, and our kids are too.” “Many kids with ADHD, and other conditions, just find their problems compounding as they get older. And they are less and less responsive to treatment. Kids with untreated ADHD often become adults with untreated ADHD, and with that comes a whole host of adult-sized problems.”
How much does it cost to test for ADHD? Consumer Reports – $700 to $1600 was the average assessment cost. – “About one-third of the parents in the survey reported that the costs of treating their child for ADHD were covered completely by their child’s health plan, with two-thirds of respondents reporting half to all treatment costs were covered by insurance.”
Managing the Costs of ADHD – by Chris Taylor – “Many parents are caught in a financial vise. They want to spend whatever it takes to ensure a successful future for their child but don’t want to bankrupt the family. Some tips: Work the public school system, be an insurance Ninja, and plan your budget early.”
The Affordable Care Act has new regulations to make sure that mental health treatment is covered to the same extent as physical care. Therapies for depression, anxiety, and substance abuse — which often come along with ADHD — are among a core set of 10 services called “essential health benefits” that must be covered with no out-of-pocket limit. Included in these are prescription medications, which are usually a major component of ADHD treatment. Knowing that a pre-existing condition won’t exclude you from getting affordable insurance is also a bonus. So is the option of keeping children on their parents’ policies until they’re 26. (1)
Before health reform, one out of five people who bought their own insurance had no mental health benefits. This change is long overdue. One drawback may be that by placing the primary care physician is at the center of treatment, Doctors may decide to treat ADHD themselves by just prescribing medication, rather than referring to a specialist. With the high rate of mental health issues and Learning Disabilities so commonly associated with ADHD, however, a complete diagnosis and a holistic treatment plan may be beyond the expertise of primary providers. (2) They may not appreciate the value of parent training to managing behavior or family therapy to educate and help all members of the family.
The news for low-income families is not as good. “In 2012, the Supreme Court gave states the choice of whether to join the Medicaid expansion or not. Unfortunately, almost half of the states have decided not to do so. That means that 6 to 7 million Americans won’t enjoy this enhanced access.”(3) Even with Medicaid, finding a physician will be difficult. “Under the present Medicaid reimbursement rates, physicians are paid only about $45.00 for a basic visit, while $75 per visit is the break-even point for most private practices. So the physician has to take a $30 loss for every Medicaid patient that he or she sees and has increased paperwork to even get the reimbursement.” (4)
Find Health Insurance
Alternatively, let your fingers do the walking. Check the Community Pages in your local phone book under Mental Health for local federally funded clinics. They accept Medicaid, Medicare, most insurances and will adjust their rate according to your income. (Note: Some areas do not consider adults with ADHD (alone) as qualified for treatment. Others will treat if it’s in combination with another mental disease or disorder). Children’s clinics, however, deal with ADHD concerns on a regular basis.
Or, use Google. I had good results using the words community mental health with city, county, and/or state
The Department of Vocational Rehabilitation is another possible way to go. You do, however, have to prove you are not employable or under-employed due to your ADHD or combination of disabilities. I know quite a few people who got a lot of help through DVR a number of years ago (including paying for a diagnosis for ADHD,) but their funding has been hit. – Find your state’s Voc-Rehab services
Clinical trials don’t cost a thing and you may even be reimbursed for your time.
(There’s no guarantee you’ll get the drug being tested, but you can often get a free evaluation for ADHD.) For a listing of current studies, see the National Institute of Mental Health.
2-1-1 is an Information and Referral service to help people connect with important community services and help them find help in their community more easily. Call 2-1-1 or Search for a 2-1-1 Call Center. Available in many states, 2-1-1 can help you find organizations that may assist with a broad range of needs. You may find help paying for medications or financial assistance with other essential needs such as food, clothing, rent and utility assistance, child care, employment supports, services for older adults, etc.
Social Security Income and Social Security Disability Income
Supplemental Security Income, or SSI, provides monthly income for those who cannot work due to a disability such as depression, bipolar disorder or other mental disorders. You must meet strict eligibility criteria to qualify.
The basics of SSDI – “Social Security Disability Insurance (SSDI) is available to any worker who has a “disability” as defined by the federal government and who has paid into the Social Security system for a specified amount of time, depending on their age. In order to qualify as “disabled,” an SSDI applicant must show that he is almost completely unable to work at any job whatsoever.”
Social Security Disability and ADHD – This article focuses primarily on children. – They need to show a MARKED inability to succeed in school and strong documentation is required. Adults must be unable to earn more than $960 per month gross (with that inability also caused by MARKED impairments. Most importantly, to win disability benefits from the Social Security Administration based on attention deficit, or ADHD, a person must have measurable functional deficits, in the context of school or work performance.
SSI / SSDI Outreach, Access and Recovery – SOAR
Help for the homeless with mental illnesses, a process where eligible individuals can have their disability case expedited. SOAR’s online training course is about 16 hours long, but it leads you through all the steps to help clients apply for SSI or SSDI. – To be eligible you must be at least 18, diagnosed with a serious mental illness, and homeless or at risk of becoming homeless. The SOAR process is designed to have a decision for disability claims within 90 days.
• “Image courtesy of Luigi/FreeDigitalPhotos.net” Modified on Canva.com
(1) “The Affordable Care Act: Good for ADHDers”
by Katherine Ellison – www.additudemag.com/adhdblogs/19/10545.html
(2) “An Update on How the U.S. Affordable Care Act Impacts Mental Health Care”
By John M. Grohol, PSY.D. – http://psychcentral.com/blog/archives/2013/11/01/an-update-on-how-the-u-s-affordable-care-act-impacts-mental-health-care/
(3) “Affordable Care Act : Will It Impact Your ADHD Child’s Treatment?” http://newideas.net/adhd-affordable-care-act-impact
(4) “One of the Best Things to Happen to People With ADHD? Obamacare” by Dennis Thompson Jr. http://www.everydayhealth.com/news/obamacare-best-thing-happen-people-with-adhd/
What to look for – Try a Local search – Online Directories – Hoarding – FREEBIES and For Professionals
It is not uncommon for someone with ADHD to be overwhelmed by a chronic lack of organization of their space and poor time management skills. At some time, it may be necessary to call in an organizer. Most can help with both issues. Traditional organizing techniques, however, often need to be adjusted when working with clients with ADHD. Most of us know what to do, but struggle to initiate action, evaluate the importance of our stuff and begin to de-clutter our space.
Organizing what is left so you can find it later is problematic and keeping everything in its place an on-going chore. You’ll need to develop and refine new organizing systems. Maintaining your organized environment will probably not come naturally. Creating new habits takes time and you may need additional help to keep things up. Remember, the goal is NOT perfection. Getting through the day with less frustration and being able to accomplish your work more efficiently is good enough.
Choose your organizer carefully and move on if you are feeling judged or shamed. Most organizers have worked with ADHD clients. Some have developed successful techniques that work with our wiring or even pursued specialized training through the Institute for Chronic Disorganization. Make sure that there is a good “fit” between you. Ideally, you will find one who is sensitive enough to your needs, but firm enough to do you some good.
Local Search: Another problem with finding a suitable organizer is, of course, that they work locally. You may need to let your fingers do the walking in your local Yellow Pages under organizers. Also, try a Google or Bing search. Whoever you contact, ask them questions about their expertise and what their experience in working with clients with ADHD has been like. If you can, try an introductory meeting.
There are also online Directories that can help you find an appropriate organizer.
Note: Hoarding issues signal a need for specialized treatment, and often require both therapy and a highly skilled organizer. See the IOCDF Hoarding Center for photos on different stages of hoarding. Compare these with the state of your home. You can also find providers to work with you here. You may also assess your stage of clutter by choosing from the Clutter Hoarding Scales from the Institute for Challenging Disorganization. You can also find highly trained professional organizers who work with hoarding there.
Free Fact Sheets for the general public on a wide variety of issues from Challenging Disorganizaton. Includes: Time Management, Overcoming Procrastination, Readiness for Change, Should I Work with an Organizer or a Friend and more!