ADHD Treatment Overview

When you may need a healthcare provider

It’s important to see a healthcare provider to get ADHD testing and a diagnosis. This will help you understand your specific symptoms and what is hard for you to do. ADHD is usually treated with a combination of medication and therapy or ADHD coaching to learn strategies for managing challenging situations.

Typically children are diagnosed with ADHD after they start school, but if you have any concerns about your child’s behavior or learning, discuss them with your pediatrician.

See a healthcare provider if you or your child have any changes in mood or behavior, are losing weight, or having poor sleep. These may be signs of another mental health or health condition or side effects from a medication.

Getting diagnosed

Children are often evaluated for ADHD at school. These assessments typically include a continuous performance test, self-reports, a complete history (social, medical, family, and educational), and a neuropsychological evaluation.

If your child isn’t tested at school, your pediatrician can provide referrals for an evaluation, typically done at a health clinic, children’s hospital, or by a private psychiatrist.

For adults who have not been diagnosed with ADHD in childhood, a healthcare provider, either a primary care provider or a psychiatrist, may be able to diagnose you using a self-report questionnaire and a complete psychosocial history. Getting more extensive neuropsychological evaluation and testing can identify areas of strengths and weaknesses to help guide treatment.

Online questionnaires and self-assessments can be helpful for noticing different symptoms of ADHD, but you need to see a provider to get an accurate diagnosis.

What to expect from your visit

A healthcare provider will discuss your health, symptoms, and preferences, and may recommend starting a prescription medication.

There are two main types of ADHD medications, stimulant and non-stimulant medications.

• Stimulant medications increase the brain’s neurotransmitters, dopamine and norepinephrine, to improve thinking and attention. They work immediately and tend to wear off throughout the day. Adults are commonly prescribed amphetamines like Adderall and Vyvanse, while children are prescribed methylphenidates, like Ritalin, Concerta, and Focalin. All stimulant medications can disrupt sleep, and may increase heart rate, and cause dizziness and poor appetite. They are carefully monitored by a healthcare provider because they can be abused and misused.
• Non-stimulant medications have fewer side effects and tend to have more long-lasting and consistent effects. They also help mood issues common with ADHD like depression and anxiety. Medications include atomoxetine (Strattera), bupropion (Wellbutrin), and clonidine.

Prescription ADHD medications

Stimulant medications

• Amphetamine salts (Adderall, Adderall XR-extended release)
• Dextroamphetamine (Dexedrine or Dextrostat)
• Lisdexamfetamine (Vyvanse)
• Methylphenidate (Ritalin, Ritalin XR)
• Dexmethylphenidate (Focalin)
• Methylphenidate Extended Release (Concerta)

Non-stimulant medications

• Atomoxetine (Strattera)
• Clonidine (Kapvay)
• Guanfacine (Intuniv)
• Bupropion (Wellbutrin)

Therapy & Coaching

Psychotherapy and coaching can be very helpful for people with ADHD.

• Cognitive behavioral therapy (CBT) can help with unhelpful thinking and behavioral patterns. It can also provide coping strategies for depression and anxiety that may occur along with ADHD.
• Dialectical behavior therapy (DBT) and acceptance and commitment therapy (ACT) are two other effective therapies for ADHD that focus on unhelpful thinking and behaviors, mood issues, and self-regulation (your ability to manage your behavior and reactions to feelings and events).
• For children, psychotherapy includes behavioral (like reward strategies) and play therapy to focus on improving behavior. It also teaches parenting skills to improve family dynamics.
• Mindfulness training can help focus your attention and awareness to better relieve stress, increase positive emotions, and self-regulation
• ADHD coaching tends to focus on executive functioning skills. It offers specific strategies for improving problematic areas and expanding on strengths. This typically includes training modules on time management, organization, goal setting and planning, task management, and self-monitoring.
• Neurofeedback and biofeedback teach you how to control your physical and emotional reactions. They use non-invasive sensors on the body to read brain activity (neurofeedback) and physiological responses (biofeedback) during cognitive tasks.

Types of providers

• A primary care physician or other prescribing healthcare provider (nurse practitioner, physician assistant) can diagnose you, prescribe medications, and provide referrals for psychotherapy or diagnostic evaluations.
• A psychiatrist is a more specialized doctor who can diagnose and treat ADHD.
• Mental health therapists like psychologists, clinical social workers, or counselors can provide therapy and support.
• ADHD coaches or life coaches are certified experts that specialize in ADHD.

How to help manage ADHD at home

ADHD is often treated by a healthcare provider, but there are many strategies you can do in your daily life to help your symptoms.

There is good evidence that a healthy diet, regular exercise, and getting enough sleep can improve ADHD symptoms.

• A healthy diet focuses on balanced nutrition and consistent meals and avoiding highly processed foods and artificial sugars.
• Regular physical activity releases endorphins, reduces stress and tension, and helps maintain a healthy weight and overall good health.
• Healthy sleep helps regulate mood, improves mental performance, improves overall health, and creates better daily structure and routine.
• Having positive and supportive people in your life who can work with you on different strategies can help you manage your symptoms. They can also learn more effective communication strategies to help reduce tension and stress.

OTC medications

There are currently no approved OTC treatments for ADHD. It is important to discuss any OTC medications you may be considering taking with your provider.

Tips for treating ADHD

• Take your medication at the same times every day to help avoid fluctuations in your focus, mood, and anxiety.
• Practice the strategies and skills from therapy or coaching on a daily basis. Often it’s helpful to include family to help with accountability and consistency.
• There are online programs, apps, and information to help with executive functioning strategies, like time management, organization, procrastination, and task management.

Wellness & Prevention

Eating a healthy diet, exercising regularly, and getting enough sleep, have been found to help reduce symptoms of ADHD

Foods that can help ADHD

• Omega-3 fatty acids from fish oils are important for brain and nerve cell function. You can increase your omega 3s by eating fish, various seeds, green leafy vegetables, and berries (blueberries, blackberries). You can also consider taking an omega-3 supplement.
• Protein releases neurotransmitters related to alertness and can help moderate sugar levels to reduce hyperactivity.
• High-fiber foods keep energy levels stable.
• Iron, zinc, and vitamins C and B6 help regulate neurotransmitter levels in the brain. You get them from eating a well-balanced diet or can be increased by taking a daily multivitamin.
• Limit highly processed foods and dyes.

Exercise

• Regular physical activity may improve cognitive functioning because it tends to release endorphins and dopamine neurotransmitters. If you don’t like exercise or sports, consider working with a physical trainer, who can help find activities you will enjoy.

Sleep

• Getting enough sleep can help improve focus and reduce fatigue and irritability. The most effective strategies for falling asleep are to reduce screen time, limit caffeine, avoid alcohol (especially before bed) and recreational substances, and follow a consistent bedtime and wake time.