​For adults with Attention Deficit Hyperactivity Disorder (ADH), daily life can be challenging. The good news is that many strategies and treatment options can help you manage the symptoms of this disorder, and working with an adult ADHD psychiatrist can be a helpful place to start.
 
Before we dive into some treatment options, let’s talk a bit about symptoms. Many adults with ADHD were not diagnosed as children and they struggle without really knowing why. This is especially true for women with ADHD, and this disorder is often less recognized in women because the symptoms can be more internalized leading to challenges such as anxiety and feeling overwhelmed. 

Women tend to exhibit internalized symptoms, such as inattentiveness and emotional sensitivity, which are often overlooked or misdiagnosed as anxiety disorders or depression.

Inattentiveness

• Difficulty staying focused on tasks or conversations.
• Often losing items like keys, wallets, or phones.

Emotional Sensitivity

• Feeling overwhelmed by emotions or situations, often leading to tears or withdrawal.
• Heightened sensitivity to criticism or perceived rejection.

Forgetfulness

• Frequently forgetting appointments, deadlines, or daily tasks like paying bills or responding to messages.

 Overwhelm & Difficulty Prioritizing

• Feeling paralyzed when faced with multiple responsibilities.
• Difficulty deciding what to tackle first, leading to inefficiency.

 Chronic Disorganization

• Struggling to keep spaces tidy or manage schedules effectively.
• Relying on lists but often losing or forgetting them.

 Hyperfocus

• Getting intensely absorbed in tasks of interest while neglecting other responsibilities.
• Losing track of time when engaged in a favorite activity.

 Fatigue or Daydreaming

• Seeming "spacey" or zoning out during conversations or tasks.
• Experiencing exhaustion from constantly managing ADHD symptoms.

 Social Challenges

• Difficulty maintaining friendships or relationships due to forgetfulness or distractibility.
• Feeling misunderstood or isolated because symptoms are perceived as laziness or carelessness.

Men are more likely to exhibit externalized symptoms, such as hyperactivity and impulsivity, which are more noticeable and often diagnosed earlier. Adult ADHD often presents differently in men, typically due to social expectations and biological factors. Symptoms include:

Hyperactivity & Restlessness

• Feeling the need to move constantly, even in inappropriate settings.
• Frequently tapping fingers, shaking legs, or pacing.

 Impulsivity

• Interrupting conversations or speaking without thinking.
• Acting without considering consequences (e.g., making rash decisions or risky financial moves).

 Difficulty Focusing

• Struggling to stay engaged in tasks, conversations, or meetings.
• Frequently losing track of thoughts or being easily distracted.

 Low Frustration Tolerance

• Becoming irritable or angry quickly.
• Difficulty handling stress or setbacks.

 Trouble with Organization & Time Management

• Forgetting deadlines or appointments.
• Starting projects but not finishing them.

 Risk-Taking Behaviors

• Seeking stimulation through risky activities, such as reckless driving or extreme sports.
• Struggling with impulse control related to alcohol, drugs, or gambling.

 Chronic Procrastination

• Putting off tasks until the last minute, leading to rushed or incomplete work.

​Again, while these symptoms of adult ADHD are typical of women or men, any individual might exhibit any of these common symptoms. However, recognizing how ADHD may present differently depending on gender helps ensure that ADHD in both men and women is properly identified and treated. Treatment plans can then be tailored to address the unique ways ADHD manifests in individuals.
 
One question I often am asked is how often does ADHD co-occur with bipolar disorder or perhaps obsessive-compulsive disorder (OCD) or autism spectrum disorder (ASD)? It is extremely common for a person to have multiple diagnoses, and while this can make management more complicated, it’s important for an adult psychiatrist to properly diagnose all of these issues.
 
I also find that for many patients with ADHD or perhaps bipolar disorder an accompanying substance use disorder is extremely common. As an addiction psychiatrist who also specializes in the treatment of adult ADHD, bipolar disorder, anxiety and depression, I can help you navigate the complexities of addiction as well as any other mental health condition, but we must address all of the issues you face.

Living with ADHD can be difficult, but there are many ways to manage this disorder. Treatment for ADHD often involves a combination of therapies, medications, and lifestyle changes tailored to the individual's needs. Here’s an overview of the most effective approaches:

Medications can significantly reduce ADHD symptoms, especially when combined with other treatments. Keep in mind, that stimulant ADHD medications often can be taken as needed while non-stimulant medications should be taken every day. Common types include:

Stimulants:

• Examples: Adderall (amphetamine), Ritalin, Concerta (methylphenidate).
• How They Work: Increase levels of dopamine and norepinephrine in the brain, improving focus and impulse control.
• Pros: Effective for many; fast-acting.
• Cons: Potential side effects include insomnia, reduced appetite, and increased heart rate.

Non-Stimulants:

• Examples: Strattera (atomoxetine), Intuniv (guanfacine), Kapvay (clonidine).
• How They Work: Affect norepinephrine levels or regulate executive functioning.
• Pros: Suitable for individuals who cannot tolerate stimulants; less risk of abuse.
• Cons: May take longer to show effects.

Therapy helps address emotional, behavioral, and social challenges related to ADHD: While medications can be highly beneficial, as an adult ADHD psychiatrist, I strongly recommend therapy as well because a combined approach provides the best results.

Cognitive Behavioral Therapy (CBT):

• Focuses on changing negative thought patterns and behaviors.
• Teaches skills for organization, time management, and emotional regulation.

Behavior Therapy:
Helps individuals develop positive habits and reduce problematic behaviors through reinforcement techniques.

Mindfulness-Based Therapy:
Teaches mindfulness techniques to improve focus, reduce impulsivity, and manage stress.
​
Family or Couples Therapy:
Addresses relationship dynamics affected by ADHD, fostering understanding and communication.

While not replacements for traditional treatments, these can complement other strategies:
 
Exercise:
Regular physical activity boosts dopamine and norepinephrine levels, improving focus and mood. Aerobic activities like running, swimming, or cycling are particularly effective.

Dietary Changes:
A healthy, balanced diet with adequate protein, omega-3 fatty acids, and complex carbohydrates can support brain health. Some individuals benefit from avoiding artificial additives or allergens (consult with a professional).

Supplements:
Omega-3 fatty acids (fish oil) may help improve attention and reduce hyperactivity.
Always consult with your primary care doctor before starting supplements.

Mindfulness & Meditation:
Regular mindfulness practice improves attention span, reduces stress, and enhances self-awareness. There are many studies to support the use of meditation and mindfulness training for individuals with ADHD. As a psychiatrist for anxiety and psychiatrist for depression, I find that this also can be of great benefit for those with anxiety and depression.

Yoga & Tai Chi:
These practices promote relaxation, improve self-control, and increase body awareness.

​As an adult ADHD psychiatrist, I always recommend incorporating therapy as well as these alternative treatment approaches. Additionally, many strategies can help those with ADHD stay organized and manage tasks of daily life.

Using a daily to-do list or organizing tasks using a calendar can help. There are even some task management apps that can help. I also recommend breaking large tasks into small steps, which can be much less overwhelming. For instance, if you need to clean your house, break this down into small manageable tasks (dust the living room, unload the dishwasher, etc.) and cross off each task as you complete it. 

There are many types of ADHD specialists – psychiatrists, psychologists, therapists, etc. All of these individuals can be crucial in your journey toward ADHD management. However, contacting an adult psychiatrist can be a good first step.

Psychiatrists are medical doctors, and they can provide you with the most comprehensive diagnosis, taking into account your mental health as well as your physical health and developing a treatment plan that meets all of your needs. ADHD psychiatrists also are able to prescribe medication, while psychologists and therapists cannot.

Psychologists and therapists are valuable for those with ADHD, as psychiatrists typically do not provide talk therapy, behavioral therapy or other types of therapy. Our focus is more on diagnoses and creating a treatment plan and monitoring the success of that plan.

While it can take some time to discover the treatments and strategies that work best for you, seeking treatment from an adult ADHD psychiatrist can make managing daily life so much easier. I encourage you to contact me at any time to set up a consultation. In addition to treating ADHD, I also offer services as a bipolar disorder psychiatrist, borderline personality disorder doctor, eating disorder psychiatrist and I treat anxiety, depression, PTSD and more.

 If you have a child struggling with ADHD, seeking the services of an ADHD psychiatrist can be beneficial. We can provide a clear, documented diagnosis and help find options to reduce symptoms and make life easier for your child. As a parent, however, you also have the opportunity to advocate for your child through the school system, and the following information may be of help.

What Is ADHD?
Attention Deficit Hyperactivity Disorder (ADHD) is a neurological disorder that can affect children and adults in many ways. People with ADHD can experience a wide range of symptoms including difficulty with attention, focus and organization. Hyperactivity and impulsivity and moodiness also are among the symptoms.

ADHD often presents more obviously in boys than in girls, but that doesn’t mean that girls don’t need just as much support. If your child is struggling in school with focus or completing homework or perhaps they seem forgetful, anxious or constantly daydreaming, ADHD could be the cause.

The best step that parents can take is to have their child evaluated by a psychiatrist or psychologist. Be sure to find a psychiatrist or psychologist that focuses on providing a thorough diagnosis that gives you a clear picture of all of the issues your child might be facing. It is very common for a person with ADHD also to have a co-occurring disorder such as anxiety, depression, OCD or Autism Spectrum Disorder and we must uncover all of these issues to provide the best possible support.

Is ADHD a Disability?
We often think about disabilities as something physical or perhaps we think of a student with an intellectual disability such as Down’s Syndrome. However, neurological disorders also are disabilities.

The Americans With Disabilities Act (ADA) defines an individual with a disability as a “person who has a physical or mental impairment that substantially limits one or more major life activities.” These activities would include attending school, and, as anyone with ADHD can attest, school can be tough when you have ADHD.  

Children with disabilities are entitled, by law, to have an education equal to that of their peers. To ensure that level of equality, accommodations may be needed and the school site will need to create a plan to facilitate a learning environment that supports a child with ADHD or with any type of disability.

As a parent, you are well within your rights to contact the school and ask to meet with the teacher and administrators to talk about what types of plans can be put into place for your child. This can be easier to do once you have a diagnosis in writing either from a psychiatrist or psychologist, but you definitely don't have to wait in order to seek support from your school.

IEP Vs. 504 Plans Vs. SSTs
The educational system throws plenty of acronyms and abbreviations at parents, and you may hear a teacher or special education provider talk about terms such as an IEP, an SST or a 504 plan. Let’s take a look at each of these plans and how they can benefit a student with ADHD.

Individualized Education Plans (IEPs) – These are binding legal documents that create a plan for a child struggling with one or more disabilities. The IEP might include special education instruction, outside support services and classroom accommodations that are deemed necessary to ensure student success.

With an IEP, parents also can request an Independent Educational Evaluation (IEE). If the school approves the request, the district will pay to have an outside expert evaluate the student. Keep in mind, the district might not agree to your request for an IEE. If you still want an IEE, this will mean you must pay for it out of pocket.

Additionally, the IEP can only be used to help students that fit within one of the 13 disability categories listed in the Individuals with Disabilities Education Act (IDEA), which is an act that requires all public schools to provide special education services to any student that is eligible. The 13 categories include:

• Specific Learning Disability (i.e., Dyslexia, Dysgraphia)
• Other Health Impairments (i.e., ADHD and other conditions that affect energy and alertness)
• Autism Spectrum Disorder
• Emotional Disturbance (i.e., anxiety, depression, bipolar disorder, OCD)
• Speech or Language Impairment
• Visual Impairment
• Deafness
• Hearing Impairment (including auditory and language process disorders)
• Deaf-Blindness
• Orthopedic Impairment
• Intellectual Disability (i.e., Down’s Syndrome)
• Traumatic Brain Injury
• Multiple Disabilities

It’s not uncommon for children with IEPs to fall into the last category of Multiple Disabilities. For instance, you might encounter a student with ADHD and Autism Spectrum Disorder. This latter section simply means that the IEP must address all of the disabilities that are present, rather than simply using a plan to fit one of the diagnoses.

504 Plans – These are known as 504 Plans because they are derived from section 504 of the U.S. Rehabilitation Act of 1973. This act prohibits any organization that receives federal money from discriminating against people with disabilities. Because ADHD is considered a learning disability, this means that students diagnosed with ADHD are protected under section 504. As with an IEP, a 504 Plan is a binding legal document.

504 plans provide specific accommodations for students with ADHD, such as allowing a student to have extra time to complete an exam or assignment. For older students, this also might entail being allowed to record a classroom lecture. For younger students, this might include allowing them to take a break and walk around or perhaps placing them in a seat that helps to limit distractions. Every student's needs and accommodations are unique, so teachers and administrators need to be flexible to create plans that meet the needs of a specific student.

The main differences between the 504 Plan and an IEP are that the 504 includes a broader range of disabilities, but you cannot request the IEE. A 504 Plan also doesn’t typically include special education services and instead focuses on creating goals and classroom accommodations to help a student.

Student Study Team (SST) – This is often the first step you will take as a parent toward acquiring support for your child. Sometimes a teacher will suggest the formation of an SST, but parents also can request it. This team typically consists of the child’s parents and teacher and at least one other school staff member. This could be a special education teacher, a student’s former teacher, the school principal or the school counselor. 

During a Student Study Team meeting, the team will address issues and create some goals and perhaps identify some accommodations or support that could be helpful to a student. SSTs aren’t as binding as a 504 plan or IEP, but they can be an excellent first step to take while you are setting up therapy and meeting with an ADHD psychiatrist. In some cases, a child with mild ADHD might only need a few minor accommodations and an SST might be all that is warranted.

ADHD Medication: Is This A Good Option?
Parents are often hesitant about having their children use medication for ADHD, and as a pediatric psychiatrist, I understand the hesitation, but as a medical professional, I also feel that medication can be very beneficial for some patients.

The most common medications used to treat ADHD include methylphenidate (brand names Ritalin and Concerta) and dextroamphetamine with amphetamine (Adderall). Another stimulant medication is lisdexamfetamine (Vyvanse),

These are in a class of drugs known as stimulants, and they help to boost the levels of norepinephrine and dopamine in your brain. These are brain chemicals that help us focus and pay attention to tasks.

Because these drugs are stimulants and because some people (without ADHD) abuse them recreationally, they have a dubious reputation. However, both of these medications have a long history of use to treat ADHD and other disorders and the majority of children taking these drugs, or about 80%, report a significant reduction of ADHD symptoms when using these medications.

Ritalin was developed in the 1940s and has been used for more than 50 years to treat symptoms of ADHD. Concerta, which is essentially an extended-release type of Ritalin, was approved for use more than 20 years ago. Adderall has been used for nearly 30 years, and Vyvanse, is essentially the extended-release version of Adderall. Unlike some medications, a few of these ADHD medications can be taken as needed, such as just on school days.

While these medications can be effective, there are a few side effects that some children experience. One of the most significant side effects is a reduced appetite, so parents must pay close attention to their child’s eating habits to ensure they are continuing to get proper nutrition. In some cases, these drugs can upset sleep schedules and cycles, and we can adjust the dosage or adjust the type of drug to help with this issue. It is also important to note that if your child has another condition, such as bipolar disorder, some ADHD drugs aren’t going to be an appropriate treatment option.  

Non-stimulant drugs for ADHD include atomoxetine, which is in a class of drugs known as selective norepinephrine reuptake inhibitors (SNRIs). Guanfacine is yet another option, in a class of drugs known as centrally-acting alpha2A-adrenergic receptor agonists. This drug is meant to affect the portions of the brain responsible for attention and impulsivity. 

Therapy Is Crucial
Your ADHD psychiatrist can prescribe medication and will provide you with information about all of these drugs and recommend options that seem to be the best fit for your child. However, we usually also recommend some behavioral therapy. Medications prescribed by a child psychiatrist can help with focus, but patients experience the highest level of success with a combination of therapy and medication. These therapies teach essential coping mechanisms and strategies to help a patient deal with their ADHD long-term.

Adult With ADHD? Contact Me Today
While I don't offer services as a pediatric psychiatrist or child psychiatrist, I can help young adults and older adults struggling with ADHD, including providing a diagnosis that covers all of the issues you may be facing. I can meet with patients in person and offer telepsychiatry services if you prefer to meet with an online psychiatrist or live too far from my offices in Thousand Oaks.