Managing ADHD: Insights From An Adult ADHD Psychiatrist

​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. 

Symptoms Of Adult ADHD In Women

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.

Symptoms Of ADHD In Men

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.

Managing Adult ADHD

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:

1. Medications

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.

2. Therapy

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.

3. Alternative & Complementary Approaches

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. 

​Why Contact An ADHD Psychiatrist

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.