ADHD Treatment
Understanding ADHD
ADHD is a neurodevelopmental condition affecting approximately 4.4% of American adults. Despite being one of the most common psychiatric conditions, it remains significantly underdiagnosed in adults.
Attention-Deficit/Hyperactivity Disorder is far more than difficulty paying attention or sitting still. It is a complex neurodevelopmental condition rooted in measurable differences in brain structure and function, particularly in the prefrontal cortex, basal ganglia, and cerebellum -- regions responsible for executive function, attention regulation, impulse control, and motor coordination. ADHD involves dysregulation of the dopamine and norepinephrine neurotransmitter systems, which explains why medications that enhance these neurotransmitters can be so dramatically effective.
At RECO Integrated Psychiatry, we recognize that adult ADHD presents differently than childhood ADHD and requires specialized diagnostic expertise. While hyperactivity may diminish with age, inattention, executive dysfunction, emotional dysregulation, and impulsivity often persist and can significantly impact career performance, relationships, financial management, and self-esteem. Many adults with ADHD have spent decades being told they are lazy, careless, or not trying hard enough, when in reality they have a neurobiological condition that responds remarkably well to proper treatment.
The average age of ADHD diagnosis in adults is 36 years old, meaning many individuals spend decades struggling without understanding why. This diagnostic delay is particularly common in women, who more frequently present with the inattentive subtype rather than the more visibly recognizable hyperactive-impulsive presentation. Our comprehensive evaluation process is specifically designed to identify ADHD across all presentations, including subtle cases that may have been missed throughout childhood and adolescence.
Types We Treat
Predominantly Inattentive (formerly ADD)
Characterized by difficulty sustaining attention, poor organizational skills, frequent careless mistakes, difficulty following through on tasks, being easily distracted, and forgetfulness. This presentation is more common in women and girls and is frequently overlooked because it does not involve the outwardly disruptive behaviors associated with hyperactivity. Adults with inattentive ADHD often describe feeling like they are in a fog, struggling to keep track of responsibilities, and experiencing chronic underperformance relative to their intellectual ability.
Predominantly Hyperactive-Impulsive
Characterized by fidgeting, difficulty remaining seated, excessive talking, difficulty waiting turns, and impulsive actions. In adults, hyperactivity often manifests as internal restlessness, an inability to relax, workaholic tendencies, or constantly seeking stimulation. Impulsivity may present as interrupting others, making impulsive financial decisions, difficulty managing anger, or engaging in risky behaviors. This presentation is more commonly diagnosed in males.
Combined Presentation
The most commonly diagnosed form, combined ADHD involves significant symptoms of both inattention and hyperactivity-impulsivity. Individuals with combined presentation often face the broadest range of functional challenges, as they struggle with both sustained focus and impulse regulation simultaneously. This presentation typically has the most obvious functional impact and is therefore most likely to prompt clinical evaluation.
Causes & Risk Factors
ADHD has a heritability of approximately 74%, making it one of the most heritable psychiatric conditions. If a parent has ADHD, there is roughly a 50% chance their child will also have the condition. Environmental risk factors include prenatal exposure to tobacco, alcohol, or toxins, premature birth, low birth weight, and early childhood lead exposure. Neuroimaging studies consistently show that individuals with ADHD have slightly smaller total brain volume, with particularly notable differences in the prefrontal cortex, caudate nucleus, and cerebellum. These structural differences correspond to the executive function, attention, and motor coordination challenges that characterize the disorder.
Signs & Symptoms
Inattention Symptoms
- ✓ Difficulty sustaining attention during tasks, meetings, conversations, or reading
- ✓ Frequent careless mistakes in work or other activities requiring accuracy
- ✓ Difficulty organizing tasks, managing time, and meeting deadlines -- chronic procrastination
- ✓ Frequently losing items necessary for daily tasks (keys, phone, wallet, documents)
- ✓ Being easily distracted by unrelated thoughts or external stimuli
- ✓ Difficulty following through on instructions or completing projects
Hyperactivity & Impulsivity
- ✓ Internal restlessness, feeling driven by a motor, difficulty relaxing or sitting still
- ✓ Excessive talking, monopolizing conversations, difficulty listening to others
- ✓ Interrupting others, blurting out answers before questions are completed
- ✓ Impulsive spending, job changes, or relationship decisions without considering consequences
- ✓ Difficulty waiting in lines, for turns, or through slow-paced activities
- ✓ Emotional impulsivity: quick to anger, frustration, or excitement with difficulty regulating responses
Our Treatment Approach
Stimulant Medications
Stimulant medications are the most effective treatment for ADHD, with approximately 70-80% of patients experiencing significant improvement. Methylphenidate-based medications (Ritalin, Concerta, Focalin) and amphetamine-based medications (Adderall, Vyvanse, Dexedrine) work by increasing dopamine and norepinephrine availability in the prefrontal cortex. We carefully titrate dosing, monitor for side effects, and offer both immediate-release and extended-release formulations to match your lifestyle and needs. Pharmacogenomic testing can help predict which stimulant class may work best for you.
Learn MoreNon-Stimulant Medications
For patients who cannot tolerate stimulants, have co-occurring conditions that contraindicate them, or prefer non-controlled alternatives, we offer non-stimulant options including atomoxetine (Strattera), guanfacine (Intuniv), clonidine (Kapvay), and bupropion (Wellbutrin). While generally less potent than stimulants, these medications can be effective and are particularly useful when ADHD co-occurs with anxiety, tic disorders, or substance use history.
Learn MoreBehavioral Strategies & CBT
Cognitive Behavioral Therapy adapted for ADHD helps patients develop practical strategies for organization, time management, prioritization, and emotional regulation. Unlike medication, which primarily addresses the neurobiological aspects of ADHD, therapy addresses the behavioral patterns, avoidance strategies, and negative self-beliefs that often develop over years of untreated ADHD. We teach concrete skills including external organizational systems, breaking tasks into manageable steps, and techniques for managing the emotional toll of living with ADHD.
Learn MoreComprehensive ADHD Evaluation
Our thorough ADHD evaluation includes clinical interview, validated rating scales (such as the ASRS and Conners scales), review of developmental and academic history, assessment for co-occurring conditions (anxiety, depression, bipolar disorder, substance use), and when appropriate, referral for neuropsychological testing. We also screen for conditions that can mimic ADHD, including thyroid disorders, sleep disorders, and mood conditions, to ensure an accurate diagnosis.
Learn MoreWhen to Seek Help
If you have been struggling with chronic disorganization, difficulty concentrating, impulsive behavior, or underperformance at work or in relationships that you suspect may be more than normal -- especially if these patterns have been present since childhood -- a comprehensive ADHD evaluation can provide clarity and a path forward.
Seek immediate help if you experience:
- ! Severe impulsive behavior putting yourself or others at risk
- ! Co-occurring depression with suicidal thoughts
- ! Substance use escalating to cope with untreated ADHD symptoms
- ! Inability to function at work or maintain basic daily responsibilities
Crisis Resources: Call 988 (Suicide & Crisis Lifeline), text HOME to 741741, or go to your nearest emergency room. These services are available 24/7.
Frequently Asked Questions
Related Conditions
Anxiety Disorders
Nearly half of adults with ADHD have a co-occurring anxiety disorder. Both conditions must be addressed for optimal outcomes.
Depression
Adults with ADHD are nearly three times more likely to develop depression, often resulting from years of untreated ADHD-related difficulties.
Bipolar Disorder
ADHD and bipolar disorder share overlapping symptoms including impulsivity and distractibility. Accurate differentiation is essential for safe treatment.
Insomnia
Sleep difficulties affect up to 75% of adults with ADHD and can significantly worsen attention and executive function challenges.
