ADHD Diagnosis and Management
One of the more frequent reasons people come see me is to help them manage a confirmed or suspected diagnosis of ADHD. I get patients of all ages looking for ADHD support. And, their symptoms tend to vary depending on how old they are.
In adults, ADHD frequently shows up with difficulty concentrating at work. People have a hard time getting projects started and then finished. Their desks are littered with half-finished memos and indecipherable notes to themselves.
High-performing people develop all kinds of ways to try and manage this. They will set reminders and alarms on their phones, put fake calendar entries on their schedule to help them remember to focus and do work, write extensive to-do lists, and ask friends to remind them when they forget something. Some folks are very successful with these techniques and they manage well.
Others have a hard time even with these little strategies. Their brains are excitable and don’t like to settle down on any one particular thing. This can lead to a lot of self-doubt and negative self-talk. Some people even get very depressed, and that makes it even harder to get work accomplished.
How Do We Get from Suspected ADHD to Managed ADHD?
A few lucky folks eventually realize something is wrong and start looking for help. They’ll take an online quiz and answer yes to a bunch of questions, and end up diagnosing themselves with ADHD.
And then you need to look for professional support. Psychologists can diagnose, but can’t prescribe. Psychiatrists can diagnose and prescribe, but there is a shortage, so it can be difficult to get in to see one. And there are many physicians who don’t feel comfortable or confident with managing stimulant meds. So, finding a provider who can do something about it can be challenging! It makes it even more rewarding that I can help with both diagnosis and management for my patients.
When I see a patient who thinks they have ADHD, the first thing I do is take a good history. We want to make sure there aren’t other things going on that might mimic ADHD, like anxiety or depression. I’m curious about when the symptoms started, and what coping strategies they might use.
It’s important to get the diagnosis right. We don’t want to prescribe medications to people who don’t need them. And not everyone will do well with medicine, so sometimes we need to think about other strategies.
If we do need to use a medication, stimulant medications are the mainstay. I write prescriptions for Ritalin, Adderall, Vyvanse, and Concerta. In some cases we also try non-stimulant medicines like Strattera.
For most cases of ADHD, I don’t need my patients to see a psychiatrist. But sometimes, if the symptoms are severe or there are other diagnoses that exist at the same time, this is helpful.
Once on medication, patients need to follow up with me every three months or so, though we often schedule more frequent check-ins just as a normal part of ongoing care with me. A virtual visit is fine, but coming into the office is important occasionally so we can make sure vital signs are normal, since stimulants can increase blood pressure.
I find treating ADHD really satisfying. People do so well once they are on medication. It can be life-changing! Very often, other symptoms of depression and anxiety clear up as everything becomes easier and more satisfying.
If you have questions about ADHD, give me a call! I’d be glad to have you come in for an evaluation. And since I’m a primary care physician, we can make sure the rest of your health is in order, too.
