ADHD Treatment

How common is ADHD?

About 15% of children and 8% of adults have ADHD, and about half of affected people have severe impairments in function. The majority of people with ADHD also have other mental health conditions, including mood disorders, anxiety, autism, and sleep disorders. Unfortunately, only about 60% of people with ADHD are diagnosed and treated, and only about 30% receive adequate treatment.

Why should I seek treatment for ADHD? 

Untreated ADHD can have significant negative consequences. ADHD causes symptoms that can lead to difficulty in school, at work, at home, and in relationships. Untreated ADHD increases risk for serious accidents and injuries, obesity, substance abuse, dropping out of school, teen pregnancy, unemployment, criminality and incarceration, being the victim of violent crime and sex offenses, and suicide. Fortunately, ADHD is very treatable. With effective treatment, most people with ADHD can live happy, healthy, successful lives.

What causes ADHD?

There are three primary risk factors for ADHD:

1) Genetics. The heritability of ADHD is the highest of any psychiatric disorder at approximately 80-90%. This means that if someone in your immediate family (parents, siblings, or children) has depression, you are much more likely to have it yourself.

2) Prenatal and childhood environmental exposures. Maternal asthma, exposure to phthalates, and use of tobacco, acetaminophen, and valproate during pregnancy are associated with a higher risk of ADHD in the child. Childhood exposure to lead, organophosphates, secondhand smoke, and viral and bacterial infections can also increase risk for ADHD, and adverse childhood experiences such as poverty, residential instability, and parental substance abuse, criminality, and psychiatric disorders more than double the risk for ADHD.

3) Poor nutrition. Growing up on a diet including high amounts of red meat, processed meats, refined flour, sugar, salt, and hydrogenated fats (basically, the standard American diet!) increases the risk of ADHD by 92%. Consuming high amounts of processed foods, artificial food coloring, and soft drinks compounds the risk. Deficiencies in specific nutrients, including Vitamin D, Vitamin A, Vitamin C, Vitamin B1 and B2, calcium, zinc, iron, magnesium, copper, selenium, and Omega 3 Fatty Acids are also risk factors for ADHD. Gut dysbiosis, or imbalance in intestinal bacteria, also increases risk.

How does ADHD affect the brain?

ADHD causes the brain to develop differently in utero, so the brains of people with ADHD have measurable differences in brain structure and function from people who do not have ADHD. Structures affected include:

Basal ganglia: regulates emotion, thinking, and control of movement

Nucleus accumbens: involved in motivation

Amygdala: involved in emotional regulation and reactivity

Hippocampus: involved in memory and emotion

ADHD also causes imbalances in neurotransmitters, primarily norepinephrine and dopamine. These imbalances cause dysfunction in brain networks regulating attention, motivation, cognitive flexibility, working memory, executive function, psychomotor control, and emotional regulation.  

What are the symptoms of ADHD?

ADHD causes two main groups of symptoms:

Inattention: Due to dysregulation in the neurotransmitters norepinephrine and dopamine, people with ADHD have trouble with motivation, paying attention, focusing for prolonged periods, and switching attention back and forth between tasks. This causes difficulty starting projects, staying on task without getting distracted, and completing final details of projects. People with ADHD often “zone out” during conversations, lectures at school, and meetings at work, and will miss details or not remember topics that were discussed. They tend to make careless errors, even when they have a good understanding of a topic or task. They also frequently misplace things like phones, wallets, and keys, and forget about appointments and obligations. Because urgency causes release of norepinephrine, people with ADHD often find that they are able to focus and complete tasks better as they get closer to a deadline. People with ADHD can also perform better on tasks and topics they find interesting, because interest causes release of dopamine. People with ADHD can even hyperfocus on interesting and urgent tasks.  

Hyperactivity and Impulsivity: Dysregulation in dopamine and norepinephrine are also involved in how the brain tells the body to move, how the brain decides when it is necessary and appropriate to move, and interpreting whether behaviors and actions will be beneficial or harmful. People with ADHD often feel compelled to move constantly, which leads to difficulty slowing down and relaxing, and discomfort and fidgeting when forced to sit or stand still. They also have a hard time suppressing urges, which causes them to blurt things out at inappropriate times, interrupt, finish people’s sentences, say or do things impulsively, and have difficulty regulating their emotional reactions.

Some people with ADHD have mostly inattentive symptoms, and some have mostly hyperactive and impulsive symptoms, but the majority of people have a combination of both types of symptoms.    

What does an ADHD Assessment include?

At Owl & Eagle Health and Wellness, our team of board certified psychiatric nurse practitioners provide expert assessments for ADHD. An ADHD evaluation at Owl & Eagle Health and Wellness will include a thorough history. Your provider will ask questions about your current symptoms and symptoms you have experienced in the past, and how your symptoms have affected your function at home, school, at work, and in your relationships. They will ask you about your past psychiatric and medical history, including past psychiatric diagnoses and treatments you have tried. They will ask you about your educational and work history, your relationships with family, coworkers, and friends, and whether you have had problems with substance abuse or legal trouble. They will also ask about your family medical and psychiatric history. They will perform a mental status exam, which includes assessments of your communication, movements, behavior, mood, thoughts, memory, attention, and focus. They will perform standardized testing for ADHD, and testing for other diagnoses if needed. They may also order more extensive neurocognitive testing if needed to clarify the diagnosis. For children and teens with ADHD, they will ask parents and teachers to provide information and complete assessments indicating their perspectives on symptoms. 

How is ADHD treated?

At Owl & Eagle Health and Wellness, our team of board certified psychiatric nurse practitioners and psychotherapists treat ADHD using a holistic and integrative approach. Mild cases of ADHD often improve with coaching to improve organizational and study skills, psychotherapy to help with emotional regulation, dietary changes, vitamins, supplements, exercise, sleep hygiene, stress management, meditation, and yoga. Moderate to severe ADHD usually requires adding medication to these strategies.  Medications for ADHD include stimulants and non-stimulant options, and both can be highly effective. These medications usually have very manageable side effects, and most resolve in the first weeks of treatment. Genetic testing can help identify which medications are more or less likely to be effective and well tolerated for you. The vast majority of patients we treat for ADHD are able to effectively control their symptoms, leading to great improvement in work or school performance, management of responsibilities, relationships with friends and family, and self-esteem and well-being.

If you would like to learn more about assessment and holistic psychiatric treatment for ADHD for children, teens, and adults at Owl & Eagle Health and Wellness, Contact Us with questions or Book Now  to request an intake appointment today. Appointments are available either in-person in our offices in Golden or Denver, Colorado, convenient to the Denver Metro area, or via telehealth anywhere in Colorado. We look forward to meeting you!

Sources

https://www.nami.org

https://www.nimh.nih.gov/

https://www.samhsa.gov/

https://www.mentalhealth.gov/basics/mental-health-myths-facts

https://mhanational.org/mentalhealthfacts

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7064804/

https://pubmed.ncbi.nlm.nih.gov/31014101/

https://link.springer.com/content/pdf/10.1007/s11920-020-1141-x.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9608000/

https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/ADHD