What is ADHD?
While many people associate Attention-Deficit/Hyperactivity Disorder (ADHD) with childhood, it is a lifelong neurodevelopmental condition that affects millions of adults. In the U.S. alone, an estimated 8.7 million adults live with ADHD.
For many, symptoms evolve over time. You may not have been diagnosed as a child, but as adult responsibilities like career demands, household management, and complex relationships increase, the symptoms can become more noticeable. ADHD is highly manageable, and receiving a diagnosis as an adult can often be a "lightbulb moment" that leads to rapid improvements in your quality of life.
Common Signs and Symptoms
Adult ADHD can present in different ways. While many people associate ADHD with hyperactivity, it doesn’t always look that way. Some adults primarily experience challenges with attention and organization, while others experience hyperactivity and impulsivity (and many experience a combination of both). For a formal diagnosis, symptoms are persistent, occur across settings, and have been present for six months or longer.
Inattention Symptoms:
- Focus Challenges: Difficulty staying on task or getting easily distracted by unrelated thoughts or noises.
- Organization Hurdles: Feeling overwhelmed by to-do lists, losing track of items like keys or phones, and struggling to finish projects.
- Forgetfulness: Missing appointments or forgetting daily chores.
- Mental Fatigue: Avoiding tasks that require sustained mental effort (like paperwork or long reports).
AND/OR
Hyperactivity and Impulsivity Symptoms:
- Restlessness: Feeling like you’re "driven by a motor" or unable to sit still for long periods.
- Impulsive Decisions: Interrupting others in conversation or acting before fully thinking through the consequences.
- Hyperverbal: Noticing that you tend to talk excessively or struggle to engage in quiet activities.
Why Does ADHD Happen?
ADHD is a neurobiological condition related to how the brain regulates attention, motivation, and impulses. It is often influenced by:
- Brain Function: Differences in how certain brain networks develop and communicate (particularly those involving dopamine, a neurotransmitter linked to motivation, reward, and focus).
- Genetics: ADHD strongly runs in families.
- Masking and Compensation: Many adults have spent years "masking" their symptoms - working twice as hard as others to appear organized. While this may look like high functioning on the outside, it often comes at a cost, contributing to burnout, anxiety, and chronic exhaustion.
Steps you Can Take For Your Care
Living with untreated ADHD can feel like you are constantly swimming upstream. At Rula, we believe that mental health care should be empowering and effective. Taking the first step to understand your brain is a powerful act of self-kindness.
Here is how we can partner with you to find the relief you’re looking for:
Finding the Right Therapy for You
Therapy for ADHD isn't only about talking; it's about building a concrete toolkit to manage your unique responses.
- Cognitive Behavioral Therapy (CBT): CBT has the most scientific evidence proving its effectiveness in the treatment of adult ADHD, as it provides concrete strategies and skills for coping with the core symptoms of ADHD (inattention, hyperactivity, impulsivity).
- Mindfulness and Dialectical Behavior Therapy (DBT): These approaches help you manage the emotional side of ADHD, such as frustration and impulsivity, by teaching you how to stay grounded in the present moment.
Therapy & Medication
Research shows that for many adults, a combination of medication and behavioral therapy leads to the best results.
- Medication Management: If it’s appropriate for your situation, finding a psychiatry provider may be useful. They can discuss stimulant or non-stimulant options tailored to your needs.
ADHD Assessment at Rula: If you're seeking an ADHD diagnosis, our psychiatric providers conduct evaluations through a clinical assessment process, which typically includes:
- A clinical interview (discussing your symptoms, history, and how they impact your daily life)
- The use of standardized screening tools (structured questionnaires used to assess ADHD symptoms)
This process is considered a comprehensive ADHD evaluation in a clinical setting and is often the first step in diagnosis and treatment planning.
Rula does not provide formal neuropsychological or computerized ADHD testing, which is a more in-depth evaluation typically conducted over several hours with a psychologist.
In some cases, if additional diagnostic clarity is needed, you provider may recommend or refer you to a specialist for neuropsychological testing. However, this is not required for all patients.
→ As a reminder, it is beyond the scope of a therapist to suggest specific medications, groups of medications, specific supplements, or advise on the frequency of taking or stopping medications.
These discussions must only be carried out by a medical provider.
| As a reminder, it is beyond the scope of a therapist to suggest specific medications, groups of medications, specific supplements, or advise on the frequency of taking or stopping medications. These discussions must only be carried out by a prescribing clinician such as a medical doctor or nurse practitioner. |
Getting Care at Rula
Can Rula diagnose and treat ADHD?
Yes. Many patients find that their ADHD can be effectively managed through the clinical services available at Rula - both therapy and psychiatric medication management. Our providers use clinical interviews, history taking, and standardized screening tools to assess for ADHD. For many people, this clinical assessment is sufficient to begin a treatment plan and ongoing care.
When should I see a specialist outside of Rula?
While Rula providers can treat the majority of ADHD cases, there are specific scenarios where you or your child may need a comprehensive neuropsychological evaluation from an outside specialist.
You may need to seek external testing if:
- You require formal accommodations: If you need a formal evaluation for your child to qualify for a 504 Plan or IEP in school, or for formal workplace accommodations under the ADA, most institutions require a comprehensive neuropsychological battery that goes beyond a standard clinical diagnosis.
- The diagnosis is complex: If there is a question of whether you or your child’s symptoms are ADHD, Autism Spectrum Disorder (ASD), a specific learning disability, or a complex mood disorder, a specialist can perform the multi-day testing required to differentiate between these potentially overlapping conditions.
Even if you find you need a referral for evaluation from an outside specialist, you can always return to Rula for ongoing care!
Self-Care and Coping Strategies
You can begin supporting your focus today with a few environmental shifts:
- "Body Doubling": Try working in the presence of someone else (even virtually). Often, just having another person nearby can help you stay on task.
- Externalize Your Memory: Don't rely on your brain to remember. Use alarms, digital calendars, and visible checklists for everything.
- Movement as Medicine: Regular exercise helps boost dopamine levels naturally, which can improve focus and reduce restlessness.
- Break it Down: When a task feels too big, break it into "micro-steps” or “chunks”. Completing one tiny 5-minute task can provide the momentum you need to keep going.
Disclaimer: ADHD in Children and Adolescents
This care guide focuses on best practice guidelines for the treatment of adult ADHD, however, ADHD is one of the most common neurobehavioral disorders of childhood and can profoundly affect children’s academic achievement, well-being, and social interactions. (AAP). For information on providing effective care for children and adolescents with ADHD, check out the below resources:
- Treatment of ADHD in Children and Adolescents (CDC)
- ADHD in the Classroom: Helping Children Succeed in School (CDC)
A Note on Safety
Adults with ADHD are at a higher risk for accompanying conditions like anxiety and depression. If you are feeling overwhelmed or experiencing thoughts of self-harm, please reach out:
- Rula 24/7 Crisis Hotline: +1 (877) 371-5488
- 988 Suicide and Crisis Lifeline: Call or text 988 for free, confidential support 24/7.
Visit the Rula Blog for helpful strategies and resources for understanding and managing symptoms associated with ADHD.
References
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). American Psychiatric Association Publishing. https://doi.org/10.1176/appi.books.9780890425787
National Alliance on Mental Illness. (n.d.). Identity and cultural dimensions. https://www.nami.org/your-journey/identity-and-cultural-dimensions/
National Institute of Mental Health. (n.d.). Attention-deficit/hyperactivity disorder in adults: What you need to know. https://www.nimh.nih.gov/health/publications/adhd-what-you-need-to-know
Schein, J., Adler, L. A., Childress, A., et al. (2022). Economic burden of attention-deficit/hyperactivity disorder among adults in the United States: A societal perspective. Journal of Managed Care & Specialty Pharmacy, 28(2), 168–179. https://pubmed.ncbi.nlm.nih.gov/34806909/
World Health Organization. (n.d.). Adult ADHD Self-Report Scale (ASRS-v1.1) symptom checklist. https://www.hcp.med.harvard.edu/ncs/asrs.php
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