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WhileADHDis not something that can be or should be “treated”, there are strategies that can be implemented to manage it.
Effective management methods are important for targetingsigns of ADHDthat interfere with personal, social, academic, and occupational functioning across the lifespan, such as emotion dysregulation,mood swings, and executive dysfunction.
This article provides an overview of evidence-based pharmacological and non-pharmacological methods for ADHD.
ADHD management is important because it can help improve focus, organization, emotional regulation, and motivation. Medication and therapy provide coping skills and strategies to manage symptoms more effectively. This leads to better outcomes in school, work, relationships, and overall wellbeing.
Medication
Stimulant medications are recommended as part of first-line ADHD treatment for children (ages 6+), adolescents, and adults under the care of a medical provider (although they can come with side effects and may not be suitable for everyone).
When selecting a stimulant, factors like speed of desired symptom relief, duration of action needed to cover daytime hours of highest impairment, mode of delivery (tablet, patch, liquid), likelihood of compliance, potential adverse side effects, and abuse risk (for adults or adolescents) help determine the most appropriate medication and dosage schedule for each person’s needs.
Types of Stimulant Medications
Most common: Decreased appetite, headaches, irritability, insomnia, cardiovascular effects – often dose-dependent and diminish over time for most people. Rare risks require prompt medical care like prolonged painful erections or suicidal thoughts during early treatment.
Non-Stimulant Medications
These medications have a different mechanism of action but also target biological components of ADHD. If prescribed, they must be taken daily long-term to maintain symptom relief.
Options include:
Around 30% of those with ADHD have limited response to stimulants but experience a reduction in ADHD symptoms from non-stimulants. These medications may also be combined with stimulants or used alone when stimulant treatment is ineffective/problematic.
Sedation, headaches, irritability, gastrointestinal symptoms – often diminish over time. Rare risks of liver injury or suicidal thoughts during early treatment require prompt medical care. Gradual taper of these medications reduces complications if discontinued.
Psychotherapy
Various types of therapy and support teach individuals with ADHD new skills to directly improve their psychological and behavioral regulation.
Cognitive-Behavioral Therapy
Cognitive-behavioral therapy (CBT) for ADHDmay help identify and shift negative thinking patterns like “I just can’t focus, nothing will help,” which exacerbates ADHD struggles.
Reconstructing self-defeating thoughts builds confidence to apply new skills taught in CBT like:
Both individual and group CBT improve core symptoms,emotional regulation, productivity, motivation and life satisfaction in various ADHD populations.
A meta-analysisexamining 28 studies indicates CBT effectively reduces both core ADHD symptoms (inattention, hyperactivity, impulsivity) and emotional symptoms like anxiety and depression in adults with ADHD.
Considerations:
Acceptance and Commitment Therapy
Acceptance and Commitment Therapy (ACT) is a branch of CBT that can be a valuable approach for individuals with ADHD. By learning to accept their thoughts and feelings without judgment, people with ADHD can reduce the emotional impact of their challenges.
ACT also teaches techniques to detach from unhelpful thoughts, stay present in the moment, and cultivate a sense of self that is separate from one’s diagnosis.
Through the practice of self-compassion and mindfulness,ACT can help people with ADHDdevelop greater resilience and adaptability in the face of their unique challenges, ultimately leading to a more fulfilling life.
Dialectical Behavior Therapy
Dialectical behavior therapy (DBT) blends CBT with mindfulness exercises and emotional coping tactics from Zen Buddhist traditions using concepts of radical acceptance and tolerating distress.
DBT provides psychological skills training in four areas:
Since ADHD can affect emotion regulation and impulsivity,DBT may be a helpful management optionfor individuals with ADHD.
Research indicatesDBT improves ADHD symptoms along with emotional impulsivity and may be particularly helpful for adults with co-occurring mood disorders and suicidal ideation.
Behavior Therapy Techniques
Parents, teachers and medical providers can be trained to implement these strategies:
Methods aim tomotivate individuals with ADHDusing frequent feedback matched to their struggles with delayed reinforcement from consequences as well as facilitating environmental supports.
Commonbehavior therapyprograms include:
Other Interventions
Other non-pharmacological options forcoping with ADHDimpairment continue emerging, though more research is needed to confirm their efficacy and feasibility for widespread use.
Mindfulness interventions
Dr. Dawn-Elise Snipesexplains how mindfulness training can be helpful for improving ADHD symptoms and executive functioning deficits.
She notes that mindfulness interventions that encourage individuals to slow down, be more thoughtful, and tune into the present moment showed improvements in attention regulation, impulse control, organization, and emotional dysregulation.
Often, mindfulness training will incorporate environmental cues or triggers to remind the ADHD individual to check in with themselves and consciously choose skillful responses instead of acting on autopilot. For example, setting cell phone alerts for short mindfulness breaks.
Additionally, mindfulness involves self-awareness of which environments and situations bring out the best versus worst in symptoms. Dr. Snipes gives the example of her son choosing study spots carefully to limit distracting stimuli and optimize his concentration abilities.
Being mindful of your personal rhythms, energy levels, peak performance times, and early warning signs that attention or focus is declining can also be very strategic. Then, the individual can take timely breaks or switch tasks proactively.
The key premise behind usingmindfulness for ADHDis to promote conscious choices and wise responses instead of impulsive, habitual reactions.
Customizing the training to the individual’s unique symptoms and challenges is important, as is starting small with reasonable expectations for someone with executive functioning deficits.
Neurofeedback
Success in practicing self-regulation of brain waves may then reinforce similar attention skills in daily life.
Some evidence shows ADHD symptom reduction but little data confirms functional or persisting gains fromneurofeedback.
Dietary Supplements
Certain vitamins, minerals and amino acids affect neurotransmitter systems linked to ADHD impairment.
Daily iron, zinc, magnesium, omega-3s or S-adenosylmethionine (SAMe) supplementation demonstrates potential as safe ADHD interventions yet requires further study to specify efficacy and proper dosing.
Physical Activity
Aerobic exercise elevating heart rate prompts the release of neurotransmitters that influence ADHD abilities for concentration, cognitive flexibility, and mood stability.
Sleep Hygiene
Many with ADHD suffer co-occurring sleep disturbances that worsen daily symptoms. Getting adequate quality restorative sleep sustains attention, memory, and emotional regulation impaired in ADHD.
Building Organizational Skills
Dr. Dawn-Elise Snipesexplains how organizational skills can be helpful for managing ADHD symptoms like inattention, distractibility, and executive functioning challenges.
She notes that research has found that explicitly teaching organizational skills leads to moderate improvements in ADHD issues.
Some examples of helpful organizational strategy training include using checklists, setting up systems and designated homes for important items, and creating assignment templates or frameworks.
For instance, having a special box, basket, or “launch pad” area for keys, bags, phones and other essentials when entering the house can assist with memory, planning ahead, and losing track of items.
Organizational skills and other strategies can be implemented on your own orADHD coachingmay be a promising option for those who may require some external support.
ADHD Support Groups
ADHD support groups connect individuals facing similar struggles, reducing isolation. Sharing personal experiences and successful strategies provides motivation and ideas for practical symptom management.
Groups foster accountability through encouragement and empathy from those managing the same disorder and understanding ADHD’s impact. This motivates persevering with management methods and builds self-compassion.
Treatment Planning and Monitoring
Selecting Appropriate Initial ADHD Services
Input from individuals, parents, teachers, and medical experts identifies:
These factors shape what services start treatment – often medication and/or training for parents and teachers in proven ADHD behavior strategies.
Monitoring Progress Over Time
Frequent check-ins following ADHD management initiation determine:
Changes should align management better with shifting needs from neurodevelopment, life transitions or new impairments manifesting over time.
Promoting Generalization and Maintenance
For lasting benefits, individuals with ADHD continually apply trained strategies and perform emergent skills in natural environments like:
Reinforcement from experiencing self-efficacy and natural rewards for success help new ADHD-targeted behaviors endure so supports can fade.
Special Considerations
Unique factors shape ADHD management for people of different ages, supporting the need for specialized care across the lifespan tailored to each population’s needs.
Preschool Kids
Distinct diagnostic challenges in differentiating neurotypical childhood activity from ADHD symptoms in this group mean medication is rarely prescribed. However, behavioral difficulties can be addressed effectively through early intervention.
Common Preschool ADHD Management Elements:
Adolescents
Pubertal changes interact uniquely with ADHD challenges emerging as expectations increase for older students. Assessment should determine if previous accommodations still help overcome current barriers.
Common Adolescent ADHD Management Elements:
Adults
Symptoms often resemble childhood history but require updated screening. Stigma delays many adults from seeking help despite significant impairment.
Common Adult ADHD Management Elements:
Older People
Distinguishing lifelong ADHD from new attentional deficits in older ages proves difficult. Emotional dysregulation and sleep disturbances should be managed too.
Common Management Considerations for Older People with ADHD History:
Conclusion
In summary, ADHD is a common neurodevelopmental disorder often causing substantial lifelong impairment, but evidence-based management tailored to each person’s needs helps manage symptoms and skill deficits interfering with optimal functioning.
The most robust response usually comes from combining pharmacological and behavioral approaches to respectively target biological and developmental aspects of ADHD in a coordinated multimodal care plan.
Still, given the considerable heterogeneity observed in ADHD clinical presentations, treatment tolerance/response and access among various populations, highly individualized ongoing assessments should always guide delivery of interventions and services.
Management planning must consider developmental stage, symptom profiles, co-occurring conditions, and available supports to successfully address one’s current daily obstacles related to ADHD while also helping build lifelong self-efficacy in managing persistent struggles.
Though no cure exists, consistent, dedicated management teaches individuals with ADHD how to minimize their disorder’s disruption across all facets of life – learning, working, parenting, relationships, and health management.
Care must be taken with ADHD management that individuals are not being encouraged to simply mask their symptoms of ADHD, which in itself can come with issues. People with ADHD should be encouraged to be authentically themselves while also working towards their specific goals and taking accountability for their actions.
Researchers build on growing insights about ADHD’s precise neurobiological and genetic underpinnings to keep improving diagnostic accuracy and expanding management possibilities for individuals along the lifespan journey with ADHD.
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Saul McLeod, PhD
BSc (Hons) Psychology, MRes, PhD, University of Manchester
Saul McLeod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.
Olivia Guy-Evans, MSc
BSc (Hons) Psychology, MSc Psychology of Education
Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.
