9 Frequently Asked Questions About ADHD (and their Answers)

Dr. Melissa Shepard Smiling in white lab coat

By Dr. Melissa Shepard

Disclaimer: Please note that this is not medical advice but for educational purposes only. Only a trained professional who has completed a clinical evaluation can diagnose and treat ADHD and other mental health conditions.

 

Attention deficit hyperactivity disorder (ADHD) is one of the most requested topics on my

 

social media platforms. I think this is, in part, because it is still so misunderstood by the general public. Many of us still tend to think of ADHD as a disorder of hyperactive little boys running around a classroom. But it’s much more complicated than that, and probably much more common than you realize.

 
 
 
 

Here are some of the most frequently asked questions on my posts about ADHD:

 

I think I might have ADHD. What kind of doctor should I see?

 
In general, medical doctors that diagnose ADHD include psychiatrists, pediatricians, internal medicine doctors, and family medicine doctors. Psychologists (usually but not always doctorate level) are also often able to diagnose ADHD.
 
Although these different professionals may be qualified to diagnose ADHD, individuals vary greatly in how comfortable they are with diagnosing and treating ADHD. If you can, try to find a specialized ADHD clinic or a professional who advertises special expertise in ADHD treatment.
 

How do you determine if someone has ADHD?

 
I screen all of my patients for ADHD because it’s something that can go undetected for a long time, especially in people who have good social skills, are very intelligent, women (who have been historically neglected in studies on ADHD and tend to present with different symptoms- for more info on this see my previous blog post here), or those who have not responded well to traditional treatments for anxiety or depression.
 

When screening for ADHD I ask questions that help me determine whether the person has trouble with :

  • Hyperactivity/restlessness

  • Impulsivity

  • Inattention

  • Memory

  • Emotion regulation

  • Organization

  • Hyperfocus

  • Procrastination

  • Low self-esteem

  • Rejection sensitivity

 

For more information on the specific questions I ask, click here to see my previous blog post on symptoms of ADHD.

 

There are several scales available to help us diagnose ADHD and monitor treatment response. These can certainly be helpful but aren’t always necessary. Validated scales include the Adult ADHD Self-Report Screening Scale (ASRS v1.2, revised from ASRS v1.1), Connors’ Adult ADHD Rating Scale (CAARS) and the Wender Utah Rating Scale. Some clinicians may also use the criteria listed in the DSM-5 to assess for ADHD.

 

For additional information on screening scales, see this helpful article by CHADD.

 

Because other mental health disorders (including anxiety, depression, bipolar disorder, substance use disorders, and autism spectrum disorders) can show up with ADHD-like symptoms, I also screen very carefully for these disorders and treat them as needed.

 

It is also important to note that ADHD symptoms can sometimes occur in people without ADHD. The diagnosis of ADHD is only made when the symptoms are severe and persistent enough that they cause significant distress or interfere with someone’s ability to function. The symptoms must also be present in multiple different settings (for example, someone who only has trouble focusing at school during exams would not be diagnosed with ADHD unless they were having symptoms at home and in social situations as well).

 

I have anxiety, depression, or (any other mental health disorder). Can I still have ADHD?

 

Absolutely! In fact, you are much more likely to have ADHD if you have another mental health disorder. Over half of adults with ADHD have at least one other mental health condition. About 9% of patients with anxiety or depression also have ADHD (Fayyad, 2017).

I have struggled with drug or alcohol use in the past. Does this mean I can’t get treated for ADHD?

 

No! And you aren’t alone. ADHD is a risk factor for substance use disorders. It makes sense if you think about it: people with ADHD are more impulsive, tend to have difficulty regulating their emotions, and may have trouble envisioning the consequences of their actions. They may use substances in an attempt to quiet their racing minds or as a way to cope with chronic boredom. All of these factors can increase someone’s risk for substance use disorders.

 

Some of the medications we use for ADHD (specifically the stimulant medications like Adderall and Ritalin) are controlled substances because they are at high risk for abuse, misuse, or diversion. Because of this risk, we do have to be careful not to prescribe these medicines to people who may be misusing them. When they are prescribed, we have to abide by certain rules to limit the risk of misuse (such as not authorizing early refills and limiting supply to 30 days at a time).

 

But this doesn’t mean that stimulant medications are off-limits for people with a substance use history. We may have to be more thoughtful about how we prescribe, but the potential benefits of stimulants may still outweigh the risks, even in someone who has a history of addiction.

 

If someone does have a history of substance abuse that makes it unsafe for them to take stimulant medications, there are other non-stimulant medications (see below) that may still be very helpful.

 
 

I think I might have ADHD. How do I talk to my doctor/therapist about it?

 

There is no wrong way to bring it up. Your doctor should make you feel comfortable and should be open to addressing any and all concerns you may have, without judgment.

 

You can say something like, “I have been reading a lot about ADHD and realized that it seems to explain many of the symptoms I’ve been experiencing. Could we talk more about that?”

 

It may also help to bring a list of the symptoms that you are experiencing that you think may be related to ADHD and the results of any scales you have completed.

 
 

Are there any non-stimulant medications for ADHD?

 

Yes! There are several, including medications like atomoxetine (Strattera), Bupropion (Wellbutrin), and tricyclic antidepressants (such as desipramine and nortriptyline).

 

For more information on these (or on stimulant medications for ADHD) check out this blog post.

 

Are there any non-medication treatments for ADHD?

There are quite a few non-medication options for ADHD, and they can be very effective. Some of my favorite non-medication treatments for ADHD include therapy (of course), exercise (anything that gets your heart rate up and tires you out a bit), and mindfulness meditation.

 

In addition to therapists who are knowledgeable about ADHD, executive functioning coaches and ADHD coaches can be really helpful.

 

What is the difference between ADD and ADHD?

 

Many people recall being diagnosed with ADD when they were younger. It can be really confusing because nowadays, clinicians almost exclusively talk about ADHD.

 

This is because, in 1987, the American Psychiatric Association removed ADD from its “Diagnostic and Statistical Manual of Mental Disorders” and reclassified the disorder as attention deficit hyperactivity disorder (ADHD).

 

As our understanding of ADHD has evolved so have the diagnostic classifications. We now think of ADHD as having three different types, or presentations: predominantly hyperactive, predominantly inattentive, or combined type. ADHD, predominantly inattentive type, is probably most similar to what was once called ADD.

 

What do I do if my doctor/therapist isn’t taking my concerns seriously?

 

Unfortunately, misconceptions about ADHD are not just limited to the general public. There are many health professionals who lack the education and expertise to identify and treat ADHD and may brush off your concerns or make you feel disrespected.

 

While the outcome of every visit may not be exactly what you want, your doctor should never make you feel invalidated or disrespected. If they do, don’t be afraid to seek out a second opinion with someone who makes you feel comfortable.

 

References, Further Reading, and Other Resources:

 

Please note that some links may include Amazon links. As an Amazon Associate, I earn from qualifying purchases. This means that I get commissions for purchases made through links in this post. This helps me run the site, including this resources section.

 

ADDitude

 
  • Free articles on coping with ADHD, quizzes on symptoms, resources

Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD)

 
  • Advocacy, free resources, free hotline to talk with an ADHD specialist, info for parents, educators, and people with ADHD.

Books/Workbooks (Click for Amazon Link)

 

Thriving with Adult ADHD: Skills to Strengthen Executive Functioning by Phil Boissiere MFT

 

Smart but Scattered: The Revolutionary “Executive Skills” Approach to Helping Kids Reach Their Potential

 
 

Smart but Scattered Teens: The “Executive Skills” Program for Helping Teens Reach Their Potential

 

The Smart but Scattered Guide to Success: How to Use Your Brain’s Executive Skills to Keep Up, Stay Calm, and Get Organized at Work and at Home

 
 

The Work-Smart Academic Planner, Revised Edition: Write It Down, Get It Done

 
  • For students in grades 6-12

Taking Charge of Adult ADHD by Russell Barkley, PhD

 

Understanding Girls with ADHD: How They Feel and Why They Do What They Do by Kathleen Nadeau, PhD, Ellen Littman, PhD, and Patricia Quinn, MD

 
 

Attention Girls!: A Guide to Learn All About Your ADHD by Patricia Quinn, MD

 
  • A guide for girls ages 7-11 who want to learn more about their ADHD and how to cope

AD/HD and the College Student: The Everything Guide to Your Most Urgent Questions by Patricia Quinn, MD

 

ADD-Friendly Ways to Organize Your Life: Strategies that Work by Judith Kolberg and Kathleen Nadeau, PhD

 
 

Referenced in this post:

 

Fayyad J, Sampson NA, Hwang I, et al. The descriptive epidemiology of DSM-IV Adult ADHD in the World Health Organization World Mental Health Surveys. ADHD Atten Def Hyp Disord 2017; 9: 47-65.

 
 
 
 
 

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https://www.patreon.com/DrShepard

 

If you need help managing anxiety, check out my Anxiety Bootcamp course here: https://www.drmelissashepard.com/courses-1

 
 

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