The short answer is yes, absolutely: if you receive a diagnosis for attention-deficit hyperactivity disorder (ADHD) and you’re an adult, a psychiatrist can help you manage your ADHD.
What’s interesting about that statement is that not long ago, members of the medical community, including the psychiatric/mental health community, thought that adult ADHD was not real, and that the ADHD diagnosis only applied to children and teens.
In the paper “Treatment Of Adult ADHD: A Clinical Perspective,” the study authors offer this perspective on the attitude toward adult ADHD we describe above:
“We were taught that patients with adult attention deficit/hyperactivity disorder (ADHD) had a dubious diagnosis and were probably seeking stimulants for nefarious purposes. Doctors working in this field were viewed with suspicion. They were regarded either as gullible, permissive clinicians or, worse, unscrupulous suppliers of stimulants to drug seekers.”
We know now that what clinicians – those training to become a psychiatrist, therapist, or counselor – from preceding generations learned about adult ADHD during training was inaccurate. However, since then, according to the study authors:
“In the face of this resistance to ADHD as a diagnosis, evidence of the validity and clinical relevance of adult ADHD has accumulated.”
In this article, we’ll review that evidence, including prevalence rates of adult ADHD in the U.S., then review the latest best practices for the treatment and management of adult ADHD.
Adult ADHD is Real: Facts and Figures
The epidemiological evidence that debunks the reality of adult ADHD is available in studies such as “Attention-Deficit/Hyperactivity Disorder Diagnosis, Treatment, and Telehealth Use in Adults,” which used data published by the Centers for Disease Control (CDC) Morbidity and Mortality Weekly Report (MMWR).
Here’s the data from that study:
Prevalence of Adult ADHD: 2023
- Total: 6% (15.5 million)
- By specific age group:
- 18-24: 21.7%
- 25-29: 62.8%
- 50-64: 10.6%
- 65+: 4.9%
- By gender:
- Female: 44.2%
- Male: 55.8%
- By level of education:
- High School: 41.8%
- Some college: 30.1%
- College or more: 28.1%
- By race/ethnicity:
- Black: 7.4%
- White: 70.4%
- Hispanic/Latino: 16.6%
- Other: 5.6%
To learn about the current prevalence of ADHD in children and teens, please navigate to our blog and read this article:
How Many Children and Teens in the U.S. Have ADHD?
Next, we’ll look at two different metrics: age at diagnosis, and treatment rates for the year 2023. Note: when patients engage in therapy, the provider may a psychiatrist, a therapist, or a counselor with experience treating adult ADHD. Here’s the treatment data:
Age at ADHD Diagnosis/Treatment Rates: 2023
- Age:
- Before 18: 44.1%
- After 18: 55.9%
- Treatment:
- No treatment: 36.5%
- Medication and therapy: 35.2%
- Medication or therapy only: 13.3%
- 15.1 percent received medication only
- Prescribed ADHD medication in past year: 50.4%
- Took prescription stimulant medication for ADHD in past year: 33.4%
- Took prescription non-stimulant for ADHD in past year: 5.9%
- Problems getting prescription filled, past year:
- Any ADHD medication: 61.8%
- Stimulant ADHD medication: 71.5%
Read that first bullet section again:
Over half the people diagnosed with ADHD received their diagnosis as adults.
This debunks the idea that increasing prevalence rates of ADHD among young adults represents teens diagnosed recently, aging out of adolescence, and counting as adults in prevalence data. Based on the data we share above, we can leave behind the mistaken idea that only children and teens can develop ADHD and receive a diagnosis for clinical ADHD.
Now let’s look at the current best practices for treating adult ADHD.
Do I Need a Psychiatrist for Treatment for Adult ADHD?
Yes and no.
You don’t need a psychiatrist to treat adult ADHD, but what you may need, if you want to make progress in treatment, is to engage in a holistic, whole person approach to treatment. A comprehensive approach to ADHD treatment starts with therapy and medication, with various complementary modalities and approaches included as needed.
And yes:
If your ADHD requires medication, then you need a psychiatrist to prescribe and manage that medication.
The contents of a treatment plan for adult ADHD may vary, but will most likely include a combination of the following:
- Medication
- Psychotherapy
- Organization and Time Management
- Coaching
We adapted reliable information on each of these components of treatment for adult ADHD from the outstanding resources provided by the non-profit organization Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD). We’ll describe each component below, beginning with medication.
Medication for ADHD
Medication for adult ADHD comes in two forms: stimulant and nonstimulant. While many people are reluctant to use stimulant medication, extensive research shows that the medications used for ADHD are safe and effective. Most ADHD patients respond well to stimulant medication. However, some don’t, and therefore receive a prescription for nonstimulant medication.
Stimulants:
- Stimulant medication for ADHD includes a variety of formulations based on methylphenidate (MPH) and amphetamine (AMP). These are the two most common medications for adult ADHD and are among the most researched medications we use in modern medicine.
- Stimulant medication is effective in managing ADHD symptoms in adults. It’s available in both short- and long-acting variations.
Nonstimulants:
- A medication called atomoxetine, brand name Strattera, is a selective norepinephrine reuptake inhibitor, is the first nonstimulant medication for ADHD approved by the Food and Drug Administration (FDA).
- Nonstimulant medication takes longer to reduce ADHD symptoms than stimulant medication. However, studies show that atomoxetine can reduce symptoms for up to 34 weeks in adults.
Next, we’ll look at the effective psychotherapeutic approaches to adult ADHD treatment.
Psychotherapy for ADHD
In recent years, therapists around the world have worked to adapt various modes of psychotherapy for adult ADHD. Evidence shows the three following approaches can reduce symptoms and improve quality of life:
- Cognitive behavioral therapy (CBT) helps patients identify non-productive/irrational beliefs and understand their impact on behavior.
- Mindfulness-based cognitive behavioral therapy (MBCBT) builds on the skills developed during CBT treatment by applying concepts from mindfulness such as acceptance, nonjudgment, and living in the moment.
- Dialectical behavior therapy (DBT) is a variation of CBT developed to help people with high levels of emotional reactivity and problems controlling emotion-based impulses. Combining CBT and MBCBT, a DBT therapist focuses on teaching patients effective, practical distress tolerance and emotion regulation skills.
Now we’ll look at another way adult ADHD patients can learn to manage their symptoms: learning how to stay organized and manage time effectively.
Organization and Time Management for ADHD
Treatment for adult ADHD often involves education and skill-building workshops. If you know anyone with ADHD, two primary challenges they have are organization and time management. While building these skills does not require a psychiatrist, a person in treatment for adult ADHD can benefit from workshops facilitated by licensed and experienced mental heath therapists and/or counselors.
Benefits of learning organization and time management skills include:
- Decreased anxiety
- Increased productivity
- Improved work performance
- Improved academic performance
- Increased consistency in family, spousal, and peer relationships
- Modeling healthy behavior for others with ADHD
Learning effective organization and time management skills can improve overall quality of life for an adult with ADHD. However, learning to apply new organization and time management skills – after learning them – can present challenges for adults with severe ADHD symptoms. That brings us to the last component of ADHD treatment we’ll discuss: ADHD coaching.
Coaching for ADHD
This is a relatively new development in the field of ADHD treatment. An ADHD coach may not be psychiatrist or therapist, but they can play an essential role in adult ADHD treatment. While other components of treatment focus on treating and managing the symptoms of ADHD, coaching helps patients manage the elements of life negatively impacted by ADHD. These include work performance, academic achievement, and interpersonal relationships.
ADHD coaches also help adults with ADHD:
- Stay focused
- Translate goals into actionable objectives
- Achieve those goals
- Meet deadlines
- Improve motivation
Studies on coaching in a group setting among college students with ADHD show improvements in:
- ADHD symptoms
- Executive function
- Anxiety
- Time management
- Interpersonal relationships
- Planning
- Organization
- Completing assigned classwork and projects
- Test-taking
- Assertiveness
- Self-esteem
- Self-awareness
- Wellbeing
The information above tells us that while yes, a psychiatrist can help treat adult ADHD, but the therapy and medication management a psychiatrist provides are only two parts of an effective treatment plan for ADHD. They’re important components that most often come first in ADHD treatment, but they’re part of a larger picture.
Comprehensive, Multi-Modal, Holistic Treatment for Adult ADHD
Treatment for ADHD involves medication because it’s a neurological disorder characterized by atypical function in brain areas associated with attention and impulse control, and medication helps attenuate the atypical brain function that causes ADHD symptoms.
Treatment for ADHD requires therapy because in many cases, patients need help untangling the emotional and behavioral consequences of ADHD symptoms in order to heal and effectively participate in their day-to-day lives. A psychiatrist, therapist, or counselor can help patients explore emotions, thoughts, and behaviors, and give them practical tools to manage symptoms, emotion, and behavior.
Treatment to help ADHD patients with organization and time management – with therapists or counselors, but mostly with coaches – is important because it helps patients transfer the new knowledge they gain in the other components of treatment to real situations in real life.
That’s why comprehensive treatment for adult ADHD is essential. It’s a disorder that has an impact on a diverse range of life domains, and therefore, requires an approach to treatment that addresses impaired function in all of those domains.
We’ll close this article with another topic that many people that don’t have ADHD rarely consider: the impact of ADHD on self-esteem.
ADHD and Emotions, Self-Confidence, and Self-Esteem
We’ll close this article with another topic that many people that don’t have ADHD rarely consider: the impact on self-esteem. We mention above that ADHD coaching for college improves overall wellbeing and self-esteem.
After reading that, you may have thought something like this:
What does self-esteem have to do with ADHD? Isn’t ADHD all about impulses and attention?
Think of it this way. Say you have a child or adolescent with undiagnosed ADHD. The kid is smart – you can tell by just talking to them. The lights, as the saying goes, are on. They engage in intelligent, interesting conversation. But their ADHD – which they may or may not know they have – has a negative impact on their grades.
They get Cs. But they know they can get As. This frustrates them. Eventually, the lack of academic success takes a toll, and their self-esteem suffers. When they think about school, the thoughts are not always great. School is something they know they should be good at, but just – can’t get there. Over time, they form ideas about themselves that just aren’t true:
I’m not smart, I can’t get good grades, I guess I’m a below average person.
Then, if that person reaches college, receives a diagnosis for adult ADHD, gets treatment in the form of therapy, medication, and coaching, things might start to change. Their therapist helps them correct false notions about themselves. They learn the organizational and time management skills it takes to succeed in college. Then their grades start to improve, and they become successful in college. They feel good about it.
In fact, they feel great about it, and their self-esteem improves.
That’s one way self-esteem and emotion is related to ADHD – and that’s a hypothetical example. There are countless variations on that story, and countless paths to managing the symptoms of ADHD. We can confirm through experience that treatment can improve life for a person with ADHD: we see it happen in our child, adolescent, and adult patients every day.
