ADHD Education and Treatment

What is Attention Deficit Hyperactivity Disorder (ADHD)?

ADHD is a disorder that is characterized by inattention and distractibility. These symptoms can be accompanied by hyperactivity in some individuals but not in others. 

The difference is specified by subtype. This is a commonly occurring disorder in childhood, but more than half of patients may continue to have symptoms that persist into adulthood. While the cause of ADHD is not known, science has identified some possible things that may play a role in the development of ADHD. 

These include genetic predisposition, alterations in brain activation during task engagement, neurotransmitter activity, prenatal factors, and environmental factors.

Consequences of Untreated ADHD:

  • ADHD can cause impairment in School & Work Achievement
  • Relationship & Social Problems
  • Low Self-Esteem
  • Accidents, Poor Driving Record, Poor Decision Making (Inability to stop and think through risks)

ADHD is commonly associated with other illnesses:

  • Patient are at higher risk for nicotine dependence
  • Anxiety
  • Behavioral disturbances in teens and children
  • Substance Use Disorders
  • Depression

What is Attention Deficit Hyperactivity Disorder (ADHD)?

ADHD is a disorder that is characterized by inattention and distractibility. These symptoms can be accompanied by hyperactivity in some individuals but not in others. 

The difference is specified by subtype. This is a commonly occurring disorder in childhood, but more than half of patients may continue to have symptoms that persist into adulthood. While the cause of ADHD is not known, science has identified some possible things that may play a role in the development of ADHD. 

These include genetic predisposition, alterations in brain activation during task engagement, neurotransmitter activity, prenatal factors, and environmental factors.

Consequences of Untreated ADHD:

  • ADHD can cause impairment in School & Work Achievement
  • Relationship & Social Problems
  • Low Self-Esteem
  • Accidents, Poor Driving Record, Poor Decision Making (Inability to stop and think through risks)

ADHD is commonly associated with other illnesses:

  • Patient are at higher risk for nicotine dependence
  • Anxiety
  • Behavioral disturbances in teens and children
  • Substance Use Disorders
  • Depression

How do you test, assess or monitor for ADHD?

The most important part of developing an effective treatment plan is getting an accurate diagnosis. While this may be straight-forward in some people, for others it may be challenging. In younger patients, those with developing mood disorders can have symptoms very similar to those with ADHD. 

Those with predominately inattentive type ADHD may seek help for depression and low self-esteem having never recognized the underlying disorder. Patients who have sleep disorders can present with inattention and problems with concentration. It will be important for you and your provider to work together to better understand your symptoms. In addition to the diagnostic interview your provider may ask you to undergo additional testing.

Doctor reviewing test results.

Standard Assessments for ADHD

  • Physical Exam: If you have not seen your PCP within the last year, your provider will likely encourage you to have a physical. If you do not have a PCP, you may schedule with one of the Salience Health providers.

  • Lab Work: Your provider may need to get some information about your health status so that they can safely prescribe medications, if needed.

  • Allergy Testing: Allergy testing may be appropriate for some individuals.

  • ECG: An electrocardiogram (ECG) may be needed prior to the use of some medications.

How do you test, assess or monitor for ADHD?

The most important part of developing an effective treatment plan is getting an accurate diagnosis. While this may be straight-forward in some people, for others it may be challenging. In younger patients, those with developing mood disorders can have symptoms very similar to those with ADHD. 

Those with predominately inattentive type ADHD may seek help for depression and low self-esteem having never recognized the underlying disorder. Patients who have sleep disorders can present with inattention and problems with concentration. It will be important for you and your provider to work together to better understand your symptoms. In addition to the diagnostic interview your provider may ask you to undergo additional testing.

Doctor reviewing test results.

Standard Assessments for ADHD

  • Physical Exam: If you have not seen your PCP within the last year, your provider will likely encourage you to have a physical. If you do not have a PCP, you may schedule with one of the Salience Health providers.

  • Lab Work: Your provider may need to get some information about your health status so that they can safely prescribe medications, if needed.

  • Allergy Testing: Allergy testing may be appropriate for some individuals.

  • ECG: An electrocardiogram (ECG) may be needed prior to the use of some medications.

Innovative Testing Available at Salience

CNS Vital Signs Neurocognitive Testing: A Computerized Neurocognitive Screening (CNS) is an assessment that tells us how well your brain is managing tasks, such as working memory, concentration, processing speed, and executive functioning. These results can provide insight into how you may perform in your daily life at work and at home, and help your provider identify levels of impairment. The overall duration takes about one hour to complete. 

Brainview: We know that behavioral health and physical health go hand-in-hand, and this assessment helps us see how they are impacting each other. The Brainview test is a cognitive assessment that provides information on your brain's functionality related to stress, memory, and cognition, while also tracking physical functions such as heart rate and metabolic rates. This test will help your provider develop a more informed treatment plan for you and better coordinate your overall care.

Girl in a gradient circle
Girl in a gradient circle

Innovative Testing Available at Salience

CNS Vital Signs Neurocognitive Testing: A Computerized Neurocognitive Screening (CNS) is an assessment that tells us how well your brain is managing tasks, such as working memory, concentration, processing speed, and executive functioning. These results can provide insight into how you may perform in your daily life at work and at home, and help your provider identify levels of impairment. The overall duration takes about one hour to complete. 

Brainview: We know that behavioral health and physical health go hand-in-hand, and this assessment helps us see how they are impacting each other. The Brainview test is a cognitive assessment that provides information on your brain's functionality related to stress, memory, and cognition, while also tracking physical functions such as heart rate and metabolic rates. This test will help your provider develop a more informed treatment plan for you and better coordinate your overall care.

Monitoring ADHD

Clinical scales are collected at assessment and at every visit. This information is important to your provider who will use these results to track your symptoms. In addition to scales for ADHD, the clinic will check on depression and anxiety symptoms as these are common for those with ADHD.

Current Treatment Options for ADHD

Treatment will likely require more than one type of intervention to achieve the best results. Some individuals may need to try a combination of treatments. These may include:

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Medication

  • Stimulant medications are commonly used. However, these drugs do have abuse potential and are not prescribed to individuals who have Substance Use Disorders. These medications are closely monitored and are not refilled if appointments are missed.
  • Some ongoing lab testing such as a urine drug screen will be required. Other testing may become necessary if other medical problems arise, other medications are prescribed, or complications of these medications occur.
  • Stimulant medications may cause a decreased appetite, cause anxiety, interfere with sleep, cause weight loss, and do carry a small risk for psychosis in younger patients. You may experience an increased heart rate. For patients with cardiovascular disease, such as uncontrolled hypertension or arrythmias, testing such as an ECG may be required, and at times, may prohibit the use of these medications.
  • Other medications may be used including Strattera (atomoxetine), antidepressant medications, or modafinil. A class of medications called alpha 2 agonists may be used in children. These can cause sedation and can have impact on blood pressure.
  • Medications alone will not manage all the symptoms. Stimulant medications have short time periods during which they remain active in the body. Other interventions will be needed to manage symptoms including: increased structure and routine, use of planners or calendars, having an organized work space, as well as the recommendations listed above.
Black pensive woman wearing warm scarf looking up to the autumn trees at the park.

Current Treatment Options for ADHD

Treatment will likely require more than one type of intervention to achieve the best results. Some individuals may need to try a combination of treatments. These may include:

Black pensive woman wearing warm scarf looking up to the autumn trees at the park.
Salience Health Logo Mark With White Star

Medication

  • Stimulant medications are commonly used. However, these drugs do have abuse potential and are not prescribed to individuals who have Substance Use Disorders. These medications are closely monitored and are not refilled if appointments are missed.
  • Some ongoing lab testing such as a urine drug screen will be required. Other testing may become necessary if other medical problems arise, other medications are prescribed, or complications of these medications occur.
  • Stimulant medications may cause a decreased appetite, cause anxiety, interfere with sleep, cause weight loss, and do carry a small risk for psychosis in younger patients. You may experience an increased heart rate. For patients with cardiovascular disease, such as uncontrolled hypertension or arrythmias, testing such as an ECG may be required, and at times, may prohibit the use of these medications.
  • Other medications may be used including Strattera (atomoxetine), antidepressant medications, or modafinil. A class of medications called alpha 2 agonists may be used in children. These can cause sedation and can have impact on blood pressure.
  • Medications alone will not manage all the symptoms. Stimulant medications have short time periods during which they remain active in the body. Other interventions will be needed to manage symptoms including: increased structure and routine, use of planners or calendars, having an organized work space, as well as the recommendations listed above.
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Exercise

  • Exercise can be beneficial for individuals with ADHD.
  • Additionally, exercise is a healthy option to use as a stress management tool. Salience Health Clinics endorse the commitment to improving overall health and support the adoption of a healthy lifestyle.
Patient Education Exercise Tablet
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Exercise

  • Exercise can be beneficial for individuals with ADHD.
  • Additionally, exercise is a healthy option to use as a stress management tool. Salience Health Clinics endorse the commitment to improving overall health and support the adoption of a healthy lifestyle.
Salience Health Logo Mark With White Star

Therapy

Mature businessman working on laptop. Handsome mature business leader sitting in a modern office with large windows
  • Several different types of therapy have been identified as beneficial for those with ADHD.
  • In children and teens with behavioral problems, therapy will be essential to help the child learn new coping strategies and self-regulation skills.
  • Social skills may lag behind in youth with ADHD and therapy may assist in the acquisition of needed skills.
  • Family therapy may be recommended when conflicts within the family are significant or when the family feels overwhelmed and needs help learning to manage their child’s behavioral problems.
  • When untreated ADHD has resulted in long-standing impairments in work or social life, therapy may be needed to address the consequences to self-esteem.
Mature businessman working on laptop. Handsome mature business leader sitting in a modern office with large windows
Salience Health Logo Mark With White Star

Therapy

  • Several different types of therapy have been identified as beneficial for those with ADHD.
  • In children and teens with behavioral problems, therapy will be essential to help the child learn new coping strategies and self-regulation skills.
  • Social skills may lag behind in youth with ADHD and therapy may assist in the acquisition of needed skills.
  • Family therapy may be recommended when conflicts within the family are significant or when the family feels overwhelmed and needs help learning to manage their child’s behavioral problems.
  • When untreated ADHD has resulted in long-standing impairments in work or social life, therapy may be needed to address the consequences to self-esteem.
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Diet

  • There have been limited and mixed results in studies of dietary changes to improve ADHD.
  • If your child suffers from food sensitivities, the elimination of these foods will be important in establishing better health.
  • Some medications used to treat ADHD may diminish appetite. Children and teens will need to be monitored to ensure proper growth and development.
Diet Education Picture
Diet Education Picture
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Diet

  • There have been limited and mixed results in studies of dietary changes to improve ADHD.
  • If your child suffers from food sensitivities, the elimination of these foods will be important in establishing better health.
  • Some medications used to treat ADHD may diminish appetite. Children and teens will need to be monitored to ensure proper growth and development.

Future Treatment Options for Bipolar

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Transcranial Magnetic Stimulation

  • TMS is a form of neuromodulation therapy. TMS is not currently FDA-approved for Bipolar Depression, but has been used in the U.S., Europe, and Asia with good results. There has been a low rate of treatment-emergent mania described with TMS.
  • TMS is a safe and effective outpatient treatment option. Side-effects are minimal for most patients: scalp discomfort, fatigue after treatment, occasional headaches, and nausea. You may drive yourself to-and-from treatment. Many protocols are short and treatment time can be under thirty minutes, daily for a couple of weeks, for most patients.
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ECT

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Bright Light Therapy

  • For patients in severe episodes of mania or depression that either do not respond to medications, or represent a serious threat to safety, ECT may be considered.
  • This treatment is usually started within the hospital but may be completed on an outpatient basis once the crisis has been stabilized.
  • Although studies are limited, initial results suggest this can be an effective strategy for some depressed patients with Bipolar Disorder.
  • This does require the purchase of a light device.

Future Treatment Options for Bipolar

Salience Health Logo Mark With White Star

Transcranial Magnetic Stimulation

  • TMS is a form of neuromodulation therapy. TMS is not currently FDA-approved for Bipolar Depression, but has been used in the U.S., Europe, and Asia with good results. There has been a low rate of treatment-emergent mania described with TMS.
  • TMS is a safe and effective outpatient treatment option. Side-effects are minimal for most patients: scalp discomfort, fatigue after treatment, occasional headaches, and nausea. You may drive yourself to-and-from treatment. Many protocols are short and treatment time can be under thirty minutes, daily for a couple of weeks, for most patients.
Salience Health Logo Mark With White Star

ECT

  • For patients in severe episodes of mania or depression that either do not respond to medications, or represent a serious threat to safety, ECT may be considered.
  • This treatment is usually started within the hospital but may be completed on an outpatient basis once the crisis has been stabilized.
Salience Health Logo Mark With White Star

Bright Light Therapy

  • Although studies are limited, initial results suggest this can be an effective strategy for some depressed patients with Bipolar Disorder.
  • This does require the purchase of a light device.

How to Get Better Outcomes with Treatment For Bipolar?

Things to Avoid to Achieve Better Outcomes

  • Avoid stopping your medications. If you are unhappy with the side-effects you are experiencing, please talk to your provider. Stopping medications can have very negative consequences, including the need for hospitalization. Work with your provider to find a medication regimen that you can tolerate.
  • Avoid using drugs and alcohol to manage stress. Alcohol is a depressant and can disrupt mood. A number of recreational drugs can have serious effects on mood and may lead to cycling or disruption of mood.
  • Inform your provider of any new prescriptions. Some drugs may interact with your medications (e.g., lithium and anti-inflammatory medications; lithium and certain antihypertensive medications). Other medications may have effects on mood (e.g., steroids). Keep your provider up-to-date on all medications and over-the-counter products that you may be using.
  • Staying up all night or sleeping at different times.
  • Do not isolate yourself. Work to establish a support system and have regular contact with the people you have identified.
  • Do not harm yourself. Report any thoughts or urges to harm yourself to your provider. Work with your provider to create a safety plan. If at any point you feel you cannot remain safe, call 911 or go to the nearest Emergency Room and notify your provider. It is best to have a trusted family member or friend aware of who to call or where to take you if at any point you cannot be well enough to recognize your need of treatment.
  • Avoid tobacco. Smoking can worsen anxiety and depressive symptoms and is associated with serious medical risks.
  • If you are a parent of a child or teen who suffers from Bipolar Disorder, you will need to be actively involved in their care. This includes attending appointments, reporting on symptoms, and monitoring for safety and behavioral clues to impending crisis. Family therapy may be recommended to improve communication and to assist the family in managing the illness.
  • Bipolar Disorder is a chronic illness for which there is not currently a known cure. However, there are treatments that can vastly improve symptoms and reduce impairments. Work with your provider to stabilize your mood and to have a plan to maintain your health over time.

Achieving Better Outcomes

Become Education About Bipolar Disorder

  • Learn all you can about your illness. Educated patients are more likely to follow through on treatment and engage in activities that foster wellness.
  • At every visit you will be asked to complete clinical scales. These measurements are important and help your provider track your progress over time. Please assist your provider by filling out these scales every time you come to the clinic.
  • Take every dose of medication every day. Failure to take medications as prescribed is one of the leading causes of relapse and hospitalization.
  • Be a partner in your care. You and your provider should agree on your goals for treatment and should work together to achieve them. Your participation and cooperation are essential to achieving the best outcomes.
  • Remember that it may take more than one trial of medication or another intervention to feel better. Give treatment a fair chance. Give your provider accurate information about your progress, the stresses, and other medical problems that might impact your course of illness. Work with your provider to identify triggers that you might need to avoid, as well as strategies that support your health
Man in suit

How to Get Better Outcomes with Treatment For Bipolar?

Things to Avoid to Achieve Better Outcomes

  • Avoid stopping your medications. If you are unhappy with the side-effects you are experiencing, please talk to your provider. Stopping medications can have very negative consequences, including the need for hospitalization. Work with your provider to find a medication regimen that you can tolerate.
  • Avoid using drugs and alcohol to manage stress. Alcohol is a depressant and can disrupt mood. A number of recreational drugs can have serious effects on mood and may lead to cycling or disruption of mood.
  • Inform your provider of any new prescriptions. Some drugs may interact with your medications (e.g., lithium and anti-inflammatory medications; lithium and certain antihypertensive medications). Other medications may have effects on mood (e.g., steroids). Keep your provider up-to-date on all medications and over-the-counter products that you may be using.
  • Staying up all night or sleeping at different times.
  • Do not isolate yourself. Work to establish a support system and have regular contact with the people you have identified.
  • Do not harm yourself. Report any thoughts or urges to harm yourself to your provider. Work with your provider to create a safety plan. If at any point you feel you cannot remain safe, call 911 or go to the nearest Emergency Room and notify your provider. It is best to have a trusted family member or friend aware of who to call or where to take you if at any point you cannot be well enough to recognize your need of treatment.
  • Avoid tobacco. Smoking can worsen anxiety and depressive symptoms and is associated with serious medical risks.
  • If you are a parent of a child or teen who suffers from Bipolar Disorder, you will need to be actively involved in their care. This includes attending appointments, reporting on symptoms, and monitoring for safety and behavioral clues to impending crisis. Family therapy may be recommended to improve communication and to assist the family in managing the illness.
  • Bipolar Disorder is a chronic illness for which there is not currently a known cure. However, there are treatments that can vastly improve symptoms and reduce impairments. Work with your provider to stabilize your mood and to have a plan to maintain your health over time.

Achieving Better Outcomes

Become Education About Bipolar Disorder

  • Learn all you can about your illness. Educated patients are more likely to follow through on treatment and engage in activities that foster wellness.
  • At every visit you will be asked to complete clinical scales. These measurements are important and help your provider track your progress over time. Please assist your provider by filling out these scales every time you come to the clinic.
  • Take every dose of medication every day. Failure to take medications as prescribed is one of the leading causes of relapse and hospitalization.
  • Be a partner in your care. You and your provider should agree on your goals for treatment and should work together to achieve them. Your participation and cooperation are essential to achieving the best outcomes.
  • Remember that it may take more than one trial of medication or another intervention to feel better. Give treatment a fair chance. Give your provider accurate information about your progress, the stresses, and other medical problems that might impact your course of illness. Work with your provider to identify triggers that you might need to avoid, as well as strategies that support your health
Man in suit