Understanding Adult ADHD

Attention-deficit/hyperactivity disorder (ADHD) in adults is often misunderstood. It's not simply being "distracted" or "disorganized"—it's a neurodevelopmental condition affecting executive function, attention regulation, impulse control, and often emotional regulation. ADHD involves dysregulation of dopamine and norepinephrine systems in the prefrontal cortex, the brain region responsible for executive functions.

Adult ADHD can present differently than childhood ADHD. While hyperactivity may be less prominent in adults, difficulties with attention, organization, time management, task completion, and emotional regulation often persist. Many adults with ADHD have developed coping strategies that mask symptoms, but these strategies require significant effort and may not address underlying difficulties.

The National Institute of Mental Health reports that ADHD affects approximately 4.4% of adults in the United States. Many adults weren't diagnosed in childhood, particularly women and individuals with primarily inattentive symptoms, leading to years of undiagnosed struggles.

An Integrative Approach to Adult ADHD Treatment

Integrative psychiatry recognizes that ADHD has multiple drivers and requires a comprehensive treatment approach. Medication can be highly effective, but it's most beneficial when combined with psychotherapy, lifestyle optimization, and attention to co-occurring conditions.

My approach includes:

Comprehensive Evaluation: Thorough assessment of ADHD symptoms, developmental history, academic and work history, relationships, daily functioning, and co-occurring conditions. This includes reviewing childhood symptoms, even if ADHD wasn't diagnosed at that time
Medication Management: When medication is indicated, I use evidence-based approaches including stimulant medications (methylphenidate, amphetamines) or non-stimulant options (atomoxetine, guanfacine) based on individual needs, medical history, and preferences. Medication decisions are made collaboratively
Psychotherapy Integration: Evidence-based psychotherapeutic approaches including cognitive-behavioral therapy for ADHD, skills training for organization and time management, and support for emotional regulation
Lifestyle Medicine: Attention to sleep architecture (many adults with ADHD have sleep disorders), circadian rhythms, nutrition, physical activity, and stress management. Sleep optimization alone can significantly improve ADHD symptoms
Co-occurring Conditions: Assessment and treatment of conditions that often co-occur with ADHD, including anxiety, depression, substance use, and sleep disorders

This integrative model recognizes that ADHD affects multiple areas of functioning. Treatment addresses these comprehensively, supporting both symptom reduction and improved quality of life.

Executive Function Challenges

ADHD involves difficulties with executive functions—the cognitive processes that enable goal-directed behavior. These include:

Working Memory: Holding information in mind while performing tasks
Inhibition: Controlling impulses and resisting distractions
Cognitive Flexibility: Shifting between tasks and adapting to change
Planning and Organization: Breaking down tasks, sequencing steps, and managing time
Emotional Regulation: Managing emotional responses and reactivity

These challenges can significantly impact work performance, relationships, daily functioning, and self-esteem. Treatment addresses both the neurobiological aspects (through medication) and the functional aspects (through psychotherapy and skills training).

Co-occurring Conditions

Many adults with ADHD also experience other conditions that need attention:

Anxiety Disorders: The constant effort to manage ADHD symptoms can lead to anxiety. Additionally, ADHD and anxiety share some neurobiological features
Depression: Years of struggling with undiagnosed ADHD can lead to depression. Additionally, ADHD and depression can co-occur independently
Sleep Disorders: Many adults with ADHD have circadian rhythm disorders or other sleep difficulties that worsen ADHD symptoms
Substance Use: Some adults with undiagnosed ADHD may self-medicate with substances. Treatment addresses both ADHD and substance use concerns

Effective treatment addresses ADHD while also attending to co-occurring conditions, recognizing how they interact and influence each other.

What to Expect in Treatment

Your initial evaluation is comprehensive—typically 90 minutes—allowing time to understand your ADHD symptoms, developmental history, current functioning, and goals thoroughly. We develop initial diagnostic impressions and discuss evidence-based treatment options. Treatment proceeds collaboratively, with regular check-ins to assess progress and adjust approaches as needed.

Follow-up appointments may focus on medication management, psychotherapy, or both, depending on your needs. Some patients benefit from short-term treatment to establish effective medication and develop coping strategies. Others benefit from ongoing treatment focused on long-term support and skill development.

The goal isn't just symptom reduction—it's improved functioning, increased capacity to achieve goals, better relationships, and increased self-understanding. Treatment is individualized, paced thoughtfully, and grounded in clinical evidence.

Serving Los Angeles Area

I provide adult ADHD treatment to patients throughout Los Angeles County, including Hollywood, Beverly Hills, Santa Monica, West Hollywood, Burbank, Glendale, Pasadena, and surrounding areas. The practice is located in Hollywood and offers both in-person and telepsychiatry visits for adults throughout California.

If you're experiencing symptoms of ADHD or have been diagnosed with ADHD and are seeking treatment, know that effective help is available. ADHD is a treatable condition, and many adults experience significant improvement with appropriate care.

References & Resources

For additional information about ADHD, I recommend these authoritative sources:

Contact us to schedule a consultation or learn more about our approach to adult ADHD treatment.

Adult ADHD Treatment in Los Angeles