Optimal Treatment for ADHD: It’s All in the Details

Understanding the specifics of how attention deficit affects you personally can help you and your doctor get a leg up on symptoms.
The Experts | posted by Robert D. Hunt, M.D.

What does this have to do with ADHD medication? Almost everything.


If you or your child has been diagnosed with ADHD, you probably know that there is more than one treatment approach to living successfully with the disorder: one-on-one and group counseling, medication, and life skills coaching all have a place in a holistic ADHD treatment plan.

You also know that an ADHD diagnosis is based on the combined and persistent presence of several specific behaviors in a person. These behaviors are straightforward yet distinctive, such as “failing to give close attention to details” or “often has difficulty sustaining attention on tasks.”

But fewer people realize that each one of these simple-sounding ADHD symptoms can present itself in a number of different ways (and severities) from one person to the other.

You or your child may be able to handle several tasks at once, but you may not be able to deeply concentrate on a single task for a sustained period of time. Other patients have the opposite challenge: The only time they feel capable of intense and sustained focus is when they can concentrate exclusively on a single task, especially a novel one. ADHD spans age and gender, and affects each person it touches differently.

What does this have to do with ADHD medication? Almost everything. These fine-grained distinctions in how different people experience ADHD symptoms are critical — yet not well understood — in determining which medication is likely to be most effective for them.

To increase your chances of getting the best medication and the right dosage for your specific symptoms, you and your physician need to know how your ADHD affects your ability to perform: different kinds of tasks require different types (and intensity levels) of concentration over differing periods of time. Understanding this information — and arming your physician with it — is one of the best ways to ensure that you’re getting the medication that is best suited to you. I recommend doing the following:

> See your doctor frequently. Scheduling — and keeping — regular appointments keeps your doctor aware of how your treatment is progressing, and keeps you in the habit of staying aware of how your treatment plan is working in relation to your goals.

> Take the time to tell your whole story. You are not bothering your doctor! Take sufficient time during your appointment to clearly review your experience with medication in relation to the actual tasks you are performing — especially those tasks that require a stimulant medication because of the intensity of focus and attention required.

> Plan ahead to give your doctor the best information you can. It takes a little planning and some diligence, but there is a better way to give your doctor a more complete, more accurate, and more informative picture of how you’re doing with your medication. Manually track your response to medication several times through the day for a week. It is the best way to gather an overall idea of how well your medication is working. As you see trends emerge, your doctor should be able to make adjustments to get your treatment plan just right — and to put you on the path to improved health and wellbeing.

Robert D. Hunt, M.D. is a board-certified adult, child and adolescent psychiatrist trained at Harvard University School of Medicine, University of California School of Medicine, San Francisco; and UCLA (Child Psychiatry). He is the founder of Hunt Psychiatric Innovations, the creator of the MedOptimizer ADD/ADHD iPhone app.

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