ADHD Treatment Scottsdale | Phoenix
Psychologists and psychiatrists at Shier Private Practice in Scottsdale, AZ specialize in the treatment of attention deficit hyperactivity disorder (ADHD). Our private outpatient clinic offers a comprehensive psychiatric/medical assessment and treatment plan. Treatment may include medications, behavioral therapies or a combination of treatments.
What is Attention Deficit Hyperactivity Disorder (ADHD)?
Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental psychiatric disorder characterized by persistent patterns of inattention, hyperactivity, and impulsivity that significantly interfere with with an individual’s development and level of functioning.
What are the symptoms of Attention Deficit Hyperactivity Disorder (ADHD)?
The DSM-5 Criteria defines ADHD as a persistent patterns of inattention and/or hyperactivity-impulsivity that interferes with functioning or development, as characterized by Inattention and/or Hyperactivity and Impulsivity:
Inattention: Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities:
- Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities.
- Often has difficulty sustaining attention in tasks or play activities.
- Often does not seem to listen when spoken to directly.
- Often does not follow through on instructions and fails to finish schoolwork,chores, or duties in the workplace.
- Often has difficulty organizing tasks and activities.
- Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort.
- Often loses things necessary for tasks or activities.
- Is often easily distracted by extraneous stimuli.
- Is often forgetful in daily activities.
Hyperactivity and Impulsivity: Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities:
- Often fidgets with or taps hands or feet or squirms in seat.
- Often leaves seat in situations when remaining seated is expected.
- Often runs about or climbs in situations where it is inappropriate.
- Often unable to play or engage in leisure activities quietly.
- Is often “on the go,” acting as if “driven by a motor”.
- Often talks excessively.
- Often blurts our an answer before a question has been completed.
- Often has difficulty waiting his or her turn.
- Often interrupts or intrudes on others.
What are the consequences of untreated ADHD?
ADHD may have a detrimental effect on an individual’s level of functioning in multiple domains. The inability to perform tasks that require sustained effort as a result of these executive function deficits may be interpreted by others as laziness, selfishness, irresponsibility, or failure to cooperate. Consequently, these individuals may have increased family conflicts and higher likelihood of social rejection from peers. ADHD is associated with poor academic performance and academic attainment, poor occupational performance, higher rate of unemployment, poor social relations, and increased interpersonal conflict. Individuals suffering from the disorder may have reduced self-esteem as a result of social rejection and repeated failures and have an elevated risks for co-morbid disorders such as depression, anxiety, and substance abuse.
What is the cause of ADHD?
The cause of ADHD is unknown. It is believed to be caused by genetic factors and environmental factors to a lesser degree. ADHD is substantially elevated in first degree biological relatives. A number of genes have been correlated with ADHD many involving Dopamine transmission, however, causal relationships with specific genes has not been established. A number of environmental factors have been correlated with ADHD including low birth weight, exposure to drugs and toxins, and trauma.
What else could be cause these symptoms?
It is important to understand that symptoms of ADHD are variable and differ from one individual to the next. The symptoms may resemble other disorders that share certain features or may overlap other disorders. These additional disorders should be evaluated and ruled out prior to making a diagnosis of ADHD: Intermittent explosive disorder, other neurodevelopmental disorders, specific learning disorders, intellectual disability, Autism spectrum disorder, Reactive Attachment disorder, anxiety disorders, depressive disorders, Bipolar disorder, Disruptive mood Dysregulation disorder, substance use disorders, personality disorders, psychotic disorders, medication induced-symptoms of ADHD, neurocognitive disorders, and other medical disorders.
The treatment of ADHD involves medications and /or behavioral therapies.
The medications used in the treatment of ADHD may be classified into two broad categories: Stimulants and non-stimulants. Stimulants include medications such as Concerta/Methylphenidate, Ritalin/Methylphenidate, Focalin/Dexmethylphenidate, Dexedrine, Adderall/Amphetamine/Dextroamphetamine), and Vyvanse. Non-stimulants include medications such as Clonidine, Intuniv/Guanfacine, Strattera, and Wellbutrin/Buproprion.
Behavioral therapies may include Cognitive Behavioral Therapy (CBT), Family therapy, Parent/Child Behavioral Training, and school-based interventions.
How is Adult ADHD treated?
Similar to children with the disorder, adults are treated with medications, behavioral therapies, or a combination of treatments.
What are the side effects of stimulants?
Side effects with stimulant medications may occur in some individuals. The most common side effects include insomnia, loss of appetite, anxiety, and irritability. In rare instances it may cause hallucinations at therapeutic doses. These side effects may be mitigated by dosing, timing, and frequency adjustments. If symptoms persist, switching to a different medication may be necessary.
Are stimulants addictive?
Stimulants have the potential for addiction and are considered a class II controlled substance. However, there is no substantial evidence demonstrating a causal relationship between therapeutic doses of stimulants used to treat ADHD and substance abuse or worsening outcomes in individuals with a substance use disorder. Risk factors including an individual or family history of a substance use disorder should be discussed for a risk/benefit analysis. Alternatives such as non-stimulants or behavioral therapies may also be considered in such cases.
Are stimulant medications safe?
Stimulant medications are considered to be safe under the appropriate medical supervision by a physician. Monitoring may include but is not limited to the following: Periodic detailed medical/psychiatric examination, review of side effects, review of active medication lists, electrocardiogram (EKG), vital signs (blood pressure, heart rate, weight), laboratory values, and rating scale assessments.
Tips to help your kids
- Keep a schedule – children with ADHD do best with structure. Keep a schedule to help them know what to expect and they will feel less frazzled and more emotionally prepared during a transition.
- Establish a routine – establishing specific routines for activities can also help your child get into regular habits and develop routines of their own.
- Plan things in advance – children do best when they can prepare themselves emotionally for an upcoming event particularly if it is an unfamiliar one.
- Limit distractions – reducing noise or clearing the area can help your child focus on their activities and also help them learn how to minimize distractions on their own.
- Have a place for everything and keep things organized- making sure everything has its place will help your child learn the value of finding things in their respective places and also minimize the frustrations they experience when they misplace things.
- Break tasks into manageable pieces – if it’s too hard to take the first step, the step is too big! Help your child succeed in getting from point A to point B without them feeling overwhelmed.
- Be clear and concise with your directions – complex directions can be overwhelming and frustrating for your child. Be clear and very specific with single tasks before progressing to multi-step tasks.
- Be consistent with parenting – make sure you and your spouse are on the same page when setting rules and establishing consequences. It is far more effective to be consistent than to be inconsistent and overly harsh with punishment.
- Encourage exercise – exercise will not only improve overall cardiovascular function but also help them get their energy out.
- Develop sleep patterns/rituals – sleep is critically important for normal brain function. Establishing a routine before bed can help signal the brain to relax and improve sleep.
- Give praise when rules are followed – positives go much farther than negatives. Praise your child when they succeed. Nothing feels more rewarding to a child than when their parents notice their accomplishments.
Last update: February 22, 2019
The content on this website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.