How I Approach Treating ADHD
How I Approach Treating ADHD: Thoughtful, Thorough, and Integrative
Attention-Deficit/Hyperactivity Disorder (ADHD) can be life-altering. When properly diagnosed and treated, I have seen stimulant medication dramatically improve focus, confidence, academic performance, and quality of life. For some patients, they are truly life-changing. There are patients who suffer from symptoms of anxiety and depression due to un-treated ADHD.
At the same time, I have heard experts describe ADHD as a diagnosis of exclusion. That means we must thoughtfully evaluate whether other psychiatric, medical, hormonal, nutritional, or lifestyle factors are contributing to symptoms like poor focus, distractibility, impulsivity, and executive dysfunction before simply prescribing a stimulant.
In my practice, my goal is not just symptom suppression — it is understanding root contributors and building a sustainable, whole-person treatment plan.
ADHD Is Often Multifactorial
Many conditions can mimic or worsen ADHD symptoms:
Anxiety disorders
Depression
Trauma-related disorders
Sleep deprivation
Thyroid dysfunction
Nutrient deficiencies
Blood sugar instability
Gut imbalances
Hormonal shifts (particularly in women)
Social media has increased awareness of ADHD, which can be positive. However, over-reporting and self-diagnosis are also growing concerns. Focus and motivation problems are common in modern life — especially in a high-dopamine, screen-saturated world. Not every attention issue is ADHD.
A careful diagnostic process matters. I may even request that patients seek neuropsychiatric testing when the diagnosis is unclear.
My Concerns About Stimulants (And Why I Still Use Them When Appropriate)
Stimulants such as methylphenidate and amphetamine-based medications increase dopamine and norepinephrine. They can be extremely effective.
However, there are important considerations:
Animal studies show that amphetamines induce dopaminergic damage. This has not been reproduced in humans; and we cannot extrapolate these findings to humans- but it is worth being aware.
Misuse and diversion are well documented in certain populations, particularly high school and college settings.
They can worsen anxiety, sleep disturbance, appetite suppression, and mood instability in some individuals.
They do not correct underlying nutrient deficiencies, gut dysfunction, sleep deprivation, or trauma.
Research shows that 2-3% of people prescribed simtulants develop psychotic symptoms or bipolar disorder, with amphetamines carrying 60% higher risk than methylphenidate. This is likely related to errors in diagnosis or psychiatric assessment.
For the above reasons, a thorough evaluation including mental health history, family history of psychiatric of psychiatric conditions, sleep patterns and substance use- all are an essential safetly measure to ensure you receive the correct diagnosis and treatment. And once diagnosed, medication can be a powerful tool — but it should be part of a comprehensive plan, not the entire plan.
