ADHD
ADHD is a long-standing pattern of difficulty with executive function and attention that starts in childhood and often interferes with many aspects of life. Many patients are not diagnosed until adulthood, sometimes because strategies that used to work are no longer enough to meet increased demands of life. Fortunately, adult ADHD responds well to treatment, both medication and therapy.
Signs of ADHD in adults
You might have ADHD if:
- You have trouble getting started, and deadlines only get met in a last-minute panic
- You often lose track of keys, appointments, and paperwork
- You drift off mid-conversation, or re-read the same page without taking any of it in
- This has been true since you were a kid
- Your symptoms are not better explained by something else, like anxiety, depression, or poor sleep
How BPA doctors approach ADHD
Our first step is making sure the diagnosis is right. There is no single test for ADHD, so it comes down to a careful conversation about your history: where you struggle, and how long that has been the case. Other issues, like anxiety, depression, or poor sleep, can sometimes cause overlapping issues, so teasing these apart with your psychiatrist is important.
If the picture points to something other than ADHD, our psychiatrists can help you manage those issues too.
What are the treatment options?
Most adults with ADHD are treated with medication, and there are two broad kinds. Stimulants are the ones most people have heard of; they work well and quickly for many. They are controlled substances, which means ongoing monitoring of their use is required and important.
Many patients also find significant benefit from non-stimulant medications, which can be a better fit if stimulants are not tolerated or safe for you. Your BPA doctor will help you decide whether or not they might be a better option for you than stimulants.
ADHD experts consider combined medication and skills-based ADHD-specific therapy to be the gold standard of treatment. Our psychiatrists can help you build some of these skills as part of your visits, and can refer you to a therapist if more regular weekly work would be supportive of your ADHD treatment.
Stimulants and non-stimulants at a glance
| Stimulants | Non-stimulants | |
|---|---|---|
| Controlled substance | Yes | No |
| How soon you notice a change | Within days | Usually a few weeks |
| Follow-up | More frequent visits often necessary | Standard follow-up |
| Often considered | First choice for most adults | When stimulants are not safe for you or are likely to cause more side effects |
How do I get started with care?
Most people with ADHD start by requesting a general outpatient care intake, whether you are looking for a first evaluation or you already have a diagnosis and want to continue treatment with a new psychiatrist. Our staff will always reach out to answer any questions before the intake is scheduled.
Care starts with an hour-long conversation with one of our psychiatrists to go through your history, how things are going now, and what you are hoping to improve. At times, more than one visit is necessary to clarify the diagnosis before treatment with medication starts.
What to expect over time
Finding a medication and dose that fits usually takes some adjusting, and the first thing you try is often not the one you stay on. Visits are more frequent early while that is being sorted out, then usually less often once you get to a regimen that works for you without side effects.
ADHD treatments can make a dramatic difference and improve your ability to function across work, school, health, and relationships. They can also carry risks, which is why ongoing monitoring visits are part of your care.
BPA clinicians treat the full range of ADHD
Every clinician at Bay Psychiatric Associates evaluates and treats ADHD. We match you by availability, location, and fit, not by narrowing you to a short list. Here are all 38 clinicians, in alphabetical order, practicing across our Bay Area offices.
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- Anthony DiGiovanni, MD
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- Karen Marcus, MD
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Common questions about ADHD
Can ADHD really be diagnosed for the first time in adulthood?
Yes, and it is common. ADHD is a long-standing pattern, so part of the evaluation is looking for evidence of it earlier in life, not just now. Many adults are accurately diagnosed for the first time as adults, usually because demands went up or the strategies that used to work stopped working.
Are stimulants the only option?
No. Stimulants work well for many adults, but many patients get significant help from other options, including non-stimulant medication and therapy. You and your doctor decide together what makes the most sense for your life overall.
Are ADHD medications safe?
In carefully screened and monitored patients, ADHD medications can be quite safe. They do, however, also come with some risks, including potentially serious ones like high blood pressure or more significant mental health problems. A careful review of your overall history is important before you get started.
What conditions can look like ADHD?
Anxiety, depression, sleep problems, and the effects of substances can all cause trouble with attention that can resemble ADHD, and any of them can also occur alongside it. Asking about these is a standard part of the evaluation, and if these issues are present, you may find more benefit in other treatments.
Let's match you to the right care
Your first visit is typically an hour-long evaluation. By the end, you leave with a working diagnosis and a treatment plan you feel confident in.