"I think I have ADHD, what do I do now?" This question may be the first that comes to mind for many adults who may have symptoms of ADHD. Because of the long-standing myth that ADHD is a disorder affecting only children (see myth #2 on the NRC's webpage on Myths and Misunderstandings), finding treatment for adults may be more difficult than finding treatment for children. Due to the mistaken belief that ADHD symptoms would usually be outgrown, most ADHD research and treatment was focused on children for much of the 20th century.
This trend has changed over the last two decades, with more researchers and treatment providers focusing on ADHD in adults. The next edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), due out in the next several years, is expected to contain guidelines for ADHD in adults, whereas the current fourth edition only classifies ADHD as a disorder among those "Usually First Diagnosed in Infancy, Childhood, or Adolescence."
With this in mind, it is easier for adults to find information and treatment for ADHD than it has been in the past, but there are still many questions to answer. In addition to the opening question posed above, others may include:
How do I find a provider who can treat ADHD in adults?
Will my family doctor be able to work with me on ADHD?
Will I need to see a specialist, like a psychologist or psychiatrist?
What kind of treatment will I need?
Will I need to take medication?
How much will treatment cost?
Will my health insurance cover the costs?
A good first step is to speak with a family practitioner. The NRC's information sheet, What We Know #9: Diagnosis of ADHD in Adults, advises adults to ask their primary care physician for a referral to a health care professional in the community who is qualified to evaluate and treat ADHD in adults. In some cases, family physicians may be familiar with diagnosing adults with ADHD and the treatment options available. CHADD maintains an online professional directory as well, allowing adults with ADHD to search for local providers. Another option is to contact a local university-based hospital, medical school or graduate school in psychology. The NRC maintains a listing of Hospitals and University Centers on its website.
Another way to find a qualified professional is to attend a local ADHD support group. Having experience with ADHD treatment providers, the people who attend the group are likely to have worked with healthcare professionals and may be willing to share their experiences and other information. CHADD has a number of such support groups around the country. For a searchable list of CHADD chapters, visit the CHADD Chapter locator on the CHADD website.
ADHD treatment or supporting services can be provided by a number of different types of professionals depending on the severity of symptoms and the nature of treatment or services needed. Some professionals who can help adults with ADHD are:
Physicians, including Psychiatrists and Neurologists
Nurse Practitioners
Physician's Assistant
Psychologists, especially Clinical Psychologists
Clinical Social Workers
Licensed mental health therapists
ADHD Coaches
Professional Organizers
In most situations, adults consult with more than one type of professional, sometimes having a team rather than an individual provide treatment. If medication is needed as part of the treatment, it is usually necessary to have a physician (i.e. someone with an M.D. or O.D. degree) or other qualified medical professional write the prescription (although one state, New Mexico, also allows clinical psychologists with advanced training in pharmacology to write certain prescriptions in certain circumstances). Medication may be, but is not necessarily, part of ADHD treatment for adults. If medication is not part of the plan, a psychologist, social worker or other mental health provider can be the primary professional involved, and some adults will be able to manage their ADHD with help from those "emerging professions" such as ADHD Coaching or Professional Organizing.
Information on medication for adults with ADHD can be found in What We Know #10: Managing Medication for Adults with ADHD. Information on coaching can be found in What We Know #18: Coaching for Adults with ADHD. Treatment options for adults do vary, especially as there is a portion of the adult population with ADHD that does not respond to medication treatment. Some treatment options that go beyond medication are discussed in the May 2010 NRC News article Beyond Medication: Treating ADHD in Adults.
Cost of treatment can vary greatly depending on the kind of treatment plan needed and the type of insurance coverage available. In years past, many insurance companies did not cover mental health treatment to the same extent as physical health treatment. However, in fall 2008, Congress enacted the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act, which limited the ability of insurance companies to provide different levels of coverage for mental and physical conditions. According to the CHADD fact sheet on Mental Health Parity, "The law makes it illegal for health insurance plans sponsored by businesses with fifty or more employees to impose day and visit limits that are more restrictive than physical illness coverage. It also prohibits applying different deductibles, copayments, out-of-network charges, and other financial requirements for mental health treatment compared to physical health treatment covered in a plan."
One thing noted in the fact sheet regarding adult ADHD is that, "Health plans have discretion on which conditions to cover. Until the published science is as sound for adult ADHD as it is for childhood ADHD, there will be plans that will not cover adults." So adults will have to check with their insurance providers to see what services are covered. Adults who are privately insured or work for companies with fewer than 50 employees will also have to check with their plan to see what is covered and what is not.
Finding the right provider or team can be challenging, but it can sometimes be as simple as talking to a family physician. If the physician does not know of anyone who can treat ADHD in adults, there are other options to consider as outlined above. Finding the right providers and enacting the right plan is a vital step in the process of living a meaningful life as discussed in CHADD's Professional Advisory Board's statement on ADHD and Recovery. Although adults with ADHD may feel their lives are in a state of constant chaos, finding the right professionals to work with can go a long way towards empowerment and taking control of one's own life.
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