Understanding and Managing Attention-Deficit/Hyperactivity Disorder (ADHD)

Thrive • Oct 19, 2022

By Thrive Wellness Sacramento Interim Executive Director & Psychiatrist Jaime Avra Ley, M.D.

Almost 10% of children and about 4% of adults in the U.S. struggle with attention-deficit/hyperactivity disorder (ADHD), a condition that diminishes one’s ability to focus, feel at ease, and control impulses. The distressing disorder can interfere greatly with daily life, but a variety of clinical interventions can help make ADHD more manageable.

WHAT IS ADHD?

ADHD is characterized by difficulty regulating a group of important brain processes, called executive function, responsible for:

Attention
Organization
Working memory
Control of emotional and physical behaviors

Executive function prioritizes information by encouraging focus on information deserving attention and allowing less important data to fade to the background. These mental processes also help regulate behaviors by allowing or inhibiting actions, a process called impulse control.

Three types of executive function deficits correspond to three types of ADHD:

ADHD, predominantly inattentive : Difficulty with attention, focus, and organization primarily
ADHD, predominantly hyperactive/impulsive : Difficulty with impulse control and hyperactivity primarily
ADHD, combined type: Having both deficits in attention and impulse control

Symptoms of ADHD are associated with attention, hyperactivity, and impulsivity.

ADHD symptoms associated with attention include:

Difficulty paying close attention to details
Making seemingly careless mistakes often
Trouble listening
Difficulty with organization and prioritization
Feeling reluctant, disliking, or avoiding tasks that require extended focus
Frequently losing important items
Becoming distracted easily
Forgetfulness

ADHD symptoms associated with hyperactivity and impulsivity include:

Often engaging in fidgeting or squirming
Trouble staying in one’s seat
Engaging in physical activity inappropriate for the current environment
Difficulting participating in leisure activities quietly
Frequently feeling “on the go”
Engaging in excessive talking often
Interrupting frequently
Difficulty waiting for one’s turn

Risk factors for ADHD include genetic makeup, premature birth , and exposure to drugs and alcohol in utero.

MISCONCEPTIONS ABOUT ADHD

ADHD is frequently misunderstood. A couple of commonly mistaken beliefs about ADHD include:

Individuals may misperceive those with ADHD as defiant or lazy. In reality, tasks that may seem simple can require much more effort for individuals with ADHD. As a result, those with ADHD may resist undertakings that demand their full concentration.
When individuals with ADHD present symptoms of impulsivity, others may misperceive them as disrespectful, unruly, or disobedient. While there may be defiance involved in their actions, those with ADHD face more of a challenge restraining their impulses and moderating their conduct. Authority figures may rightfully implement consequences for inappropriate behavior. They may also validate the increased difficulty that those with ADHD face which can help reduce any shame stemming from the condition.

THE CONNECTION BETWEEN ADHD AND PERINATAL MENTAL HEALTH

Pregnancy and caring for an infant generally entail biological changes, diminished quantity and quality of sleep , and feelings of overwhelm — all of which can impair executive function and make organization, focus, and emotion regulation tough. If a new parent has ADHD, the perinatal period can aggravate the symptoms of the condition.

THE CONNECTION BETWEEN ADHD AND EATING DISORDERS

ADHD varies in the ways it affects different types of eating disorders , such as:

Binge eating disorder (BED) : Characterized by feeling a lack of control when eating as well as difficulty regulating portions, BED can be worsened by ADHD. Executive function deficits associated with ADHD can make it hard to regulate one’s eating behavior.
Bulimia : Expressed by frequently eating large quantities of food followed by compensatory purging behaviors , bulimia can also be exacerbated by ADHD. ADHD can make controlling the impulse to engage in compensatory actions more challenging.
Anorexia and avoidant restrictive food intake disorder (ARFID) : Individuals who struggle with ADHD and restrictive eating disorders, such as anorexia and ARFID are often able to easily disregard their hunger cues. If ignored long enough, hunger cues can dissipate. During recovery, these individuals may require additional guidance as they learn to be more mindful of returning hunger cues .

INDIVIDUAL BEHAVIORAL THERAPY FOR ADHD

Individual behavioral therapy allows those with ADHD to strengthen desired behaviors and reduce problematic conduct. Throughout the process, the clinician integrates appropriate goals, incentives, and consequences to help shape the client’s regulation skills.

Therapists can also help with any emotional challenges associated with the disorder. For example, ADHD can contribute to strained relationships as well as diminished work or school performance. Low self-esteem , social skill deficits, anxiety , and depression may result. Therapy can help treat all aspects of the condition, including any co-occurring diagnoses.

FAMILY THERAPY FOR ADHD

For an individual struggling with ADHD, family support can be essential to the successful management of the disorder. A family therapist can guide family members in supporting their loved one with ADHD while also providing them with skills to keep the family dynamic healthy amid the challenge.

ADDITIONAL INTERVENTIONS FOR MANAGING ADHD

A well-rounded approach to treating ADHD is often beneficial.

Some other ADHD management strategies that can complement therapy include:

School support resources: Schools can provide accommodations for students with ADHD to promote their academic success and behavioral modification.
Physical activity in nature: Movement and natural environments can provide a calming, restorative experience which can reduce the stress and anxiety that exacerbate ADHD.
Neurofeedback: A non-invasive procedure, neurofeedback can help a person understand their brain activity and strengthen their brain’s ability to focus, problem-solve, and control impulses.
Medication: Certain medications can help stimulate the parts of the brain needed for focus, attention, and behavior regulation.

TREATMENT FOR ADHD AT THRIVE WELLNESS

Thrive Wellness’ mental and behavioral health experts specialize in treating individuals of all ages struggling with ADHD, including those facing perinatal ADHD and ADHD that co-occurs with eating disorders . By implementing interventions such as individual and family therapy, medication management, and educational advocacy, our clinicians guide individuals in managing ADHD in a way that promotes attention, organization, and impulse control. To learn more about our therapeutic services , reach out .

While all Thrive Wellness locations offer interdisciplinary clinical teams who collaborate to treat eating disorders, perinatal mood and anxiety disorders (PMADs), and additional mental and behavioral health conditions, programs and services may vary by location.

About the Author

Thrive Wellness Sacramento Interim Executive Director & Psychiatrist Jaime Avra Ley, M.D.

Born and raised in Nevada, Dr. Jaime Avra Ley earned her doctorate in medicine at the University of Nevada, Reno Medical School where she also completed a residency in adult psychiatry and a fellowship in child and adolescent psychiatry. As an established and esteemed psychiatrist, Dr. Ley specializes in working with children and adolescents.

Dr. Ley considers comprehensive wellness to be inclusive of the health of one’s relationship with themself and others. She is passionate about addressing mental health barriers that may interfere with one’s ability to live authentically and reach their innate potential. Dr. Ley believes a multidisciplinary approach to care increases the efficacy of treatment for lasting results and is dedicated to supporting the various aspects of an individual’s well-being by providing diagnoses and medication management as appropriate.

At Thrive Wellness Sacramento, Dr. Ley enjoys working alongside a diverse treatment team of compassionate clinical colleagues to help individuals and families on their path to healing.

The post Understanding and Managing Attention-Deficit/Hyperactivity Disorder (ADHD) first appeared on Thrive Wellness.

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Clean House, Healthy Mind: Spring Cleaning Benefits for Mental Health

By Sage Tippie • 23 Apr, 2024

Spring Cleaning Benefits for Mental Health Spring is a time of new beginnings, change, and transitions, including in our homes. With the warmer weather kicking motivation into high gear, Spring can be a prime time to do a deep clean. Not only is a clean space aesthetically pleasing to the eyes, but it can also help to improve your mental health. Learn about how tidying up your space can also tidy up your thoughts below along with tips for cleaning when you’re struggling with your mental health. 4 Reasons Why Cleaning is Beneficial to Mental health 1.Decreased Stress Not only does an uncluttered space provide a sense of calm, but the physical act of cleaning can release feel-good endorphins, reducing feelings of stress and anxiety. As you cross tasks off your checklist, your body also releases Dopamine. Also known as the “happy hormone”, Dopamine provides a sense of accomplishment and pride that can promote motivation in other areas of our lives. 2. Improved Focus Studies have shown that an uncluttered space can also lead to an uncluttered mind. Your focus can be drawn away from important tasks by a chaotic, messy space. Research has also shown a connection between procrastination and clutter, as an unwillingness to tackle larger chores like cleaning can translate over into various areas of our lives. By keeping your space tidy, it can inspire you to stay on top of other major tasks like work and school assignments. 3. Regulated Emotions According to this 2015 study , cleaning can function as a practice in mindfulness, providing an increased sense of calm and inspiration. Slowing down while cleaning gives you room to relax and free your mind of burdens, stressors, and irritants that can affect your mental health. Cleaning can even be considered a practice of self-care as the action helps you to connect with yourself and the outcome allows you to better enjoy your own space. 4. Sense of Order and Control When experiencing mental health struggles, people may feel a lack of control over their lives and emotions. Cleaning even small areas of the home can provide an increased sense of order and control as you cross tasks off your to-do list. Through realizing your own power by simply completing minor tasks like cleaning, it can reaffirm your ability to do more. 10 Tips for Cleaning When Struggling with Mental Health Mental health struggles and disorders commonly create barriers to one’s ability to clean and properly practice personal hygiene. Although these behaviors are normal side effects of mental health disorders, we want to work to aid our clients in cleaning to the best of their ability even in difficult times. Below, Thrive Wellness occupational therapist Meadow Deason shares some helpful tips she gives to clients when they struggle with cleaning due to mental health conditions: 1.Ask For Help Having support to clean can make a huge difference. Do the cleaning with the person helping you and have them hold you accountable. 2. Don't Wait for Motivation Motivation might not come before action, but it can build as you begin to see the results of your efforts. 3. Start Small Start with one area or one task and go from there. For example, concentrate on your bedroom first and then move on to the living room and bathroom. 4. Do Something Daily Even if you do only one small cleaning task a day, doing that one task creates momentum and prevents small tasks from building up and becoming overwhelming. 5. Use Sensory Modulation Change your environment by playing music, adjusting the lighting, or using aromatherapy. This can help to put you in a new headspace for cleaning. 6. Start with "High Impact" Tasks Start with more intensive or all-over cleaning tasks such as picking up clutter or doing the dishes. The visual "noise" of some tasks makes a large impact on the entire space, building motivation to continue cleaning. 7. Make a To-Do List Write a detailed to-do list of tasks and cross them off as you go. Physically marking down what you’ve accomplished can promote increased motivation. 8. Reward Yourself Set up a reward system where you reward yourself with a favorite activity or item when you complete a task as an incentive to clean. 9. Use the Rocket Method Don't think about it, just choose a task, countdown from five or ten and then start. This can help you to avoid potential anxiety and dread that can prevent you from cleaning. 10. Gamify Tasks Make up a game for your tasks or time yourself to promote increased engagement in cleaning. Your ability to complete tasks can be affected by a multitude of different factors and conditions including OCD , anxiety, depression , ADHD , and more. If you are struggling with motivation due to your mental health, help is here at Thrive Wellness.

child getting bandaid from doctor while mother smiles

The Importance of Whole Family Primary Care: A Q&A with Dr. Stephanie Wright

26 Mar, 2024

By serving the whole family, physicians are able to have a better understanding of family dynamics, family health care goals, and history of disease in the family.