ADHD Therapy: What is it and how does it work.
9 Key Components of ADHD Therapy
If you have ADHD and have been in therapy before, you might have noticed your therapist addressing everything but your adult ADHD. In fact, your ADHD has been pushed so far back that it’s not even on the “back burner” anymore. Sure, you are still discussing your “other issues” like underlying depression, anxiety and why your relationships are burning to the ground, but you still can’t ignore the feeling that you are not getting to the root of your problems. The unfortunate truth is that there is a BIG gap in clinical care for adults struggling with ADHD and a generalist therapist may not have the experience or confidence in diagnosing and treating ADHD. There’s not doubt that it’s difficult to find that unicorn therapist who really understand the complexities of neurodivergence, executive function and it’s co-existing conditions. My first pro-tip for you is…find a therapist who specializes in ADHD and provides neurodiversity affirming care. It’s essential. Most therapists offer a free consultation where you can ask a few questions, gauge if your a good fit and find out more about their experience and approach to ADHD.
So what is ADHD therapy anyways? ADHD therapy is generally and integrative approach that focuses on education, executive functioning, cognitive behavioral therapy, mindfulness, coping skills, medications, lifestyle changes, coaching, treatment of co-existing conditions and more. So let’s break it down.
Education
Let’s be real. A lot of things have changed over the years in the world of ADHD and neurodivergence. Following ADHD testing and evaluation, I like to start the ADHD therapy journey with education because it helps you understand the neurobiology of ADHD, learn about the parts of the brain impacted by ADHD and gain insight into your symptoms and why you struggle with certain things. The education piece of therapy should not be ignored; it helps put the puzzle pieces together, make sense of your experiences, examines the role of stigma, combats years of isolation and validates years of feeling misunderstood. You’re not on Mars alone!
Executive Functioning
We’ve all heard the buzz word…executive function. So what does that mean really? Well, executive function refers to a set of cognitive processes in the pre-frontal cortex of the brain…and this is the part of the brain specifically impacted by ADHD. Executive functioning skills include planning, prioritizing, task initiation, organization, impulse control, emotional regulation, flexible thinking and self-monitoring. Sound familiar? Executive functioning is directly related to procrastination, or why you have difficulty getting started on things and why you lost your keys for the third time today. These skills are impaired due to ADHD and frequently cause distress in various domains of life. The focus of ADHD therapy is to identify areas of distress or impairment and develop goals to improve day-to-day functioning struggles.
Cognitive Behavioral Therapy
Cognitive Behavioral Therapy (CBT) is an evidenced based-treatment frequently used to treat ADHD, depression, anxiety, addiction, sleep and more. CBT helps increase awareness of unhelpful thinking that contributes to mood issues and inevitably interferes with completing tasks and getting things done. One major goal of the CBT-ADHD model is to help you think more adaptively and decrease the frequency of those anxiety and/or shame spirals. CBT also helps you tackle core beliefs, that constant nagging feeling that you are not good enough or that you’re a failing at life. CBT helps you gain control of your thoughts, improve your self-confidence and expand your self-compassion so you can navigate life with more ease.
Mindfulness
Hear me out! Mindfulness therapy is thought to help ADHD by thickening your prefrontal cortex…the parts of your brain responsible for executive functioning. Mindfulness practices can help enhance focus, improve attention, reduce stress, promote relaxation and help you manage your emotions. Mindfulness therapy also contributes to increased levels of dopamine in the brain, which we know is in short supply in ADHD humans.
Coping Skills
ADHD therapy should provide you with a robust tool-box of coping skills to manage ADHD and it’s co-existing conditions. Because you followed my pro-tip of finding a therapist who specializes in ADHD, the skills you learn should be practical and neurodivergent friendly. Learning skills that are tailored to your ADHD brain and that are neurodiversity affirming sets you up for success and helps you feel supported and understood. The things that work for your neuro-typical peers may not work for you. A therapist that does not understand neuro-diversity may offer you strategies that will not work for you.
Medications
Stimulant medications are the number one treatment for ADHD; they are generally considered safe, accessible and are well tolerated by most people. Stimulant medications increase levels of serotonin, norepinephrine and dopamine in the brain. There are a lot of options out there now-a-days so if one isn’t the right fit, try again. I should probably mention here that stigma, stimulant shortages and side effects can interfere with finding a successful treatment option. It’s important to work closely with your provider to find something that works for you. Sometimes the side effects of a stimulant medication outweigh the benefits but don’t worry there are alternative options for treating ADHD such as psychotherapy and lifestyle changes.
Lifestyle Changes
Recent research has shown that ADHD impacts life expectancy by up to 13 years. Yikes! Symptoms of ADHD such as impulsivity, inattention and difficulty sticking with routines often need to be addressed in ADHD therapy. Contributing factors to shortened life expectancy in ADHD adults include poor diet, addiction, risky behaviors, lack of exercise and more. ADHD therapy helps you focus on lifestyle changes and creating new healthy routines that mitigate these risks and improve life expectancy outcomes. Cognitive Behavioral Therapy (CBT) can also be useful in this area because it addresses maladaptive thoughts, feelings and behaviors regarding lifestyle choices so that you can think more adaptively and make progress towards healthy change.
Coaching
ADHD therapy often involves coaching around executive functioning skills, organization strategies, time-management strategies, lifestyle changes and managing distractibility. Most ADHD therapists are open to addressing the psychological and emotional aspects of ADHD alongside the the practical approach or providing skills and strategies. Although it’s nice if you can get both of these services in one place, it may not always be practical. If you are significantly struggling with other co-existing conditions such as as depression, anxiety or addiction; it might make sense to split these services so that your therapist can focus solely on addressing and treating the underlying mental health concerns.
Treatment of Co-Existing Conditions
The reality is that ADHD rarely travels alone. In fact approximately 80% of adult humans diagnosed with ADHD also have a co-existing condition and 50% of individuals with ADHD have a 3rd coexisting condition. The biggest culprits include: anxiety, depression and addiction. ADHD therapy frequently involves treatment for these other conditions especially if they are co-morbid.
“ADHD touches every piece of your life, it’s a whole-person condition.”
