We make time for everything and everyone but ourselves. We consistently prioritize the needs of others. We feel guilty erecting boundaries. And this struggle to carve out space for our own wellbeing is the biggest barrier to mental and emotional health for more than half of adults with ADHD, according to a new survey of 1,898 ADDitude readers.

“I have a hard time putting myself first. I worry about others to my own detriment.”

“I really want to journal but, when I remember to, I spend an hour writing and then find myself thinking, ‘I don’t have time for this!’”

On a 10-point scale, where 10 is extremely satisfied, ADDitude readers rated their mental and emotional health a 5.2. Additional barriers to mental health care cited by readers include the following:

• Defining effective self-care strategies: 45%
• Sticking with a routine: 45%
• Practicing mindful meditation and/or gratitude: 38%
• Affording a mental-health practitioner: 23%

“Insurance makes things impossible sometimes. Also, I’ve had to switch mental healthcare doctors many times due to clashes of ideals and personality. One actually said ADHD wasn’t real and that I just needed discipline to work through my ‘laziness’.”

“I have not found a single counselor who is highly familiar with adult ADHD and its nasty companions.”

[Get This Free Download: Make Mindfulness Work for You]

Top Mental Health Apps and Tools

Following are the top apps, websites, podcasts, books, and other resources recommended by ADDitude readers for improving mental and emotional health.

Self-Care Apps

• Insight Timer: Guided meditation sessions, music, and courses for mindfulness and relaxation
• Balance: Personalized meditation that adapts sessions to your goals and progress
• Gratitude: Foster daily gratitude and positivity via journaling
• Happify: Activities and games to boost happiness and reduce stress
• Headspace: Mindfulness and meditation tools, sleep sounds, mindful movement, and exercise.
• Calm: Sleep stories and music, meditation and inspirational stories, mood tracking, and relaxation tools
• Healthy Minds: Unlock wellbeing my practicing four skills — awareness, connection, insight, and purpose
• Finch: Nurture a virtual pet by completing daily wellness and self-care tasks

Self-Care YouTube Channels, Podcasts, and Websites

• How to ADHD: A YouTube channel created by Jessica McCabe that offers practical tools and insights for living with ADHD.
• The Happiness Lab: A podcast by Laurie Santos, Ph.D., that explores science-backed strategies for a happier life.
• The Teen Anxiety Maze : A podcast by Cynthia Coufal, a teen anxiety coach.
• Therapy in a Nutshell : A mental health and strategies podcast, YouTube channel, and website by Emma McAdam, LMFT.
• Something Shiny: A podcast by therapists David Kessler and Isabelle Richards that tackles ADHD and relationships with humor and authenticity.
• ADDitude ADHD Experts: Leading experts in ADHD and mental health share the latest research and proven strategies.

Self-Care Books

• ADHD 2.0 (#CommissionsEarned)by Edward M. Hallowell, M.D., and John Ratey, M.D.
• Your Brain Is Not Broken (#CommissionsEarned) by Tamara Rosier, Ph.D.
• The Gift of Imperfection (#CommissionsEarned) by Brené Brown
• Get Out of Your Mind and Into Your Life (#CommissionsEarned) by Steven C. Hayes and Spencer Smith

Daily Self-Care Approaches

To prioritize self-care, many ADDitude readers incorporate small practices and routines into daily life. Here is their advice.

“Take three deep breaths a few times a day. Connect it to something you are doing anyway; do it after going to the bathroom first thing in the morning or when you get into your car.”

“I have a ‘blow off steam’ playlist that I listen to when I feel wired or hostile. (I also have calming playlists!)”

“As weird as it sounds, I find ChatGPT great for journaling. It asks me questions about what I’ve written and helps me develop a deeper understanding of my thoughts.”

“Exercise is the magic medicine for my mental health. I notice a difference in my energy, focus, attitude, and motivation to get things done when I exercise. I try to walk three days a week and attend a class at my local YMCA three days a week.”

“I write about three good things every morning. It gives me a sense of achievement and agency and calms my anxiety.”

“I have set aside Fridays after work as ‘nothing needs to get done’ time.”

“I try to have 30 minutes of ‘me’ time every day. I take a bath, listen to an audiobook, or watch a show.”

[Read: 31 Ways to Work Out the Kinks in Your Workout Plan]

The Power of Therapy and Medication for Mental Health

Readers report that taking prescribed medications and working with mental health professionals do wonders for their health, and assigned the following “helpfulness” ratings to each tool (on a 5-point scale where 5 is extremely helpful):

• Therapist (in-person or online): 4.11
• Medication for ADHD: 3.91
• Medication for another condition: 3.88
• Psychiatrist: 3.67

“ADHD meds have helped so much with emotional regulation that I’m quite upset I didn’t have access to them earlier!”

“Medication for anxiety has largely cleared up my ADHD mess, so much that I’m able to handle other sides that come up (time blindness, forgetfulness, etc.)”

“Accessing a therapist is paramount to understanding your emotions, triggers, and boundaries.”

“Medication can be so helpful, but it can take a while to figure out what works for you. Try some stuff and don’t be afraid to try something else if it is not working or if side effects make life unfun. Also, know that medication is a helpful tool, but it doesn’t do the work for you. It helps you do the work of setting up systems, finding coping skills and accommodations, and looking honestly at how your current patterns are helping or hurting you as you seek to be the best you.”

More Recommended Mental Health Supports

What other supports are helpful for improving mental and emotional health? ADDitude readers contributed the following “helpfulness” ratings:

• ADHD coach: 3.67
• Yoga or meditation class: 3.50
• Spouse, family member, friend: 3.38
• Anger-management training: 2.75
• Journaling: 3.08

“Get a good yoga teacher who focuses on the emotional benefits of yoga as well as the physical benefits. It is so much more than exercise and is really beneficial for all sorts of ADHD symptoms, too.”

“Find safe spaces to talk about your feelings, even if it is just an online community of strangers. Communities of people with ADHD are great to engage with because they have empathy for what you are experiencing and often really great advice for ways to better your daily life.”

“There is something therapeutic about writing on paper while curled up in a chair. It clears my mind and gets the chaos out of my head.”

“My most helpful experiences come from seeing others with similar struggles and finding that I am normal.”

How to Improve Mental Health: Next Steps

• Celebrate Every Step: Join the Small Wins Appreciation Network!
• Read: 11 Self Care Strategies for ADHD Brains
• Read: “Your ADHD Self-Improvement Plan — 6 Steps to a Better You”
• Join Us! ADHD Support Group for Adults

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

#CommissionsEarned As an Amazon Associate, ADDitude earns a commission from qualifying purchases made by ADDitude readers on the affiliate links we share. However, all products linked in the ADDitude Store have been independently selected by our editors and/or recommended by our readers. Prices are accurate and items in stock as of time of publication.

In this final installment of ADDitude magazine’s two-part series, “The Future of ADHD” (the first part appeared in the Winter 2023 issue), I’ll explain each of the developments poised to revolutionize ADHD understanding and treatment.

New Pharmacologic Interventions for ADHD

Development of pharmacologic interventions for ADHD has mushroomed over the last two decades. Though researchers have made progress in developing non-stimulant treatment options (i.e., long-acting forms of clonidine and guanfacine, as well as atomoxetine and viloxazine), most of the FDA-approved agents are simply tweaks of methylphenidate and amphetamine compounds.

There are now more choices available to prescribers and patients, offering stimulant preparations of varying durations, delivery formats (patch, liquid, tablet, capsule), and pharmacokinetic profiles. It should be noted that both older and newer preparations are exceptionally effective for most patients and, when comparing them to non-stimulants in head-to-head trials and in clinical practice, the psychostimulants generally win hands-down. However, the various forms of psychostimulants differ in their rate of onset, duration of coverage, convenience (once daily vs. multiple doses daily), and cost.

Psychostimulants, however, are not effective for everyone; about 30% of patients may not have a satisfactory response.¹ As a result, researchers are increasingly exploring the benefits of combining psychostimulant treatment with other compounds (e.g., methylphenidate paired with atomoxetine, or a dextroamphetamine compound plus guanfacine).

[Get This Free Download: 2024 Scorecard of ADHD Treatments]

The robust effectiveness of psychostimulants in treating ADHD has somewhat slowed the development of alternatives. However, researchers are exploring newer agents that target different neurotransmitter systems, including:

• Solriamfetol (used to treat excessive daytime drowsiness)
• Tipepidine (used as a cough suppressant)
• Amantadine (used to treat Parkinson’s disease)
• Dasotraline (used to treat depression and other disorders)

Not yet FDA-approved for ADHD, these compounds face two main challenges: matching the effectiveness of psychostimulants and effectively targeting symptoms not currently treated by psychostimulants.

ADHD and the Gut-Brain Axis

Emerging research suggests a significant, but underappreciated, relationship between the gut biome — a diverse community of microorganisms living in the digestive tract — and behavior and emotions. The gut and the brain communicate through the gut-brain axis, allowing gut microbiota to influence brain function and vice versa.

Multiple studies have now shown that abnormalities in the gut microbiome can affect mood, anxiety, and stress levels.² Certain gut bacteria can even produce neurotransmitters like serotonin and gamma-aminobutyric acid (GABA), which play a crucial role in regulating emotions.³ Other gut bacteria can produce toxins, inflammatory molecules, and other metabolites that can cross the blood-brain barrier to adversely impact brain health and cognitive function.⁴

[Get This Free Download: Lifestyle Changes for Adults with ADHD]

Imbalances in the gut microbiome can be caused by diet, stress, and even antibiotic use during the prenatal period or during infancy.^{5 6} Longitudinal studies have shown that these gut factors can be linked to mental health disorders, including ADHD, in later childhood.⁷ Multiple studies also suggest that restoring a healthy gut balance through probiotics, prebiotics, or dietary changes might improve emotional wellbeing.⁸ Research involving the microbiome’s impact on human behavior and emotions is still emerging.

ADHD and Gene-Environment Interactions

ADHD is highly heritable; however, environmental influences are exceptionally important in determining whether, when, and how a set of genes will manifest in ADHD symptoms. Environments determine whether a particular illness or disease manifests. This area of research — how certain genes are differentially expressed due to differences in environments — is in its infancy.

A major challenge: Because there are so many genes and possible environmental factors unfolding over time, there are literally trillions of possible gene-environment interactions that could affect the timing, severity, and persistence of ADHD. Due to the likely number and complexity of these interactions, multiple replications across independent studies will be essential.

Several studies have already shown that the severity and persistence of ADHD can be a function of parent-child interactions and supervision across different settings.⁹ This is not a “blame the parents” finding, but, instead, suggests that certain interventions from caregivers (and possibly teachers, coaches, and other adults) may mitigate a child’s symptom severity and persistence. For example, teaching parents how to remain neutral, or even express warmth in the face of difficult behaviors, is likely an important area of intervention. Related findings indicate that parental rejection¹⁰ can affect a child’s outcomes, as can the level of household disorganization¹¹, overall life stress¹², and other factors. Attention to such challenges offers an opportunity for targeted interventions.

Many different factors contribute to ADHD’s etiology, timing of onset, and severity, as well as possibilities for prevention and person-specific treatment. Our research to date, and our research programs unfolding over the next decades, will continue to lead to advances in the way we diagnose and treat ADHD in childhood and in adults.

ADHD Research: Next Steps

• Read: The Evolution of ADHD — Examining the Last 25 Years and the Future
• Read: Prenatal and Early Life Risk Factors of ADHD
• Watch: Epigenetics — Understanding Its Role in ADHD and Future Applications
• Hub: ADHD News & Research

Peter S. Jensen, M.D., is the founder of The REACH Institute, which trains providers in interventions for children’s mental health care.

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Sources

¹ Spencer, T., Biederman, J., & Wilens, T. (2004). Nonstimulant treatment of adult attention-deficit/hyperactivity disorder. The Psychiatric clinics of North America, 27(2), 373–383. https://doi.org/10.1016/j.psc.2003.12.001

² Xiong, R. G., Li, J., Cheng, J., Zhou, D. D., Wu, S. X., Huang, S. Y., Saimaiti, A., Yang, Z. J., Gan, R. Y., & Li, H. B. (2023). The Role of Gut Microbiota in Anxiety, Depression, and Other Mental Disorders as Well as the Protective Effects of Dietary Components. Nutrients, 15(14), 3258. https://doi.org/10.3390/nu15143258

³ Chen, Y., Xu, J., & Chen, Y. (2021). Regulation of Neurotransmitters by the Gut Microbiota and Effects on Cognition in Neurological Disorders. Nutrients, 13(6), 2099. https://doi.org/10.3390/nu13062099

⁴ Parker, A., Fonseca, S., & Carding, S. R. (2020). Gut microbes and metabolites as modulators of blood-brain barrier integrity and brain health. Gut microbes, 11(2), 135–157. https://doi.org/10.1080/19490976.2019.1638722

⁵ Madison, A., & Kiecolt-Glaser, J. K. (2019). Stress, depression, diet, and the gut microbiota: human-bacteria interactions at the core of psychoneuroimmunology and nutrition. Current opinion in behavioral sciences, 28, 105–110. https://doi.org/10.1016/j.cobeha.2019.01.011

⁶ Fish-Williamson, A., Hahn-Holbrook, J., Hobbs, M., Wallander, J., & Morton, S. M. B. (2022). Prenatal antibiotic exposure in pregnancy and early childhood socioemotional development. JCPP advances, 2(2), e12066. https://doi.org/10.1002/jcv2.12066

⁷ Cassidy-Bushrow, A. E., Sitarik, A. R., Johnson, C. C., Johnson-Hooper, T. M., Kassem, Z., Levin, A. M., Lynch, S. V., Ownby, D. R., Phillips, J. M., Yong, G. J. M., Wegienka, G., & Straughen, J. K. (2023). Early-life gut microbiota and attention deficit hyperactivity disorder in preadolescents. Pediatric research, 93(7), 2051–2060. https://doi.org/10.1038/s41390-022-02051-6

⁸ Bistas, K. G., & Tabet, J. P. (2023). The Benefits of Prebiotics and Probiotics on Mental Health. Cureus, 15(8), e43217. https://doi.org/10.7759/cureus.43217

⁹Haack, L. M., Villodas, M. T., McBurnett, K., Hinshaw, S., & Pfiffner, L. J. (2016). Parenting Mediates Symptoms and Impairment in Children With ADHD-Inattentive Type. Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53, 45(2), 155–166. https://doi.org/10.1080/15374416.2014.958840

¹⁰ Brinksma, D. M., Hoekstra, P. J., de Bildt, A., Buitelaar, J. K., van den Hoofdakker, B. J., Hartman, C. A., & Dietrich, A. (2023). Parental rejection in early adolescence predicts a persistent ADHD symptom trajectory across adolescence. European child & adolescent psychiatry, 32(1), 139–153. https://doi.org/10.1007/s00787-021-01844-0

¹¹ Agnew-Blais, J. C., Wertz, J., Arseneault, L., Belsky, D. W., Danese, A., Pingault, J. B., Polanczyk, G. V., Sugden, K., Williams, B., & Moffitt, T. E. (2022). Mother’s and children’s ADHD genetic risk, household chaos and children’s ADHD symptoms: A gene-environment correlation study. Journal of child psychology and psychiatry, and allied disciplines, 63(10), 1153–1163. https://doi.org/10.1111/jcpp.13659

¹² Hartman, C. A., Rommelse, N., van der Klugt, C. L., Wanders, R. B. K., & Timmerman, M. E. (2019). Stress Exposure and the Course of ADHD from Childhood to Young Adulthood: Comorbid Severe Emotion Dysregulation or Mood and Anxiety Problems. Journal of clinical medicine, 8(11), 1824. https://doi.org/10.3390/jcm8111824

Dialectical behavior therapy (DBT) combines elements of mindfulness and cognitive behavioral therapy (CBT) to treat conditions marked by emotional dysregulation, including ADHD, mood disorders, and anxiety disorders.

Initially developed by Marsha Linehan, Ph.D., in the 1980s to treat borderline personality disorder (BPD), DBT helps people learn to tolerate internal experiences (i.e., emotions), physical sensations (i.e., agitation and restlessness), and the urge to fidget or interrupt. It has become a go-to treatment for ADHD.

A central tenet of DBT is validation — accepting uncomfortable emotions and situations before trying to change them. By coming to terms with troubling thoughts and emotions, change appears possible, and patients can work with their therapists to create a recovery plan.

In this download, you will learn:

• The four modules that comprise DBT skills training
• Types of coping strategies presented in DBT
• How DBT improves emotional regulation skills
• How DBT improves ADHD symptoms
  The difference between cognitive behavioral therapy (CBT) and DBT
• And much more!

Dialectical Behavior Therapy (DBT) is an effective treatment for improving emotional regulation in adults with ADHD. DBT is a lesser known but important intervention under the Cognitive Behavioral Therapy (CBT) umbrella of treatments for ADHD.

DBT aims to improve emotional dysregulation through four basic skills modules: core mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. DBT modified for adult ADHD also integrates skills that improve executive function.

In this webinar, you will learn:

• About basic DBT skills modules and how they are modified to treat adult ADHD symptoms and traits
• How DBT teaches skills to improve management of intense emotions, impulsivity, mood swings, stress intolerance, and related behaviors
• How DBT teaches skills to improve executive functioning
• How DBT teaches approaches to activate the emotions needed for task initiation and persistence
• About the actionable strategies that DBT provides to bring about lasting changes in behavior and motivation

Watch the Video Replay

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Download or Stream the Podcast Audio

Click the play button below to listen to this episode directly in your browser, click the symbol to download to listen later, or open in your podcasts app: Apple Podcasts; Audacy; Spotify; Amazon Music; iHeartRADIO

DBT Skills for ADHD Symptoms: More Resources

• Download: What Is Dialectical Behavior Therapy (DBT)?
• Read: Why Dialectical Behavior Therapy Works
• Read: DBT Plus tDCS May Best Improve ADHD Symptoms in Adults
• eBook: The Adult’s Guide to Stronger Executive Functions
  

Obtain a Certificate of Attendance

If you attended the live webinar on October 31, 2024, watched the video replay, or listened to the podcast, you may purchase a certificate of attendance option (cost: $10). Note: ADDitude does not offer CEU credits. Click here to purchase the certificate of attendance option »

Meet the Expert Speaker

Scott Spradlin, a licensed professional counselor and licensed master’s addiction counselor, is the co-director of Wichita DBT at NorthStar Therapy, along with his wife, Mariah Spradlin, a licensed clinical social worker and licenses clinical addiction counselor. They provide adherent comprehensive DBT and Wise Mind for the Distracted Mind: DBT for Adult ADHD, a modified DBT for adult ADHD.

Scott completed DBT intensive training with DBT founder Marsha Linehan, Ph.D., and Linda Dimeff, Ph.D., in 2000 in Seattle, Washington. He served as an adjunct professor for the College of Education and School Psychology at Wichita State University, where he taught courses on DBT and related topics, the assessment and treatment of suicidality and self-harm, and the ethical integration of religion and spirituality in psychotherapy for undergraduate and graduate students. Scott authored Don’t Let Your Emotions Run Your Life: How Dialectical Behavior Therapy Can Put You in Control (New Harbinger, 2003).

He and his wife are co-authoring a new workbook on DBT for adult ADHD scheduled for release in 2026.

Listener Testimonials

“I found today’s webinar to provide a great overview of how DBT principles can be applied to ADHD treatment.”

“I’m a psychologist with ADHD specializing in ADHD and I loved this! I’ve done some generic DBT training but there was so much in this and so much that’s relevant to my clients and I.”

“Absolutely brilliant speaker. That was excellent; so gentle and kind for us ADHD adults and yet loads of really good theory and simple steps that could really help.”

Webinar Sponsor

The sponsor of this ADDitude webinar is….

Are your emotions taking you on a rollercoaster you can’t control? You’re not alone. For adults with ADHD, managing feelings can be tough. That’s where Inflow steps in. Our expert-designed app-based program offers practical techniques to help you identify thought patterns, regulate emotions, and boost your overall well-being. With Inflow, you’re not just surviving – you’re thriving. Ready to take charge of your emotional world for good? Take the free ADHD quiz today to kick off your self-care journey.

ADDitude thanks our sponsors for supporting our webinars. Sponsorship has no influence on speaker selection or webinar content.

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EndeavorOTC is an over-the-counter digital therapeutic authorized by the Food and Drug Administration (FDA) for the treatment of adults 18 and older with primarily inattentive or combined-type ADHD. In the U.S., it is indicated to improve attention and functioning as measured by computer-based testing. It is available without a prescription.

EndeavorOTC is not intended to be used as a stand-alone therapeutic and is not a substitution for ADHD medication.

Developed by Akili Interactive, EndeavorOTC is the first FDA-authorized over-the-counter digital therapeutic treatment for adult ADHD. It uses the same proprietary technology as EndeavorRx, an FDA-approved digital therapeutic for the treatment of children ages 8 to 12 with primarily inattentive or combined-type ADHD.

EndeavorOTC is available in the U.S. in the Apple App Store for iOS and the Google Play Store for Android mobile devices.

How Does EndeavorOTC Work?

Through its immersive video game experience, EndeavorOTC presents specific sensory stimuli and simultaneous motor challenges designed to alter pathways in the brain related to focus.

Adults typically interact with EndeavorOTC on mobile devices for 25 minutes daily, five days a week.

The EndeavorOTC games, which challenge players to simultaneously target and navigate through a series of obstacles, are designed to boost cognitive functions related to attention, focus, multitasking, and prioritization.

How Long Does EndeavorOTC Take to Work?

The clinical study supporting EndeavorOTC’s FDA clearance found that, after six weeks of EndeavorOTC use, 83% of participants saw clinical improvements in their ability to focus as measured by the TOVA attentional control score. Nearly three-quarters (72.5%) of participants reported some quality-of-life improvements as measured by the Adult ADHD Quality of Life Scale (AAQoL), and roughly half (45.8%) of adults met a prespecified threshold for clinically meaningful improvement.¹

What are the Side Effects of EndeavorOTC?

The clinical trial for EndeavorOTC reported no lasting or serious side effects. Of the 221 adults who received EndeavorOTC for six weeks in the trial, 11 (5%) reported a treatment-emergent adverse device event, most commonly nausea (1.8%) and headache (1.4%).¹

What Precautions are Associated with EndeavorOTC?

EndeavorRx may not be appropriate for patients with photosensitive epilepsy, color blindness, or physical limitations that stop a patient from comfortably holding a device.

To learn more about EndeavorOTC, visit EndeavorOTC.com.

What is EndeavorRX?

EndeavorRx, a version of EndeavorOTC designed for children ages 8 to 12 with ADHD, was approved by the FDA in June 2020. Through its immersive video game experience, EndeavorRx presents specific sensory stimuli and simultaneous motor challenges designed to target neural systems in the brain related to attentional control. Children interact with EndeavorRx on mobile devices and typically play for 25 minutes per day, five days a week. It is available by prescription from a licensed healthcare provider.

Learn more about EndeavorRx at www.endeavorrx.com/

Source

¹ Stamatis, C.A., Mercaldi, C., Kollins, S.H. (2023). A Single-Arm Pivotal Trial to Assess the Efficacy of Akl-T01, a Novel Digital Intervention for Attention, in Adults Diagnosed With ADHD. Journal of the American Academy of Child & Adolescent Psychiatry. https://doi.org/10.1016/j.jaac.2023.09.510

The therapeutic potential of psychedelic drugs for treatment-resistant conditions including mood disorders has sparked renewed interest among researchers, psychiatrists, and patients. New research and ongoing clinical trials are shedding light on the safety and efficacy of these substances, used in controlled therapeutic settings, for conditions that have been challenging to treat using conventional methods. A growing body of research indicates that several classical psychedelics and “psychedelic-like” compounds (e.g. psilocybin, ketamine, MDMA, and LSD) have shown promise for the treatment of substance use disorders, post-traumatic stress disorder (PTSD), anxiety disorders, and treatment-resistant depression (TRD). Some psychedelic treatments, such as MDMA-assisted psychotherapy for PTSD, are currently undergoing phase 3 clinical trials, indicating a significant level of scientific and medical interest in their potential therapeutic applications.

In this webinar, you will learn about:

• The history of psychedelic therapy and its research
• The science behind how psychedelic compounds may be targeting clinical conditions, like major depressive disorder
• The possible benefits and side effects of using psychedelics to conditions after other conventional therapies have failed
• What questions to ask when considering psychedelic usage in a clinical setting for yourself or loved ones

Watch the Video Replay

Enter your email address in the box above labeled “Video Replay + Slide Access” to watch the video replay (closed captions available) and download the slide presentation.

Download or Stream the Podcast Audio

Click the play button below to listen to this episode directly in your browser, click the  symbol to download to listen later, or open in your podcasts app: Apple Podcasts; Audacy; Spotify; Amazon Music; iHeartRADIO.

Treatment for Mood Disorders: More Resources

• Download: Solving the Bipolar and ADHD Puzzle
• Self-Test: Depression in Adults
• Read: Mental Health’s Psychedelic Revolution
• Get: 9 Conditions Often Diagnosed with ADHD

Obtain a Certificate of Attendance

If you attended the live webinar on April 23, 2024, watched the video replay, or listened to the podcast, you may purchase a certificate of attendance option (cost: $10). Note: ADDitude does not offer CEU credits. Click here to purchase the certificate of attendance option »

Meet the Expert Speaker

Adrian Jacques H. Ambrose, M.D., MPH, MBA, FAPA, is the Senior Medical Director at ColumbiaDoctors Psychiatry at Columbia University Irving Medical Center. For over a decade, Dr. Ambrose has also served as a senior consultant in designing national and global programming in strategy, management, and operations implementation for mid-to-large-sized entities, including Fortune 500 companies. In addition, he specializes in cultivating psychological safety, team building, and culture acceleration for senior managers and executives.

Clinically, Dr. Ambrose specializes in treatment-refractory mood disorders for both the adult, child, and adolescent populations in interventional and novel therapeutics, such as neuronavigated TMS, ketamine, and psychedelics.

Dr. Ambrose completed his medical training at Dartmouth and MGH/McLean Hospital, and value-based healthcare training at the Dartmouth Institute for Health Policy. He also completed the Minority Health Policy Fellowship at Harvard Medical School.

Listener Testimonials

“Excellent information and points about balancing the potential therapeutic uses with the clinical evidence at the moment.”

“Thank you for providing so much info for practitioners! It is very helpful.”

“Great speaker! I would definitely take another of his courses!”

Follow ADDitude’s full ADHD Experts Podcast in your podcasts app:
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On that fateful day, my psychedelic guide gave me magic mushrooms and said, “Look at the forest one last time; you will never see it the same way again.”

To say he was right would be an understatement.

I arrived with a simple intention: to get to know myself better. What emerged were aspects of myself that I never knew existed. The psychedelic experience revealed the roots of my depression and provided insight about how to regulate my emotions — a godsend for me as I struggled with intense mood swings and disorders. Whereas therapy had failed, this journey transformed me entirely.

To be clear, it was not a magical solution that solved all my problems overnight. But my psychedelic journey gave me a vision of the destination to drive toward. It filled me with an intrinsic motivation to change the patterns that were keeping me stuck.

[Read: The Truth About Lion’s Mane, Psychedelics & Caffeine]

Fast-forward 12 years, following numerous psychedelic experiences combined with therapy: I have achieved a state of emotional stability. Severe mood swings and depression are a distant memory.

I was diagnosed with ADHD last year, and I consider this revelation the last missing piece of my puzzle. Today, I find it easy to love myself for who I am. I have developed new ways to live and embrace my ADHD brain without using medication.

Helping Others Follow the White Rabbit

In 2016, I decided that I wanted to help others by becoming a psychedelic-assisted therapy facilitator. At the time, psychedelic facilitator training programs didn’t exist, so I pursued extensive training in various modalities. I trained in inner child work and trauma integration therapy. I attended workshops and seminars conducted by experts in the field of psychedelic-assisted therapy.

Since then, I have co-founded a psychedelic-assisted therapy company and guided hundreds of people through psilocybin journeys in the Netherlands, where this work is legal. The changes I have witnessed in people, especially those with ADHD and neurodiversity, have been nothing short of astounding.

[From WebMD: A Long, Strange Trip — Psychedelics Meet Mainstream Medicine]

Most of the people undergoing this form of therapy experience significant changes in their lives, overcome addictions and depression, transform their self-doubt, and reduce their rejection sensitivity.

It is important to say that this therapy is not for everyone, nor is it a one-size-fits-all solution. Individuals who are prone to psychosis, diagnosed with schizophrenia or bipolar disorder, or who have a family history of these conditions should abstain from this therapy.

That said, it helped me to redefine my life, and I hope it can benefit others like me.

Psychedelic Assisted Therapy: Next Steps

• Free Download: Free Guide to the Top 5 Vitamins and Supplements for ADHD
• Read: LSD, MDMA, Magic Mushrooms Clinical Trial Guidelines Released by FDA
• Read: Real Stories of Using Ketamine for Depression, Anxiety, PTSD
• Read: “Therapy Helped Me…”

Alice Smeets is a neurodivergent psilocybin-assisted therapy facilitator and co-founder of The Inner Shift Institute, which offers guided, private psilocybin therapy sessions and group retreats in the Netherlands.

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Amphetamine and methylphenidate have been used to treat ADHD for at least 80 years, and their safety and efficacy have been studied relentlessly. But according to a recent ADDitude survey, less than half (42%) of parents opt to medicate their children in the months after a diagnosis, largely due to the fear of real or perceived side effects like appetite suppression or sleep disruption — both possible impediments to growth.

In the end, 85%  of all people with ADHD end up taking medication and they rate its efficacy higher than any other treatment approach included in the survey, ADDitude’s largest to date. More than 11,000 adults with ADHD and caregivers of children with the condition participated in the survey from July to December 2023.

“We hesitated for a long time and tried diet changes first in an attempt to avoid medication,” said one respondent. “Although diet is very important, medication has given our child the opportunity to enjoy life by having more emotional control, better friendships, and the ability to complete work and think things through. Greater self-confidence flows from all of this.”

Most Popular ADHD Medications

To be clear, ADHD medication is not a quick fix. On average, children try 2.75 different medications and adults try 2.56 prescriptions before finding one that works for them. Survey respondents also said that 17% of children and 14% of adults cease treatment with medication for one reason or another — cessation rates lower than reported in other studies.¹

Biggest Impediments to ADHD Treatment

Access to treatment professionals with experience in ADHD is the biggest impediment to effective treatment, according to both caregivers and adults. Other barriers include side effects, long wait times, poor access to diagnosing clinicians, and comorbid conditions that complicate evaluation and treatment (82% of children and 92% of adults with ADHD report comorbid diagnoses).

ADHD’s Most Common Comorbid Conditions

The average age of ADHD diagnosis in children is 8 for boys and 9 for girls, according to survey respondents. On average, adults not diagnosed as children learn of their ADHD around age 39. Most of these late diagnoses are among women, who report years of struggle preceding their diagnosis.

“I wish I had been diagnosed and treated sooner,” wrote one survey respondent. “The struggle is so profound and deep. And the longer you go through it without help or knowing what you’re really struggling with, the harder it feels to get others to hear and see you. You feel alone.”

Persistence, flexibility, and self-advocacy are vitally important when working to find the right medication. Though the trial-and-error phase was described as frustrating by most survey respondents, research tells us the benefits of ADHD medication use — reduced risks of automobile accidents, substance abuse, unwanted pregnancy, sexually transmitted diseases, and self harm in teens — are worthwhile and meaningful.²

“I wish I had known that ADHD medication helps prevent addictions to dangerous substances,” wrote one survey respondent, “and car accidents for people with ADHD.”

ADHD Medication Formulation, Duration & Satisfaction

Barely half of patients taking a long-acting medication are satisfied with its duration of coverage, which is 9.5 hours for children and 10 hours for adults, on average. This is a flunking grade, but it’s far superior to the satisfaction ratings for short-acting formulations. So why do up to 23 percent of children and 30 percent of adults take short-acting stimulants? Perhaps because clinicians are more likely to prescribe them, and some adults like the medications’ relative flexibility.

“Sometimes, in a social setting, I quite like taking only 5 mg of short-release (rather than my prescribed 10 mg),” wrote one survey respondent. “Other times, when working on something that I find really dull, I often take 15 mg (3 x 5 mg tablets).”

In the end, adults are more likely than children to take short-acting formulations, to be dissatisfied with their medications, and to be considering a switch, according to the survey data.

ADHD Medication Side Effects

Caregivers are likely to try fish oil, eliminate food dyes, and sign up for karate before considering a prescription for their child. Once they decide to try medication, caregivers prioritize finding the one with the fewest side effects.

At the same time, 53% of children who end up taking medication try methylphenidate, 36% take amphetamine, and just 11% take a non-stimulant. So given its popularity, methylphenidate must deliver the fewest side effects, right?

No. According to caregiver reports, slightly more children reported side effects from methylphenidate than amphetamine, and those side effects were nearly identical, with appetite suppression being the most common by far; it impacted 61% of children taking any stimulant.

Adults use amphetamine for what they cite as their top priority in choosing a medication: symptom control. Yet they gave it an efficacy rating that was only slightly better than methylphenidate, which is associated with fewer side effects.

So should more adults consider trying Concerta, Ritalin, or a newcomer like Azstarys? One-quarter to one-third of adults said they are now considering some kind of medication switch.

ADHD Treatments Scorecard

Most Highly Recommended ADHD Treatment Approaches

ADHD Treatment Approaches with Highest Efficacy Ratings

Rated According to Effectiveness on ADHD Symptoms, Specifically

What Readers Say vs. What They Do

The most highly recommended approach to managing ADHD symptoms (exercise) has been used by less than half of ADDitude survey respondents. The second most recommended approach among adults (ADHD coaching) has been adopted by only 17 percent of people. And the vitamins, minerals, and supplements used by 49 percent of people surveyed don’t even earn a passing grade. All of this hints at problems with availability, cost, and medical advice in the world of ADHD treatment.

Diet and Nutrition Approaches for ADHD

What dietary changes move the needle?

At least half of caregivers and adults reported that the following dietary changes have a positive impact on ADHD symptoms:

• Decreasing or eliminating artificial colors/preservatives/sweeteners³
• Decreasing or eliminating sugar⁴
• Increasing protein

Research generally supports these observations and reader efficacy ratings are high. So why are fewer than 30% of caregivers and adults making dietary changes to address ADHD? For one, 61% of children using stimulant medication to treat their ADHD experience appetite suppression as a side effect, according to their caregivers. Dietitians generally advise that children should focus on eating first and eating heathy second.

“We struggle to get enough calories into our child due to decreased appetite,” wrote one parent. “We are happy to have her eat, regardless of what or when, to keep energy levels up.”

Psychotherapy More Prevalent Than ADHD Coaching

Though the recommendation rates are nearly identical, far more people engage in psychotherapy than work with an ADHD coach. Therapy generally helps clients work through comorbid conditions like anxiety and depression, and negative beliefs or self-defeating behaviors. Coaching helps to strengthen skills to mitigate ADHD deficits and reach goals, but its benefits are short-lived, readers say.

“ADHD coaching helped me to narrow down my biggest challenges and work on practical solutions for the day-to-day things I struggle with,” said one survey respondent.

Parent Training or Behavioral Therapy for ADHD

This first-line treatment is used by less than 6 out of 10 study participants.

The American Academy of Pediatrics recommends parent training in behavior management as a first-line ADHD treatment for children diagnosed before age 7, and a complementary treatment approach thereafter. Despite this recommendation, and a high rate of reported satisfaction, just more than half of parents say they’ve ever used it. Possible reasons for this: Clinicians aren’t recommending parent training nearly enough; behavioral therapists versed in ADHD are difficult to find; and/or therapy is expensive and time-consuming. Likely, all of these reasons are true.

“Changing the way we parented was a game changer,” wrote one survey respondent. “It brought the stress in the house down significantly and meant we could focus on the lagging skills and promoting the behaviors we wanted to see versus punishing behaviors we didn’t want to see.”

Exercise Is Invaluable and Infrequent

Does exercise eradicate ADHD symptoms? Hardly. Readers rated its efficacy on ADHD just 2.4 out of 5, but they also called it invaluable — especially vigorous cardiovascular morning exercise. It aids sleep, mood, and hyperactivity, our readers say. So why isn’t exercise a universal component of treatment plans? As we know, the ADHD brain is easily bored and resists routine.

“When I get into a good stride with routine exercise, it almost always goes hand-in-hand with better eating habits, better focus, energy levels, mental clarity, and stronger relationships and productivity,” said one adult with ADHD. “Exercise is undoubtedly a crucial piece of the (treatment) puzzle.”

Most Impairing Symptoms of ADHD

ADHD Treatment Options: Next Steps

• Download: Share This Report with Your Doctor
• Read: ADHD Medication Reviews
• Get: The ADHD Treatment Guide for Adults

Sources

¹ Brikell I, Yao H, Li L, Astrup A, Gao L, Gillies MB, Xie T, Zhang-James Y, Dalsgaard S, Engeland A, Faraone SV, Haavik J, Hartman C, Ip P, Jakobsdóttir Smári U, Larsson H, Man KK, de Oliveira Costa J, Pearson SA, Hostrup Nielsen NP, Snieder H, Wimberley T, Wong IC, Zhang L, Zoega H, Klungsøyr K, Chang Z. ADHD medication discontinuation and persistence across the lifespan: a retrospective observational study using population-based databases. Lancet Psychiatry. 2024 Jan;11(1):16-26. doi: 10.1016/S2215-0366(23)00332-2. Epub 2023 Nov 27. PMID: 38035876.