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ADHD and ADD ADHD Specialist In Atlanta

The main symptoms of ADHD include inattention, distractibility, and impulsivity. In most cases of adult ADHD, these symptoms are present in childhood but don’t become problematic until adulthood. ADHD affects 4.4% of adults.

Specialized Help for Adult Attention Deficit Disorder

Dr. Darvin Hege, MD is an Atlanta board certified psychiatrist and board certified addictions specialist who specializes in treating adult attention deficit disorder(AADD) and ADHD with FDA approved medications. This Atlanta doctor has treated more than 1000 patients in the last five years with adult attention deficit disorder. He reads and studies at least 50 or more hours per year in the field of psychiatry, addiction, and adhd diagnosis and treatments. He searches the adult attention deficit disorder literature weekly in particular for any concerns about any possible neurotoxicity of psychostimulant medications used for adult attention deficit disorder.

How can I have Adult ADHD when I did not have ADD as a child?

 

Adult ADHD (Attention Deficit Hyperactivity Disorder) affects 4.4 % of adults. Hallmark Adult ADHD symptoms are inattention, distractibility, and impulsivity. If you have adult ADHD, the symptoms were present in childhood but may not have become a prominent problem until adulthood. As adults, we accumulate an increasing burden of responsibilities. These responsibilities include marriage, family, job, and finances. Our brain’s ability to filter and prioritize the multitude of demands placed upon it may be overwhelmed. Expectations of us as mature, responsible adults include modulating our anger and fears, listening to and hearing our spouses and bosses explicit and implied instructions, and to be able to focus and concentrate to read required reports and instructions. If we have the drag of ADHD present, we may become “stressed out”, depressed, overly anxious, or turn to alcohol, drug, or medication abuse. If the patient presents for help at this point, the overlying problem of depression, anxiety, or substance abuse may be diagnosed and treated. However, the foundational problem of ADHD may be missed. Unless the ADHD is successfully treated, the person may improve temporarily but still struggle unnecessarily and be more prone to relapsing to another bout of depression, anxiety, or substance abuse.

Dr. Hege treats a significant number of adult ADHD patients, which is an advantage to those who are seeking treatment from someone who specializes in ADHD.

How is the diagnosis of adult ADHD made?

The following is the official diagnostic criteria from the American Psychiatric Association manual. American Psychiatric Association’s Diagnostic and Statistics Manual (DSM-IV) criteria for Attention Deficit (ADHD) This file contains American Psychiatric Association’s Diagnostic and Statistics Manual (DSM-IV) criteria for Attention Deficit (ADHD), which will now be broken into three distinct categories. This is provided for information purposes only. An accurate diagnosis is the important first step in addressing any needs; such a diagnosis can only be performed by a qualified professional who’s familiar with the individual’s history. Attention-deficit/Hyperactivity Disorder A. Either (1) or (2):

1. Inattention: at least *6* of the following symptoms of inattention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:

  • often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities;
  • often has difficulty sustaining attention in tasks or play activities;
  • often does not seem to listen to what is being said to him/her;
  • often does not follow thru on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions);
  • often has difficulties organizing tasks and activities;
  • often avoids or strongly dislikes tasks (such as schoolwork or homework) that require sustained mental effort;
  • often loses things necessary for tasks or activities (e.g., school assignments, pencils, books, tools, or toys);
  • is often easily distracted by extraneous stimuli;
  • often forgetful in daily activities;

2. Hyperactivity-Impulsivity: at least *4* of the following symptoms of hyperactivity-impulsivity have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:

    • often fidgets with hands or feet or squirms in seat;
    • leaves seat in classroom or in other situations in which remaining seated is expected;
    • often runs about or climbs excessively in situations where it is inappropriate (in adolescents or adults)
    • may be limited to subjective feelings of
    • restlessness);
    • often has difficulty playing or engaging in leisure activities quietly
    • a) often blurts out answers to questions before the questions have been completed; often has difficulty waiting in lines or awaiting turn in games or group situations.
      • b) Onset no later than age 7.
      • c) Symptoms must be present in 2 or more situations (e.g., at school, work, and at home).
      • d) The disturbance causes clinically significant distress or impairment in social, academic, or occupational functioning.
      • e) Does not occur exclusively during the course of PDD, Schizophrenia or other Psychotic Disorder, and is not better accounted for by Mood, Anxiety, Dissociative, or Personality Disorder.

 

      • 1) 314.00 ADHD, Predominantly Inattentive Type if criterion A(1) is met but not criterion A(2) for the past 6 months.
      • 2) 314.01 ADHD, Predominantly Hyperactive-Impulsive Type: if criterion A(2) is met but not criterion A(1) for the past 6 months.
      • 3) 314.01 ADHD, Combined Type: if both criteria A(1) and (2) are met for past 6 months [note: should this be 314.02? It's not clear - RDF]
      • 4) 314.9 is ADHD NOS, for other disorders with prominent symptoms of attention-deficit or hyperactivity-impulsivity that do not meet criteria above.

Hyperactivity: Impulsivity: Code based on type:

How do the symptoms of ADHD change from childhood to adult?

If a child has the inattentive symptoms without hyperactivity, they are much less apt to be detected as having the disorder. Since a higher proportion of girls than boys have the inattentive symptoms without the hyperactivity, they are much less likely to be diagnosed. Those who have hyperactivity in childhood tend to lose some or much of the hyperactivity as they mature into adulthood. Hence, the diagnosis is more often missed in adults. However, the inattention symptoms do not tend to diminish from childhood to adulthood as hyperactivity symptoms do.

What treatments help ADHD the most?

Our medicines often help inattentiveness somewhat more than hyperactivity. Since the adult form of ADHD is predominantly inattention, our medicines are usually quite helpful. Psychotherapy of different forms is usually non-effective in improving the core inattention, hyperactivity, and impulsivity. Psychotherapy may be quite helpful in resolving psychological and social consequences of the disorder, especially if medications have first reduced the core symptoms of inattention, impulsiveness, and distractibility. Know that there are long acting ADHD medications as well as short acting. Being aware of how each type of medication works will help you make the best decision for your treatment. Some of the most popular ADHD medications are:

What are the adult ADD medications? There are 3 groups of medications, group I , group II, and group III. Group I are the psychostimulants. There are two psychostimulants. The generic names are methylphenidate and amphetamine. Methylphenidate is marketed under brand names Ritalin, Metadate, Methylin, Focalin, Focalin XR, Concerta, and Daytrana (patch). Amphetamine is marketed under the brand names Vyvanse, Adderall, Adderall XR, Dexedrine, Dextrostat, and Dexedrine spanules. Read more about the new Vyvanse on my blog. The pros of group I:

      1. They work quickly, i.e. in one hour
      2. They leave the blood quickly. These medication’s effects are gone within 4-12 hours. These medications can be taken on the day that you want their assistance and do not need to be taken every day
      3. Psychostimulants have a higher response rate than group II, i.e. 85-90 % of people that have ADHD improve with this group.

The cons of group I:

      1. These medicines only work for 4-12 hours. Therefore, the problem with poor concentration and focus to do work or study in the late afternoon or evening require additional doses.
      2. These medicines do not work well for the first 30 min. to three hours in the morning until they are absorbed into the blood. If you have trouble responding to the alarm clock, getting up and getting organized to get ready for the day, you have to wait for the medicine to start working.
      3. Psychostimulants have a significant risk for abuse and/or addiction.

Group II are the nonstimulant ADHD medications. They include Wellbutrin, Strattera, Provigil, and Aricept. The pros of group II:

      1. These medicines work around the clock. Therefore, they are working when the alarm clock goes off in the morning, when you are getting ready and when you are trying to “get it together” to get out of the house in the morning. They are also working throughout the day and into the evening and up until bedtime. Hence, you can study or work with the benefit of these medicines throughout the evening.
      2. These medications may be missed for a day or so without losing the benefit of the medication after you have been on it for weeks or months.
      3. These medications do not have the abuse and addiction potential of group I.

The cons of group II: You have to wait 2-4 weeks for this group of medications to have much benefit. You may have to wait 2-3 months to get a 100% of the benefits of these medications. Only 50-70% of people may respond to medications in this group Group III are alpha adrenergic agonists, clonidine and guanfacine. These are medications that help some ADHD patients and have also been used for high blood pressure treatment. Intuniv is a long-acting preparation of guanfacine that is approved by the FDA for use in children and adolescents. The manufacturer of a long-acting clonidine is seeking FDA approval. The pros of group III: 1. These medications are not controlled or abusable substances. 2. They may have calming and sleep enhancing activity. The cons of group III: 1. A lower percentage of patients respond to these medications and they tend to help more with hyperactivity and impulsivity than with inattention. 2. They may cause faintness upon standing quickly, sedation, or tiredness.

Do I have to take medication every day?

Studies have found that people with ADHD have more motor vehicle accidents than those who have ADHD but are on medications for treatment of symptoms. If you take the medication every day, then you are always ready to read, study or work if the need arises–even when you were not expecting to need to perform well. There is an increasing body of knowledge and consensus in the field that relationships are enhanced by the medication. If you are paying attention to your partner, children, boss, and customers, you are much more apt to grasp the explicit and implicit feelings and requests from the other person.

What are the advantages of having a psychiatrist diagnose and treat for adult ADHD?

Diagnosing the condition may be a challenge for many reasons. One of the common reasons is that the symptoms of ADHD frequently overlap other disorders such as bipolar disorder. ADHD and bipolar occur together 30% of the time. As a well-known ADHD specialist, Dr. Darvin Hege sees 10 patients each day for new patient evaluations or follow-up for ADHD. They have ADHD as the primary diagnosis or secondary diagnosis. This volume of experience hones his skills for diagnosing the condition, treating it with the best choice of medication, and being familiar with side effects. Every day Dr. Hege learns more about the nuances of adult ADHD’s effects on patients’ lives. He sees the deepening satisfaction in patient relationships and careers when the correct medicine, optimal dose, and best timing of dosing are discovered.