Attention-Deficit Hyperactivity Disorder (ADHD) and Attention Deficit Disorder (ADD) are neurodevelopmental conditions that affect millions of individuals worldwide, influencing their ability to focus, regulate emotions, and manage daily tasks. ADHD is characterized by inattention, hyperactivity, and impulsivity, while ADD is an older term often used to describe the predominantly inattentive subtype of ADHD.
Predominantly Hyperactive-Impulsive symptoms: Excessive restlessness, impulsivity, and difficulty waiting or staying still, speaking without thinking.
Predominantly Inattentive symptoms: Difficulty sustaining attention, organizing tasks, or following through on instructions, procrastination. This subtype was historically referred to as ADD.
These symptoms often lead to a range of behavioral issues, causing difficulty in school, work, and social interactions. The prevalence of ADHD/ADD continues to grow every year, and many are diagnosed, but it remains the most misunderstood and incorrectly treated disorder in the modern world.
Recent statistics estimate that over 11 % of children and 6% of adults have ADHD. Research further shows that only 20% have ever been diagnosed or received treatment for ADHD; thus, the actual number may be much higher.
This condition is often overlooked in those who only exhibit the inattention part of the diagnosis; the disruptive hyperactivity issue is what doctors, teachers, and parents tend to focus on, leaving many to go undiagnosed into adulthood.
One of the main problems in diagnosing and treating children and adults with ADHD correctly is that 78% have co-occurring conditions. ADHD, in many cases, is the symptom of an underlying condition.
For instance, children with PTSD (often from witnessing abuse and violence) usually exhibit hyperactivity and inattention. The usual focus becomes solving the hyperactivity behavior, frequently using medication, rather than finding the underlying cause. In this instance, the underlying cause is anxiety and depression from the PTSD. The anxiety and depression become worse in adulthood when not treated correctly. This is just one example of misunderstanding and incorrect treatment.
The most common suggested treatment from physicians, teachers, and parents is to give medication to control the behavior (symptom). It is the easy route, but seldom the best option. The medication route often has adverse physical and mental health side effects and can mask the actual cause of the behavior or symptom. Every year, children and adults are misdiagnosed with ADHD because the provider never investigates other possible causes or co-occurring disorders. These co-occurring issues complicate matters and exacerbate academic, behavioral, and social challenges.
Proper assessment for ADHD should include screening for other possible causes of the symptoms. This means that a holistic approach, examining all areas of the patient’s life, should be part of the evaluation before a treatment plan can be determined. In general, a licensed psychologist or clinical social worker should be your first choice in determining a diagnosis and treatment options.
Anxiety
Depression
PTSD
Trauma
Learning disorders
Aspergers/autism
Speech/language disorders
Conduct disorders
Sleep disorders
Allergies
Nutritional deficiencies
Heavy metal toxicity
Those who never received treatment for ADHD/ADD have higher incidences of problems in life and into adulthood. Statistics show that 33% of kids with ADD/ADHD never finish high school, which typically means that they end up in jobs that don’t pay well. It is important to remember that some symptoms of ADHD/ADD overlap with other mental health and physical health conditions, as stated earlier, as co-occurring issues with ADHD. Untreated conditions and symptoms typically worsen over time.
Untreated ADHD/ADD is also associated with higher rates of;
Depression
Anxiety
Substance use
Addictions (drugs, alcohol, video games, porn, junk food)
Incarceration
Job failures
Unemployment
Obesity
Financial problems
Divorce
Suicide
Traffic accidents
The exact causes of ADHD are not fully understood; however, there are contributing factors that lead to possible causes.
Here’s a breakdown of what contributes to ADHD:
These conditions stem from differences in brain function, which can be observed through advanced imaging techniques like Single Photon Emission Computed Tomography (SPECT). In a healthy brain, concentration causes blood flow to increase appropriately in certain regions, especially the prefrontal cortex. This helps us to focus, plan ahead, stay organized, and follow through on tasks. However, when people with ADD/ADHD try to concentrate, blood flow decreases in the prefrontal cortex, making it more difficult for them to focus and filter out distractions. The harder they try to concentrate, the harder it can get.
ADHD brains are unique and function differently. When these differences can be identified, a therapist can provide the tools and skills to help the patient manage the negative symptoms and enhance the positive symptoms.
This type of ADHD is usually evident early in life. As babies, they tend to be colicky, active, and wiggly. As children, they tend to be restless, noisy, talkative, impulsive, and demanding. Their hyperactivity and conflict-driven behavior gets everyone’s attention early on. Classic ADD is often called ADHD, with an emphasis on the hyperactive behavior trait.
Parents of these kids are often tired, overwhelmed, and even embarrassed by the behavior of their non-stop and hard-to-control children. Classic ADD tends to be more frequently seen in boys. Even as adults, those with this type of ADHD tend to have a great deal of energy and a preference for physical activity rather than a more sedentary lifestyle.
Common Symptoms in Classic ADHD include:
Classic ADHD SPECT scan findings often show normal activity at rest, but during concentration there tends to be decreased activity in the underside of the prefrontal cortex as well as in the cerebellum and basal ganglia. The latter are structures deep in the brain that produce dopamine, a neurotransmitter that is critical for motivation, attention, and setting the body’s idle speed.
Inattentive ADD is the second most common type of ADD. Those suffering with this type are usually quiet, more introverted, and appear to daydream a lot. They may be labeled as unmotivated—even slow or lazy. Inattentive ADD is common but is often missed because children with this type tend to have fewer behavioral problems. They don’t draw the negative attention to themselves as do those with Classic ADHD.
Common Symptoms in Inattentive ADD Include:
Inattentive ADD is the perfect example of why the general term “ADHD” does not fit all ADD types. If clinicians and parents are looking for hyperactivity to reach a diagnosis, those with this type, which does not have hyperactivity, may be left untreated and go on living life below their true potential.
SPECT scan findings of Inattentive ADD show normal activity at rest, but during concentration there tends to be decreased activity in the underside of the prefrontal cortex, cerebellum, and basal ganglia.
In order to focus, it is necessary to be able to shift your attention as needed. People suffering with Overfocused ADD have most of the ADD features, but rather than not being able to pay attention, they have difficulty shifting their attention; they become hyper-focused on certain things while tuning out everything else. These folks tend to get stuck or locked into negative thought patterns and behaviors. This type of ADD is often found in substance abusers as well as the children and grandchildren of alcoholics.
Common symptoms in Overfocused ADD
Overfocused ADD SPECT scan findings show increased activity at rest and during concentration in the anterior cingulate gyrus (the brain’s “gear-shifter”), as well as decreased activity in the underside of the prefrontal cortex, cerebellum, and basal ganglia.
People with this type of ADD have the hallmark features of ADD plus symptoms associated with temporal lobe problems, such as issues with learning, memory, mood instability, aggression, temper outbursts, and sometimes, even violence. It is not unusual to see this type of ADD in people who have had head injuries.
Common symptoms in Temporal Lobe ADD
Temporal Lobe ADD SPECT scan findings show decreased activity (and occasionally increased) activity in the temporal lobes at rest and during concentration, as well as decreased activity in the underside of the prefrontal cortex, cerebellum, and basal ganglia during concentration.
In Limbic ADD, the prefrontal cortex is underactive during concentration while the deep limbic area—which sets your emotional tone, controlling how happy or sad you are—is overactive. Depression is also associated with overactivity in the deep limbic area, yet a person’s developmental history in addition to some subtle differences on SPECT scans (between Limbic ADD and depression) helps us differentiate between the two conditions so we can choose the best course of treatment to resolve symptoms.
Common Symptoms in Limbic ADD
Limbic ADD SPECT scan findings typically show increased deep limbic activity at rest and during concentration. There is also decreased activity in the prefrontal cortex, cerebellum, and basal ganglia during concentration.
In Ring of Fire ADD, there is a pattern of overall high activity in the brain. Those with this type tend to have difficulty “turning off” their brains and typically feel overwhelmed with thoughts and emotions. This type tends to get much worse on stimulant medications alone. Ring of Fire ADD can be related to some form of allergy, infection, or inflammation in the brain, or it can be related to bipolar disorder. There are some subtle differences between Ring of Fire ADD and bipolar disorder in the scan data as well as some differences in the presentation of a person’s symptoms. For instance, we have found that the kids with Ring of Fire ADD tend to have their problems all the time whereas bipolar kids tend to cycle with their mood and behavior problems. Adults with bipolar disorder have episodes of mania or hypo-mania, whereas adults with Ring of Fire ADD do not—their behavior issues tend to be consistent over long periods of time.
Of note: It is possible to have both conditions—in fact some research studies suggest that as many as 50% of those with bipolar disorder also have ADHD.
Common Symptoms in Ring of Fire ADD
SPECT Findings
Ring of Fire ADD SPECT scan findings show patchy increased activity in many areas of the brain, which looks like a “ring” of overactivity. We have found that there is some variability in Ring of Fire patterns from individual to individual. In differentiating between bipolar disorder and Ring of Fire ADD, it is important to consider the patient’s history and SPECT scan data when possible.
With Anxious ADD, there is low activity in the prefrontal cortex while there is overactivity in the basal ganglia, which sets the body’s “idle speed” and is related to anxiety. The ADD symptoms in people suffering with this type tend to be magnified by their anxiety. Treatment for people with Anxious ADD often includes both calming and stimulating the brain.
Common Symptoms in Anxious ADD
Anxious ADD SPECT scan findings show increased activity in the basal ganglia at rest and during concentration. Additionally, there is decreased activity in the prefrontal cortex and cerebellum during concentration.
To be effective, treatment for ADHD needs to be individualized, specific to the client, their symptoms, patterns, and co-occurring issues. Counseling, including approaches like Cognitive Behavioral Therapy (CBT) and ADHD coaching, offers tailored strategies to manage symptoms, leverage strengths, and improve quality of life. In some cases, medication might be necessary; it should be well monitored and appropriate for the specific brain type, and used along with counseling.
Counseling provides a structured, supportive framework for individuals with ADHD to develop skills, manage symptoms, and improve their quality of life. Unlike medication, which addresses behavior and symptoms based on the theory of neurological imbalances, counseling focuses on practical strategies, emotional resilience, and self-awareness. Below are the key benefits of counseling, informed by an understanding of ADHD’s neurological basis:
Counseling helps individuals develop tools to compensate for executive function challenges. CBT, for example, teaches techniques like task segmentation, time-blocking, and using external reminders (e.g., planners or apps). ADHD coaching, a specialized form of counseling, offers personalized systems for organization and accountability, helping individuals manage daily responsibilities more effectively. This helps to increase prefrontal cortex activity.
The overactive limbic system in ADHD can lead to emotional volatility. Counseling, particularly through mindfulness-based approaches or CBT, provides strategies to regulate emotions. Techniques like deep breathing, journaling, or cognitive reframing help individuals respond to stressors calmly, reducing the impact of emotional “hot spots” in the brain.
Many individuals with ADHD internalize negative feedback, leading to low self-esteem. Counseling reframes these perceptions by highlighting strengths, such as creative problem-solving or adaptability, which are often preserved despite abnormal brain patterns. Therapists help clients understand how their brain functions differently, reducing self-blame and fostering confidence to pursue goals.
ADHD-related impulsivity or inattention can strain relationships, as seen in the interplay of prefrontal cortex and limbic system dysfunction. Family therapy educates loved ones about ADHD, fostering empathy and better communication. For children, parent training teaches consistent strategies to support behavior at home. Couples counseling can help partners navigate ADHD-related challenges, improving relational harmony.
Counseling addresses specific challenges in academic or workplace settings. For students, therapists may focus on study skills, test-taking strategies, or advocating for accommodations like extended time. For adults, ADHD coaching targets workplace challenges, such as managing distractions or meeting deadlines, and aligning strategy with the individual’s unique ADHD profile to optimize performance.
Counseling equips individuals with lifelong tools to navigate ADHD’s challenges across different life stages. By understanding their brain’s functional patterns, individuals can adapt strategies to transitions like starting college, entering the workforce, or parenting. This adaptability fosters resilience, empowering individuals to thrive despite neurological differences.
Counseling is an effective method for the treatment of ADHD and ADD by building skills, fostering resilience, and addressing emotional and social challenges. Counseling transforms lives, helping individuals with ADHD/ADD navigate their world with confidence and success. Counseling empowers individuals to manage symptoms, harness their potential, and thrive. If you or a loved one has ADHD, ADD, or any symptoms, consider reaching out to us to explore how counseling can unlock a brighter, more fulfilling future.
Several counseling approaches are effective for ADHD, each addressing different aspects of the condition and the individual’s needs. Here are the most common therapies used today:
We tailor each approach to the individual’s symptoms and brain function, ensuring a personalized intervention. Most clients benefit from a combination of these therapies.
Counseling is effective because it addresses both the neurological and practical aspects of ADHD. While medication can stabilize dopamine levels to improve PFC or basal ganglia function, it doesn’t teach skills or address emotional challenges that make for long-term success in life. Counseling fills this gap by:
Research supports counseling’s efficacy. Studies, such as those published in the Journal of Clinical Child & Adolescent Psychology, show that CBT and behavioral interventions significantly reduce ADHD symptoms and improve functioning. Combining counseling with lifestyle changes often yields optimal results.
Professional counseling help for your ADHD and ADD symptoms can make a huge difference in your life. With the skills and tools learned from an ADHD expert therapist, you can thrive and find success in school, work, relationships, and life. Here are the basic steps towards a new path.
Anything new, like an appointment with a therapist, can bring on some anxiety. This is why it’s essential to make a list and bring it with you; otherwise, it’s too easy to become nervous and forget your symptoms and questions. It might also be a good idea to have your list in hand when you visit their office (instead of keeping it in a pocket or purse). The therapist will guide you through the process of identifying and developing a plan for managing the symptoms.
Each type of ADHD/ADD has its own set of symptoms, and when it comes to treatment, one size does not fit all. What works well for one person with ADD/ADHD may not work for another; it could even make the symptoms worse. This is why we treat each client as an individual with a personalized treatment plan. Enrichment Services and Dr. Roberts have over thirty years of experience helping children and adults with ADHD and ADD symptoms gain the tools and skills to manage their symptoms, resulting in a better brain and a better life.
If you’re struggling with ADHD/ADD symptoms in Tallahassee or the North Florida area, we offer in-office appointments. We also offer virtual sessions for Florida residents and those who are unable to meet in person. In-office sessions for ADHD/ADD counseling are the most effective mode of treatment. Our holistic and individual approach in identifying the underlying causes leads to effective treatment that lasts. Let us help you find solutions that work.
Therapy@Enrichment-services.com
850-296-7807 (text/phone)
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