3 Things You Should Consider Before Starting ADHD Meds

by Tina M. Roemersma, Ph.D.  Licensed Psychologist


Difficulty remembering dates and names?  Unfinished projects?  Reading a paragraph only to get to the end and realize you have no idea what you just read?  Restlessness?  Impulsivity?  You may have ADHD…but, you may not.  Other factors may be contributing to the aforementioned types of symptoms (i.e., mood, environment, age, lack of sleep, simply having a lot “on your plate”, etc.).    The best way to know for sure if you have a formal attention disorder is to participate in a comprehensive evaluation.  The results can clarify diagnoses and guide a course of action, which may or may not include psychotherapy, ADHD coaching, on-line programs, or medication management of symptoms. 


  1. False Positives on Screening Instruments are the number one reason that comprehensive testing for ADHD is encouraged instead of the brief screening inventories commonly administered at doctor offices.  While the screening instruments are quite helpful and are routinely integrated in comprehensive evaluations, solely relying on them is risky.  To meet diagnostic criteria for ADHD, symptoms must be present across various settings.  For example, just asking parents to complete a rating scale without getting teacher input or having a child formally tested, can produce false positives for ADHD when the real problem might be better explained by a multitude of possibilities, including, but not limited to:  stress at home, fatigue after school, attempting homework late in the day due to after afterschool activities, distractions of video games, or parent-child dynamics. 


  1. Rule out Other Disorders.  Anxiety and ADHD present very similarly to one another.  When someone is anxious, they can be consumed by their thoughts and seemingly inattentive.  They may also feel restless and fidget, which can appear hyperactive.  Anxiety can be recurring and chronic, making it even more difficult to distinguish from ADHD.  Other disorders can also be misconstrued as ADHD.  Depression can impact attention and focus.  Substance abuse impacts cognitive functioning and affects behaviors and can also present like symptoms of ADHD.  Thus, before starting medications for ADHD, it is important to consider the possibility of anxiety, depression, or substance use.  If any of those are present, a different medication or different intervention may be more advantageous. 


  1. Cognitive and Behavioral Interventions.  Medications are most certainly a highly recommended treatment option when it is deemed necessary.  In fact, ADHD is one of the mental health disorders in which proper medication can make an obvious and positive difference.  It is, however, not always necessary for the treatment of ADHD.  Cognitive strategies to improve working memory and processing speed, both of which are often contributing factors to ADHD, can be highly beneficial.  Furthermore, behavioral strategies, such as instructing organization and memory strategies; changing behavioral patterns; or providing sensory input (i.e., using exercise balls as chairs, kicking an elastic band place across bottom of desks, etc.) can also help reduce symptoms of ADHD. 


For more information regarding treatment options or evaluations, Dr. Roemersma can be contacted at Finding Solutions Counseling Centers (703) 636-2888 ext. 3.