ADHD- The Basics for Contemporary Understanding

My name is William Conway, MD.  I am a general internist with a subspecialty in addiction medicine.  I have been a member of the American Academy of Addiction Psychiatrists since 2013. In my practice of suboxone, I have many patients with ADHD. For my patients who choose me for their primary care, I also provide comprehensive general internal medicine in my practice, Nashville Concierge Medicine.

This blog explains today’s  contemporary understanding of attention deficit disorder. The current understanding of ADHD from the thought leaders is very different from the older misunderstandings  of attention deficit disorder.  Thank you for opening your perspectives to the contemporary understanding of ADHD.

Executive Summary

ADHD lasts a lifetime as a chronic illness

ADHD has been previously considered a disease of misbehaved boys, which normally resolved spontaneously by their passage into adulthood. This understanding is flawed in many fundamental fashions. Girls as well as boys have ADHD. Inattention is as serious as acting out. Inattention can  persist throughout a lifetime. For many patients, stimulant medications such as Adderall are part of the long term treatment.

ADHD, as both hyperactivity and inattention, can persist throughout a lifetime. I, Dr. Conway, treat ADHD in my Nashville Concierge Medicines, based right here in Nashville, TN.

ADHD is not just ADHD. It has many associated illnesses, all requiring treatment.

ADHD is not just ADHD.  ADHD is commonly associated with multiple other illnesses, both medical and psychiatric. Obesity is strongly linked  with ADHD, as well as diabetes. Similarly, ADHD affects common pathways of the brain, with bipolar, major depression, and anxiety commonly associated.   The implications for treatment are clear. The best treatment addresses all the comorbidities which a given patient has, not just treatment for ADHD in isolation.  For ADHD itself, stimulants such as Adderall are often prescribed, while depression, anxiety, or obesity may require their own tailored therapies.

In my Nashville Concierge Medicines, I, Dr. Conway, treat the common comorbidities seen in general internal medicine and addiction medicine associated with ADHD

ADHD is often diagnosed in adults

One of the previous “truths” which is not true is that ADHD only presents in adulthood.  In fact, over half of the cases of ADHD are diagnosed in adulthood.  For adults receiving treatment, Adderall is one of the common first-line medications offered under careful physician supervision.

ADHD Runs in families.

ADHD is a disease of families. Mom, the children, and the grandchildren can all have ADHD due to genetic inheritance. In my practice of Concierge Medicine in Nashville, I have several patients whose children also have ADHD

ADHD and Risk of Addiction

ADHD produces significant emotional pain and dysfunction. Turning to substances for relief or self-medication is easily done and is common. All addictions, both legal and illicit,  shorten life or create illnesses. The illegal addictions, such as with opioids, cocaine, or methamphetamines carry a significant risk of death, incarceration, or homelessness. I treat ADHD in some of my suboxone patients, and I treat both conditions. For patients with both ADHD and substance use disorders, medications such as Adderall must be prescribed thoughtfully, with careful monitoring to prevent misuse. In my Suboxone+Primary Care™, I treat both conditions together.

I, Dr. Conway, find that patients in which both addiction and ADHD are treated have better outcomes. Providing primary care through Nashville Concierge Medicines allows me to treat both.

ADHD in Women are commonly not diagnosed until adulthood.

ADHD is one of the diseases where women may experience delayed care . Girls with ADHD do not fit the expected profile of hyperactivity that boys may demonstrate, leading to a failure of diagnosis.  The diagnosis of ADHD in women only catches up with men in adulthood. When finally diagnosed, women often begin treatment with stimulants such as Adderall, which can help organization, focus, and daily function

Conclusion

ADHD is common, comorbid, and serious. It is very treatable. I, Dr. Conway, look forward to treating you at Nashville Concierge Medicines.

 

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