Why do therapy for AD/HD?

When I tell people that I spend a good chunk of my time providing therapy for people with AD/HD, I often get the same few questions: "Isn't AD/HD a brain disorder?  Aren't there medications for that?"

Well, yes.  And yes.

As to the first question: AD/HD clearly has biological underpinnings.  There is ample evidence that the brains of individuals with AD/HD display distinct patterns of neurological activity from those of individuals who don't have AD/HD .  Also, AD/HD is highly heritable, a fact supported by research and a great deal of anecdotal evidence (many of my clients can attest that AD/HD runs in their family!).

However--and this is the key--just because a problem has a biological origin does not mean that it requires a biological remedy.

Take hypertension, for example.  High blood pressure is clearly a heritable, biologically-based, medical condition.  But proper management of hypertension involves medication AND changes in lifestyle, diet, and exercise.  Medication is important and helpful, but it's only part of the solution.

Similarly, medications can help relieve some of the symptoms of AD/HD.  Inattention, impulsivity, and distractibility are particularly responsive to meds.  Some individuals find that medication drastically improves their functioning and quality of life.

However, medication can't help with all of the symptoms of AD/HD, such as disorganization.  Ritalin can help you stay focused, but it won't necessarily help you remember what project you need to complete that day.  Therapy for AD/HD involves making concrete plans for getting organized, reducing distraction, and building a lifestyle that enables success.

So, when is therapy for AD/HD indicated?

Again, there are 2 answers:

Strictly speaking, the best way to decide whether to pursue therapy for AD/HD is to consult with a mental health professional who is skilled in the diagnosis and treatment of this disorder.

Practically speaking, it depends on your needs.  If you've tried medication and it didn't work for you (either because it didn't relieve your symptoms, or because the side effects were intolerable), you might benefit from therapy.  Or, if medication is helpful, but you continue to have residual symptoms, you might want to look into it.  Ultimately, you need to find what works for you.