ADHD
Not a lack of effort — a difference in how the brain regulates attention and impulse.
ADHD affects the brain's ability to regulate attention, impulse control, and activity level. It is not a failure of willpower or intelligence — many people with ADHD are highly capable but struggle disproportionately with sustained attention, organization, and follow-through. Both children and adults are affected, and ADHD in adults is significantly underdiagnosed.
Signs and symptoms
Inattentive presentation
- Difficulty sustaining attention on tasks, especially those that are routine or uninteresting
- Frequently losing items or forgetting appointments and obligations
- Easily distracted by external stimuli or unrelated thoughts
- Difficulty following through on instructions or completing projects
- Avoidance of tasks requiring sustained mental effort
Hyperactive-impulsive presentation
- Fidgeting, difficulty sitting still, or a sense of restlessness (in adults)
- Talking excessively or difficulty waiting for one's turn in conversation
- Acting impulsively — making decisions without considering consequences
- Interrupting others frequently
Combined presentation (most common in adults)
- Features of both inattentive and hyperactive-impulsive presentations
- Often presents as chronic underachievement despite clear ability
- Emotional dysregulation — quick frustration, low frustration tolerance
Dr. Patil's approach
How this condition is treated here.
Diagnosis is clinical — there is no blood test or brain scan. Dr. Patil takes a thorough developmental and academic history, reviews current functional impairment, and carefully rules out other contributors including anxiety, depression, thyroid issues, and sleep disorders that can mimic ADHD. Cardiac history is reviewed before starting stimulant medication.
Stimulant medications
Methylphenidate (Ritalin, Concerta) and amphetamine-based medications (Adderall, Vyvanse) are the most effective treatments for ADHD. Response is often apparent within the first few doses.
Non-stimulant options
Atomoxetine (Strattera), guanfacine, and clonidine are effective alternatives — particularly useful when stimulants cause side effects, when there is a history of substance use, or for patients who prefer a non-controlled medication.
Managing co-occurring conditions
ADHD frequently co-occurs with anxiety and depression. These often need to be addressed alongside ADHD treatment — sometimes treating anxiety first improves ADHD symptoms significantly.
What to expect at your first visit
The first ADHD evaluation is thorough. Dr. Patil will ask about symptoms going back to childhood (ADHD requires symptoms to be present before age 12), current functional impairment across multiple settings, and any history of cardiac symptoms before discussing stimulant options.
- A developmental history — school performance, attention problems since childhood
- Assessment of current impairment at work, home, and in relationships
- Cardiac history and review of any family history of heart conditions
- A realistic discussion of stimulant vs. non-stimulant options and what to expect
Common misconceptions
Myth
"ADHD is overdiagnosed — it's just kids being kids."
Fact
ADHD is a well-validated neurodevelopmental condition with robust genetic and neuroimaging evidence. It is true that accurate diagnosis requires careful evaluation — which is why a thorough assessment is essential.
Myth
"Stimulant medications are dangerous or addictive."
Fact
When prescribed appropriately and at therapeutic doses, stimulants are safe and have been used for decades. Research suggests that treating ADHD with medication actually reduces the risk of substance abuse long-term.
Myth
"You can't have ADHD if you can focus on things you enjoy."
Fact
ADHD involves difficulty regulating attention — which means hyperfocus on interesting tasks is common. The impairment shows up with sustained effort on tasks that aren't immediately rewarding.
Frequently asked questions
Can adults be diagnosed with ADHD for the first time?
Yes. Many adults with ADHD were never diagnosed in childhood — particularly women, who more often present with inattentive features that can be overlooked. Adult diagnosis is common and valid.
Do I need neuropsychological testing to be diagnosed?
Not necessarily. ADHD is a clinical diagnosis. Neuropsychological testing can be helpful in complex cases or when educational accommodations are needed, but it is not required for a psychiatric evaluation.
Will I need to be on medication forever?
Some people take ADHD medication indefinitely because it significantly improves their quality of life. Others try periods off medication or use it situationally. This is an individual decision made over time.
Ready to get evaluated?