We’ve decided to merge the ADHDKCTeen site with the parent organization’s website.
Find us at ADHDKC.org!
We’ve decided to merge the ADHDKCTeen site with the parent organization’s website.
Find us at ADHDKC.org!
Take our quiz and learn more about the answers with the links below the quiz.
8 Things That Go Into an ADHD Evaluation for a Child (Understood)
How ADHD is diagnosed after high school (Understood)
Supplements for ADHD (Quest for Health KC)
Special diets for ADHD (Quest for Health KC)
Labels – Why should my child be diagnosed? (Quest for Health KC)
Developmental Age in ADHD (Quest for Health KC)
Is there a link between ADHD and tics? (Understood)
Pharmacogenetic testing (Quest for Health KC)
Week 4’s video to honor ADHD Awareness Month tackles common myths about ADHD.
Common Myths that are NOT True:
Week 3 of ADHD Awareness Month’s question is one of the most commonly asked:
What’s the best treatment for ADHD?
If you missed the first two weeks:
CHADD’s Toolkit has fantastic information and printables: https://chadd.org/nrc-toolkit/
Parent to Parent: Family Training on ADHD provides parents with a comprehensive understanding of ADHD as well as strategies to improve life at home and school.https://chadd.org/parent-to-parent/
Understood (use their search bar for ADHD)
Healthy Children and ADHD (AAP site)
We’re honoring ADHD Awareness Month this year with a weekly video about ADHD.
This week’s question: What does ADHD look like at different ages?
See Week 1’s video about Executive Functioning.
Each Sunday during October 2020 we are answering a new question about ADHD in honor of ADHD Awareness Month. Week 1: What are executive functions and how are they related to ADHD?
Each Sunday during October 2020 we are answering a new question about ADHD in honor of ADHD Awareness Month.
Some people can have sustained attention on things they enjoy despite struggling to maintain focus on the task at hand. Others don’t have hyperactivity at all.
The name ADHD can be misleading but it is a diagnosis that physicians and psychologists can diagnose. Executive functioning is a term used to describe how the brain manages tasks, not a diagnosis.
Understanding executive functioning can help us identify problem areas and use accommodations or other methods to minimize the problems that arise from them.
Learn what this is and what it may look like in this short video.
Dr. Kristen Stuppy shared tips on building self esteem to improve self confidence and success.
Dr. Kristen Stuppy shared tips on building self esteem to improve self confidence and success at our May 5, 2020 online meeting.
Resources from the slides:
The Positive Affirmations download has extra spots to add your own affirmations.
Finding the best medication for ADHD management includes finding one that is affordable. Is a generic version the answer?
If you’ve had problems finding a medication for ADHD that you can afford, you’re not alone. In years past generic medications were equivalent to the name brand and were always a lot cheaper.
In recent years many new versions of methylphenidate (ritalin) and amphetamines (adderall) have come on the market and generic versions of many of the older medicines have become available.
The FDA has rules that generic medications must have the same amount of active ingredient and be available in the same forms (pill vs liquid) as the original medication. They can often be sold at a much lower cost because the company does not need to spend money researching and developing the medicine. They also offer competition to the original company, which can bring costs down.
A very useful resource that has ADHD medications grouped by type, dosages offered, if they have generic versions available, if they can be put into food or drink, and more is available from the Cohen Children’s Medical Center. This fantastic list of medications can help you and your doctor look at your insurance medication list to pick a medication that is affordable.
Most often the short acting medications are less expensive than the long acting medications. The short acting medications typically last 3-4 hours, whereas the long acting medications last 6-12 hours. Because it is difficult to take medications mid-day for many people, the long acting medications are typically favored.
In general there are stimulants (amphetamines and methylphenidates) and non stimulants (atomoxetine, guanfacine, and clonidine) that are approved to treat ADHD.
Stimulants are controlled substances because they have the potential to be abused and misused. When they are used appropriately for ADHD they have been shown to help prevent drug and alcohol abuse but they require close monitoring by the prescriber.
This article is about medical treatments, but that does not mean that behavioral therapy isn’t helpful. For preschool aged children, parent training in behavior management is the first treatment preferred. Parent training in behavior management is recommended for at least a part of the treatment regimen for children of all ages with ADHD.
The American Academy of Pediatrics ADHD Guidelines recommend stimulants as first line medical treatment in most instances. One is not preferred over the other. Individuals may respond better to one type of medication over another, but until the medications are tried, it can be difficult to know which will work best.
Family history can help. If a parent or sibling does best on one type of medication, it makes sense to try that medication first.
Pharmacogenetic testing is specifically not recommended in the most recent guidelines. Most insurance companies will not pay for this expensive testing because it has not been shown to be beneficial.
It is important to have close follow up with your prescriber with new medications and routine follow up as long as medications are used. These visits should assess how well they’re working as well as any side effects noted. It can take several medication trials before the right one is found.
If you have side effects, learn to manage them in Tips to Manage ADHD Medication Side Effects.
I’m a pediatrician who treats many with ADHD, but when my own child was starting treatment it took a few tries before we found the right one. I talk about this and more in A Conversation About ADHD.
Side effects are similar with both types of stimulants, but some people tolerate one medication better than another.
Common side effects include appetite suppression, sleep problems, headaches, stomach aches, and mood changes.
Most of the time either a dose adjustment or change in medication can help alleviate the side effects.
Encouraging eating at times the medication is not active can help with the daytime appetite decrease.
Common long acting amphetamines include Adderall XR, Vyvanse, and Dexedrine spansules. There are others, such as Adzenys XR and Dyanavel, that do not have generic versions available.
Adderall XR is a long acting medication composed of dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, and amphetamine sulfate. This is often referred to as mixed amphetamine salts. It lasts about 8-10 hours.
Vyvanse is a prodrug that lasts 10-12 hours. Prodrug means that it is chemically inert until it interacts with an acid in the gastrointestinal tract. It does not have any mood altering effects if it is crushed, injected or snorted, so it does not have the resale value of other stimulants. This is a potential reason that some insurance companies prefer this over more expensive medications.
Dexedrine spansules are made up of dextroamphetamine sulfate. They are less commonly used compared to Adderall XR, but they are available as a generic and name brand. The long acting form lasts about 8 hours.
There are several long acting methylphenidate medicines that have generic versions. These include Concerta, Metadate ER, Focalin XR, Ritalin LA and Metadate CD. (There are others that do not yet have generic versions.)
Metadate CD releases methylphenidate from beads (30% immediate release and 70% extended release) to mimic the effect of 2 doses of immediate-release methylphenidate.
Ritalin LA is also a once-daily agent designed to mimic the effect of the 2 doses of immediate-release methylphenidate. The capsule releases methylphenidate from beads: 50% immediate release and 50% delayed release. It tends to last about 6-8 hours, so it isn’t sufficient for a full school day plus homework for most kids.
The active ingredient in Focalin XR is similar to ritalin, but half of the ritalin molecule is removed, which often helps minimize the side effects. Focalin XR is a 50% immediate-release and 50% delayed-release agent that is similar to using the immediate release Focalin twice a day.
Concerta uses a unique mechanism to release the medication over time. There is an outer covering that immediately starts working, followed by a chamber that slowly and consistently releases medicine over the next several hours. It tends to work for a total of 10-12 hours and avoids the mid-day drop in effectiveness that is common to other forms of long acting medicines.
Unfortunately the laws regarding generic substitutions were written before some of the new technology of medication was invented. The FDA is once again allowing substitutions that use a different delivery system than the original Concerta. I discuss this separately on my other blog if you want more information.
If you’ve noticed a change in your medicine, please keep track of any differences you notice in effectiveness and side effects. If these differences are significant, share this with the FDA. It is easy to file a MedWatch report online – just follow this link and follow the instructions on that site.
It can take a while for enough reports to be filed to trigger an investigation, but it’s the best way to alert them. If they investigate and find that there are sufficient differences, they will remove a generic version. This is what happened in 2014-2016 when the FDA took steps toward removing two generic versions of Concerta.
Please see Gina Perry’s most recent article on generics for Concerta – it’s worth the time if you take Concerta or one of its generics!
Atomoxetine is a non stimulant approved to treat ADHD and has been available as a generic since 2017.
Side effects of atomoxetine include stomach aches, sleepiness, slowed growth (during the first 2 years of treatment), and rarely hepatitis.
Guanfacine and clonidine affect the blood pressure and heart rate. Both are available in short and long acting forms and have generics available.
They can lead to tiredness, dry mouth, dizziness, irritability, headache, and abdominal pain. Most of these side effects are minimized by slowly increasing the dose. Neither should be stopped abruptly due to side effects.
Of course cost is not the only thing to consider when choosing a medication, but if you cannot afford it, you will not be able to continue it. It must be affordable to be a reasonable choice.
There are two things you must check to estimate how much a medication will cost.
One resource to find the cash price is GoodRx. This site allows you to search for any medication and lists how much various pharmacies charge. It also allows you to print out coupons, which may or may not be able to be used with your insurance. They often have a link to less expensive alternatives, which is a very helpful function to estimate if you will be able to afford a medication.
The second thing to always check before starting a long term medication is your insurance formulary and preferred pharmacy.
The insurance formulary is a list of how much different medications will cost if you use your insurance plan. Some will allow you to use coupons with insurance, some won’t.
If you can identify your insurance company’s preferred pharmacy, it might save you money each month. I’ve had personal experience when this didn’t work, so sometimes it pays to visit different pharmacies.
You will also need to know if you can get your medications cheaper as a 90 day prescription. Many insurance companies will not allow a 90 day supply of controlled substances (methylphenidates and amphetamines) but will allow the non-controlled substances (guanfacine, clonidine, and atomoxetine).
Your prescriber will not know which medication is cheapest for you because each individual insurance plan varies – in other words, one Blue Cross Blue Shield plan differs from another Blue Cross Blue Shield plan. One Aetna plan varies from another Aetna plan. The same with United Healthcare and all the other insurance plans. They have many plans that all sound similar.
You can often access this list online by logging into your insurance plan’s website. If you cannot find this list, you will need to speak with someone at your insurance company. When you make this call, be sure to have a list of medications to check easily available. I recommend asking about each of the medicines listed on the Cohen Children’s Medical Center ADHD Medication Guide.
When looking at medications, be sure to look for subtle differences, such as an “ER” or “XR” after the name. These indicate a long acting form of a medication and often cost more than the short acting version of the same active ingredient.
Also check the amount in each pill. For example, methylphenidate ER 30mg is probably a generic for Metadate CD, but methylphenidate ER 36mg is a generic for Concerta (though it doesn’t specify which generic). If you’re not sure what all the medications are, bring the full list with you to your ADHD (or any chronic condition) appointments.
Before you start a new medication, if you have new insurance, or if it is the start of a new year, log into your insurance portal to look up medications before your appointment with your prescriber.
This can help prevent the need for multiple prescriptions for medications that are not affordable. You can work with your prescriber to help find the most cost effective medication that will work for you.
For more on affording medications, please see my other blog’s post, Affording Medications.
If you want to learn more about how medications work for ADHD, see Brain Function 101.
If you need to be convinced that ADHD is a real disorder, see Genetics of ADHD.
CHADD offers Parent to Parent training (a form of parent behavior training).
What can you do when worry sets in? How can you stop the panic? Check out these ways to calm the chaos in your mind when you start to worry and panic.
People with ADHD are often overly sensitive or have true anxiety and panic attacks. What can we do to stop the panic?
We all can get stuck in a rut. Catastrophizing is common. When we catastrophize, it’s as if the sky is falling and we lose the ability to cope.
Learning to cope when life throws problems and stressors in our way builds our resilience. Being resilient helps us to be successful.
Let’s look at ways to stop the negative thinking of panic.
Most of us recognize how good we feel when we help someone else out, yet we hesitate to ask for help. Why is that? When we’re in need, there are many people who can help.
It’s preferable if you can talk to someone who is at least in their mid-20s. Their maturity can offer many benefits. If you’re not sure who you can talk to, think of the many adults in your life who would be happy to listen. Parents, aunts, uncles, grandparents, coaches, teachers, neighbors… there are many people who care about you.
If you choose to talk to a peer, choose wisely. Some people can’t take the pressure of hearing negativity. Others will shut you out. And of course many kids overshare other people’s business, so don’t talk about things that are private with peers.
Don’t roll your eyes and presume mindfulness won’t help.
Mindfulness trains your brain to be aware of your body and environment without judgement.
Yes, it takes time to learn how to be mindful, but a lot of research shows that mindfulness can help with anxiety, chronic pain, stress, focus, and more.
Mindfulness is often referred to as a practice for a reason. You should practice it often, but there are no right or wrong ways to do it.
If you can’t sit still, don’t. It’s okay to get up and walk while being mindful.
When your brain keeps thinking of things, don’t get upset. Just redirect.
Start simple with breathing. You breathe every day, so you can do this step. Take deep belly breaths. Nice and slow. Focus on the breathing.
For more tips on being mindful with ADHD, see
Sometimes it helps to get your thoughts written. Even if you don’t like to write school papers, journaling can help.
Grab a pen and paper or start typing.
It doesn’t need to be grammatically correct or interesting to anyone else. You can just make word jumbles or lists. If you like poetry, make it into a poem.
Just get your thoughts written down.
There’s a very cathartic benefit towards journaling.
You can even take it a step further and write down things you’re thankful for each day. Gratitude helps our overall mindset, and focusing on gratitude can lift our mood.
There’s something really soothing about coloring or just doodling.
You can even use free printables like these online if you want some coloring sheets.
And this is something that can be done nearly anywhere.
What better way to get into a good mood? Listen to a favorite song. Sing along!
Research has shown that listening to music can reduce anxiety, blood pressure and pain. It can also help sleep quality, mood, mental alertness, and memory.
Pick your favorite feel good songs and make a playlist that you can pull up when needed.
We’ve all heard that exercise helps our bodies, but many people minimize the value it has for our mental health.
Regular exercise helps our mindset in general, but if you have the opportunity to work out when you’re upset, it can help lift your mood.
Combine numbers 5 and 6 and workout to some great tunes!
If you’re getting worked up, it can help to get up and walk around.
Especially if you are worried you will say or do something you’ll regret, leave the situation if you can.
If you can go outside, even better. Fresh air can be mood-lifting.
We tend to ruminate about what’s wrong. Negative thoughts are all we can think about. We need to learn to stop this rumination.
When you recognize that you’re ruminating, accept that you’re having whatever thoughts you’re having. Recognize that the thoughts might not be accurate and allow the thoughts to pass rather than trying to block them out. Trying to block out negative thoughts will just cause increased intensity of the thoughts you’re trying not to have. You can replace negative thoughts with positive thoughts: what is going right? What is the best possible outcome? How can you turn the situation around?
If this is hard, start to make it a practice to write down at least one thing at the end of each day that went well. Your hard studying paid off. You met a new friend. You had a good hair day. Whatever it is, keeping a list gives you something to reflect upon when you’re really down. Doing this daily also helps your brain practice finding the good in things. Like anything, practice makes things easier. It is really hard to find good things to think about when you’re in a bad place, but it gets easier when you’ve practiced when you’re not in a foul mood.
You have to use this one sparingly.
Obviously in the middle of class you can’t start being silly, but if you’re able to get to a place that you can do a silly dance or anything silly to unwind: do it. Acting the part can help relax you and set the mood.
Be careful to not offend anyone or be hurtful in your humor and silliness.
Run through questions that help put your worries into perspective.
Sensory items can help calm our minds. Think of sounds, smells, textures, and visually relaxing things.
Cognitive Behavioral Therapy (CBT) is very effective for anxiety management. Ask your physician to help find a good therapist for you.
If you’re not willing or able to work with a therapist, there are some interesting options to try online. These are not meant to replace professional help, but they help to remove the most common roadblocks to working with a therapist: cost, time, and not wanting to talk to a real person. Learning online might help you see what can be done with therapy and open your mind to finding a therapist.
There are many traits common to people with ADHD that can make them seem self centered or conceited. Learning about them can help loved ones understand behaviors and people with unintended behaviors work on having expected behaviors.
Most people with ADHD are very empathetic and kind, but can come off as self centered and uncaring. Why is there this discrepancy? What can you do to help others realize that you really do care about them and not just yourself?
Many of the traits of ADHD can make a person seem self absorbed. Let’s go over a few of them. Once you understand why you do what you do and how those actions are perceived by others, can you think of ways that you can help others to recognize that your actions do not mean what they seem to mean?
Many people with ADHD have significant problems with time awareness. This makes it easy to run late. All. The. Time.
When you’re often late to meet ups with friends (or forget about them all together), they can see you as not caring.
Working on improving time management and organization might be a long process, but it’s worth it.
It might not be obvious to others how much mental preparation is needed to shift gears. If you’ve been planning to do something and plans change, it is disappointing. When your mind is finally in the zone and someone interrupts, it’s frustrating.
It’s hard for people to understand why a sudden change in plans is met with resistance. This is especially true when we often seem impulsive. Resistance to change in plans seems contradictory to the impulsiveness that often comes out.
If you tend to lash out at people when they alter plans, the first step to change the behavior is to recognize it. Learn to recognize triggers. Whenever you note a trigger, learn what you can do to help yourself have a positive reaction.
Have a talk with those close to you about why you don’t like to suddenly change plans. They won’t know how you feel if you don’t share it, and most people who care about you will help accommodate if you understand. You might need to remind them when you’re in the moment, but it’s best to have the first conversation at a time in advance.
If you’re in the zone getting stuff done, it is really frustrating to be interrupted. You know that you’ll have to re-enter the zone, which can take a long time and a ton of energy.
Most of us know what it feels like to be deep in concentration only to have someone ask a question or make a noise that ruins it. The mental energy to get back into the zone is huge. How do you handle the situation?
Your reaction may not be appropriate – there’s that impulsivity at work. If you yell, blurt unkind words, or try to ignore the interruption, it will not be received well. You will seem self centered if you lash out.
Learn to take a few big breaths before you react to a disruption.
Give your mind a chance to settle. You were able to get into the zone once, you can do it again.
A little break can help.
Working memory is like the RAM in a computer. It’s where information is temporarily held while constructing a sentence or forming an idea, solving an equation, remembering where we put something. If the information is “valuable” we then store it in long term memory, like saving to a disk, from which we can pull the information later. Information that doesn’t seem valuable, such as names or dates, isn’t stored.
Forgetting details is common among people with ADHD.
When it comes to forgetting birthdays, anniversaries, and other important dates, it can make you appear uncaring.
Many people with working memory problems fear that their thought will be gone if they don’t blurt it out right away. Unfortunately, interrupting others is socially inappropriate. If you do it often, you come off as self absorbed.
For more on working memory, see Say Goodbye to “Oh, I forgot”
ADHD can lead to many problems with communication.
As mentioned above, working memory problems can lead to communication problems. If a thought pops into your head, you’re likely to share it right away. It doesn’t matter if someone else is talking. You don’t want to forget it, so you blurt it out.
It’s also common that if someone interrupts when you are talking, you get very upset because it breaks the line of concentration. That’s especially common among people with ADHD because it’s so hard to retain a line of thinking, but people might find it annoying that you interrupt them but won’t tolerate being interrupted.
Maintaining eye contact during a conversation might be really difficult. You might tend to look around the room or out the window when someone’s talking to you. This can be perceived as not paying attention.
A similar issue is found during class when you’re listening to the teacher, but doodling or playing with a button on your shirt. This can make it appear that you’re not paying attention, even when you are.
It’s also really easy for you to become bored with a conversation. This means you might suddenly change the topic to something unrelated. This can make others in the conversation feel that you don’t appreciate what they’re saying. Maybe you don’t. But there are social norms that others can follow that help them wait patiently for others to finish before changing the subject.
It can even be hard for you to keep on track with your own thoughts. You can be talking about one topic, then something leads you astray, leaving others confused. Your brain might be ahead of your words, so your sentences lose their meaning to others.
It sounds silly, but practice does help. Sometimes we get frustrated with ourselves and just stop trying, but then we never get better at communicating.
Watch others in group settings to see how they interact and how others perceive what they say and do. Replicate the things that are well perceived and avoid doing the things that are not appreciated.
Mantra: don’t interrupt.
It isn’t uncommon for people with ADHD to be overly sensitive. This happens after years of being told you’re doing things wrong, being too loud, forgetting stuff, and the million other ways you get negative feedback.
Rejection sensitivity can lead you to become upset at friends for no apparent reason from their point of view. They might feel like you push them away because they don’t understand that their response hurt your feelings.
If you’re overly sensitive, read about Rejection Sensitivity.
People with ADHD often seem outgoing because of their unlimited energy and talkative nature, but they also can have trouble being around a lot of people. Too much input and stimulation can be distracting, especially to the ADHD brain.
When people perceive you as the “life of the party” type personality, it can make it difficult to explain why you don’t want to go to an outing or event that will have a lot of people. It might seem to others that you feel above everyone else so don’t want to participate.
Have an escape plan to leave early if the crowd is too overwhelming.
If you turn down an invite, be sure to let your friend know why. For example, if the crowd is just too overwhelming, let them know you’d rather do something with a smaller group.
Impulsivity can get us in trouble in the humor department, making people with ADHD seem uncaring and downright mean.
Sometimes saying a “funny” thought that pops into our minds is not the right thing to do. It might feel good to make people laugh, but if that laughter is at the expense of others, you will not be perceived as a nice person.
Watch for real reactions when people are laughing. Are some people uncomfortable or upset about the joke? Those are the types of jokes that you want to steer clear of.
One good rule of thumb: Don’t make fun of other people or groups of people. You might hurt someone’s feelings, and that is never funny. (Even if it makes some people laugh.)
If you are careful, you can make fun of something temporary or non-identifiable, such as bad drivers or people who fall. This is easier to do if you include yourself in the group, such as joking about a time you fell or walked into a wall.
Society and school teach us to conform. We should act as expected. Clothing styles dictate what we should wear.
Many people with ADHD are non-conformists. This can be a great trait because it can lead to new ideas and change. Leaders and inventors are non-conformists. This trait can help you make a difference in the world.
But if the expectation is that you work a math problem showing your work in a specific way, you need to do it that way. If you’re supposed to dress for a formal dinner or a group function, you can come off as uncaring if you show up in attire that doesn’t fit expectations.
Keep being you!
Think outside the box and create as much as possible, but when a certain behavior is expected, try to conform.
This means if your teacher wants a project done a certain way, do it that way.
If you’re going to a location with a dress code, follow it as much as you can. Don’t wear something that will bring attention to you unless you’re supposed to be the center of attention, such as at your birthday party.
Remember to always stay in your role.
If your role is a student, let the teacher teach. When you earn the role of teacher, you can teach.
When you are the athlete, let the coach coach. If you earn the role of coach, you can coach.
When you hang out in a group, let others help to decide what to do. Take turns. Even if it’s not your choice, try to stay focused on the activity. Don’t let your friends think you think they are boring, even if the activity is boring to you. Find something in it that interests you.
If you’re motivated and learn knowledge as well as people skills along the way, one day you’ll be the leader. Then you can lead. Until then, you will be seen as bossy in a negative way if you try to take charge prematurely or inappropriately.