In my years of working with adults with ADHD, I've come to realize just how complex and misunderstood this condition really is. Between 6.5 million to 12 million adults in the U.S. live with ADHD, and I've seen firsthand how these challenges can impact careers, relationships, and overall well-being.
The research is pretty clear – individuals with ADHD often experience lower lifetime earnings, higher divorce rates, increased risk of unemployment, and sometimes even involvement in the criminal justice system.
From what I've observed, many adults with ADHD that I work with fall into one of three categories:
Those diagnosed in childhood who continue to struggle and seek support.
Those who suspect they have ADHD but have never been formally diagnosed.
Those unaware they have ADHD, instead presenting with anxiety, depression, or work-related difficulties.
I've found that understanding and treating ADHD in adults requires moving beyond traditional behavioral approaches and addressing the core issue: executive function impairments. Read more on ADHD treatment in Los Angeles
What is ADHD?
An Impairment in Executive Functioning
I like to think of executive function as an umbrella term for the mental processes that help us regulate our reactions, plan, and interact effectively with our environment. While experts debate the exact number of executive functions, I've found three key areas particularly relevant in my ADHD treatment work:
1. Sustained Attention (Concentration)
I often explain attention to my clients like this: Think of attention as a flashlight. Neurotypical individuals often have a bright, steady beam, while those with ADHD may experience a flickering, unreliable light.
ADHD makes it difficult to maintain focus on tasks, especially when distractions are present. I've had clients tell me they can focus intensely on some things, but can't seem to direct that focus where they need it most.
2. Working Memory
I love this analogy:
Working memory is like a whiteboard in your brain. Neurotypical individuals have a large, well-maintained board, while those with ADHD experience a constantly erased and smudged surface, making it hard to retain and organize information.
This affects everything from remembering instructions to completing tasks efficiently. I can't tell you how many times I've heard, "I know I'm smart, but why can't I remember what I was just about to do?"
3. Response Inhibition (Impulse Control)
Response inhibition is the ability to pause before reacting. In my practice, I explain that neurotypical individuals can resist distractions, while ADHD individuals often feel like they have a demanding puppy pulling at their attention, constantly interrupting focus.
By helping my clients understand and name these challenges, I've seen how therapy provides a crucial shift—from seeing ADHD as a personal failing to understanding it as a neurological difference.
Two-Pronged Approach to ADHD Treatment For Adults
In my experience, effective ADHD treatment for adults requires addressing both the brain and the emotional world of the person.
1. The Brain: Executive Function Skills
I've learned that therapy must focus on building compensatory strategies that support executive function impairments.
Attention Management Strategies
Breaking down tasks: Large, vague tasks trigger experiential avoidance, leading to procrastination. I teach my clients to break tasks into manageable chunks (e.g., cleaning 10 items instead of the entire kitchen).
Time-limited work sessions: I encourage clients to use timed focus periods (e.g., the Pomodoro Technique: 25 minutes of work followed by a short break). I use this myself when writing content like this blog post!
Visual reminders: Externalize important tasks using whiteboards, sticky notes, or task management apps. I've found this particularly helpful for my clients who are visual learners.
Working Memory Strategies
Externalizing information: I suggest clients use calendars, planners, apps like Notion, or bullet journals to manage information. As I like to tell my clients, "Your brain is for having ideas, not holding them."
Timers and alerts: ADHD brains struggle with time perception. Using multiple timers for different daily tasks can offload cognitive load. I use this technique myself constantly!
Recording ideas immediately: Whether in a notebook or an app, I encourage clients to develop the habit of jotting down thoughts, tasks, and reminders instantly. I keep a small notebook with me at all times for this very reason.
Impulse Control Strategies
We all have a response to stimuli - it's unavoidable so the strategy is to minimize and cope with them in a healthy way - but first of all we have to notice what the distractions are.
Distractibility delay: When a distraction arises (e.g., "I should check my email"), I teach clients to write it down instead of acting on it immediately.
Distraction control: Environmental adjustments like noise-canceling headphones, dedicated workspaces, and 'Do Not Disturb' phone settings can significantly reduce distractions. I've found these to be game-changers for many of my clients.
2. The Heart: The person & Feelings
ADHD is more than just executive function struggles. Many of my clients experience deep-rooted shame, self-judgment, and emotional dysregulation, often stemming from years of being misunderstood. This is the part of ADHD treatment that I find most people overlook.
ADHD as a Developmental Trauma Experience
Many adults with ADHD have spent their lives feeling fundamentally flawed, often labeled as lazy, careless, or lacking motivation.
Family members, teachers, and employers frequently misinterpret symptoms, leading to internalized self-criticism. I've heard so many heartbreaking stories from clients about how these experiences shaped their self-image.
I believe therapy must address the impact of these early experiences, helping clients reframe their past and develop self-compassion.
Addressing Internalized Shame and Negative Self-Talk
Rewriting the Narrative: In my sessions, I validate clients' experiences and challenge the harmful messages they've internalized.
Identifying Repetitive Criticism: I ask clients to reflect on the phrases they heard repeatedly as children ("Why can't you just focus?"), recognizing their impact.
Self-Compassion Techniques: Using mindfulness-based practices, I help clients learn to observe their inner critic and replace harsh self-judgment with understanding.
Emotional Regulation Techniques
ADHD can lead to intense emotional reactions and difficulties with self-regulation. I've found techniques from trauma therapy—such as DBT (Dialectical Behavior Therapy), self-compassion training, and shame resilience work—to be highly effective for ADHD treatment.
Identifying emotional triggers: Helping clients recognize what activates their shame, frustration, or anxiety allows for better coping strategies.
Grounding techniques: Breathwork, progressive muscle relaxation, and sensory-based grounding exercises can help manage emotional intensity. I often practice these alongside my clients in sessions.
Cognitive restructuring: I work with clients to challenge negative self-beliefs by examining evidence and reframing their experiences.
Affect Regulation Skills
ADHD Treatment For Adults: West Hollywood
I firmly believe that ADHD treatment for adults must go beyond surface-level behavioral interventions. A comprehensive approach integrates both cognitive and emotional work, ensuring that clients develop practical skills while healing from years of misunderstanding and shame.
By addressing both the brain (executive function skills) and the heart (emotional regulation and self-compassion), I've seen how clients can rewrite their story, develop resilience, and thrive in a neurotypical world.
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