ADHD/ADD

What is ADHD (and ADD)?

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental brain disorder that presents uniquely in adults and teenagers.

A Note on ADD: You might often hear the term ADD (Attention Deficit Disorder) used interchangeably with ADHD. In modern medicine, ADD is technically considered an older term, but it is still widely used to describe Inattentive Type ADHD—a form of the disorder where hyperactivity is not present, and the primary struggle is with focus, organization, and mental fatigue.

In older patients, ADHD generally manifests through three main behavioral presentations:

• Inattention (Historically called ADD): Teens and adults, this often looks like difficulty organizing complex tasks, chronic procrastination, trouble staying focused during long lectures or work meetings, running late, and frequently losing items like keys, phones, or school assignments.

• Hyperactivity: While younger children might physically run around, hyperactivity in teens and adults usually shifts inward. It manifests as constant mental restlessness, an inability to sit through a movie or long dinner, intense fidgeting, or talking excessively.

• Impulsivity: This refers to taking sudden action without thinking through the long-term consequences. In older patients, impulsivity can lead to impulse buying, interrupting others during conversations, making reckless decisions, or struggling with an intense need for instant gratification that disrupts daily life.

How is ADHD/ADD diagnosed in adults and teens?

One of the reasons ADHD and ADD are frequently overlooked or misdiagnosed in teenagers and adults is that the symptoms are often mistaken for laziness, stress, or poor time management. Furthermore, individuals with the inattentive type (ADD) are often quiet and don't cause disruptions, meaning their struggles go unnoticed for years.

To differentiate ordinary stress or lack of focus from ADHD, a trained professional such as Dr. Raccuglia ensures that the behaviors meet specific medical criteria. The symptoms must be:

• Severe

• Frequent

• Interfering with daily functioning (such as failing grades, poor work performance, or strained relationships)

• Affecting quality of life

Diagnosis of ADHD/ADD in older patients requires a comprehensive evaluation that the team performs at the practice, sometimes in collaboration with a mental health professional, to rule out or address overlapping conditions like anxiety or depression.

How is ADHD/ADD treated?

The treatment for ADHD and ADD varies from patient to patient depending on the severity of their condition and their personal lifestyle goals. For mild cases, the team typically recommends targeted behavioral coaching, executive functioning strategies, and time-management exercises that help structure daily routines.

For more moderate to severe cases, Dr. Raccuglia may recommend medical management:

• Stimulants — The most frequently prescribed and effective class of medication for managing both hyperactive and inattentive symptoms.

• Non-stimulants — An alternative for patients who experience unwanted side effects or do not respond well to stimulant-based medications.

It’s important to note that these medications are not cure-alls. Combining medication with behavioral modifications, therapeutic support, and academic or workplace accommodations goes a long way toward helping patients successfully manage the disorder.

How is medication monitored?

Stimulant medications prescribed for ADHD/ADD require careful management due to potential side effects and the risk of misuse. The team closely monitors all patients who take these medications with regular screenings and frequent check-ins to evaluate symptom improvement and physical health.

For teenagers, the practice collaborates with both the teen and their parents—and can provide guidance for school accommodations—to ensure the treatment plan is supporting their academic and personal growth. For adults, the focus is placed on optimizing focus, time management, and emotional regulation for workplace and relationship success.

To learn more about managing adult or adolescent ADHD and ADD, call Joseph R Raccuglia, MD, or book an appointment online today.