High levels of distractibility, frequent mistakes, missed deadlines, lack of focus, and misplaced items are common occurrences in everyday life. But when these occur simultaneously, consistently, or begin to interfere significantly with work or personal life, then they may indicate a larger underlying issue. For instance, individuals diagnosed with ADHD (Attention-Deficit/Hyperactivity Disorder) often experience these difficulties daily, often needing the use of medication and/or therapy to manage symptoms.
If this is you or someone you know, and you are just starting a medication to treat ADHD, how will you know if it is working?
This is a question we are frequently asked at our practice, and this article provides guidance on initiating treatment and understanding when it is working.
Why ADHD Can Feel Worse as an Adult
Many of our patients were diagnosed with ADHD as children but were able to manage their symptoms. They developed coping skills to complete homework, pass tests, maintain focus, and manage tasks.
However, as time went on, they faced new and more difficult challenges, which led to a breakdown of these coping strategies and learned skills. Stressors such as lack of sleep, increasing home responsibilities (like having children), or a job promotion can exacerbate symptoms that had been dormant for years.
When these strategies break down, feelings of frustration, embarrassment, and incompetence can arise. Friends and family may also become involved. It's not uncommon for a spouse to express worry because the stove was left on, or to note that the individual has a "thousand" projects but never finishes any. In the worst-case scenario, the boss starts to notice, and the individual's job (and livelihood) is put at risk.
Common ADHD Medications
When symptoms reach this point, consulting a professional can help them understand what is happening, providing clarity on whether the symptoms are indeed ADHD-related or explaining why they are returning with greater severity.
If these symptoms are, in fact, due to ADHD, treatment is likely available depending on the severity. For mild cases, simple therapy or body-doubling during tasks may suffice. For more severe cases, medication may be recommended.
When medication is recommended, ADHD is treated with two categories of drugs: stimulants and non-stimulants.
Non-Stimulant Medications
The most common non-stimulant medications for ADHD treatment include:
- Bupropion (Wellbutrin)
- Atomoxetine (Strattera)
- Guanfacine (Intuniv)
- Clonidine (Catapres)
Stimulant Medications
The most common stimulant medications for ADHD treatment include:
- Methylphenidate (Ritalin)
- Long-Acting Methylphenidate (Concerta)
- Amphetamine-dextroamphetamine salts (Adderall and Adderall Extended Release)
- Lisdexamfetamine (Vyvanse)
The Way ADHD Medications Work
However, contrary to popular belief, the term "stimulant" does not describe how the medication makes you feel, but rather its underlying mechanism of action. Unlike caffeine or energy drinks, which affect various brain and body chemicals, ADHD medication works by stimulating (increasing) dopamine levels in the brain's prefrontal cortex.
This area, located directly behind the forehead, is responsible for thought processing, decision-making, attention, and overall cognition. When this part of the brain is underperforming, it is often associated with low levels of dopamine.
Once you begin either a stimulant or non-stimulant treatment, the goal is to increase dopamine in this region of the brain. That being said, without measurable metrics like cholesterol levels or blood pressure values, how can you know if the medication is working? How do you know if it's helping the prefrontal cortex? Are the effects instant? Will you feel like you have superpowers?
As the flow of dopamine into the prefrontal cortex improves, each person will feel slightly different. Since no two individuals have the exact same metabolic process or brain chemistry, everyone's experience is unique.
How to Know If Your ADHD Medication is Working
With that in mind, a brief, universal overview of how to monitor your ADHD medication's effectiveness is outlined below:
Step 1: Use the medication as recommended by your healthcare provider.
Step 2: Within the first 1–2 weeks, monitor for any side effects.
Step 3: Observe for signs of improvement.
Step 4: Track the results (both side effects and improvements).
Step 5: Ask others for their observations.
Step 6: Ask yourself what changes you notice.
Step 7:Report back to your clinician.
Finding the right ADHD medication is often a process of trial and error. Unfortunately, healthcare providers have difficulty predicting exactly how each individual will respond to a mental health medication. This is why there is no single, clear answer to the question of whether your ADHD medication is working; the response is highly specific to each person.
That being said, look for positive trends based on the steps above. If you are able to focus on tasks, complete your work on time, lose fewer items, receive compliments from others, and generally feel your life is in order without significant side effects, then your medication is likely working. As always, discussing these facts and any issues with your healthcare provider is critical for ensuring continued benefits.
Conclusion
Finding the right ADHD medication is a highly individualized process that involves trial and error. To determine if it’s working, patients should consistently follow the seven-step monitoring process, which includes tracking both side effects and positive improvements. Positive trends in symptom management and organization, without significant side effects, generally mean the medication is working. Ultimately, maintaining open communication with your healthcare provider is essential for ensuring the continued benefits of treatment.
FAQs to Know if Your ADHD Medication is Working
1. What are common symptoms that might suggest an underlying issue like ADHD?
Common symptoms include high levels of distractibility, frequent mistakes, missed deadlines, lack of focus, and misplaced items, especially when they occur consistently and significantly interfere with work or home life.
2. Why might ADHD symptoms feel worse for adults who managed them as children?
As adults, individuals often face new and more difficult challenges (such as lack of sleep or increased home/work responsibilities) that can cause previously successful coping strategies and learned skills to break down, leading to a resurgence of more severe symptoms.
3. What are the two main categories of medication used to treat ADHD?
ADHD is treated with two categories of drugs: stimulants (like Methylphenidate/Ritalin and Amphetamine-dextroamphetamine salts/Adderall) and non-stimulants (like Bupropion/Wellbutrin and Atomoxetine/Strattera).
4. How do ADHD medications work in the brain?
ADHD medications work by stimulating (increasing) dopamine levels in the brain's prefrontal cortex, the area responsible for thought processing, decision-making, attention, and overall cognition.
5. What are the key steps to monitor the effectiveness of ADHD medication?
The article outlines a seven-step monitoring process:
- Use the medication as recommended.
- Monitor for any side effects within the first 1–2 weeks.
- Observe for signs of improvement.
- Track the results (both side effects and improvements).
- Ask others for their observations.
- Ask yourself what changes you notice.
- Report back to your clinician.