ADHD

Attention-deficit/hyperactivity disorder (ADHD) doesn't only affect children — it's increasingly recognized and diagnosed in adults. Greater Boston Psychiatric Services provides psychiatric evaluation and ongoing medication management for adult ADHD, by telehealth or in person at our office in Medway.

What Is ADHD?

ADHD is a neurodevelopmental condition that affects attention, impulse control, and, in some cases, activity level. While it's often associated with childhood, ADHD frequently persists into adulthood, sometimes undiagnosed for years because symptoms look different in adults — less hyperactivity, more difficulty with organization, time management, follow-through, and sustained focus, especially on tasks that aren't inherently interesting.

Types of ADHD

• Predominantly Inattentive Presentation — difficulty sustaining attention, following through on tasks, and staying organized, without significant hyperactivity

• Predominantly Hyperactive-Impulsive Presentation — restlessness, impulsivity, and difficulty staying still or waiting turns — less common as the primary presentation in adults

• Combined Presentation — a mix of inattentive and hyperactive-impulsive symptoms, the most common presentation overall

Signs & Symptoms

• Difficulty sustaining attention on tasks, especially ones that aren't engaging

• Frequent careless mistakes or difficulty with details

• Trouble organizing tasks and managing time

• Losing items necessary for tasks (keys, phone, documents)

• Forgetfulness in daily activities

• Difficulty following through on instructions or finishing tasks

• Restlessness or a persistent feeling of being "on the go"

• Impulsivity in decisions, spending, or conversation

• A pattern of these symptoms dating back to childhood, even if undiagnosed at the time

Causes & Risk Factors

• Genetics — ADHD has one of the strongest genetic links of any psychiatric condition

• Differences in brain structure and neurotransmitter activity, particularly involving dopamine

• Prenatal exposure to certain substances, or premature birth

• ADHD is not caused by poor parenting, lack of discipline, or excessive screen time, though these factors can affect how symptoms present

How It's Diagnosed

Adult ADHD is diagnosed through a detailed clinical evaluation, including a history of symptoms both currently and going back to childhood (a core diagnostic requirement — ADHD symptoms must have been present before age 12, even if not formally diagnosed then). Your clinician will also screen for overlapping conditions, such as anxiety or depression, which can mimic or coexist with ADHD, and rule out other explanations for attention difficulties.

Treatment Options

ADHD is most effectively treated with medication, behavioral strategies, or both. Stimulant medications (such as methylphenidate- or amphetamine-based medications) are the most well-studied and effective treatment for most adults; non-stimulant options are available for patients who can't take stimulants or prefer to avoid them. Because stimulant medications are controlled substances, treatment includes careful monitoring, and our clinicians will discuss the right medication and dosing strategy based on your evaluation and response over time.

When to Seek Help

If a pattern of inattention, disorganization, or impulsivity has affected your work, relationships, or daily life for an extended period — and especially if you recognize similar patterns going back to childhood — an evaluation can clarify whether ADHD is a factor and what treatment options make sense.

Insurance & Self-Pay

We're in-network with Blue Cross Blue Shield, Aetna, Harvard Pilgrim Healthcare, Optum, Tufts Health Plan, Wellpoint, United Healthcare, HPI, Mass General Brigham, Carelon, UMR, and UniCare. Self-pay options are available. We are unable to bill Medicare, Medicaid, or supplemental plans.

Frequently Asked Questions

Can adults be diagnosed with ADHD for the first time?

Yes. Many adults are diagnosed for the first time later in life, often after symptoms became more disruptive due to increased responsibilities at work or home. A diagnosis requires that symptoms were present in some form before age 12, even if they weren't recognized as ADHD at the time.

Do I need to be tested with a formal neuropsychological exam?

Not necessarily. Adult ADHD is most often diagnosed through a clinical evaluation and symptom history, not formal neuropsychological testing, though testing can be a useful additional step in complex or ambiguous cases.

Are ADHD medications safe for long-term use?

Stimulant medications have a long track record of safety and effectiveness when monitored appropriately, which is why ongoing medication management — not just an initial prescription — is part of treatment. Your clinician will monitor for side effects and adjust your plan as needed.

What if I don't want to take a stimulant medication?

Non-stimulant medication options are available and can be an appropriate choice depending on your health history, other medications, and personal preference. Your clinician will walk through the options with you.

Can ADHD medication be misused?

Stimulant medications are controlled substances with misuse potential, which is why they require regular follow-up visits and careful monitoring rather than long prescriptions written without review.

Is ADHD just a lack of discipline?

No. ADHD is a neurodevelopmental condition rooted in brain structure and neurotransmitter function, not a character flaw or lack of effort. Many adults with undiagnosed ADHD have spent years working harder than peers just to keep up, often at a real personal cost.

Related Conditions We Treat

ADHD often overlaps with, or can be mistaken for, other conditions. We also provide evaluation and medication management for Mood & Emotional Regulation Concerns, Anxiety & Panic Disorders, Depression.

Get Started

If you're experiencing symptoms of adhd, the first step is a comprehensive psychiatric evaluation, available by telehealth or in person at our office in Medway. Schedule an appointment or view our full list of conditions we treat.