“I thought medication would fix everything…”
…so why is this still so hard?
“There’s only one voice in my head!”
When my client found the right ADHD medication, she described experiencing focus and clarity in ways she’d never felt before. She could write for an hour without getting distracted, listen to her partner without getting lost in thoughts, pause for a minute to think before clicking “add to cart.”
But she was still frustrated. Even with medication, she was showing up late to meetings, feeling overwhelmed by her inbox, and pulling all-nighters to meet work deadlines.
“The medication is working…so, why am I still stuck?”
Medication can be a powerful tool – and yet, it might not provide all of the support that you need.
To be clear, there is solid evidence that medication can dramatically improve ADHD symptoms for many people.1
In studies of ADHD medication, research participants consistently report less distractability and greater impulse control – and there’s evidence that these symptom improvements can prevent adverse outcomes like car accidents and substance use disorders.2
However, there are fewer studies of medication’s impact on complex, work-related skills like planning, prioritization, time management, and organization. While we need more research on this, the studies we do have suggest that medication may have a fairly small impact on these types of skills.3
Rather, research suggests that “psychosocial interventions” – like cognitive behavioral therapy (CBT) or coaching – tend to have a more notable impact on work-related skills. And combining medication with therapy and/or coaching is likely to be more effective than medication alone.4
I think of medication like an unfurnished home. You’ve got a floor, walls, a roof, plumbing. It’s a really good start – but not really a comfortable place to live.
Coaching can help you actually move in, setting up the comfy couch, the bed, the refrigerator, the kitchen tools, the wall art – all the stuff that makes the place livable, and makes it feel like it’s really yours.
If it feels like medication isn’t enough – that doesn’t mean you’re broken. You are, in fact, in very good company. In many cases, medication is just one piece of a much bigger puzzle.
What’s one tool – whether medication, exercise, coaching, therapy, or something else – has really helped you recently? Reply and let me know - research can tell us some things, but your personal experience is another important source of insight!
Warmly,
Taylor
P.S. Research shows that many ADHDers stop taking medications – most commonly because the medication isn’t effective enough for them or because of negative side effects.5 In these situations, non-medication approaches (like therapy or coaching) may still be helpful.6
That’s why I love exploring all the different tools that can help us work with our brains, not against them.
Cortese, S., et al. (2018). Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis. The Lancet Psychiatry, 5(9), 727-738.
Boland, H., DiSalvo, M., Fried, R., Woodworth, K. Y., Wilens, T., Faraone, S. V., & Biederman, J. (2020). A literature review and meta-analysis on the effects of ADHD medications on functional outcomes. Journal of Psychiatric Research, 123, 21-30.
Lauder, K., McDowall, A., & Tenenbaum, H. R. (2024). A meta-analysis of pharmacological and psychosocial interventions aiming to improve work-relevant outcomes for adults with ADHD. Neurodiversity, 2(27546330241292984). https://doi.org/10.1177/27546330241292984
Safren, S. A., Sprich, S., Mimiaga, M. J., Surman, C., Knouse, L., Groves, M., & Otto, M. W. (2010). Cognitive behavioral therapy vs relaxation with educational support for medication-treated adults with ADHD and persistent symptoms: A randomized controlled trial. JAMA: The Journal of the American Medical Association, 304(8), 875–880. https://doi.org/10.1001/jama.2010.1192
Schein, J., Childress, A., Cloutier, M., Desai, U., Chin, A., Simes, M., Guerin, A., & Adams, J. (2022). Reasons for treatment changes in adults with attention-deficit/hyperactivity disorder: a chart review study. BMC Psychiatry, 22(1), 377. https://doi.org/10.1186/s12888-022-04016-9
Ahmann, E., Tuttle, L. J., Saviet, M., & Wright, S. D. (2018). A Descriptive Review of ADHD Coaching Research: Implications for College Students. Journal of Postsecondary Education and Disability, 31(1), 17–39. https://eric.ed.gov/?id=EJ1182373
Young, Z., Moghaddam, N., & Tickle, A. (2020). The efficacy of cognitive behavioral therapy for adults with ADHD: A systematic review and meta-analysis of randomized controlled trials. Journal of Attention Disorders, 24(6), 875–888. https://doi.org/10.1177/1087054716664413