Effective Treatment for ADD and ADHD During and After the Pandemic
“The literature indicates that externalizing behaviors significantly increased in children with ADHD during the pandemic and that both children and parents' overall mood state significantly predicted those behaviors. Impulsivity was found to interfere with compliance with public health guidelines, such as hygiene and social distancing. Hyperactivity was difficult to manage during quarantine restrictions that reduced access to physical activity outdoors. Social isolation could exacerbate underlying social vulnerability. Emotional dysregulation and oppositional behavior increased strain on families. Parents of children with ADHD have increased child-rearing stress, which may be amplified during the pandemic. Finally, school closures and reduced primary care visits have decreased access to mental health care and reduced referral rates. Guidelines were published to help navigate remote management and treatment of this population during the pandemic.” (J AM Child Adolescent Psychiatry, Oct. 16, 2020, 59 (10), retrieved on Internet on 11/1/2021).
I have been doing a lot of research on the resurgence of Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) because I have noticed a marked increase in the severity and frequency of both ADD and ADHD, both in my adolescent and adult clients. Although a causal relationship cannot be proven between the pandemic and the increase in clients diagnosable with ADD or ADHD, the association is evident. What I find particularly striking is that social isolation has caused a profound impact on depression and anxiety as well as oppositional behavior among teens and adults. There is no doubt in my mind that many of my clients who may have had mild or moderate symptoms of ADD or ADHD developed severe symptoms of both during the pandemic. The question is: what can be done to treat this uptick in cases of ADD and ADHD?
The first step is to acknowledge the problem. The second step is to commit to addressing the problem directly. And the final step is to create a structured and specific plan on how to deal with the self-acknowledged increase in symptoms of ADD or ADHD. With both diagnoses, it is imperative that the client create an individualized plan in concert with his or her therapist that they are confident will work.
Client participation is critically important. It is not a matter of one size fits all. Yes, there are some commonalities on what needs to be done to treat ADD and ADHD, such as eliminating task avoidance, effectively dealing with procrastination, and acquiring better organizational and planning skills, but these provide only a broad framework for treatment.
Each client has specific issues that are unique to him or her which need to be identified early in treatment. Every client has different reasons and triggers for task avoidance or having difficulty with organization and planning. This requires a very thorough and exhaustive initial diagnostic assessment which includes a complete bio-psycho-social assessment. Every treatment plan needs to be specifically tailored to the client and the client must have total buy in of the treatment plan for it to be effective. This is how I treat ADD and ADHD. It is a method that I have fine-tuned and have used with great success.
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