Attention Deficit Hyperactivity Disorder (ADHD) Treatment, Signs, and Symptoms

What Is ADHD?

Attention deficit hyperactivity disorder (ADHD) is a common mental disorder that affects children, adolescents, and adults. The symptoms of ADHD can include inattention, hyperactivity, and impulsivity that can disrupt daily life, particularly in academic and professional settings and interpersonal relationships.[1]

In addition to lack of attentiveness, hyperactivity, and impulsivity, the signs and symptoms of ADHD may include:[2]

• Becoming distracted easily
• Difficulty finishing tasks
• Problems listening
• Struggles with organization or maintaining responsibilities
• Forgetfulness
• Constant fidgeting
• Inability to control speech or actions
• Losing or misplacing items often

An estimated 8.4% of children and 2.5% of adults have ADHD [3]. It’s often identified in children first due to disruptions at school or struggles with schoolwork, though it’s possible for adults to be diagnosed.[4] While many children have problems sitting still, paying attention, or acting impulsively, there are strict diagnostic criteria for ADHD.[5]

Researchers haven’t yet identified a specific cause of ADHD, but factors like genetics, low birth weight, premature birth, exposure to toxins during pregnancy, and extreme stress during pregnancy can contribute to it.[6]

The Link Between ADHD and Addiction

ADHD and addiction can be closely related. Because people with ADHD often struggle with concentration, attention, and impulsivity, they may turn to substance use to self-medicate their symptoms or cope with feelings of frustration, stress, or low self-esteem.[7]

Impulsivity also increases the risk of engaging in dangerous behaviors, including experimentation with drugs and alcohol. Over time, this can develop into an addiction. ADHD and addiction also affect similar areas of the brain, particularly those related to reward, motivation, and executive function.[8] This can increase the risk of someone with ADHD developing substance use disorders or vice versa.

When ADHD and addiction co-occur, these mental health conditions can influence and impact each other. The symptoms of ADHD may exacerbate substance abuse, and the self-medication for ADHD symptoms can build a tolerance to substances and a subsequent addiction.

Effective treatment for ADHD and co-occurring addiction effectively requires an integrated approach that addresses both conditions simultaneously, the individual aspects of both conditions, and the interplay between them.

Why ADHD Increases the Risk of Substance Use Disorders

People who have ADHD have a much greater likelihood of developing a substance use disorder compared to the general population. There are many reasons why this is so. One reason for the increased likelihood is because of several neurological deficits, cognitive deficits, and behavioral deficits associated with ADHD:

• Dopamine Transmitter Deficits: People with ADHD usually have altered dopamine signaling in the reward areas of their brains.[9] As a result, there are less than normal amounts of dopamine being transmitted. Some people with ADHD may feel constantly under-stimulated while others may feel continually unsatisfied, making substances that stimulate dopamine production and can provide instant gratification a tempting fix.
• Executive Function Impairments: ADHD results in impaired executive function, which includes working memory, emotional regulation, and decision-making.[10] Impairment in these three areas makes it difficult for someone to consider the long-term effects of substances against their short-term relief.
• Behavioral Impulsivity: Impulsivity is another major component of ADHD and those with the disorder find it difficult to pause and evaluate risks.[11] This means that those with impulsivity will tend to experiment with various forms of substance use prior to giving consideration to possible future consequences, making it easier for them to make the transition from chronic use to dependence.
• Chronic Academic and Social Stress: Unmanaged ADHD symptoms often lead to academic difficulties, employment instability, and strained interpersonal relationships. The resulting emotional distress, anxiety, and low self-esteem frequently trigger substance use as a coping mechanism.[12]

ADHD and The Self-Medication Hypothesis

The self-medication hypothesis posits that drug users do not choose their substances randomly. Rather, they select specific substances in order to manage certain uncomfortable symptoms, such as chronic restlessness, lack of focus, or others that cause them discomfort.[13] For individuals with ADHD, self-medication often represents an attempt to regulate chronic restlessness, lack of focus, or emotional distress.

Depending on the specific ADHD presentation, self-medication typically manifests in distinct ways:

• Stimulant Use: Individuals with undiagnosed or untreated inattentive ADHD may turn to central nervous system stimulants (such as cocaine or non-prescribed prescription stimulants). These substances temporarily increase synaptic dopamine and norepinephrine, sharpening focus, reducing mental fatigue, and organizing thoughts .
• Depressant and Alcohol Use: Individuals with hyperactive or impulsive ADHD symptoms often struggle with racing thoughts, anxiety, depression,  insomnia, and internal agitation. They may use central nervous system depressants, such as alcohol, marijuana, or opioids, to quiet mental noise, dull sensory overload, and induce relaxation.
• The Tolerance Trap: While self-medication may offer temporary relief, it disrupts the brain’s natural neurochemistry over time.[14] As tolerance builds, higher quantities of the substance are needed to achieve the same effect, accelerating physical dependence and creating a secondary substance use disorder alongside the unmanaged ADHD.

Factors in ADHD and Addiction

There are several factors that increase the risk of developing ADHD or addiction, including:

• Genetics: Genetics are believed to be a factor in developing ADHD, and they also play a role in addiction.[15]
• Exposure to toxins: Research suggests that there’s a connection between the use of tobacco or alcohol during pregnancy and the development of ADHD.[16] Lead exposure can also contribute to ADHD, while the use of illicit substances during pregnancy can predispose the baby to substance use.
• Trauma: Physical injury to the brain, disease, tumors, or strokes can affect attentiveness and impulse control, though this is not a common cause of ADHD.[17] Similarly, brain trauma can contribute to addiction.

Treatment for ADHD and Addiction

Addiction and ADHD can influence and impact one another, so it’s crucial that they receive comprehensive treatment simultaneously. Otherwise, ADHD symptoms can lead to more self-medication with alcohol or drugs.

A specialized ADHD treatment center will have multiple levels of care designed to meet patients where they are. Treatment typically begins with an assessment and, from there, an experienced treatment team will build individualized treatment plans that combine evidence-based behavioral therapy, medication management, and structural support.

ADHD treatment options can include:

• Cognitive behavioral therapy (CBT): CBT works to identify unhealthy thoughts and patterns and develop practical behavioral strategies to manage impulsivity and emotion distress.. Once you understand how and why you behave as you do, you can make a conscious effort to change these patterns.
• Acceptance and Commitment Therapy: Commitment therapy helps patients accept their thoughts and feelings rather than fighting them, encouraging actions aligned with personal values.
• Group Therapy: Participating in group therapy within a supportive group setting allows individuals to share experiences, build accountability, and practice social coping skills.
• Motivational Interviewing: This client-centered therapy helps individuals resolve ambivalence, build internal motivation, and commit to positive lifestyle changes.
• Medication-assisted treatment (MAT): Sometimes the right medication can make a meaningful difference. MAT therapy relies on medication management for addiction treatment to alleviate withdrawal symptoms, reduce cravings, and give you an opportunity to focus on your ADHD treatment program without distractions.
• Experiential therapies: Experiential therapies rely on musical or art activities, time in nature, and other therapies to promote healing and quality of life.
• Holistic therapies: Holistic therapies take an integrative approach that includes the mind, body, and spirit to promote healing and build self-esteem and internal motivation.
• Psychodrama: Psychodrama combines traditional psychotherapy with dramatic interactions guided by mental health professionals to help you understand yourself and what motivates you, empowering you to take a proactive role in your recovery.
• Lifestyle Changes: Incorporating structured daily routines for everyday life, including healthy sleep habits, and regular exercise helps naturally boost dopamine and stabilize mood.

Seek Treatment for ADHD and Addiction

If you’re struggling with addiction and co-occurring disorders like ADHD, then your best course of action is to seek treatment at an accredited ADHD treatment center.

Epiphany Wellness offers treatment for addiction and co-occurring disorders, including ADHD, anxiety, depression, and other mental health conditions. We offer multiple levels of care, including a partial hospitalization program (PHP), intensive outpatient programs (IOP), and standard outpatient therapy to equip our clients with the necessary coping skills and tools they need for lasting recovery. Our dual diagnosis approach is designed to address both conditions and help you live a healthier and happier life. If your addiction is severe enough to require round the clock care and you require a medical detox or residential treatment center, our team can quickly refer you to one of our trusted partners to get you the support you need.

Reach out to our admissions team today. Our experienced professionals are available to answer your questions and help you find the personalized treatment plan that fits your unique situation.