Why it is important to find an ADHD specialist in Toronto if you have ADHD or think you have ADHD?

Attention Deficit Hyperactivity Disorder (ADHD) seems to be one of the most controversial and misunderstood diagnoses in the Diagnostic and Statistical Manual – 5 (DSM 5).  Everyone and their brother and sister, seems to have an opinion on ADHD. The media often question whether it is a “real” diagnosis, whether it is “over-diagnosed”, whether the medication used to help with symptoms turns people living with ADHD into “zombies”, whether the medication renders ADHD folks “addicted” to stimulants and they frequently report on University or College students who abuse stimulants to get a competitive edge on studying.

ADHD is a neurodevelopmental condition present in approximately 4% of the population.  It is hypothesized that the ADHD brain has a deficit in the production of two neurotransmitters, norepinephrine and dopamine. ADHD brains develop and work differently than non-ADHD brains (neurotypical brains). Hence, stimulants work with the production of the affected neurotransmitters to help mitigate some of the executive functioning and attention challenges of the ADHD brain.   

In my experiences, as an ADHD specialist in Toronto, living my life with the disorder and being a mother to three children with the disorder, I have witnessed, and lived with, the daily challenges that  living with unmanaged symptoms has on self-esteem. All the negative media attention and biases towards the existence and treatment of ADHD, adds to further shaming of the people who are living with ADHD and can lead to a misunderstanding of the disorder itself amongst the health community and the population at large.  Many clients say to me that health professionals are worried about prescribing stimulants because of the reputation of their abuse. It is for many of the above reasons that I believe it is important to choose an ADHD specialist if you have been diagnosed with ADHD or THINK you may have ADHD. Here are a few things that I believe are important when choosing a specialist to work with you:

Executive functioning Support

When choosing a psychotherapist in Toronto specialized in ADHD  (or any other areas) to help you, it is important that they have a very good understanding of the executive functioning (EF) challenges of the disorder. The EF’s are higher level cognitive processes that operate unconsciously. Typically, ADHD folks will have deficits in their executive functioning. These deficits are what can give ADHD folks trouble at home, work, school and interpersonally. Some examples of EFs are: response inhibition, working memory, attention modulation, strategy development, planning, organization, emotion and motivation management and problem-solving to name a few. As you are aware, these functions are SO important in daily living.  Like the uniqueness of each snowflake, each person living with ADHD has a unique EF profile. Therefore, an ADHD specialist can help tailor EF strategies to your EF profile. While most EF deficits can be moderately mitigated with strategies, you and your ADHD coach may determine that some of your EF deficits will have to be outsourced to a third party. For example, getting a relative or close friend to remind you to take your medication if your working memory is impaired, or making sure that you have multiple copies of keys strategically located with trusted friends and relatives for those days when you lose them. The key words for EF support are “tailored for you” to support YOUR deficits. An ADHD specialist will support you in knowing that your EF deficits are not stemming from a lack of willpower on your part, but from a lack of robust strategies to support some neurological differences in your brain. These weaknesses are not YOUR fault, it is a question of finding helpful strategies!

Self-esteem and co-morbid disorders

As an ADHD specialist working in Toronto, I have witnessed first-hand the collateral damage that unmanaged symptoms and EF deficits of ADHD can have on a person’s self-esteem. Often, a person diagnosed as an adult, has lived a lifetime trying to “brute force” their way through their executive functioning weaknesses instead of building “scaffolding” for their EF weaknesses. ADHD is an invisible disorder which is not necessarily obvious to a person’s community. Often, well meaning people, offer advice (solicited or unsolicited) to “help” the person with their executive functioning weaknesses unaware that the symptoms are neurologically driven not “lack of willpower” driven. This can lead people to use adjectives describing the ADHD person such as “lazy, stupid, wasted potential, doesn’t listen, gives up, unorganized, doesn’t care”. Over time, the affected person starts to believe these things to be true and internalizes shame over their symptoms, leading to a damaged self-esteem.  Therapists who aren’t ADHD specialists, informed about the collateral damage and the environmental feedback that ADHD folks get, may not understand this phenomenon and may inadvertently minimize the client’s experience in this area and the lifelong messages they have been receiving. An ADHD specialist get this and can work with the client to re-frame their past experiences through the lens of their diagnosis. This experience is important in the recovery and building of healthy self-esteem.

It is very rare that ADHD comes alone. Often ADHD is accompanied by co-morbid disorders such as: depression, sleep disorders, bipolar disorder, anxiety, post-traumatic stress disorder, learning disabilities and many others. Often a person will get diagnosed with the co-morbid disorder first before they get a diagnosis of ADHD. An ADHD specialist is aware of the complexity of the diagnosis and can be helpful to collaborate with in determining whether further assessment needs to be done to determine the presence of co-morbid disorders.

ADHD specialists committed to continuous learning in a rapidly changing field

ADHD science is changing rapidly.  It is not too long ago that healthcare professionals and researchers believed ADHD was only a childhood disorder. Fast-forward 20 years and we now know that this is a false and that ADHD is alive and well in the adult population. The sad thing about this fact is that many adults with ADHD remain undiagnosed and untreated because of the legacy of this belief in society. While we hear about ADHD being over-diagnosed in children it is very much under-diagnosed in adults. This leaves a significant amount of people trying to manage their symptoms by themselves probably feeling over-whelmed, frustrated and alone.

An ADHD specialist understands the importance of keeping up-to-date on the current research and literature around the disorder. They seek out extra training and conferences to keep updated in the neurobiology and latest treatments around the disorder. For you, this means that you will be getting support from a therapist/health care provider who is working with current information and is able to help you sort out all the “muddled” information and urban myths about the disorder. You owe it to yourself to have support of a professional who is committed to continuous learning in the field.

Conclusion

The above overview represents a collection of my thoughts and insight that I have gained over the past few years. My hope is that you get some good information from this to assist you in choosing your own ADHD specialist in Toronto. I can’t over emphasize the importance of choosing the right ADHD specialist for you. For many people, seeing the specialist is a big “AHA!! Moment” in their life, kind of like the first time you put on a new pair of prescription glasses. It can be so illuminating when you finally feel like you meet someone who gets you and gets what you have dealing with.

If you think you may have this disorder or know someone who might be struggling with it, you can get in touch with me today. I will be more than glad to assist with.

Jennifer Tiviluk, MACP, Registered Psychotherapist

ADHD Specialist, Toronto