I’m Unsure if Therapy or Medication Is The Best Treatment For My ADHD

ADHD Medication vs. Therapy
A side-by-side comparison of taking medication versus receiving psychotherapy for Adult ADHD.

Helping patients understand what causes ADHD, how stimulants work for treating ADHD symptoms, and what to think about when considering ADHD therapy

Albert Hernandez

December 24, 2021
 Medically Reviewed by Tanya Hernandez, PMHNP-BC
Updated on: October 20, 2022
  5 min read

December 24, 2021
 Medically Reviewed by Tanya Hernandez, PMHNP-BC
Updated on: October 20, 2022
  5 min read


My patients are very busy people. Whether I’m seeing patients from El Paso, Las Cruces, Albuquerque, or another area of New Mexico, people always want the most effective treatment for their adult Attention Deficit Hyperactivity Disorder (ADHD) symptoms. So, when people come to our practice and are diagnosed with ADHD, they might ask, “Should I choose medication or therapy for my adult ADHD?”

Understanding what causes ADHD, how stimulant medication like Concerta, Adderall, or Vyvanse works to treat ADHD, and what the outcome and commitment of ADHD therapy might entail can help my patients make the best decision for their ADHD treatment.

Cause of ADHD

ADHD is caused by a chemical imbalance in the brain. When a person has ADHD, the neurotransmitters (brain chemicals) dopamine and norepinephrine aren’t working as well as they should be within the brain and central nervous system. When they are working correctly in your brain, dopamine and norepinephrine help with focus and concentration. In ADHD, these brain chemicals aren’t as available and/or aren’t being used in the most efficient way by your brain. This can lead to the lack of attention and impulsivity that characterizes ADHD.

ADHD is not diagnosed by any one blood test or an imaging scan, like an MRI of the brain. Instead, patients are screened by a health professional to see if they have specific symptoms that are interfering with their life. Assessment checklists can guide providers to make sure they are checking for ADHD symptoms. These symptoms can include:

  • Frequently losing important items at work, school, or home
  • Inability to sit still
  • Talking over your supervisor or coworkers
  • Being unable to finish a task
  • Not listening when being spoken to
  • Irritability
  • Being unwilling or unable to start a task that will have a lot of steps
  • Restlessness, being unable to sit still at work or school

Stimulant Medication For The Treatment of ADHD

A capsule of an ADHD medication surrounded by electrons.

Stimulants like Adderall, Concerta, and Vyvanse are the most commonly-used medications for treating adult ADHD. Often, my patients will tell me that after taking their first dose of a stimulant, they notice an improvement in their ADHD symptoms. Stimulant medication seems to help make dopamine and norepinephrine more available to the brain, therefore helping patients focus better and act less impulsively.

The timing and dose of stimulant medication can be customized to the individual patient’s needs. For example, some patients only find a need to take their Vyvanse when at work or school, but not on the weekends. Other patients might find they feel best when they take their Adderall every day. We always try to help patients find the lowest dose of a stimulant med that still manages their ADHD symptoms. That way, side effects can be kept to a minimum.

Factors To Consider When Contemplating Therapy For ADHD Symptoms

Therapy or coaching for ADHD is treatment that will take place over multiple sessions. If a patient is interested in therapy or coaching for ADHD, I educate them on the following considerations.

Time Commitment

Often, the busy professionals that I see in my practice don’t feel like they have time for regularly-scheduled therapy appointments. Work and family activities take up the bulk of my patients’ schedules. Allocating extra time to therapy sessions, especially if travel to the appointments is re

quired, can be more of a commitment than my patients are willing to make.

Financial Cost

A clock and money bag depicting the time commitment and expensive cost of psychotherapy for Adult ADHD.

When my patients are considering if therapy will be the right route for treating their ADHD, they also need to look at what they will end up paying for therapy. If their insurance co

vers therapy for ADHD, what will be their copay expense for the sessions? If their insurance doesn’t cover counseling for ADHD, is there a therapist available that will take them on as a self-pay client? If so, is paying for therapy out-of-pocket an expense that can be added to their budget? For some people, the monetary cost of 

regular ADHD therapy or ADHD coaching will be covered by insurance or otherwise within budget; for other patients, this cost will be too much.

At this time, there have not been many studies that directly compare stimulant treatment for ADHD to therapy for ADHD. The limited studies that do exist, like this one, do not demonstrate that cognitive behavioral therapy is better for reducing ADHD symptoms than the known standard treatment for ADHD, stimulant medication, such as Vyvanse, Adderall, and Concerta.

Due to the time commitment and financial costs of therapy, my patients often find that starting with medication for the treatment of their ADHD symptoms is a good choice. If they are interested in pursuing ADHD therapy, I frequently recommend the videos and resources at the ADDitude website. I also let patients know we can start with stimulant medication and see if, after they begin medication, they are still interested in trying ADHD therapy or ADHD coaching as well. Lots of patients find that they feel so great after starting stimulants, they don’t feel the need to pursue therapy.

If you live in or near El Paso, Las Cruces, Albuquerque, or any of the other locations where we offer services, we would love to discuss ADHD treatment with you. Please fill out this application for treatment to see if Upper Valley Behavioral Health can assist you in the journey of conquering your ADHD symptoms.

Disclaimer: This post is for informational purposes only. It does not replace instructions from your licensed prescriber. Please consult your healthcare provider for guidance on your specific medication regimen.

Tags: stimulants, adhd medication, adhd therapy, adhd behavioral, psychiatric stimulants, behavioral therapy, stimulants adhd, adhd doctor, adhd therapist

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