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ADHD and Risky Behavior in Adults

Why risky behavior sometimes accompanies ADHD

Getting Help with Medications

After that crisis, Amanda knew that she had to confront the risk-taking head-on, she says.

Her psychiatrist, David W. Goodman, MD, has treated her with ADHD medication, as well as a drug for alcoholism. Goodman is director of the Adult Attention Deficit Disorder Center of Maryland and an assistant professor at Johns Hopkins University School of Medicine.

For patients, it’s important to treat not only the ADHD, but any accompanying psychiatric problems, including mood disorders, anxiety disorders, and substance or alcohol abuse, Goodman says. That’s because treating ADHD alone won’t necessarily curb a drug or drinking problem, he says.  

But combining ADHD and other psychiatric treatments often works well to reduce high-risk behaviors, Goodman says -- if patients follow the plan. “You have to get people who are motivated to stay in treatment consistently, take medication consistently, and appear at their therapy sessions consistently.”

Counseling and Coaching

Besides medication, counseling can provide concrete and practical help to reduce risk-taking. Even with medication, “You still have to learn how to behave in some different ways,” says Lew Mills, PhD, MFT, a therapist in San Diego who counsels adults with ADHD.

Mills works with some clients to avoid red-hot situations in which they might lose impulse control. For example, if a man with ADHD habitually gets into bar fights, it’s useless to counsel him not to swing at someone who insults him. “At that point, it’s too late,” Mills says.

Instead, Mills will help the man find ways to steer clear of danger, perhaps by controlling how much he drinks or choosing not to visit rowdy bars. “There’s some chain of events that leads them to that calamity that they have to break earlier,” Mills says.

A reputable ADHD coach can also offer useful strategies. But expertise varies widely, so check credentials carefully, experts say.

One ADHD coach, Jodi Sleeper-Triplett, MCC, SCAC, has worked with hundreds of teens and adults. She also wrote the book, Empowering Youth with ADHD. She has seen people in their thirties and forties express remorse for the relationship, job, or financial ruins that happened before they were diagnosed.

“There’s a lot that we can do in a safe space of coaching, with no judgment,” Sleeper-Triplett says. She says coaches can help ADHD clients weigh decisions and consequences, set goals, and build the “skills to get from point A to point B.”

Coaching is also forward-looking, she says. “We’re not delving back into the emotional, therapeutic past. The fact that someone is reaching out and saying, ‘I really didn’t do a good job up to now,’ -- OK, let’s start with today and see where we can go.”

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