Learn more about ADHD treatment from an expert

Dr. Leslie Tsang, DO

Read through Dr. Tsang's answers to common questions to see if getting an ADHD assessment may be right for you.

Dr. Les Tsang is the lead psychiatrist at Circle Medical.  He is Board Certified by the American Board of Psychiatry & Neurology (ABPN) and trained at UCLA.  He previously served as the Director of Behavioral Medicine at the Napa - Solano Family Medicine Residency program at Kaiser Permanente. 

Dr. Tsang employs the latest scientific research combined with over a decade of clinical experience to develop an integrated, technology-enabled approach to ADHD treatment.

What is ADHD, and how does it differ from a regular lack of focus?

Hi!  Thanks for having me.  ADHD is often misunderstood as being unable to pay attention, but there’s actually a bit more involved.  People with ADHD typically *can* focus and pay attention to certain tasks, but have a hard time controlling or regulating their attention span.  This will result in being able to focus on tasks that are interesting but having difficulty with starting and staying focused on any task that is routine, repetitive or boring. 

I see.  So it’s more a dysregulation of attention instead of being unable to focus.

Right!  

What about some of the other parts of ADHD I often hear about that don’t sound related to concentration?  Can you tell us more about that?

I’m glad you asked!  The other two components of ADHD that can often be overlooked are activity and impulse control.  Activity affects the internal drive for physical movement while I think of impulse control as our internal filter that keeps us from saying or doing the wrong thing at the worst time.  When our internal drive for movement is not controlled, it’s really difficult to sit or stand in one place if our drive is telling us to “move”!  This is why some people with ADHD have such a hard time waiting in line or sitting through a meeting.  

That makes sense!  I have a coworker who doodles mindlessly and / or shakes his leg during meetings which seems like he needs to keep moving because he’s supposed to be sitting and listening to the meeting.  

Right.  That could be his coping mechanism for that situation.   

What happens when a person has a hard time controlling their impulses?  

Without any impulse control, we would share thoughts or ideas without thinking them through or even make decisions or act based on just how we felt in the moment.  For example, some people with ADHD will often interrupt and finish the sentences of others.  

Interesting.  And what are some of these problems an adult with ADHD might experience?

An adult with ADHD might have difficulty staying on track and completing tasks that need to be done repeatedly on a daily basis and in the same way, which can happen at work or home. 

Each person is different and not everyone experiences the same symptoms or the same severity of symptoms.  It’s very possible for adults with mild to moderate ADHD symptoms to not recognize their experience as ADHD symptoms.  

How common is undiagnosed ADHD?

ADHD is diagnosed in about 14% of adolescents and about 5% of adults, making it a very common condition.It is estimated that fewer than 20% of adults with ADHD are currently diagnosed and/or being treated.  

Ginsberg, Y., Quintero, J., Anand, E., Casillas, M., & Upadhyaya, H. P. (2014). Underdiagnosis of attention-deficit/hyperactivity disorder in adult patients: a review of the literature. The primary care companion for CNS disorders, 16(3), PCC.13r01600. https://doi.org/10.4088/PCC.13r01600

What are the risks of having undiagnosed ADHD?

Most adults with ADHD have mild to moderate symptoms, but these symptoms can still negatively impact their quality of life. ADHD can cause impaired performance at work and difficulty managing personal relationships. Nearly half of adults with ADHD also have anxiety.

15 Katzman, M. A., Bilkey, T. S., Chokka, P. R., Fallu, A., & Klassen, L. J. (2017). Adult ADHD and comorbid disorders: clinical implications of a dimensional approach. BMC psychiatry, 17(1), 302. https://doi.org/10.1186/s12888-017-1463-3

I think I may have ADHD, but I'm nervous to get tested. What can I do?

It can definitely be intimidating to seek out an official diagnosis for the first time. If you have been researching adult ADHD and believe that you may have mild or moderate symptoms, you can book a video ADHD assessment with a primary care provider through our website. The assessments are done in the privacy of your own home so that you are as comfortable as possible.

If you are not yet ready to book an assessment and would like to do more research, consider watching this video about ADD/ADHD from Dr. Thomas Brown, the Associate Director at the Yale Clinic for Attention and Related Disorders.