What Is ADHD and Why Is an Integrative Approach Needed?
DR. SURUCHI CHANDRA | NEUROTHERAPy
BETHESDA, MARYLAND I WASHINGTON DC
- National Institute of Mental Health (NIMH) — Attention-Deficit/Hyperactivity Disorder (ADHD) https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd
- Mayo Clinic — Adult ADHD https://www.mayoclinic.org/diseases-conditions/adult-adhd
- NIH / PubMed — Stimulant Treatment of ADHD https://pubmed.ncbi.nlm.nih.gov/18005445/
- The New York Times Magazine — ADHD Research Takeaways (2025)https://www.nytimes.com/2025/04/13/magazine/adhd-children-research-takeaways.html
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About Dr. Chandra
Dr. Suruchi Chandra, a Harvard- and Yale-trained psychiatrist, brings together emerging neuroscience-based therapies, trauma-informed care, nutritional approaches, and systems-level biology to advance thinking in psychiatry and help more patients find clearer paths forward.
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Serving patients in Bethesda, Maryland, Washington DC, and Northern Virginia.
Medically reviewed by Suruchi Chandra, MD. This content is for educational purposes only and does not substitute for individualized medical advice.
Updated February 2026
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Medically reviewed by Suruchi Chandra, MD. This content is for educational purposes only and does not substitute for individualized medical advice.
Updated February 2026
How We Treat ADHD at Suruchi Chandra MD
At Suruchi Chandra MD – Integrative Psychiatry & Neurotherapy, we work with individuals seeking a comprehensive and individualized approach to ADHD.
Our clinic is centrally located in downtown Bethesda, MD, just three miles from the Washington, DC border, easily accessible from DC, Potomac, and Northern Virginia, and metro-accessible.
- Our care model includes:
- Integrative psychiatry, addressing diet, gut health, inflammation, sleep, and stress physiology
- Neurofeedback and neurotherapy, supporting brain regulation and attention patterns
- Thoughtful medication management, when indicated
- Collaborative care, working alongside therapists or other providers when helpful
Our clinic is centrally located in downtown Bethesda, MD, just three miles from the Washington, DC border, easily accessible from DC, Potomac, and Northern Virginia, and metro-accessible.
What Causes ADHD?
There is no single cause of ADHD. Research suggests it develops through a combination of biological and environmental factors.
Contributors may include:
These factors can interact over time, which helps explain why ADHD symptoms often worsen during periods of stress, poor sleep, or burnout.
Contributors may include:
- Differences in brain development and regulation
- Genetic vulnerability
- Chronic stress and nervous system strain
- Sleep disruption
- Diet and metabolic factors
- Inflammation and immune signaling
- Environmental and psychosocial stressors
These factors can interact over time, which helps explain why ADHD symptoms often worsen during periods of stress, poor sleep, or burnout.
What’s the Difference Between ADD and ADHD?
ADD is an older term that is no longer used diagnostically. Today, ADHD is the official diagnosis and includes different presentations.
Some people primarily struggle with attention and focus, while others experience more impulsivity or restlessness. Many adults continue to use the term “ADD” because it reflects how their symptoms were originally described, but clinically these patterns are now understood as part of ADHD.
Some people primarily struggle with attention and focus, while others experience more impulsivity or restlessness. Many adults continue to use the term “ADD” because it reflects how their symptoms were originally described, but clinically these patterns are now understood as part of ADHD.
What Medications Are Used for ADHD and How Do They Work?
Several medications are commonly used to treat ADHD, including stimulant and non-stimulant options. Stimulant medications, such as those containing methylphenidate or amphetamine compounds, work by increasing the availability of neurotransmitters involved in attention, motivation, and impulse control. Non-stimulant medications affect related brain pathways and may be helpful for individuals who do not tolerate stimulants well.
ADHD medications can improve focus, reduce impulsivity, and make daily tasks feel more manageable for many people. However, they do not teach skills, address underlying contributors such as sleep or stress, or resolve every aspect of ADHD. Whether medication is appropriate — and which medication to use — should always be discussed with a qualified medical provider who can consider individual needs, risks, and benefits.
ADHD medications can improve focus, reduce impulsivity, and make daily tasks feel more manageable for many people. However, they do not teach skills, address underlying contributors such as sleep or stress, or resolve every aspect of ADHD. Whether medication is appropriate — and which medication to use — should always be discussed with a qualified medical provider who can consider individual needs, risks, and benefits.
What Are the Signs and Symptoms of ADHD?
ADHD symptoms vary from person to person and may change with age, stress level, and life demands.
Common signs and symptoms include:
In adults, ADHD often shows up as chronic overwhelm, burnout, difficulty managing responsibilities, or feeling inconsistent despite strong effort and insight.
Common signs and symptoms include:
- Difficulty sustaining attention or focus
- Forgetfulness or losing track of tasks
- Impulsivity or acting before thinking
- Restlessness or internal mental overactivity
- Difficulty starting or completing tasks
- Emotional reactivity or frustration tolerance challenges
In adults, ADHD often shows up as chronic overwhelm, burnout, difficulty managing responsibilities, or feeling inconsistent despite strong effort and insight.
What Are the Limitations and Side Effects of ADHD Stimulant Medications?
While stimulant medications can be helpful for some symptoms for a subset of people, they also have limitations. Common side effects can include appetite suppression, sleep disruption, increased anxiety, mood changes, or physical discomfort. Some individuals experience diminishing benefit over time or find that medication helps in certain settings but not others.
Can ADHD Be Managed Without Medication?
For some individuals — particularly adults — ADHD symptoms can be managed without medication, or with lower doses used alongside other supports. Whether medication is needed depends on symptom severity, daily demands, and co-occurring conditions.
A non-medication approach may focus on:
These approaches are not meant to replace medical care, but to complement it and support long-term resilience.
A non-medication approach may focus on:
- Dietary strategies to support steady energy, blood sugar balance, and brain function
- Gut microbiome support, recognizing the connection between gut health, inflammation, and brain regulation
- Neurofeedback and neurotherapy, which aim to support healthier attention and regulation patterns
- Antioxidant and anti-inflammatory support, when appropriate
- Sleep optimization, stress management, and structured routines, which strongly influence focus and follow-through
These approaches are not meant to replace medical care, but to complement it and support long-term resilience.
What Is ADHD?
ADHD is a neurodevelopmental condition that affects the brain’s ability to regulate attention, behavior, and mental effort. It can impact children, adolescents, and adults, and symptoms often persist into adulthood even if they look different over time.
People with ADHD may struggle to sustain focus, organize tasks, manage impulses, or maintain consistent energy and motivation. These challenges are not due to laziness or lack of intelligence — they reflect differences in how the brain processes information and regulates effort.
People with ADHD may struggle to sustain focus, organize tasks, manage impulses, or maintain consistent energy and motivation. These challenges are not due to laziness or lack of intelligence — they reflect differences in how the brain processes information and regulates effort.
Attention-deficit/hyperactivity disorder (ADHD) is commonly discussed, but often oversimplified. Many people think of ADHD only in terms of distractibility or childhood behavior concerns. In reality, ADHD is a complex, lifelong condition that affects how the brain regulates attention, motivation, impulse control, and follow-through — often in ways that change across different stages of life.
An integrative approach recognizes that ADHD is not caused by a single neurotransmitter imbalance. Instead, symptoms are shaped by brain regulation, stress physiology, sleep, diet, gut health, inflammation, and environment. For many individuals, especially adults, addressing these factors alongside thoughtful medical care leads to more sustainable improvement.
An integrative approach recognizes that ADHD is not caused by a single neurotransmitter imbalance. Instead, symptoms are shaped by brain regulation, stress physiology, sleep, diet, gut health, inflammation, and environment. For many individuals, especially adults, addressing these factors alongside thoughtful medical care leads to more sustainable improvement.
How Do We Treat ADHD?
Effective ADHD care is individualized and often involves multiple strategies working together.
Treatment may include:
For many people, combining approaches leads to more meaningful and sustainable improvement than relying on any single intervention.
Treatment may include:
- Thoughtful medication management when appropriate
- Integrative psychiatry addressing biological and lifestyle contributors
- Neurofeedback and neurotherapy
- Nutritional and gut-health support
- Stress regulation and sleep optimization
For many people, combining approaches leads to more meaningful and sustainable improvement than relying on any single intervention.
Why an Integrative Approach to ADHD Is Needed
ADHD is not simply a dopamine problem or a condition that can be fully managed with medication alone. Symptoms are influenced by how the brain responds to stress, how well the body recovers, and how environmental and biological factors interact.
An integrative approach allows care to be tailored to the individual, addressing contributors that may be overlooked in standard models. This broader perspective can be especially helpful for adults who have partial benefit from medication or continue to struggle despite long-term treatment.
An integrative approach allows care to be tailored to the individual, addressing contributors that may be overlooked in standard models. This broader perspective can be especially helpful for adults who have partial benefit from medication or continue to struggle despite long-term treatment.
