You started a stimulant medication for a young woman with ADHD.

When she returns, her symptoms are 70% better, but what can we do about the rest?

Today, a conversation with psychiatrist Scott Shapiro about behavioral interventions for adult ADHD.

Welcome to the Carlet Psychiatry podcast, keeping psychiatry honest since 2003.

And this is a Thurback Thursday episode, where we're going to update this 2019 classic with new research and CME credits at the end.

In our November-December issue, we covered some of the more controversial topics in adult ADHD,

such as what really happens when people don't have ADHD but take stimulants to enhance their

cognition. But what about real adult ADHD? Symptoms of ADHD

tend to improve as the brain matures into adulthood, but for about one in three, the disorder

continues to affect their adult life. Today, I'll talk with Dr. Scott Shapiro, a psychiatrist

in New York City who specializes

in combined psychotherapy and medication for adults with ADHD.

Dr. Shapiro, from your perspective, is ADHD a trait that many people have to some degree, or is it a disorder that you either have it or you don't?

So, Chris, that's a great question.

People can have traits of ADHD, such as procrastination or struggling with focus or getting up and down at work.

But that's not necessarily ADHD.

ADHD really is a cluster of symptoms both that are in the DSM-5 as well as many symptoms

that are not in the DSM-5, such as executive dysfunction in emotional

dysregulation. I definitely myself see it as a disorder as opposed to trait. Executive dysfunction.

You said that's not in the actual DSM criteria, but I imagine that's got to cause some problems for the patients.

Well, it does.

Even more than some of the core symptoms that are discussed in the criteria, such as focus,

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