Pleasures
There are many pleasures in an adult ADD practice. The most important one for most clinicians is the pleasure they get from providing a treatment that can have such a dramatically positive effect on such a large portion of patients they see. About 20% of patients in private ADD practice change with treatment in a way that can be described as transformative. Most others change significantly not only in their ability to complete tasks but in their ability to relate to important people in their lives, including children, parents, and important others. If you like gratitude, there are few medical specialties that will please you more.
Sometimes the pleasure when people change can be bitter-sweet. I’ve have middle aged patients tell me with tears in their eyes how much they wish they had been treated earlier in their lives. But for many younger adults, the changes they see in their functioning and relationships is a source of great pride and excitement for them.
It’s a pleasure too that once an effective dose of medication is reached, the change in the patient is immediately apparent. No waiting four to six weeks. The benefits of treatment grow over time as patients remember more of what they have learned and gradually improve the quality of their relationships. Occasionally there is some decrease in medication’s effectiveness during the first year of treatment or when the patient is facing greater stress in life, and the dose of medication may be temporarily be increased, but adults with ADD usually remain on the same dose for their lifetime.
For the practicing clinician, ADD practice is fairly predictable. There tend to be no emergencies related to ADD although when comorbid conditions are present, it is like any other practice.
The brain research on adult ADD is very interesting. Fortunately there are newsletters that can help keep the clinician up to date on the recent scientific literature including the ADHD Report and The Brown University Child & Adolescent Psychopharmacology Update.
