Areas › Focus, starting, and ADHD › Systems for daily life
Medication can make the learning possible. It does not do the learning. If no tools get built while things are steadier, there is nothing standing there when the dose wears off.
A common disappointment runs like this: the medication helps, then it seems not to be enough, then it gets stopped. Often what happened is that nothing was put in place during the better window. Use that window on purpose for the unglamorous things: a calendar you actually look at, one place where the keys live, a way of starting work that does not depend on how you feel. Then the medicine is holding a system up instead of standing in for one.
Qur’an and Sunnah
After that will come seven years of hardship which will consume all but a little of what you stored up for them (Quran 12:48). What gets put away during the easier stretch is what carries you through the harder one.
ثُمَّ يَأۡتِي مِنۢ بَعۡدِ ذَٰلِكَ سَبۡعࣱ شِدَادࣱ يَأۡكُلۡنَ مَا قَدَّمۡتُمۡ لَهُنَّ إِلَّا قَلِيلࣰ ا مِّمَّا تُحۡصِنُونَ
After that will come seven years of hardship which will consume all but a little of what you stored up for them
Qur’an 12:48read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
A randomised trial in 88 adults with ADHD ran twelve sessions of manualised group CBT with individual coaching, both alongside medication and without it, to see what the psychological work adds on top of the drugs. A second study of 124 adults doing twelve weeks of that kind of programme came at it from the other side, comparing those also taking medication with those who were not, across symptoms, mood, self esteem and functioning. Both are modest in size, and together they show this is a live research question rather than a settled one.
Cherkasova MV, French LR, Syer CA, Cousins L, Galina H, Ahmadi-Kashani Y, Hechtman L. (2020). Efficacy of Cognitive Behavioral Therapy With and Without Medication for Adults With ADHD: A Randomized Clinical Trial.. Journal of attention disorders doi
Pan MR, Huang F, Zhao MJ, Wang YF, Wang YF, Qian QJ. (2019). A comparison of efficacy between cognitive behavioral therapy (CBT) and CBT combined with medication in adults with attention-deficit/hyperactivity disorder (ADHD).. Psychiatry research doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
Treatment can free up attention, but attention is not a habit, and the habit still has to be practised.
When not to
Do not change or stop a prescription on the strength of this; talk to whoever prescribes it.
This one is still a draft. It is waiting on a scholar and a clinician to read it before it is published.
Near this one
The classroom is the strongest place to help and most clinicians cannot get into one. That is a reason to work well in the next best place, not a reason to give up.
ADHD clutter and hoarding look alike from the doorway and are not the same thing. Many people living among piles would be delighted if the lot vanished overnight.
If everything came apart the moment school ended, it may be that the structure was never yours. It belonged to the timetable, and the timetable stopped.