Understanding and Managing Attention-Deficit/Hyperactivity Disorder (ADHD)

Thrive • October 19, 2022
By Thrive Wellness Sacramento Interim Executive Director & Psychiatrist Jaime Avra Ley, M.D.

Almost 10% of children and about 4% of adults in the U.S. struggle with attention-deficit/hyperactivity disorder (ADHD), a condition that diminishes one’s ability to focus, feel at ease, and control impulses. The distressing disorder can interfere greatly with daily life, but a variety of clinical interventions can help make ADHD more manageable.

WHAT IS ADHD? 

ADHD is characterized by difficulty regulating a group of important brain processes, called executive function, responsible for:
  • Attention
  • Organization
  • Working memory
  • Control of emotional and physical behaviors

Executive function prioritizes information by encouraging focus on information deserving attention and allowing less important data to fade to the background. These mental processes also help regulate behaviors by allowing or inhibiting actions, a process called impulse control. 

Three types of executive function deficits correspond to three types of ADHD: 
  • ADHD, predominantly inattentive : Difficulty with attention, focus, and organization primarily 
  • ADHD, predominantly hyperactive/impulsive : Difficulty with impulse control and hyperactivity primarily
  • ADHD, combined type: Having both deficits in attention and impulse control

Symptoms of ADHD are associated with attention, hyperactivity, and impulsivity.

ADHD symptoms associated with attention include:
  • Difficulty paying close attention to details
  • Making seemingly careless mistakes often
  • Trouble listening
  • Difficulty with organization and prioritization
  • Feeling reluctant, disliking, or avoiding tasks that require extended focus
  • Frequently losing important items
  • Becoming distracted easily
  • Forgetfulness
ADHD symptoms associated with hyperactivity and impulsivity include:
  • Often engaging in fidgeting or squirming
  • Trouble staying in one’s seat
  • Engaging in physical activity inappropriate for the current environment  
  • Difficulting participating in leisure activities quietly
  • Frequently feeling “on the go”
  • Engaging in excessive talking often
  • Interrupting frequently
  • Difficulty waiting for one’s turn

Risk factors for ADHD include genetic makeup, premature birth , and exposure to drugs and alcohol in utero. 

MISCONCEPTIONS ABOUT ADHD

ADHD is frequently misunderstood. A couple of commonly mistaken beliefs about ADHD include:
  • Individuals may misperceive those with ADHD as defiant or lazy. In reality, tasks that may seem simple can require much more effort for individuals with ADHD. As a result, those with ADHD may resist undertakings that demand their full concentration.
  • When individuals with ADHD present symptoms of impulsivity, others may misperceive them as disrespectful, unruly, or disobedient. While there may be defiance involved in their actions, those with ADHD face more of a challenge restraining their impulses and moderating their conduct. Authority figures may rightfully implement consequences for inappropriate behavior. They may also validate the increased difficulty that those with ADHD face which can help reduce any shame stemming from the condition.

THE CONNECTION BETWEEN ADHD AND PERINATAL MENTAL HEALTH 

Pregnancy and caring for an infant generally entail biological changes, diminished quantity and quality of sleep , and feelings of overwhelm — all of which can impair executive function and make organization, focus, and emotion regulation tough. If a new parent has ADHD, the perinatal period can aggravate the symptoms of the condition. 

THE CONNECTION BETWEEN ADHD AND EATING DISORDERS

ADHD varies in the ways it affects different types of eating disorders , such as:
  • Binge eating disorder (BED) : Characterized by feeling a lack of control when eating as well as difficulty regulating portions, BED can be worsened by ADHD. Executive function deficits associated with ADHD can make it hard to regulate one’s eating behavior. 
  • Bulimia : Expressed by frequently eating large quantities of food followed by compensatory purging behaviors , bulimia can also be exacerbated by ADHD. ADHD can make controlling the impulse to engage in compensatory actions more challenging.
  • Anorexia and avoidant restrictive food intake disorder (ARFID) : Individuals who struggle with ADHD and restrictive eating disorders, such as anorexia and ARFID are often able to easily disregard their hunger cues. If ignored long enough, hunger cues can dissipate. During recovery, these individuals may require additional guidance as they learn to be more mindful of returning hunger cues

INDIVIDUAL BEHAVIORAL THERAPY FOR ADHD

Individual behavioral therapy allows those with ADHD to strengthen desired behaviors and reduce problematic conduct. Throughout the process, the clinician integrates appropriate goals, incentives, and consequences to help shape the client’s regulation skills. 

Therapists can also help with any emotional challenges associated with the disorder. For example, ADHD can contribute to strained relationships as well as diminished work or school performance. Low self-esteem , social skill deficits, anxiety , and depression may result. Therapy can help treat all aspects of the condition, including any co-occurring diagnoses. 

FAMILY THERAPY FOR ADHD

For an individual struggling with ADHD, family support can be essential to the successful management of the disorder. A family therapist can guide family members in supporting their loved one with ADHD while also providing them with skills to keep the family dynamic healthy amid the challenge.

ADDITIONAL INTERVENTIONS FOR MANAGING ADHD

A well-rounded approach to treating ADHD is often beneficial.

Some other ADHD management strategies that can complement therapy include:
  • School support resources: Schools can provide accommodations for students with ADHD to promote their academic success and behavioral modification. 
  • Physical activity in nature: Movement and natural environments can provide a calming, restorative experience which can reduce the stress and anxiety that exacerbate ADHD. 
  • Neurofeedback: A non-invasive procedure, neurofeedback can help a person understand their brain activity and strengthen their brain’s ability to focus, problem-solve, and control impulses.
  • Medication: Certain medications can help stimulate the parts of the brain needed for focus, attention, and behavior regulation.  

TREATMENT FOR ADHD AT THRIVE WELLNESS

Thrive Wellness’ mental and behavioral health experts specialize in treating individuals of all ages struggling with ADHD, including those facing perinatal  ADHD and ADHD that co-occurs with eating disorders . By implementing interventions such as individual and family therapy, medication management, and educational advocacy, our clinicians guide individuals in managing ADHD in a way that promotes attention, organization, and impulse control. To learn more about our therapeutic services , reach out

While all Thrive Wellness locations offer interdisciplinary clinical teams who collaborate to treat eating disorders, perinatal mood and anxiety disorders (PMADs), and additional mental and behavioral health conditions, programs and services may vary by location.

About the Author
Thrive Wellness Sacramento Interim Executive Director & Psychiatrist Jaime Avra Ley, M.D.

Born and raised in Nevada, Dr. Jaime Avra Ley earned her doctorate in medicine at the University of Nevada, Reno Medical School where she also completed a residency in adult psychiatry and a fellowship in child and adolescent psychiatry. As an established and esteemed psychiatrist, Dr. Ley specializes in working with children and adolescents.

Dr. Ley considers comprehensive wellness to be inclusive of the health of one’s relationship with themself and others. She is passionate about addressing mental health barriers that may interfere with one’s ability to live authentically and reach their innate potential. Dr. Ley believes a multidisciplinary approach to care increases the efficacy of treatment for lasting results and is dedicated to supporting the various aspects of an individual’s well-being by providing diagnoses and medication management as appropriate.

At Thrive Wellness Sacramento, Dr. Ley enjoys working alongside a diverse treatment team of compassionate clinical colleagues to help individuals and families on their path to healing.

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November 14, 2025
The Greenhouse at Thrive Wellness A New Chapter of Hope and Healing in Nevada On Friday, November 14 , we gathered with our partners at Molina Healthcare to share an important moment for our community. Together, we celebrated Molina’s generous $50,000 grant , an investment that is helping bring The Greenhouse to life. Their support is not only a financial contribution—it’s a statement of belief in the young people and families of Nevada who deserve access to compassionate, evidence-based mental healthcare close to home. This gathering marked the beginning of something we’ve dreamed about for years: a place designed specifically for adolescents and emerging adults to receive the care, connection, and support they need during some of the most vulnerable moments of their lives. Something New Is Growing In early 2026 , Thrive Wellness will open The Greenhouse , Nevada’s first residential treatment center devoted to adolescents and emerging adults navigating eating disorders, anxiety, and OCD . For too long, families have faced a heartbreaking dilemma—send their child far from home for treatment or go without the specialized care they need. The Greenhouse is our answer to that gap. It will be a place where young people can settle into an environment built for healing, where they are understood, supported, and surrounded by a team that believes in their capacity to recover. The Greenhouse represents a natural extension of our mission. It’s a living expression of our belief that recovery is possible—and that with the right support, families can find their footing again. 
November 11, 2025
Are you looking for a meaningful way to give back this holiday season? Thrive Wellness is excited to continue our 6th Annual Giving Tree Program in collaboration with Perenn Bakery this winter. This year, Thrive Wellness Reno and Perenn Bakery are proud to partner with Ronald McDonald House Charities® of Northern Nevada. The organization supports families with children receiving treatment at area hospitals, providing comfort, hope, and a home-away-from-home during challenging times. Ronald McDonald House Charities offers essential services, removes barriers, strengthens families, and promotes healing when children need healthcare the most. How It Works Simply take one (or a few) tags from the Giving Tree, each listing an item you can purchase and donate for residents of the Ronald McDonald House. Then, drop off your item(s) at one of our designated donation locations by Friday, December 19. Items Needed: Restaurant gift cards Walmart or Target gift cards Games, puzzles, and coloring books Toys (Barbie, Hot Wheels, Lego sets, craft sets, magnet blocks, baby dolls, action figures, journals, infant toys, etc.) Children's books (picture, chapter, and graphic novels) Toiletry sets (for adults) Lotion/self-care gift sets (for adults) Sweatshirts/hoodies (adults, XS-XXL) Scarves, gloves, fuzzy socks, pajamas (all sizes) Infant diapers, onesies, and baby bottles Bulk individually wrapped snacks (granola bars, chips, etc.) Please ensure all donations are new, in original packaging, and unwrapped. Donation Drop-Off Locations Please deliver donations by Friday, December 19, to one of the following sites: Thrive Wellness 491 Court St., Reno, NV 89501 201 W Liberty St., Suite 201, Reno, NV 89501 Perenn Grocery 7600 Rancharrah Pkwy, Suite 130, Reno, NV 89511 Perenn Rancharrah 7750 Rancharrah Pkwy, Suite 110, Reno, NV 89511 Perenn Midtown 20 St. Lawrence Ave, Reno, NV 89509 Claio Rotisserie 3886 Mayberry Dr., Suite D, Reno, NV 89519 Why We Give Back Through our Giving Tree program, we’re honoring one of our core values at Thrive Wellness: staying rooted in community. This annual tradition allows us to give back to those who need support most during the holiday season. We invite you to join us by taking a tag at any Thrive or Perenn location and helping spread kindness throughout our community. There’s no better way to embrace the holiday spirit than by supporting local families with thoughtful, heartfelt donations. We are deeply grateful for your generosity and continued support. Thank you for helping us make a difference!
September 22, 2025
Eating disorders are one of the most serious mental health concerns facing today’s adolescents. They can affect every aspect of a young person’s life, including their physical health, school performance, relationships, self-esteem, and more. According to the National Institute of Mental Health, about 2.7% of adolescents in the U.S. will experience an eating disorder in their lifetime, and many more engage in disordered eating behaviors that may not meet full diagnostic criteria. The good news is that providers are in an influential position to notice early warning signs, open conversations, and connect families to support before these patterns of behavior become too engrained. Why Early Intervention Matters The earlier an eating disorder is identified and treated, the better the treatment outcomes. Research shows that getting support quickly after the disorder’s onset is linked to faster recovery, lower relapse rates, and healthier long-term development (Treasure & Russell, 2011). Waiting too long to seek help can mean medical complications, deeply ingrained behaviors, and a more difficult path to healing. For many adolescents, a caring provider who notices the signs and advocates for treatment can make all the difference in recovery and can even save lives. Recognizing Early Warning Signs Adolescents may not always disclose their struggles directly, so providers should keep an eye out for a range of indicators: Physical signs: noticeable weight changes, menstrual irregularities, digestive issues, dizziness, or fatigue. Behavioral patterns: skipping meals, restrictive eating, excessive exercise, frequent dieting, eating in secret, or leaving for the bathroom after meals. Emotional and cognitive signs: preoccupation with weight or body shape, food rituals, heightened anxiety around eating, or perfectionistic tendencies. It’s important to remember that eating disorders don’t always “look” a certain way. Teens can be distressed about food and body image even if their weight appears to be within a “normal” range. Screening Tools and Assessments Using free screening tools available online can be an effective way to gauge a patient’s needs and gain further insight on treatment options for a possible eating disorder. Here are 4 free screening resources we recommend you use before making a referral for a higher level of care. EDE-Q (Eating Disorder Examination Questionnaire) : helps assess eating attitudes and behaviors. Nine Item Avoidant/Restrictive Food Intake disorder screen (NIAS) : helps to assess the signs of ARFID in children. Eat 26 Screening Tool : a screening measure to help you determine attitudes towards food and eating. BEDS-7 (Binge Eating Disorder Screener) : for situations where binge eating is suspected. When possible, gathering input from parents, teachers, or coaches can also help, as teens may minimize their experiences out of fear or shame. The Role of Primary Care and Pediatric Providers Routine checkups are often where eating disorders first come to light. Providers treating children, teen, and adolescents can: Incorporate simple questions about eating habits and body image into wellness visits. Track growth charts and weight trends while pairing them with questions about mood, anxiety, and behavior. Foster trust by creating a safe, nonjudgmental space where adolescents feel comfortable sharing sensitive information and know there will be no weight stigma. Coordinating Multidisciplinary Care Supporting a young person with an eating disorder works best when care is collaborative . In order to treat the whole person, there are usually multiple members of a treatment team needed, including: Medical support: monitoring vital signs, lab work, and physical health. Therapeutic care: evidence-based approaches such as family-based therapy (FBT) and cognitive-behavioral therapy (CBT) help address thoughts and behaviors. Nutritional guidance: dietitians provide education, meal support, and reassurance. Family involvement: engaging caregivers empowers them to support recovery in everyday life. Addressing Barriers and Stigma Many families face challenges in seeking help, whether due to stigma, lack of awareness, or limited access to specialists. To help, providers can: Normalize conversations about body image and mental health as part of overall well-being. Use culturally sensitive approaches that honor diverse experiences with food, body, and health. Connect families to community organizations, online resources, or telehealth when in-person specialty care is limited. Eating disorders in adolescents are serious, but with early recognition and timely support, recovery is possible. Providers are often the first to notice changes and can play a vital role in opening doors to crucial support. By blending professional expertise with empathy and collaboration, providers can guide adolescents and their families toward lasting recovery and a healthier future. References National Institute of Mental Health. (2023). Eating Disorders . Treasure, J., & Russell, G. (2011). The case for early intervention in anorexia nervosa: theoretical exploration of maintaining factors. The British journal of psychiatry : the journal of mental science, 199(1) , 5–7.
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