Optimizing Care for Patients With ADHD During COVID-19: Tips From Dr. Rakesh Jain

In this video, Psych Congress Steering Committee member Rakesh Jain, MD, MPH, shares 5 suggestions for optimizing care for patients with attention-deficit/hyperactivity disorder (ADHD) during the COVID-19 pandemic.

Read the transcript:

Hello, friends, and colleagues, and members of the Psych Congress family. I'm sending you this message from Austin, Texas where I am out on a beautiful walk. It's an unusually lovely day here in Austin, Texas. I hope you're well.

As I've been on this long walk, I've been reflecting on my patients. I was thinking about the many ADHD patients and their family members I take care of. I've been thinking about their plight. These have been difficult times for you and I, to be sure, but undeniably, they've been far more difficult for them.

I thought I would put together a short list of my top 5 best-case practices in taking care of such patients, and I would love to share them with you. Here we go.

My first top best-case practice is for all of us to appreciate how difficult this has been for our patients with ADHD, and for that matter, for their families too. We should bring our A-game to the table. Our patients' lives have been stressed beyond imagination. As you can think of it, ADHD just increases the level of complexity considerably in this whole situation.

The first best-case practice for us might be let's all bring our A-game to the table during these difficult times as we take care of such patients.

Best-case practice number two, extra watchfulness over the care of our patients with ADHD. As I said before, these are complex times. I do think our patients with ADHD require us to be extra vigilant about side-effect management with them and also adherence. In the best of times this is challenging, but now, with schedules thrown into complete disarray and social schedules as stressed as they are, adherence may be a particularly complex issue.

We should proactively talk to our patients and their families about such issues and also side effects. Side effects may be a real problem for our patients. This is a good time to be aware of that fact and to address it proactively.

Here's my third suggestion. Let's not forget that ADHD is a 24 hours a day disorder. It doesn't take a break. That's how it is. That's how it's always been. This creates huge complexity for our patients with ADHD and their family members. In these rather difficult times, that has been exaggerated. It has been magnified. Schedules have been shattered. People are working, doing schoolwork, doing office work, whatever the case may be throughout the day. This then creates a lot of difficulties for them.

As a clinician, it is rather important, I remind myself that ADHD's still a 24 hours a day disorder, and I should endeavor to find the best nonpharmacological and pharmacological interventions to address that 24 hours a day need.

Number four, let's not forget the needs of our complex ADHD children, adolescents, and adults. By complex I mean, you know what I mean, ADHD plus. These are individuals who not just have ADHD, but may also have comorbid difficulties with anxiety, or depression, or one of the multiple other challenges such patients often have.

ADHD's difficult to live with anyways, but such complex presentations do create complex difficulties in recognition, and management, and of course, treatment.

These rather complex pandemic times have made the cause of such patients even more challenging, and that's why I, as a clinician, really need to step in, really need to bring my A-game to address the needs of these complex ADHD patients.

For my fifth and final recommendation, and I brought you to one of my favorite trees in all of Austin. It's a beautiful Mimosa tree that is flowering at the moment. The fifth suggestion I have is let's think of and remind our patients and their families about the importance of exercise, sleep hygiene that's optimized, and of course optimized nutrition.

The care of someone with ADHD is not just about medications. It's also about lifestyle modifications. All three of these issues have been demonstrated to have some help in addressing the needs of our ADHD patients and often the comorbidities that exist with them.

Best-practice scenario is offer good care pharmacologically, diagnostically, but also think about these three important issues of: exercise, which I'm about to do more of, optimized sleep hygiene, as well as optimized nutrition.

Thank you for joining me on this walk. I really appreciate the opportunity to share with you some of my thoughts regarding our patients with ADHD and their family members, and how best to take care of them in such difficult times.

Thanks again, and I will see you later. Bye-bye.

MORE: Treating Children and Adolescents With ADHD Amid COVID-19