ADHD: To Medicate or Not to Medicate?
Welcome to part seven in my series ~ ADHD 101. Each article explores a different aspect of working, loving, and living with ADHD. As both a psychotherapist and someone with ADHD, I want to help bridge the gap between how the condition looks on paper and how it actually feels day-to-day.
One of the biggest, most personal decisions you’ll make after an ADHD diagnosis is whether or not to take medication. It’s also one of the most controversial. Some people are all in, others are completely against it, and many fall somewhere in between. Some take meds for a while, stopping, restarting, switching types, or fine-tuning the dose. If that’s you, you’re not alone.
Let’s talk about what ADHD medication does (and doesn’t do), what can get in the way, and how to start thinking through your own answer to the “should I take meds?” question.
Please note that this article is for information purposes only. It is not intended as medical advice and should not replace guidance from your doctor or other primary care physician. This article highlights the pros and cons of both sides - to medicate or not to medicate.
What Medication Actually Does
ADHD medications, usually stimulants, don’t “fix” ADHD, and they don’t change who you are. What they do is help your prefrontal cortex (PFC) function more effectively. That’s the part of the brain responsible for executive functioning: planning, organizing, regulating emotion, and prioritizing tasks.
Think of the PFC like the CEO of your brain. With ADHD, that CEO is often out to lunch, late, scattered, or distracted. Medication helps bring the CEO back into the boardroom. It doesn’t make decisions for you, but it gives you the capacity to make them in the first place.
What Gets in the Way
For many ADHDers, deciding to try medication is just the first hurdle. Staying on it is another.
One of the most common side effects is loss of appetite, especially in children and teens. When you’re already prone to skipping meals or forgetting to eat (thanks, executive dysfunction), taking something that suppresses hunger can make things worse. But nutrition is critical for ADHD brains. We can’t run on empty and expect to function well.
There’s also the issue of forgetting to take the medication in the first place. Ironically, the thing that helps you manage your symptoms requires you to do the very thing ADHD makes hard: stick to a routine.
Then there’s social stigma, side effects, and even internalized guilt, like the belief that needing medication means you’ve somehow failed.
Here’s the truth: medication is a tool. Nothing more, nothing less.
What Else Helps
Some people thrive on medication. Others find it doesn't make enough of a difference, or the trade-offs (like appetite suppression, anxiety, or rebound crashes) aren’t worth it. And then there are people whose environments are stimulating enough that they don’t need medication at all.
I’ve worked with ADHDers in high-intensity jobs, think ER doctors, air traffic controllers, journalists, where the adrenaline and constant novelty keep them focused better than any pill ever could. In cases like this, the job itself acts like a natural stimulant.
For others, a multi-pronged approach works best. Studies have shown that:
Regular exercise can be just as effective as antidepressants or anti-anxiety medications for some people. It increases dopamine, supports mood regulation, and improves focus.
Omega-3 supplements (specifically high-quality EPA/DHA blends) have been shown in Imperial College studies to support cognitive function and reduce ADHD symptoms.
Consistent, nutrient-dense and protein-rich meals can help stabilize mood, prevent energy crashes, and reduce impulsivity.
Sleep, stress management, and supportive routines are just as essential as any prescription. Without the basics, there's no foundations to build upon!
Medication might be one tool in the toolbox, but it shouldn’t be the only one.
The Bottom Line
Medication is affordable. It can be life-changing. It can also be frustrating, imperfect, and full of trial and error.
If you’re still figuring out what works for you, know this: there’s no one-size-fits-all path with ADHD. You’re allowed to experiment. You’re allowed to change your mind. And you’re allowed to do what works for you, not what worked for your sibling, your coworker, or your doctor’s last patient.
In the next article, I’ll cover practical ways to manage ADHD without medication, whether by choice or necessity. Until then, be curious, stay kind to yourself, and keep building the toolkit that works for your brain.
Alicia
PS - Is this the first article in this series you’ve read? If so, here are the previous articles:
