Pills Can't Teach Skills: Understanding the Role of Medication in ADHD
- Braden Young
- 2 days ago
- 5 min read
(Disclaimer: I am not a doctor. The information provided in this article is not to be taken as medical advice and is for informational purposes only.) If you spend enough time in ADHD communities, you’ll notice a familiar pattern. Someone starts medication for the first time, feels an incredible surge of focus, and for a while, everything clicks. Then it fades. The spark that helped them organize their space, start that project, or finally feel “normal” begins to disappear. That’s when the disappointment sets in: “I thought the meds would fix me.”
Here’s the truth that often gets missed: pills don’t teach skills.
Medication can open the door, but it’s the learning, structure, and strategies that help you walk through it. Think of medication as a key that unlocks access to your executive functions, not a replacement for them.
Medication as a Tool, Not a Cure
ADHD medication doesn’t cure ADHD because ADHD isn’t a disease. It’s a different wiring of the brain that affects how we regulate attention, emotion, motivation, and time. Medication helps balance the brain’s dopamine and norepinephrine systems, making it easier to focus, plan, and follow through.
But without learning how to use that focus effectively, the benefits can fade fast. This is where coaching, therapy, and self-awareness come in. Medication gives you the clarity to practice the skills that help you thrive in a world that wasn’t designed for the ADHD brain.
If you’ve read my post on How ADHD Shapes My Daily Life, you’ll see that much of living with ADHD is about recognizing patterns, building systems that work with your brain instead of against it, and forgiving yourself when those systems fall apart. Medication helps make that process possible, but it doesn’t do it for you.
The Pills: Different Types of ADHD Medication
ADHD medications generally fall into two main categories: stimulants and non-stimulants.
Stimulants are the medications most people hear about first when they start exploring ADHD treatment. They work by increasing the availability of dopamine and norepinephrine in the brain, which supports focus, motivation, and impulse control. For many people, this lift feels like someone finally turned the lights on in a room they did not even realize had gotten dim.
There are two main families of stimulant medication, and each one interacts a little differently with the brain.
Methylphenidate-based medications like Ritalin, Concerta, and Focalin tend to have a smoother ramp up and can feel gentler for some people who are sensitive to stimulation or anxiety. They often help people stay steady throughout the day, especially in extended release forms.
Amphetamine-based medications like Adderall, Vyvanse, and Dexedrine can feel more energizing or activating, which is great for folks who struggle with severe sluggishness or mental fatigue. Vyvanse in particular is known for having a slow, predictable onset that many people find easier to tolerate.
Even though these medications are grouped together, the experience from one person to the next can be wildly different. This is where patience and flexibility really come in. Your brain chemistry is unique, and what feels like a perfect fit for one person might do very little for someone else. Sometimes the benefits are there but the side effects are too strong. Sometimes the first medication works beautifully and sometimes it takes a few tries to get things dialed in.
Non-stimulants take a different path than stimulants. Instead of giving the brain a quick boost in dopamine, they work more gradually and steadily. For many people, they are a great option when stimulants cause problems like increased anxiety, appetite loss, irritability, or difficulty sleeping. They can also be helpful for people who have coexisting conditions that complicate stimulant use. Examples include:
Atomoxetine (Strattera), which increases norepinephrine levels over time. It does not deliver an immediate effect the way stimulants do, so the benefits can take several weeks to build. For some people this slow and steady approach feels more stable and predictable. It can be especially supportive for emotional regulation, long term focus, and reducing that constant sense of overwhelm that so many ADHD adults carry.
Guanfacine (Intuniv) and Clonidine (Kapvay), come from a class of medications called alpha-2 agonists originally used for blood pressure but now widely used for ADHD. They help calm the nervous system, which can make it easier to manage impulsivity, irritability, and big emotional swings. These medications can be very grounding for people who live with intense emotional reactivity or who find themselves constantly on edge.
No matter which direction someone chooses, medication is always a decision to make with a provider who understands ADHD, your life, and what you are trying to build for yourself. The goal is never to chase the idea of a perfect pill. The real goal is finding something that helps you function better, feel more like yourself, and have the capacity to use the skills and strategies that support your growth.
Medication can be part of your toolbox, not the whole toolbox. You still get to choose how you use it and how it fits into the life you want to create.
Teaching the Skills That Pills Can't: Building Scaffolding for the ADHD Brain
Even with the right medication, we still need scaffolding. These are the systems and supports that hold us up when our executive function falters. Think of them as the ramps and handrails that help us navigate a world designed for neurotypical brains.
That scaffolding might include external reminders, body doubling, structured routines, and environmental design. It might mean working with an ADHD coach (like me) to identify patterns, build accountability, and learn how to use your medication as a partner in your growth.
When we start building our scaffolding, we’re really addressing our foundational needs such as physiological needs like sleep and nutrition, ownership and safety needs, belonging, self-esteem, and realization and purpose (all elements of POWER).
Medication can help us meet those lower-level needs by improving focus and stability, which then allows us to work toward higher-level goals like connection, confidence, and fulfillment. Once those supports are in place, we can begin to build the kind of life that feels aligned and sustainable.
The Real Goal: Empowerment, Not Perfection
Medication can make it easier to start, focus, and follow through, but it can’t tell you what matters most to you. It can’t set your boundaries, manage your schedule, or quiet your inner critic. That work is deeply human and beautifully imperfect.
When medication is used alongside therapy, coaching, or self-education, it becomes a tool for empowerment. It helps you see the gap between where you are and where you want to be, and gives you the energy and clarity to start closing it.
In short, medication helps you learn how to drive, but you still have to steer.
If you’d like to explore this topic further, check out my articles on ADHD & Dopamine: Why Motivation Feels Like a Moving Target and ADHD Tools & Hacks. They expand on how our brains process reward, why traditional motivation systems don’t always work, and how we can build our own toolkit that actually does.
References
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).
National Institute of Mental Health. (2024). Attention-Deficit/Hyperactivity Disorder: What You Need to Know.
Volkow, N.D., et al. (2009). Motivation deficit in ADHD is associated with dysfunction of the dopamine reward pathway. Nature Neuroscience.
Spencer, T.J., et al. (2013). Pharmacotherapy of attention-deficit/hyperactivity disorder across the life cycle. Journal of the American Academy of Child & Adolescent Psychiatry.
Faraone, S.V., et al. (2021). ADHD medication: New developments and emerging options. The Lancet Psychiatry.
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