Perhaps the biggest misunderstanding about ADHD syndrome in adults is that it is one fixed condition that remains the same throughout the years. As I have discussed before, ADHD is best looked at on a continuum between normal behavior and areas of attention, impulse control, and hyperactivity that pose problems in day-to-day living. Our personalities evolve and adapt according to environment, culture, biology and other factors. The cookie-cutter approach that some expect to fix all aspects of what we call ADHD is a hindrance to appropriate management of the condition. One of the most difficult aspects of my work as a Cleveland area psychiatrist and physician treating ADHD conditions is to attempt to educate patients who believe a simple treatment such a such as a stimulant medication would fix all the problems in their lives. Patients have to go through the stages of disappointment and anger, bargaining and hopefully acceptance to be able to address and rebuild their lives in a bio psycho social and existential/spiritual context.