One of the main misunderstandings about ADHD assessment and therapy is that there is a state that one reaches when you feel totally normal , balanced, able to focus, and free of distraction and attention problems. Unfortunately the reality is otherwise, as I often remind my patients. To me, ADHD is not a disease to be fixed but a condition or propensity towards a pattern of brain functioning that needs to be managed. There are aspects of an ADHD brain that are helpful in day-to-day functioning such as intuitiveness, excitement, eagerness, warmth and genuineness. The goal of the treatment, both psycho-therapeutically and with medication, is to address the problematic aspects of ADHD. The clinical question then is to balance treatment versus potential side effects from medications, and determine what kind of psychological stance will be the endpoint to the goals of therapy. This is something that requires patience, education, acceptance, and commitment to goals that are both immediate and long-term. An existential spiritual center or perspective on life also reminds essential for the best outcome.