Adult ADHD and Comorbid Disorders
Many adults with ADHD suffer from comorbid disorders, such as major depression (Kessler and co., 2006). Many patients do not respond to medications for depression and may be able to benefit from psychotherapy.
Treatments that are most effective in reducing the symptoms of ADHD are those that boost and balance levels of specific neurotransmitters in the brain. The stimulants methylphenidate and amphetamine are commonly prescribed.
Medications
Adults can take a variety of medications that are used for ADHD in children. The dosages and the side effects differ. A doctor will take into consideration the individual's medical history, family history, and other health conditions to determine which medication is most suitable for them.
The most commonly used type of ADHD medication is stimulant and adjusts levels of two chemical messengers within the brain called norepinephrine and dopamine. The stimulants like methylphenidate (also known as Adderall), and dextroamphetamine enhance the supply of neurotransmitters that aid in improving focus, reduce impulsivity, and decrease aggression. They come in many forms, including chewable tablets, liquids and skin patches. These stimulants that last longer are popular due to their improved patient compliance, and a smoother, longer-lasting improvement of symptoms.
It is important to remember that co-existing conditions like anxiety and depression may affect the response to ADHD medications. Therefore, it is recommended that psychiatric issues be treated first, and then medication used as a second measure. Some medications that can be used to treat comorbid mood disorders include bupropion, atomoxetine and tricyclic antidepressants (Wilens 2004).
Some patients may experience an "rebound" effect where they experience worsening of ADHD symptoms after discontinuing stimulant medication. In these instances, a brief trial of a low dose of stimulant medication may be beneficial.
Some people are unable to tolerate stimulant medications or are in a position to not take them due to abuse of drugs or other health conditions for example, heart problems that are severe or hypertension. In these cases, nonstimulant medications like atomoxetine (Strattera) and viloxazine (Qelbree) can be effective. These medications do not cause the same level of side effects as stimulants and have lower risks of abuse and diversion.
Psychotherapy
People with ADHD may benefit from psychotherapy (talk therapy). It can help those with ADHD learn how to improve their lives, manage anxiety and stress, resolve conflicts, or manage problems at work or in relationships. It can also assist with co-occurring mental illnesses like depression and substance abuse disorders.
Talk therapies include cognitive behavior therapy (CBT), mindfulness-based cognitive therapy and schema therapy. These therapies are based upon the notion that beliefs and thoughts can influence how a person is feeling, thinks and behaves. CBT assists individuals in identifying negative patterns of behavior and thoughts and then formulate and implement strategies to change them. Mindfulness-based cognitive therapy uses techniques for meditation to teach a person how to concentrate on their thoughts and emotions, control impulses and improve their executive functioning. Schema therapy, as well as other forms of psychotherapy that focus on the family history of a person could be beneficial for people with ADHD.
Psychotherapy, in addition to medication, can aid with specific ADHD problems, such as difficulty keeping up with schoolwork or interacting with others. It can also help with forgetting important dates and responsibilities and making impulsive choices that result in legal and financial issues. It can also help individuals to address and overcome underlying issues that could be contributing to their ADHD symptoms, such as depression or anxiety.
Psychotherapy can help a person find healthy coping skills and reduce stress, for example exercises, sleep improvement and healthy eating habits. It can also provide support to a spouse or family member who may be dealing with the effects of ADHD on their relationship. Therapy for families and marriage helps couples and families learn how to communicate better and manage ADHD symptoms together.
Cognitive Behavioral Therapy
CBT is a form of psychotherapy that is focused on changing the negative patterns of thinking that clients have. It utilizes skill-based dialogue with a skilled mental health professional (a therapist) to address the root causes of their symptoms. This treatment is designed to help patients overcome difficulties and develop coping skills that are compatible with their everyday lives.
In addition to teaching clients how to identify unhelpful thoughts, those who specialize in adult ADHD CBT assist them in developing abilities that enable clients to replace their negative thoughts with more productive ones. This process can take some time. It's a possibility for those who cannot feel enough relief from their medication.
A recent RCT study found that when paired with medication, CBT is superior to CBT on its own in improving the emotional symptoms, core symptoms as well as self-esteem and social functioning of adults with ADHD (Clarke and co. 2017). The combination of CBT and methylphenidate is particularly effective for those with more severe underlying issues.
The therapists who provide this type of treatment typically collaborate with the client to devise an action plan specific to solving their issues. They teach them a set of practical skills which are easy to master and have a good chance of success. A chart system is often used to monitor progress, and reward positive behaviors. For an infant, this could include a daily report that outlines all of the school activities or positive behaviors they must perform and a system for tracking and earning rewards. The therapists can also discuss the possibility that negative consequences might be imposed if a child isn't able to finish their work. This can be done with care and support.
Metacognitive Therapy
A more recent form of therapy, metacognitive therapy, helps individuals change how they think. treating adult adhd of therapy is effective for those who suffer from a variety of mental health problems which include depression. It is a kind of cognitive behavioral therapy that helps people recognize negative thought patterns and their impact on their emotions. This type of therapy helps individuals develop psychological tools that are flexible and useful.
The goal of this study was to investigate the relationship between metacognitive capabilities and daily functioning in adults with ADHD. In order to do this, we compared self and informant-rated impairments in daily functioning with the predictors of metacognition (comprehensive Knowledge, Regulation of Cognition, Debugging, Information Management, and Evaluation). The results indicated that comprehensive knowledge was associated with daily functioning among adults suffering from ADHD but not with regulation processes. treating add in adults of a model that includes metacognition predictors was moderate, which suggests that they can explain significant proportions of the variance in the daily functioning of people with ADHD.
Metacognitive therapy (MCT) is a form of psychotherapy that focuses on changing metacognitive beliefs that cause states of anxiety or rumination as well as attention fixation. MCT was created by Adrian Wells based on an information processing model developed by Wells and Gerald Matthews. One case series has demonstrated the effectiveness of MCT in reducing anxiety, but it's still a relatively new concept and more research is needed to determine its effectiveness for other disorders.
This study was created to determine the efficacy of MCT in reducing symptoms of illness anxiety disorder, but it can be applied to a variety of disorders, and may be more effective than other treatments. It's important to keep in mind that this isn't an effective treatment for ADHD however it can be utilized as an adjunctive therapy.
Family Therapy
In family therapy, the therapist collaborates with all family members. This allows everyone to understand the client's problems and learn how to support their loved one more effectively. It also assists them in dealing with their frustrations and build more effective communication skills. This kind of counseling can be utilized to treat the underlying conditions, like substance abuse and depression that are commonly associated with ADHD.
The therapist will commence with an intake session to gain a better understanding of the family's view of the issue and determine their ability to intervene with the family. This can be done in person or via the internet. The counselor will explain to each person the purpose of therapy and the do's & don'ts for family therapy.
A therapist who has experience treating adults with ADHD will ask a lot of questions to get a better understanding of their present symptoms as well as their past and the impact they've had on their family, work, and relationships. They will also ask if there are any other mental health issues like depression or anxiety.
Cognitive behavioral therapy (CBT) is a method of counseling that is structured that teaches you how to change your negative thinking patterns and manage your behavior. It concentrates on improving your self esteem and self-control by teaching strategies to manage anger and stress. It is a short-term treatment that can be combined with other forms of psychotherapy.
Individual therapy can help those with ADHD overcome emotional trauma from a long-running pattern of underachievement, failure academic struggles as well as frequent job changes and conflict in relationships. It can help you learn coping and stress reduction techniques and teach you how to manage your time and money more efficiently. It can be used to treat the comorbidities, like anxiety and mood disorders, which are often seen alongside ADHD.