Adult ADHD and Comorbid Disorders
Many adults suffering from ADHD also suffer from comorbid conditions like major depressive disorder (Kessler and colleagues 2006). Many patients are not responsive to medications for depression and may be able to benefit from psychotherapy.
Medications that most effectively improve the symptoms of ADHD appear to increase and balance levels of specific neurotransmitters in the brain. Drugs that stimulate the brain such as methylphenidate or amphetamine are often prescribed.
Medications
Many medications that are used to treat ADHD in children can be used for adults. However the dosages differ and the drugs may cause negative side effects that aren't present in children. A doctor will consider the medical history of the patient, family history, and other health conditions to determine which medicine is best for them.
The most commonly used ADHD medication is a stimulant. It works by altering the levels of norepinephrine and dopamine in the brain. Stimulants such as methylphenidate (also called Adderall) and dextroamphetamine enhance the supply of neurotransmitters that help improve concentration, decrease impulsivity, and reduce aggression. These stimulants are available in a variety of forms, including skin patches, liquids and chewable tablets. Long-acting versions of these stimulants are preferred because they provide more patient compliance and lasting, smoother improvement in symptoms.
It is crucial to keep in mind that comorbidities like anxiety and depression can affect the response to ADHD medications. Therefore, it is recommended that these psychiatric problems be treated first, and medications be used as a secondary measure. Some medications that are used to treat comorbid psychiatric disorders include bupropion, atomoxetine and tricyclic antidepressants (Wilens 2004).
Certain patients may experience some patients may experience a "rebound effect" where their ADHD symptoms get worse after stopping stimulant medication. In these cases an experiment of a short duration with a low-dose stimulant medication may be helpful.
Some people cannot tolerate stimulant medications or are in a position to not take them due to drug abuse or other health conditions such as severe heart problems or hypertension. In these instances, non-stimulant medication such as atomoxetine (Strattera) and viloxazine (Qelbree) can be effective. These drugs do not have the same high rates of adverse effects as stimulants, and are lower risks of misuse and diversion.
Psychotherapy
Psychotherapy (talk therapy) can be beneficial for those suffering from ADHD. It can help those with ADHD learn how to improve their lives, manage stress and anxiety, manage conflicts, or deal with problems at work or in relationships. It can also help with co-occurring mental illnesses such as depression and addiction disorders.
Talk therapies include cognitive behavioral therapy (CBT) as well as mindfulness-based cognitive therapy, and schema therapy. These therapies are based on belief that one's beliefs and thoughts affect how they feel, think and act. CBT helps people identify negative behaviors and thinking patterns, then develops and implements positive strategies to change these patterns. Mindfulness-based cognitive therapy uses meditation techniques to help a person learn to concentrate on their thoughts and emotions, manage their impulses and improve their executive functioning. Schema therapy and other forms of psychotherapy focused on the family history of a person can be beneficial for those with ADHD with significant secondary issues.
Psychotherapy, along with medication, can aid with specific ADHD issues, like difficulties with schoolwork or getting along with other people. It can also help in avoiding important dates and responsibilities, and making impulsive decisions that can result in legal and financial problems. It can also help people to identify and resolve issues that be contributing to their ADHD symptoms, such as anxiety or depression.
Psychotherapy can help people discover healthy ways to cope and reduce stress. For example exercising, improving sleep, and healthy eating habits. It can also provide assistance to a family member or spouse who is struggling with the negative effects ADHD has on their relationship. Marriage and family therapy can help families and couples communicate better and learn how to manage ADHD symptoms together.
Cognitive Behavioral Therapy
CBT is a kind of psychotherapy which focuses on helping clients to change their negative thinking patterns. It utilizes skill-based dialogue with an experienced mental health professional (a therapist) to address the root causes of their symptoms. This therapy aims to help clients overcome difficulties and develop coping skills that are appropriate to their everyday lives.
Therapists who specialize in adult ADHD-CBT instruct clients how to identify unhelpful thoughts and help them learn to replace them with more productive thoughts. This process can be lengthy. However, it is a viable option for those who do not receive enough relief from medication.
In the course of a recent RCT that was conducted, it was discovered that cognitive behavior therapy in combination with medication is superior over cognitive behavior therapy by itself in terms of improving the core symptoms, emotional symptom, self-esteem and social functioning in adults suffering from ADHD (Clarke, et al. 2017). The combination of CBT and methylphenidate is particularly beneficial for those suffering from more severe underlying problems.
The therapists that provide this treatment usually collaborate with the client to develop a detailed action plan for solving their issues. They typically teach them a series of practical skills that are easy to implement and have a high chance of being successful. Charts are typically used to track progress and reward positive behaviors. In the case of a child, this might involve a daily report that outlines all of the in-school activities or positive behaviors they need to accomplish and a method of monitoring and gaining rewards. Therapists can also talk about the possibility that negative consequences may be inflicted upon a child who does not complete their task. This can be done with care and support.
Metacognitive Therapy
A newer type of therapy, metacognitive therapy assists individuals in changing how they think. This kind of treatment can be beneficial for people who suffer from a variety of mental health issues such as depression. It's a kind of cognitive behavioral therapy that helps people recognize their negative thoughts and how they affect their moods. This kind of therapy helps individuals develop mental tools that are flexible and useful.
The purpose of this study was to explore the relationship between metacognitive capabilities and daily functioning among adults suffering from ADHD. To achieve this, we examined the relationship between the self- and informant-rated impairments in daily functioning to indicators of metacognition (comprehensive knowledge and cognition regulation debugging, management of information, and evaluation). The results showed that comprehensive knowledge was linked to daily functioning in adults with ADHD, but not regulatory processes. click the next document of a model with predictors of metacognition was moderate, suggesting that they can account for an important portion of the variation in the daily functioning of people with ADHD.
Metacognitive therapy (MCT) is a form of psychotherapy that focuses on modifying metacognitive beliefs that are dysfunctional and perpetuate states of anxiety or rumination as well as attention fixation. Adrian Wells developed MCT based on an idea of information processing created by Wells and Gerald Matthews. MCT has been shown to be effective in treating illness anxiety disorders. However, it is still an emerging treatment and further research will be needed to determine if it can help with other disorders.
The purpose of this study was to evaluate the effectiveness of MCT in decreasing symptoms of anxiety disorder, but it can be applied to a range of disorders and could be more effective than other therapies. This is not an effective treatment, but it can be employed to treat ADHD.
Family Therapy
In family therapy, therapists work with all members of the family. This allows all members to understand the client's problems and learn how to support their loved one better. It also assists them in dealing with their frustrations and develop more effective communication skills. This type of counseling can be utilized to treat comorbid conditions, such as depression and substance abuse that are commonly associated as part of ADHD.
The therapist will begin with an intake session in order to understand the family's perception and determine if they're appropriate for family intervention. This can be done in person or via the internet. The counselor will explain to each client the nature of treatment and the do's & don'ts for family therapy.
A therapist who has experience in treating adults with ADHD will ask a lot of questions to gain understanding of the client's present symptoms, their history, and their impact on their work, family life and relationships. They will also ask if any other mental issues are present, such anxiety or depression.
Cognitive behavioral therapy (CBT) is a structured form of counseling which teaches you to change your negative patterns of thinking and to manage your behavior. It focuses on improving your self-esteem and self-control by teaching methods to deal with anger and stress. It is a treatment option for short-term use that can be paired with other forms of psychotherapy.
Individual talk therapy helps people with ADHD to manage the emotional baggage that comes from failure and underachievement. It can also help them deal with conflicts in relationships, job changes, and academic issues. It can teach ways to reduce stress and cope, and how to better manage your time and finances. It can also be used to tackle other comorbid conditions like anxiety and mood disorders, which are often seen alongside ADHD.