Adult ADHD and Comorbid Disorders
Many people with ADHD also have comorbid disorders, such as major depressive disorder (Kessler and colleagues 2006). Many depressed patients do not respond well to medication and may be able to benefit from therapy.
The most effective medications to treat core symptoms of ADHD seem to boost and balance levels of certain brain chemicals called neurotransmitters. Stimulants such as methylphenidate and amphetamine are commonly prescribed.
Medicines
A variety of medications used to treat ADHD in children can be used for adults. The dosages and effects differ. A doctor will consider the medical history of the patient, family history and other health issues to determine what medication is best for them.
The most well-known ADHD medication is a stimulant. It works by altering the levels of norepinephrine, and dopamine in the brain. Stimulants such as methylphenidate (also known as Adderall), and dextroamphetamine enhance the supply of neurotransmitters that aid in improving concentration, decrease impulsivity, and decrease aggression. They come in various forms such as chewable tablets, liquids, and skin patches. These long-acting stimulants are favored as they lead to better patient compliance, as well as an easier, longer-lasting improvement in symptoms.
It is important to keep in mind that co-existing conditions like anxiety and depression may influence the response to ADHD medication. Therefore it is recommended that psychiatric issues be treated first before medication is used as a secondary measure. Medications that can be used to treat comorbid mood disorders include bupropion, atomoxetine and tricyclic antidepressants (Wilens 2004).
Certain patients may suffer from some patients may experience a "rebound effect" in which their ADHD symptoms get worse after stopping stimulant medications. In these instances it is possible to try a short-term trial of the use of a low dose stimulant medication could be beneficial.
Certain people are not able to take stimulant medication or use it due to drug misuse or other health issues like severe hypertension or heart problems. In these instances, non-stimulant medication such as atomoxetine (Strattera) and viloxazine (Qelbree) can be effective. These medications do not cause the same level of adverse effects as stimulants and carry a less risk of misuse and diversion.
Psychotherapy
People with ADHD are able to benefit from psychotherapy (talk therapy). It can help them develop strategies to improve their lives, deal with anxiety and stress, work out conflicts, and manage problems in relationships or at work. It can also assist with co-existing mental disorders like depression and addiction disorders.
Talk therapies include cognitive behavioral therapy (CBT) as well as mindfulness-based cognitive therapy and schema therapy. These treatments are based on the notion that thoughts and beliefs affect how a person is feeling, thinks and behaves. CBT assists a person to recognize negative behaviors and thinking patterns, then develops and implements strategies to alter them. Mindfulness-based cognitive therapy utilizes meditation techniques to teach a person how to concentrate on their thoughts and emotions, manage their impulses, and improve their executive functioning. Schema therapy, as well as other forms of psychotherapy focusing on a person's history with their family can be beneficial for those suffering from ADHD who suffer from significant secondary issues.
In addition to medications, psychotherapy can help address the specific issues that arise from ADHD problems, like having trouble staying on track with schoolwork, resolving conflicts and being able to get along with others, forgetting important dates or obligations as well as impulsive decisions that can lead to legal or financial issues. It can assist a person overcome the root issues like anxiety and depression that could be contributing to their ADHD symptoms.
Psychotherapy can help someone find healthy coping skills and reduce stress, for example exercises, sleep improvement and healthy eating habits. It can also offer support to a family member or partner who is dealing with the effects ADHD has on their relationship. Marriage and family therapy can help families and couples communicate better and understand how to manage ADHD symptoms together.
Cognitive Behavioral Therapy
CBT is a kind of psychotherapy which focuses on helping clients to change their negative patterns of thinking. It utilizes skill-based dialogue with a trained mental health professional (a therapist) to address the underlying causes of their symptoms. This therapy aims to assist clients overcome their difficulties and develop coping skills that are in line with their daily lives.
In addition, they teach clients to recognize harmful thoughts, therapists who specialize in adult ADHD CBT help them develop abilities that enable them to replace unhelpful thinking with more productive ones. This process can take a long time. It's a possibility for those who cannot receive enough relief from their medication.
In a recent RCT study, it was concluded that cognitive behavioral therapy paired with medication is superior over cognitive behavior therapy by itself in terms of improving core symptoms, emotional symptoms, self-esteem, and social functioning in adults with ADHD (Clarke, et al. 2017). CBT coupled with methylphenidate could be particularly effective for people who suffer from more severe underlying problems.
Therapists who offer this kind of treatment work with their clients to devise an action plan that addresses their specific issues. They usually teach clients a set of practical skills that are easy to apply and have a good chance of being successful. Often a chart system is used to track progress and reward positive behavior. In the case of an infant, this could include a daily report which outlines the school tasks or positive behaviors they need to accomplish and an approach to recording and earning rewards. The therapists may consider creating negative consequences if the child fails to complete their work. This can be done with care and encouragement.
Metacognitive Therapy
A newer type of therapy, metacognitive therapy helps individuals change how they think. This kind of therapy can be effective for people who suffer from a variety of mental health problems, including depression. It's a kind of cognitive behavioral therapy that assists individuals learn to recognize their negative thinking patterns and how they affect their emotions. This kind of therapy can help them develop psychological tools that can be adaptable and beneficial.
The purpose of this study was to explore the relationship between metacognitive skills and daily functioning in adults with ADHD. To accomplish this we evaluated the self- and informant-rated impairments in daily functioning with indicators of metacognition (comprehensive knowledge and cognition regulation, debugging, information management, and evaluation). It was observed that comprehensive knowledge was connected to daily functioning in adults with ADHD but that the processes of regulation were not. The predictors of metacognition had moderate predictive power, which suggests they could explain a significant amount of variance in daily functioning of adults with ADHD.
Metacognitive Therapy (MCT) is an treatment that focuses on transforming metacognitive beliefs that cause dysfunction and perpetuate states like worry, rumination and attention fixation. Adrian Wells developed MCT based on a model of information processing by Wells and Gerald Matthews. A case series has proven the effectiveness of MCT in managing illness anxiety, but it's still a relatively new concept and more research is needed to determine its effectiveness for other disorders.
This study was conceived to assess the effectiveness of MCT to reduce symptoms of anxiety disorder. However it could be used to treat a variety disorders and may be more effective than any other therapy. It's important to keep in mind that this is not an effective treatment for ADHD but it could be used as an adjunctive therapy.
Family Therapy
In family therapy, the therapy therapist works with the entire family. Everyone is able to better understand the issues of the client and learn how to help their loved ones. It also helps them find ways to deal with their own anxieties and develop healthier communication skills. Additionally, this kind of counseling is useful for addressing comorbidities such as depression and substance misuse which are often found in conjunction with ADHD.
adult adhd treatment will start with an intake session to gain a better understanding of the family's perspective of the problem and assess their potential for intervention by the family. It can be done either in person or online. The therapist will discuss the nature of the therapy with each individual and set out the guidelines and rules of family therapy.
A therapist with experience treating adults suffering from ADHD will ask a variety of questions in order to gain insight into the client's current symptoms, their history and their impact on their work life and family life as well as relationships. They will also ask whether any other mental health issues are present, like depression or anxiety.
Cognitive behavioral therapy is a structured kind of counseling that teaches you to control your behavior and change negative thinking patterns into positive ones. It focuses on boosting self-esteem and self control by teaching you how to manage anger and stress. This is a short-term solution that can be used alongside other types of psychotherapy.
Individual talk therapy helps people with ADHD to deal with the emotional baggage that comes from failure and underachievement. It can also help them deal with relationship conflicts, job changes, and academic challenges. It can teach strategies for coping with stress and stress reduction, and how to manage your finances and time. It can be used to treat the comorbidities, like mood and anxiety disorders, that are often associated with ADHD.