Adult ADHD and Comorbid Disorders
Many adults suffering from ADHD also suffer from comorbid disorders such as major depression (Kessler and colleagues, 2006). Many patients do not respond to medications for depression and may be able to benefit from psychotherapy.
The most effective medications to treat core symptoms of ADHD are those that boost and regulate levels of certain neurotransmitters, which are brain chemicals. The stimulants methylphenidate and amphetamine are commonly prescribed.
Medicines
Adults can use many medications that are used for ADHD in children. However the dosages differ and the drugs may cause adverse effects that aren't typical of children. The doctor will look at the medical history, family health history, and other medical factors of the individual to determine which medicine is best.
The most commonly used ADHD medication is a stimulant. It works by altering the levels of norepinephrine, and dopamine in the brain. Stimulants like methylphenidate and dextro-amphetamine (commonly known as Adderall) increase the availability of these neurotransmitters. They help improve focus and reduce impulsivity and aggression. They come in many forms like chewable tablets, liquids, and skin patches. Long-acting versions of these stimulants are preferred as they result in more patient compliance and lasting and smoother improvement of symptoms.
It is important to remember that co-existing conditions like depression and anxiety disorders can alter the effectiveness of ADHD medication. Therefore, it is recommended that psychiatric disorders be treated first, and medication used as secondary measure. The drugs that can be used for comorbid mood disorders are atomoxetine (Bupropion) tricyclic antidepressants as well as bupropion (Wilens, 2004).).
Certain patients may experience some patients may experience a "rebound" effect, where they experience worsening of ADHD symptoms after discontinuing 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 helpful.
Some people are unable to tolerate stimulant medications or are in a position to not take them due to drug abuse or other health issues, like heart issues that are severe or hypertension. In these situations, nonstimulant medications such as atomoxetine and viloxazine are effective. These medications don't cause the same high rates of side effects as stimulants and have less risk of abuse and diversion.
Psychotherapy
People suffering from ADHD are able to benefit from psychotherapy (talk therapy). It can help them develop techniques to improve their lives, deal with anxiety and stress, work out conflicts, and deal with problems in relationships and at work. It can also help those suffering from mental illness that are co-existing like depression and substance abuse disorders.
Talk therapies include cognitive behavior therapy (CBT), mind-body cognitive therapy, and schema therapy. These therapies are based on belief that one's beliefs and attitudes affect how they think, feel and behave. CBT helps an individual identify negative thoughts and behaviors and then formulate and implement positive strategies to change them. Meditation techniques are employed in mindfulness-based cognitive therapy to help people focus on their thoughts and emotions to control their impulses and improve 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 have significant secondary problems.
Psychotherapy, along with medication, can aid with specific ADHD problems, such as difficulties with schoolwork or getting along with others. It can also help in avoiding important dates and responsibilities, and making decisions that are impulsive and could lead to legal and financial issues. Psychotherapy can also help a person explore and resolve issues that could cause ADHD symptoms, like depression or anxiety.
Psychotherapy can help someone develop healthy coping strategies and reduce stress, for example exercises, sleep improvement and healthy eating habits. It can also provide assistance to a partner or family member who may be dealing with the effects of ADHD on their relationship. Therapy for families and marriage can help families and couples communicate better and understand how to manage ADHD symptoms together.
Cognitive Behavioral Therapy
CBT is a form of psychotherapy that focuses on transforming 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 in line with their daily lives.
Therapists who specialize in adult ADHD-CBT teach clients to recognize harmful thinking patterns and assist them to develop skills to replace them with more productive thoughts. This process can take a while. But natural add treatment is an effective alternative for adults who are not getting adequate relief from their medication.
In a recent RCT study, it was concluded that cognitive behavior therapy in combination with medication is superior to cognitive behavior therapy alone when it comes to improving core symptoms, emotional symptom, self-esteem and social functioning for adults with ADHD (Clarke and colleagues. 2017). The combination of CBT and methylphenidate is particularly beneficial for those suffering from more severe underlying issues.
The therapists who offer this type of treatment typically collaborate with the client to devise a detailed action plan for solving their issues. They will teach them a set of practical skills which are easy to learn and have a good chance of success. Charts are typically used to monitor progress, and to reward positive behavior. This could include the daily report of children that details the tasks they have to finish at school or the positive behaviors to be displayed, as well as an approach to recording and rewarding. The therapists can also discuss the possibility that negative consequences might be imposed if a child does not complete their task. This can be done in a very sensitive and supportive way.
Metacognitive Therapy
Metacognitive therapy is a newer kind of psychotherapy that helps people change their thinking. This kind of therapy can be beneficial to those who suffer from a range of mental health problems like depression. It's a type of cognitive behavioral therapy that helps people to identify their negative thought patterns and how they impact their emotions. This type of therapy helps individuals develop mental tools that are versatile and useful.
The purpose of this study was to explore the relationship between metacognitive abilities and daily functioning in adults suffering from ADHD. To this end, we examined the relationship between the self- and informant-rated impairments in daily functioning with predictors of metacognition (comprehensive knowledge, regulation of cognition debugging, management of information, and evaluation). It was observed that the comprehensive knowledge of people was linked to daily functioning in adults with ADHD but that regulatory processes were not. The predictors of metacognition had moderate predictive power, which suggests that they could be the cause of significant variations in the daily functioning of people with ADHD.
Metacognitive Therapy (MCT) is an intervention that focuses on changing metacognitive beliefs that are dysfunctional and perpetuate states such as worry, rumination, and attention fixation. MCT was created by Adrian Wells based on an information processing model by Wells and Gerald Matthews. MCT has been shown to be effective in treating anxiety disorder. However, it is still a relatively new treatment, and further research is required to determine if it can aid in other disorders.
This study was designed to assess the effectiveness of MCT in the reduction of symptoms of illness anxiety disorder, but it can be applied to a variety of disorders, and may be more effective than other therapies. It's important to keep in mind that this isn't a cure for ADHD however it can be used as an alternative therapy.
Family Therapy
In family therapy the therapist works with the whole family. All members can better understand the issues of the client and learn how to help their loved ones. It also assists them in finding ways to deal with their own anxieties and improve their communication skills. This type of counseling could be utilized to treat the underlying conditions, like addiction and depression which are frequently associated with ADHD.
The therapist will begin with an intake session to gain a better understanding of the family's perception and determine if they are appropriate for family intervention. It can be done in person or online. The therapist will explain to each client the nature of treatment as well as the rules for family therapy.
A therapist with experience treating adults with ADHD asks a lot questions to get a better understanding of their present symptoms, their past, and the impact that they have on their family, work and personal relationships. They will also inquire whether there are any other mental health issues that are present, such as depression or anxiety.
Cognitive behavioral therapy is a type of counseling that helps you learn how to manage your behavior and change negative patterns of thinking to positive ones. It concentrates on improving your self esteem and self-control through teaching strategies to manage anxiety and stress. This is a short-term solution that can be used alongside other types of psychotherapy.
Individual therapy helps those with ADHD to overcome the emotional baggage that results from underachievement and failure. It can also help them deal with conflicts in relationships, job changes, and academic difficulties. It can teach strategies for coping with stress and stress reduction, and how to better manage your finances and time. It can also help with problems that are comorbid, such as anxiety and mood disorders, which are often seen with ADHD.