Adult ADHD and Comorbid Disorders
Many people with ADHD also suffer from comorbid disorders such as major depressive disorder (Kessler and colleagues 2006). Many depressed patients do not respond well to medications and may get better results from therapy.
Treatments that are most effective in reducing the most fundamental symptoms of ADHD are those that boost and balance levels of certain brain chemicals called neurotransmitters. The most frequently prescribed stimulants include amphetamine, methylphenidate, and similar medications.
Medicines
Adults are able to take many different drugs that are prescribed for ADHD in children. However, the dosages are different and the drugs may cause negative side effects that aren't present in children. The doctor will examine the medical history, the family health history, and other medical health conditions of the patient to determine which medication is most appropriate for the patient.
The most popular kind of ADHD medication is stimulant and is used to regulate levels of two chemical messengers within the brain, namely norepinephrine and dopamine. Stimulants such as methylphenidate (also called Adderall), and dextroamphetamine boost the supply of neurotransmitters that aid in improving focus, reduce impulsivity and reduce aggression. These stimulants are available in various forms, such as skin patches, liquids and chewable tablets. These long-acting stimulants are preferred because they improve patient compliance, and a smoother, longer-lasting improvement in symptoms.
It is important to remember that comorbidities like depression and anxiety disorders can affect the response to ADHD medications. Therefore, it is recommended that these psychiatric problems be treated first, and medication be used as a second measure. The medications that can be used to treat comorbid mood disorders include bupropion, atomoxetine and tricyclic antidepressants (Wilens 2004).
Some patients may exhibit some patients may experience a "rebound" effect where they experience worsening of ADHD symptoms after stopping stimulant medications. In these instances, a brief trial of a low dosage of stimulant medication can be beneficial.
Certain people are not able to take stimulant medicines or are unable to take them due to abuse of drugs or other health issues, like heart issues that are severe or hypertension. In these cases, non-stimulant drugs such as atomoxetine and viloxazine may be beneficial. These medications do not cause the same level of side effects as stimulants and have a lower risk for misuse and diversion.
Psychotherapy
People with ADHD are able to benefit from psychotherapy (talk therapy). It can help them learn strategies to improve their lives, deal with anxiety and stress, work out conflicts, and deal with problems in relationships and at work. It can also assist with people with mental disorders that coexist, such as depression and addiction disorders.
Talk therapies include cognitive-behavioral therapy (CBT), mindfulness-based cognitive therapy, and schema therapy. These treatments are based on the belief that one's beliefs and attitudes affect how they behave, think and feel. CBT helps a person identify negative behaviors and thinking patterns, and then formulates and implements strategies to change them. Mindfulness-based cognitive therapy uses techniques of meditation to help a person learn to concentrate on their emotions and thoughts, manage their impulses and improve their executive functioning. Schema therapy, and other forms of psychotherapy that focus on a person's family history, may be helpful for people with ADHD.
Psychotherapy, as well as medication, can assist with specific ADHD problems, such as difficulties with schoolwork or getting along with other people. It can also assist in forgetting important dates and responsibilities and making impulsive decisions that can could lead to legal and financial issues. It can also help a person explore and resolve issues that may cause ADHD symptoms, such as anxiety or depression.
Psychotherapy can help a person find healthy coping skills and reduce stress through exercises, sleep improvement and healthy eating habits. It can also provide support to a spouse or family member who is struggling with the effects of ADHD on their relationship. Marriage and family therapy helps couples and families learn how to communicate better and manage ADHD symptoms together.
treatment for adults with add is a type of psychotherapy which focuses on helping clients to change their negative patterns of thinking. It involves a skill-based dialog with a mental health professional to address the root cause of symptoms. This treatment is designed to assist clients overcome their difficulties and develop coping skills that are in line with their daily routines.
In addition, they teach clients to recognize unhelpful thoughts, the therapists who specialize in adult ADHD CBT help them develop skills that allow clients to replace their negative thoughts with more productive ones. This process can take a long time. But it is an effective option for those who aren't getting enough relief from medication.
A recent RCT study found that when paired with medication, CBT is superior to cognitive behavioral therapy on its own in reducing the severity of the emotional symptoms, core symptoms self-esteem, and social functioning in adults with ADHD (Clarke et al., 2017). The combination of CBT and methylphenidate is particularly effective for those who have more severe underlying problems.
Therapists who provide this kind of treatment work with clients to create an action plan to address their specific problems. They usually teach clients a series of practical skills that are easy to implement and have a high likelihood of success. A chart system is often used to track progress and reward positive behavior. This might include an everyday report for a child that outlines the tasks they have to complete in school or the positive behavior that must be demonstrated, and a system of monitoring and rewarding rewards. Therapists can also consider introducing negative consequences when the child fails to finish their tasks. This can be done in a very sensitive and supportive way.
Metacognitive Therapy
A more recent form of therapy, metacognitive therapy, helps people change the way they think. This type of therapy can be beneficial for people who suffer from various mental health issues like depression. It is a form of cognitive behavior therapy that helps people learn to recognize negative thought patterns and their impact on their emotions. This type of therapy may also assist in the acquisition of psychological tools that are able and effective.
This study was designed to investigate the relationship between metacognitive skills and daily functioning among adults suffering from ADHD. To achieve this, we evaluated the self- and informant-rated impairments in daily functioning with predictors of metacognition (comprehensive knowledge and cognition regulation, debugging, management of information, and evaluation). The results showed that comprehensive knowledge was linked to daily functioning among adults with ADHD however, it was not associated with regulation processes. The predictive effectiveness of a model that includes predictors of metacognition was moderate, which suggests that they can account for significant proportions of the variance in the daily functioning of adults with ADHD.
Metacognitive Therapy (MCT) is an treatment that focuses on changing metacognitive beliefs that are dysfunctional and perpetuate states like worry, rumination, and attention fixation. MCT was created by Adrian Wells based on an information processing model created by Wells and Gerald Matthews. MCT has been shown to be effective in treating anxiety disorder. However, it is still an emerging treatment and further research is needed to determine if it can aid in other disorders.
This study was created to assess the effectiveness of MCT to reduce symptoms of anxiety disorder. However it could be used to treat a variety disorders and could be more effective than other therapy. This is not a cure, but can be used to treat ADHD.
Family Therapy
In family therapy, the therapy therapist works with the entire family. Everyone can gain a better understanding of the client's issues and learn how to help their loved family members. It also assists them in finding ways to cope with their own anxieties and develop healthier communication skills. This type of counseling could be used to tackle other comorbidities, such as depression and substance abuse that are commonly associated as part of ADHD.
The therapist will begin with an intake session to better understand the family's perspective and determine whether they are appropriate for family intervention. The session can be conducted in person or online. The counselor will go over the details of the treatment with each person and spell out the guidelines and rules of family therapy.
A therapist who has experience in treating adults with ADHD will ask a variety of questions to gain understanding of the client's present symptoms, their past and their impact on their work life, family life and relationships. They will also inquire whether there are any other mental health issues present like depression or anxiety.
Cognitive behavioral therapy is a kind of counseling that teaches you how to manage your behavior and transform negative patterns of thinking into positive ones. It concentrates on improving self-esteem and self-control by teaching you strategies to manage anger and stress. It is a short-term treatment that can be used in conjunction with other forms of psychotherapy.
Individual talk therapy can help people suffering from ADHD overcome emotional burdens resulting from long-standing patterns of underachievement and failure academic issues frequent job changes, and conflicts in relationships. It can teach ways to reduce stress and cope and also how to manage your financial and time management. It can also be used to tackle other comorbid conditions like mood and anxiety disorders, which are often seen alongside ADHD.