Adult ADHD and Comorbid Disorders
Many adults suffering from ADHD also suffer from comorbid conditions such as major depression (Kessler and colleagues, 2006). Many depressed patients are not able to 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 specific neurotransmitters, which are brain chemicals. The stimulants methylphenidate and amphetamine are frequently prescribed.
Medicines
Adults can use many medications that are used for ADHD in children. However the dosages are different and the medications can cause adverse effects that aren't present in children. A doctor will take into consideration the individual's medical history, family history and other health conditions to determine which medicine is best for him or her.
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 increase the availability of neurotransmitters that help improve focus, reduce impulsivity and reduce aggression. They come in various forms like chewable tablets, liquids, and skin patches. Long-acting versions of these stimulants are preferred because they provide better patient compliance and longer lasting, smoother improvement of symptoms.
It is important to keep in mind that co-existing conditions like anxiety and depression may alter the effectiveness of ADHD medication. Therefore, it is recommended that these disorders be treated first, and then medication used as a second measure. The medications that can be used to treat comorbid disorders of mood are atomoxetine (Bupropion), tricyclic antidepressants and bupropion (Wilens 2004).
Some patients might experience a "rebound effect" where their ADHD symptoms become worse after stopping stimulant medications. In these instances, a brief trial of a low dose of stimulant medication may be beneficial.
Some people cannot tolerate stimulant medications or are unable to take them due to addiction or other health conditions, for example, heart problems that are severe or hypertension. In these instances, non-stimulant medications such as atomoxetine (Strattera) and viloxazine (Qelbree) can be effective. These medications don't cause the same negative side effects as stimulants, and they are less likely to be misused or diverted.
Psychotherapy
Psychotherapy (talk therapy) can be beneficial for people with ADHD. It can help them gain skills to improve their life manage anxiety and stress, resolve conflicts, and deal with issues in relationships or at work. It can also assist with co-occurring mental illnesses such as depression and substance abuse disorders.
Talk adult adhd treatments include cognitive behavior therapy (CBT), mind-body cognitive therapy, and schema therapy. These therapies are based upon the notion that beliefs and thoughts can affect how a person is feeling, thinks and behaves. CBT helps individuals identify negative behaviors and thought patterns and then develop and implement strategies to change these. Meditation techniques are employed in mindfulness-based cognitive therapy to help someone concentrate on their thoughts and emotions to control their impulses and improve executive functioning. Schema therapy, as well as other forms of psychotherapy that focus on a person’s family history can be beneficial for people with ADHD.
In addition to medication psychotherapy can also help with the specific problems caused by ADHD problems, like having trouble getting through schoolwork, resolving conflicts and getting together with others, losing important dates or responsibilities and making impulsive choices that lead to legal or financial problems. It can help a person overcome the root issues like anxiety and depression that could contribute to their ADHD symptoms.
Psychotherapy can assist a person to develop healthy coping methods and reduce stress through exercising, improving sleep and healthy eating habits. It can also offer support to the family member or spouse who is struggling with the effects ADHD affects their relationship. Marriage and family therapy helps families and couples learn to communicate better and manage ADHD symptoms together.
Cognitive Behavioral Therapy (CBT)
CBT is a type of psychotherapy that is focused on transforming the patterns of negative thinking of the client. It uses skill-based dialogue with an experienced mental health professional (a therapist) to address the root causes of their symptoms. The aim of this therapy is to overcome the limitations and implement coping strategies that are compatible with the person's everyday life.
Therapists who specialize in adult ADHD-CBT show clients to recognize harmful thinking patterns and assist them to build the skills to replace them with more productive thoughts. This process can be lengthy. It is a viable option for those who are unable to receive enough relief from their medications.
A recent RCT study has found that when paired with medication, CBT is superior to cognitive behavioral therapy alone in reducing the core symptoms, emotional symptoms, self-esteem and social functioning of adults with ADHD (Clarke and co., 2017). The combination of CBT and methylphenidate is especially beneficial for those suffering from more severe underlying problems.
Therapists who provide this kind of treatment work with their clients to create an action plan that addresses their specific issues. They teach them a set of practical skills that are easy to learn and have a high probability of success. Charts are typically used to track progress and to reward positive behavior. This might include an everyday report for children that details the tasks they have to complete at school, or the positive behaviors to be demonstrated, and a system of recording and earning rewards. The therapists can also discuss the possibility that negative consequences may be inflicted upon a child who isn't able to finish their work. This can be done in a sensitive and calming manner.
Metacognitive Therapy
A newer form of therapy, metacognitive therapy, assists individuals in changing how they think. This type of treatment is effective for those who suffer from a variety of mental health problems which include depression. It is a kind of cognitive behavioral therapy which helps people learn to recognize negative thoughts and their impact on their moods. This type of therapy helps individuals develop mental tools that are flexible and useful.
This study was designed to investigate the relationship between metacognitive capabilities and daily functioning in adults suffering from ADHD. To achieve this we evaluated self- and informant-rated impairments in daily functioning with indicators of metacognition (comprehensive knowledge and cognition regulation debugging, information management, and evaluation). The results showed that comprehensive knowledge was linked to daily functioning in adults with ADHD but not with the processes that regulate. The predictive power of a model with predictors of metacognition was moderate, indicating that they can explain a significant amount of the variation in daily functioning for people with ADHD.
Metacognitive therapy (MCT) is a type of psychotherapy that focuses on modifying metacognitive beliefs that cause states of worry, rumination and attention fixation. Adrian Wells developed MCT based on an idea of information processing created by Wells and Gerald Matthews. A case series has proven the effectiveness of MCT in managing illness anxiety disorder, however it's still relatively in its infancy and more research is needed to determine its effectiveness in other disorders.
The purpose of this study was to evaluate the effectiveness of MCT in reducing symptoms of illness anxiety disorder, but it can be applied to a range of disorders, and may be more effective than other therapies. It is important to keep it in mind that this is not an effective treatment for ADHD but it could be employed as an adjunctive therapy.
Family Therapy
In family therapy, the therapist collaborates with all members of the family. All members can better understand the client's issues and learn to assist their loved family members. It also helps them deal with their anger and develop better communication skills. This type of counseling can be used to tackle other comorbidities, such as addiction and depression, which are often seen as a result of ADHD.
The therapist will start with an intake session to understand the family's perception and determine if they are appropriate for family intervention. This can be done in person or via the internet. The counselor will go over the details of the therapy with each individual and set out the guidelines and rules of family therapy.
A therapist with experience treating adults with ADHD asks lots of questions to get a better understanding of their present symptoms as well as their past and the impact they have on their family, work and personal relationships. They will also ask if there are any other mental health issues, such as anxiety or depression.
Cognitive behavioral therapy is a type of counseling that teaches you how to manage your behavior and change negative patterns of thinking to positive ones. It focuses on improving self-esteem and self control by educating you on how to manage stress and anger. This is a short-term solution that can be used in conjunction with other forms of psychotherapy.
Individual talk therapy can help those with ADHD overcome emotional burdens resulting from long-standing patterns of underachievement and failure academic struggles frequent job changes, and relationship conflict. It can teach you ways to reduce stress and cope as well as 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 associated with ADHD.