Adult ADHD and Comorbid Disorders
Many people with ADHD also suffer from comorbid conditions, such as major depression (Kessler and colleagues, 2006). Many patients do not respond to medication for depression and may benefit from psychotherapy.
Treatments that are most effective in reducing the most fundamental symptoms of ADHD appear to increase and balance levels of specific brain chemicals called neurotransmitters. Commonly prescribed stimulants include amphetamine, methylphenidate and similar medications.
Medications
Adults are able to take many different medications that are used for ADHD in children. The dosages and the side effects can be different. A doctor will take into consideration the individual's medical history, family history and other health issues to determine which medicine is best for him or her.
The most common kind of ADHD medication is a stimulant. It is used to regulate levels of two chemical messengers within the brain, norepinephrine as well as dopamine. The stimulants like methylphenidate (also called Adderall), and dextroamphetamine increase the availability of neurotransmitters, which help improve focus, reduce impulsivity, and decrease aggression. They are available in a variety of forms, including chewable tablets, liquids and skin patches. Full Content -acting versions of these stimulants are preferred because they lead to greater patient compliance and a longer lasting more smooth improvement of symptoms.
It is important to keep in mind that comorbid conditions such as depression and anxiety disorders can affect the response to ADHD medications. Therefore it is recommended that these psychiatric issues be treated first before medication is used as a secondary measure. Some medications that can be used to treat comorbid psychiatric disorders include atomoxetine and bupropion and tricyclic antidepressants (Wilens 2004).).
Some patients might suffer from some patients may experience a "rebound effect" where their ADHD symptoms get worse after stopping stimulant medications. In these instances it is possible to try a short-term trial of an atypical stimulant drug could be beneficial.
Some people are unable tolerate stimulant medication or cannot take it due to drug misuse or other health issues like severe hypertension or heart problems. In these cases, nonstimulant medications like atomoxetine (Strattera) and viloxazine (Qelbree) can be effective. These medications don't cause the same level of adverse effects as stimulants and carry a lower risks of abuse and diversion.
Psychotherapy
Psychotherapy (talk therapy) can be helpful for those with ADHD. It can help those with ADHD to improve their lives, deal with anxiety and stress, resolve conflicts, or cope with problems at work or in relationships. It can also help people with mental disorders that coexist, such as depression and addiction disorders.
Talk therapies include cognitive behavioral therapy (CBT) and 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, and then develops and implements positive strategies to alter these patterns. Meditation techniques are employed in mindfulness-based cognitive therapy to help people concentrate on their emotions and thoughts, control impulses, and improve executive functioning. Schema therapy, as well as other forms of psychotherapy that focus on the family history of a person could be beneficial for people suffering from ADHD.
Psychotherapy, in addition to medication, can help with specific ADHD issues, like difficulties with schoolwork or getting along with others. It can also help with forgetting important dates and obligations and making decisions that are impulsive and lead to financial and legal problems. It can also help a person explore and overcome underlying issues that contribute to their ADHD symptoms, like depression or anxiety.
Psychotherapy can help people discover healthy coping techniques and reduce stress. For instance, exercise, sleep improvement and healthy eating habits. It can also offer support to a spouse or family member who is struggling with the effects of ADHD on their relationship. Family therapy and marriage counseling can help couples and families learn how to communicate better and manage ADHD symptoms together.
Cognitive Behavioral Therapy (CBT)
CBT is a type of psychotherapy which focuses on transforming the patterns of negative thinking of the client. It involves a dialogue based on skills with a mental health professional to address the underlying causes of the symptoms. The aim of this therapy is to correct limitations and implement strategies for coping that fit with the person's everyday life.
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. It's a possibility for those who are unable to feel enough relief from their medication.
A recent RCT study found that when paired with medication, CBT is superior to CBT on its own in improving core symptoms, emotional symptoms as well as self-esteem and social functioning of adults suffering from ADHD (Clarke et al., 2017). The combination of CBT and methylphenidate is especially effective for those with more severe underlying issues.
Therapists who provide this type of treatment work with their clients to develop an action plan to address their specific issues. They usually teach them a series of practical skills that are easy to implement and have a good chance of being successful. A chart system is often utilized to track the progress of a child and reward positive behaviour. This might include an everyday report for children that lists the tasks they must complete at school, or the positive behaviors to be demonstrated, and an organized system for recording and rewarding rewards. Therapists may also discuss the possibility that negative consequences may be imposed if a child fails to complete their tasks. This can be done in a sensitive and supportive manner.
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 variety mental health problems like depression. It's a type of cognitive behavioral therapy that assists people recognize their negative thoughts and how they affect their emotions. This type of therapy helps to develop psychological tools that can be flexible and useful.
This study was designed to investigate the relationship between metacognitive skills and daily functioning in adults with ADHD. To achieve this we compared self- and informant-rated impairments in daily functioning to predictors of metacognition (comprehensive knowledge as well as regulation of cognition debugging, information management, and evaluation). The results indicated that comprehensive knowledge was linked to daily functioning in adults with ADHD however, it was not associated with the processes that regulate. The predictors of metacognition had moderate predictive power which suggests they could be the cause of significant variance in daily functioning of adults 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. A case series has proven the effectiveness of MCT in reducing anxiety, but it's still relatively in its infancy and more research is required to determine its effectiveness for other disorders.
This study was designed for evaluating the effectiveness of MCT to alleviate symptoms of anxiety disorder. However it is also able to treat a variety disorders and is more effective than other therapy. It is important to keep it in mind that this isn't an effective treatment for ADHD but it could be used as an alternative therapy.
Family Therapy
In family therapy, the Therapist works with the entire family. This helps all family members understand the client's problems and to understand how to help their loved ones better. It also assists them in finding ways to cope with their own feelings of frustration and improve their communication skills. This kind of counseling can be utilized to treat comorbid conditions, such as substance abuse and depression, which are often seen as a result of ADHD.
The therapist will begin with an intake session in order to better understand the family's perception and determine if they are appropriate for family intervention. It can be done either in person or online. The therapist will explain to each participant the nature of treatment as well as the rules for family therapy.
A therapist with experience treating adults with ADHD will ask a lot of questions to gain an insight into the client's current symptoms, their past and their impact on their work, family life and relationships. They will also inquire whether there are other mental health issues that are present, such as anxiety or depression.
Cognitive behavioral therapy (CBT) is an organized form of counseling that teaches you how to change your negative thinking patterns and manage your behavior. It focuses on improving self-esteem and self-control by educating you on how to manage anger and stress. It is a treatment option for short-term use that can be used in conjunction with other types of psychotherapy.
Individual talk therapy can help people suffering from ADHD overcome emotional baggage from longstanding patterns of failure, underachievement academic issues, frequent job changes and conflict in relationships. It can help you develop strategies for managing stress and coping and teach you how to manage your time and finances more efficiently. It can also be used to address the comorbidities, like mood and anxiety disorders, that are often associated with ADHD.