Adult ADHD and Comorbid Disorders
Many adults suffering from ADHD also have comorbid disorders, such as major depression (Kessler and colleagues, 2006). Many patients are not responsive to medications for depression and may be able to benefit from psychotherapy.
Treatments that are most effective in reducing the most fundamental symptoms of ADHD seem to boost and balance levels of certain brain chemicals called neurotransmitters. Drugs that stimulate the brain such as methylphenidate or amphetamine are often prescribed.
Medicines
Adults can use many medications to treat ADHD in children. The dosages and side effects can be different. A doctor will look at the individual's medical history, family history and other health issues to determine which medication is most suitable for him or her.
The most popular type of ADHD medication is a stimulant. It works by adjusting levels of two chemical messengers in the brain called norepinephrine and dopamine. The stimulants methylphenidate and dextroamphetamine (commonly called Adderall) increase the amount of these neurotransmitters, which help improve focus and reduce aggression and impulsivity. They come in various forms such as chewable tablets, liquids, and skin patches. Long-acting versions of these stimulants are preferable because they provide greater patient compliance and a longer lasting, smoother improvement in symptoms.
It is crucial to keep in mind that comorbid conditions such as depression and anxiety disorders can affect the response to ADHD medications. It is therefore recommended that these psychiatric problems be treated first before medication be used as a second measure. Some medications that are used to treat comorbid psychiatric disorders include atomoxetine and bupropion and tricyclic antidepressants (Wilens 2004).
Some patients may experience an "rebound" effect, where they experience an increase in ADHD symptoms after discontinuing stimulant medication. In these instances, a brief trial of a low dose of stimulant medication can be helpful.
Certain people are not able to tolerate stimulant medication or cannot take it because of addiction to drugs or other health issues such as heart or hypertension problems that are severe. In these situations, non-stimulant medication such as atomoxetine (Strattera) and viloxazine (Qelbree) can be effective. These drugs do not have the same level of side effects as stimulants and carry a a lower risk for misuse and diversion.
Psychotherapy
People with ADHD can benefit from psychotherapy (talk therapy). It can help those with ADHD to improve their lives, deal with stress and anxiety, resolve conflicts, or manage problems in their relationships or at work. It can also aid in the treatment of those suffering from mental illness that are co-existing, like addiction and depression disorders.
Talk therapies include cognitive behavioral therapy (CBT) as well as mindfulness-based cognitive therapy and schema therapy. These therapies are based upon the notion that thoughts and beliefs influence how a person is feeling, thinks and behaves. CBT helps a person identify negative behaviors and thinking patterns, and then develops 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 types of psychotherapy focused on the family history of a person may be useful for people with ADHD who suffer from significant secondary issues.
Psychotherapy, in addition to medication, can help with specific ADHD issues, such as difficulties with schoolwork or interacting with other people. It can also help with forgetting important dates and obligations and making decisions that are impulsive and could lead to legal and financial issues. It can also assist people to identify and resolve issues that contribute to their ADHD symptoms, such as anxiety or depression.
Psychotherapy can assist a person find healthy coping skills and reduce stress through exercise, sleep improvement and healthy eating habits. It can also offer support to the family member or spouse who is struggling with the effects ADHD has 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 is a form of psychotherapy which focuses on changing the client's negative thinking patterns. treat adhd in adults involves a skill-based dialog with a mental health professional to address the underlying causes of the symptoms. The aim of this treatment is to overcome limitations and implement strategies for coping that fit with the client's daily life.
Therapists who specialize in adult ADHD-CBT teach clients to recognize unhelpful thoughts and help them learn to replace them with more productive thoughts. This process can take time. However, it's a good option for adults who do not receive enough relief from medication.
A recent RCT study concluded that when combined with medication, CBT is superior to cognitive behavioral therapy on its own in improving core symptoms, emotional symptoms, self-esteem and social functioning of adults with ADHD (Clarke and colleagues. 2017). CBT combined with methylphenidate can be particularly effective for those who suffer from more severe underlying problems.
The therapists who offer this type of treatment typically work with the client to devise an action plan that is specific to solving their issues. They teach them a set of practical skills that are easy to learn and have a good chance of success. Charts are typically utilized to track progress and reward positive behaviors. In the case of children, this could be a daily journal that lists all the school activities or positive behaviors they need to accomplish and a method of recording and earning rewards. Therapists may also discuss the possibility that negative consequences might be imposed if a child does not complete their task. This can be done with sensitivity and encouragement.
Metacognitive Therapy
A newer form of therapy, metacognitive therapy, assists individuals in changing how they think. This kind of therapy can be beneficial to those who suffer from a variety mental health problems like depression. It is a form of cognitive behavioral therapy which helps people recognize negative thoughts and their effects on their emotions. This type of therapy can also help them acquire psychological tools that are adaptable and beneficial.
The aim of this study was to examine the relationship between metacognitive capabilities and daily functioning in adults suffering from ADHD. To this end we compared the self- and informant-rated impairments in daily functioning to indicators of metacognition (comprehensive knowledge and cognition regulation debugging, management of information, and evaluation). The results showed that comprehensive knowledge was linked to daily functioning in adults with ADHD however, it was not associated with the processes that regulate. Metacognition predictors had moderate predictive power which suggests that they could explain a significant amount of variation in the daily functioning of people with ADHD.
Metacognitive therapy (MCT) is a psychotherapy that focuses on changing dysfunctional metacognitive beliefs that perpetuate states of worry and rumination, as well as attention fixation. MCT was developed by Adrian Wells based on an information processing model by Wells and Gerald Matthews. MCT has been proven to be effective in treating illness anxiety disorder. However, it is still an emerging treatment, and further research will be needed to determine whether it can help with other disorders.
The purpose of this study was to assess the effectiveness of MCT in reducing symptoms of illness anxiety disorder, however it can be applied to a variety of disorders and may even be more effective than other therapies. This is not an effective treatment, but it can be employed to treat ADHD.
Family Therapy
In family therapy, the therapist works with the whole family. This allows everyone to understand the client's problems and to understand how to help their loved ones better. It also helps them cope with their frustrations and develop more effective communication skills. This type of counseling could also be used to address comorbid conditions, such as addiction and depression that are commonly associated as a result of ADHD.
The therapist will start with an intake session to better understand the family's perception and determine if they're appropriate for family intervention. This can be conducted either in person or online. The therapist will explain to each person the purpose of therapy and the do's & don'ts for family therapy.
A therapist who has experience in treating adults suffering from ADHD will ask lots of questions in order to gain understanding of the client's present symptoms, their history and their impact on their work life and family life as well as relationships. They will also inquire whether there are other mental health issues that are present like depression or anxiety.
Cognitive behavioral therapy is a structured type of counseling that teaches you how to manage your behavior and change negative patterns of thinking into positive ones. It focuses on boosting self-esteem and self control by teaching you how to cope with anger and stress. This is a temporary option that can be utilized alongside other types of psychotherapy.
Individual talk therapy can help people suffering from ADHD deal with emotional trauma from a long-running pattern of underachievement and failure, academic difficulties as well as frequent job changes and conflicts in relationships. It can help you learn strategies for managing stress and coping and help you manage your time and money more effectively. It can also help with the comorbidity of disorders like anxiety and mood disorders, which are often seen with ADHD.