Adult ADHD and Comorbid Disorders
Many adults with ADHD have comorbid disorders such as major depression (Kessler et al 2006). Many sufferers do not respond to depression medications and may be able to benefit from psychotherapy.
Neurotransmitters are brain chemicals that regulate and increase levels of certain brain chemicals. The most commonly prescribed stimulants are amphetamine, methylphenidate, and similar medications.
Medications
Adults can take a variety of drugs that are prescribed for ADHD in children. However the dosages differ and the drugs may cause side effects that are not typical of children. The doctor will look at the medical history, family health history, and other health conditions of the patient to determine which medication is best.
The most commonly used ADHD medication is a stimulant. It works by adjusting the levels of norepinephrine and dopamine in the brain. Stimulants like methylphenidate and dextro-amphetamine (commonly called Adderall) boost the supply of these neurotransmitters. They can improve focus and decrease aggression and impulsivity. These stimulants are available in different forms, such as skin patches, liquids, and chewable tablets. These long-acting stimulants are favored due to their improved patient compliance, as well as a smoother, longer-lasting improvement in symptoms.
It is important to keep in mind that comorbid conditions like anxiety or depression can influence the response to ADHD medication. It is therefore recommended that these psychiatric issues be treated first, and medication used as secondary measure. The drugs that can be used for comorbid mood disorders are atomoxetine (Bupropion), tricyclic antidepressants, and bupropion (Wilens, 2004).).
Certain patients might have some patients may experience a "rebound effect" where their ADHD symptoms get worse after stopping stimulant medications. In these instances an experiment of a short duration with a low-dose stimulant medication may be beneficial.
Certain people are not able to take stimulant drugs or are not able to take them due to abuse of drugs or other health conditions like heart issues that are severe or hypertension. In treating adhd in adults , nonstimulant medication such as atomoxetine (Strattera) and viloxazine (Qelbree) can be effective. These medications do not cause the same high rates of side effects as stimulants, and are a lower risk for abuse and diversion.
Psychotherapy
Psychotherapy (talk therapy) can be helpful for those with ADHD. It can help people with ADHD learn how to improve their lives, deal with anxiety and stress, resolve conflicts, or cope with problems at work or in relationships. It can also assist with co-existing mental illnesses such as depression and addiction disorders.
Talk therapies include cognitive behavioral therapy (CBT) and mindfulness-based cognitive therapy as well as schema therapy. These treatments are based on the notion that a person's beliefs and attitudes affect how they behave, think and feel. CBT helps individuals identify negative behaviors and thought patterns and then formulate and implement positive strategies to change them. Mindfulness-based cognitive therapy utilizes meditation techniques to teach a person how to concentrate on their thoughts and emotions, manage their impulses and improve their executive functioning. Schema therapy, as well as other forms of psychotherapy focused on the family history of a person can be beneficial for those suffering from ADHD with significant secondary issues.
Psychotherapy, in addition to medication, can assist with specific ADHD issues, such as difficulty completing schoolwork or getting along with others. It can also help in avoiding important dates and responsibilities and making decisions that are impulsive and result in legal and financial problems. It can help a person overcome the root issues like depression and anxiety that may contribute to their ADHD symptoms.
Psychotherapy can assist a person develop healthy coping strategies and reduce stress, such as exercising, improving sleep and healthy eating habits. It can also provide assistance to a spouse or family member who is struggling with the effects of ADHD on their relationship. Therapy for families and marriage helps families and couples learn to communicate better and manage ADHD symptoms together.
Cognitive Behavioral Therapy (CBT)
CBT is a form of psychotherapy that is focused on transforming the patterns of negative thinking of the client. It uses skill-based dialogue with a skilled mental health professional (a therapist) to address the underlying causes of their symptoms. This therapy aims to help clients overcome impairments and develop coping skills that are compatible with their daily lives.
In addition to teaching clients how to identify unhelpful thoughts, therapists who specialize in adult ADHD CBT aid them in developing skills that allow clients to replace their negative thoughts with more productive ones. This process can take a while. It is an option for those who cannot feel enough relief from their medication.
A recent RCT study found that when combined with medication, CBT is superior to cognitive behavioral therapy on its own in reducing core symptoms, emotional symptoms, self-esteem and social functioning of adults suffering from ADHD (Clarke and co. 2017). The combination of CBT and methylphenidate is especially effective for those with more severe underlying issues.
The therapists who provide this treatment usually work with the client to create an action plan specific to addressing their problems. They will teach them a set of practical skills which are easy to master and have a high probability of success. A chart system is often used to track progress and to reward positive behavior. For an infant, this could include a daily report which outlines the in-school tasks or positive behavior they have to perform, as well as an approach to monitoring and gaining rewards. Therapists can also talk about the possibility that negative consequences might be inflicted upon a child who isn't able to finish their work. This can be done with care and encouragement.
Metacognitive Therapy
A newer type of therapy, metacognitive therapy assists individuals in changing how they think. This kind of therapy could be beneficial for people who suffer from various mental health problems like depression. It's a form of cognitive behavioral therapy that assists people recognize their negative thinking patterns and how they impact their moods. This type of therapy may also assist in the acquisition of psychological tools that are adaptable and useful.
The purpose of this study was to explore the relationship between metacognitive abilities and daily functioning in adults with ADHD. In order to do this we compared self and informant-rated impairments in daily functioning with the predictors of metacognition (comprehensive Knowledge, Regulation of Cognition, Debugging, Information Management, and Evaluation). The results indicated that comprehensive knowledge was linked to daily functioning among adults with ADHD but not with the processes that regulate. The predictive power of a model with predictors of metacognition was moderate, suggesting that they can account for a significant amount of the variance in daily functioning for adults with ADHD.
Metacognitive Therapy (MCT) is an treatment that focuses on transforming metacognitive beliefs that are dysfunctional and perpetuate states such as worry, rumination, and attention fixation. MCT was developed by Adrian Wells based on an information processing model developed 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 could aid in other disorders.
This study was designed to evaluate the effectiveness of MCT in the reduction of symptoms of illness anxiety disorder, however it can be applied to a range of disorders, and may be more effective than other treatments. It is important to keep in mind that this isn't an effective treatment for ADHD, but it can be utilized as an alternative therapy.
Family Therapy
In family therapy the therapist works with the whole family. Everyone is able to better understand the client's issues and learn to assist their loved ones. It also assists them in finding ways to cope with their own feelings of frustration and develop healthier communication skills. This type of counseling could be used to tackle comorbid conditions, such as depression and substance abuse, which are often seen as part of ADHD.
The therapist will begin with an intake session to gain a better understanding of the family's view of the issue and determine their suitability for family intervention. This can be done in person or online. The Therapist will explain to each participant the nature of treatment and the rules and regulations for family therapy.
A therapist with worked with adults suffering from ADHD asks a lot questions to get a better understanding of their present symptoms as well as their past and the impact they've had on their family, work, and relationships. They will also inquire if any other mental issues are present, like anxiety or depression.
Cognitive behavioral therapy is a type of counseling that teaches you how to manage your behavior and transform negative patterns of thinking to positive ones. It focuses on boosting self-esteem and self-control by educating you on how to manage stress and anger. It is a treatment option for short-term use that can be paired with other forms of psychotherapy.
Individual therapy can help people with ADHD to overcome the emotional baggage that comes from failing and underachievement. It can also assist them in dealing with relationship conflicts or job changes as well as academic challenges. It can help you develop coping and stress reduction techniques and help you manage your time and money more effectively. It can be used to treat comorbid conditions, such as anxiety and mood disorders, that are often associated with ADHD.