Adult ADHD and Comorbid Disorders
Many adults with ADHD also suffer from comorbid conditions like major depressive disorder (Kessler and colleagues, 2006). Many patients do not respond to medications for depression and may benefit from psychotherapy.
Neurotransmitters are brain chemicals that regulate and boost levels of certain brain chemicals. The stimulants methylphenidate and amphetamine are often prescribed.
Medicines
Many medications that are used to treat ADHD in children can also be used on adults. The dosages and the side effects are different. The doctor will examine the medical history, the family health history, and other medical health conditions of the patient to determine which drug is best.
The most commonly used kind of ADHD medication is a stimulant. It adjusts levels of two chemical messengers within the brain, namely norepinephrine and dopamine. The stimulants methylphenidate and dextroamphetamine (commonly called Adderall) boost the supply of these neurotransmitters, which help improve focus and reduce aggression and impulsivity. They are available in a variety of forms, including chewable tablets, liquids, and skin patches. These stimulants that last longer are popular because they improve patient compliance, as well as more consistent, long-lasting improvement in symptoms.
It is crucial to keep in mind that co-existing conditions like anxiety and depression may alter the effectiveness of ADHD medications. It is therefore recommended that psychiatric disorders be treated first, with medication used as secondary measure. Medications that are used to treat comorbid mood disorders include atomoxetine and bupropion and tricyclic antidepressants (Wilens 2004).
Some patients might experience a "rebound effect" where their ADHD symptoms become worse after stopping stimulant medication. In these cases, a short-term trial of a low-dose stimulant medication may prove beneficial.
Some people cannot tolerate stimulant medicines or are not able to take them due to addiction or other health conditions, for example, heart problems that are severe or hypertension. In these cases, non-stimulant medications such as atomoxetine and viloxazine may be beneficial. These medications don't cause the same high rates of adverse effects as stimulants and have lower risks of misuse and diversion.
Psychotherapy
Psychotherapy (talk therapy) can be helpful for people with ADHD. It can help them gain techniques to improve their lives to manage stress and anxiety, resolve conflicts, and deal with issues in relationships or at work. It can also aid in the treatment of co-existing mental disorders such as depression and addiction disorders.
Talk therapies include cognitive behavior therapy (CBT) and mind-body cognitive therapy, and schema therapy. These therapies are based upon the notion that thoughts and beliefs influence how someone behaves, thinks and feels. CBT helps a person identify negative behaviors and thinking patterns, and then formulates and implements strategies to alter these patterns. Mindfulness-based cognitive therapy uses techniques of meditation to teach a person how to focus on their thoughts and emotions, manage their impulses, and improve their executive functioning. Schema therapy, as well as other forms of psychotherapy focused on a person's history with their family could be beneficial for those who suffer from ADHD who have significant secondary issues.
In addition to medications psychotherapy can assist in addressing the particular issues caused by ADHD, such as trouble getting through schoolwork, resolving conflicts, being able to get along with others, ignoring important dates or obligations, and impulsive decisions that result in financial or legal troubles. It can help a person overcome underlying issues such as depression and anxiety that may be contributing to their ADHD symptoms.
Psychotherapy can assist a person develop healthy coping strategies and reduce stress through exercise, 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. 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 helping clients to change their negative thoughts. It utilizes skill-based dialogue with a skilled mental health professional (a therapist) to address the underlying causes of their symptoms. This treatment aims to help clients overcome limitations and develop coping strategies that are compatible with their daily lives.
In addition to educating clients how to identify unhelpful thoughts, therapists who specialize in adult ADHD CBT assist them in developing abilities that enable them to replace unhelpful thinking with more productive ones. This process can take a while. It's a possibility for adults who do not get enough relief from their medication.
A recent RCT study found that when paired with medication, CBT is superior to cognitive behavioral therapy on its own in improving core symptoms, emotional symptoms as well as self-esteem and social functioning in adults with ADHD (Clarke and colleagues. 2017). The combination of CBT and methylphenidate is particularly beneficial for those suffering from more severe underlying issues.
The therapists who provide this treatment usually collaborate with the client to devise an action plan specific to solving their issues. They usually teach clients a set of practical skills that are easy to apply and have a high chance of being successful. Charts are often used to track progress and reward positive behaviors. This could be the daily report of children that details the tasks they must complete at school, or the positive behavior that must be exhibited, and an approach to monitoring and rewarding. The therapists may also consider creating negative consequences if a child does not complete their tasks. This can be done in a very sensitive and calming manner.
Metacognitive Therapy
A more recent form of therapy, metacognitive therapy assists individuals in changing how they think. treatment for add in adults of therapy can be effective for people who suffer from a variety of mental health issues which include depression. It is a type of cognitive behavioral therapy that helps people recognize negative thoughts and their impact on their emotions. This type of therapy can assist them in acquiring psychological tools that are adaptable and beneficial.
The purpose of this study was to explore the relationship between metacognitive abilities and daily functioning in adults with ADHD. To achieve this we evaluated self- and informant-rated deficits in daily functioning to predictors of metacognition (comprehensive knowledge as well as regulation of cognition debugging, management of information, and evaluation). The results showed that complete knowledge was associated with daily functioning among adults suffering from ADHD however, it was not associated with regulatory processes. The predictive effectiveness of a model that includes predictors of metacognition was moderate, suggesting that they could explain an important portion of the variation in daily functioning for people with ADHD.
Metacognitive Therapy (MCT) is an treatment that focuses on changing metacognitive beliefs that cause dysfunction and perpetuate states like worry, rumination and attention fixation. Adrian Wells developed MCT based on a model of information processing created by Wells and Gerald Matthews. MCT has been proven to be effective in treating anxiety disorders. However, it is still an emerging treatment and further research is needed to determine if it could help with other disorders.
This study was designed to evaluate the effectiveness of MCT in decreasing symptoms of anxiety disorder, however it can be applied to a range of disorders and could be more effective than other treatments. This isn't a cure, but can be employed to treat ADHD.
Family Therapy
In family therapy, the therapist works with all members of the family. Everyone can gain a better understanding of the client's issues and learn how they can help their loved ones. It also helps them cope with their frustrations and build better communication skills. This type of counseling can be used to tackle other comorbidities, such as substance abuse and depression that are commonly associated as a result of ADHD.
The therapist will start with an intake session in order to better understand the family's perception and determine whether they are appropriate for family intervention. The session can be conducted in person or online. The therapist will discuss the nature of the treatment with each person and spell out the guidelines and rules of family therapy.
A therapist with experience treating adults with ADHD will ask lots of questions to gain insight into the client's current symptoms, their past and their impact on their work, family life and relationships. They will also ask whether any other mental health problems are present, for example anxiety or depression.
Cognitive behavioral therapy (CBT) is a method of counseling that is structured that teaches you how to change your negative thoughts patterns and control your behavior. It focuses on boosting self-esteem and self-control by educating you on how to manage stress and anger. This is a temporary option that can be used alongside other types of psychotherapy.
Individual therapy helps those with ADHD to deal with the emotional baggage that comes from failure and underachievement. It can also assist them in dealing with conflicts in relationships, job changes, and academic challenges. It can teach you stress reduction and coping techniques and also how to manage your finances and time. It can also address problems that are comorbid, such as depression and anxiety which are frequently associated with ADHD.