Adult ADHD and Comorbid Disorders
Many adults with ADHD also have comorbid disorders, such as major depressive disorder (Kessler and colleagues 2006). Many patients who are depressed aren't able to take medications and may benefit from therapy.
The most effective medications to treat the symptoms of ADHD seem to boost and balance levels of certain brain chemicals called neurotransmitters. Commonly prescribed stimulants include amphetamine, methylphenidate, and similar medications.
Medicines
Adults can use many medications that are used for ADHD in children. However, the dosages are different and the drugs can cause side effects that are not present in children. The doctor will examine the medical history, family health history, and other medical conditions of an individual to determine which medicine is best.
The most well-known ADHD medication is a stimulant. It works by altering the levels of norepinephrine and dopamine in the brain. Stimulants such as methylphenidate (also known as Adderall), and dextroamphetamine increase the availability of neurotransmitters that help improve focus, reduce impulsivity and decrease aggression. 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, and an easier, longer-lasting improvement of symptoms.
It is important to remember that co-existing conditions like anxiety and depression may alter the effectiveness of ADHD medication. Therefore, it is recommended that these psychiatric problems be treated first, with medications be used as a secondary measure. Some medications that are used to treat comorbid psychiatric disorders include atomoxetine, bupropion and tricyclic antidepressants (Wilens 2004).
Some patients may experience some patients may experience a "rebound" effect, where they experience a worsening of ADHD symptoms after stopping stimulant medications. In these cases it is possible to try a short-term trial of a low-dose stimulant medication may be helpful.
Certain people are not able to tolerate stimulant medication or cannot use it due to drug misuse or other health issues such as severe hypertension or heart problems. In these cases, non-stimulant medications such as atomoxetine and viloxazine can be effective. These medications do not cause the same amount of adverse effects as stimulants, and are less risk of abuse and diversion.
Psychotherapy
Psychotherapy (talk therapy) is a great option for people with ADHD. It can help people with ADHD to improve their lives, deal with anxiety and stress, resolve conflicts, or manage issues at work or in relationships. It can also help with co-existing mental illnesses such as depression and substance abuse disorders.
Talk therapies include cognitive behavior therapy (CBT) as well as mind-body cognitive therapy and schema therapy. These therapies are based upon the notion that beliefs and thoughts can affect how a person behaves, thinks and feels. CBT assists a person to identify negative behaviors and thinking patterns, and then develops and implements positive strategies to change them. Meditation techniques are employed in mindfulness-based cognitive therapy to help people focus on their emotions and thoughts as well as control their impulses and improve executive functioning. Schema therapy, along with other forms of psychotherapy that concentrate on a person’s family history, may be helpful for those suffering from ADHD.
Psychotherapy, along with medication, can assist with specific ADHD issues, such as difficulty keeping up with schoolwork or interacting with other people. It can also assist in avoiding important dates and responsibilities and making impulsive choices that could lead to legal and financial issues. It can help a person overcome underlying issues such as depression and anxiety that may be contributing to their ADHD symptoms.
Psychotherapy can help a person find healthy coping skills and reduce stress, for example exercising, improving sleep and healthy eating habits. It can also offer support to a family or partner member who may be dealing with the effects of ADHD on their relationship. Marriage and family therapy helps couples and families learn how to communicate better and manage ADHD symptoms together.
Cognitive Behavioral Therapy
CBT is a kind of psychotherapy that focuses on transforming the negative patterns of thinking that clients have. It uses skill-based dialogue with an experienced mental health professional (a therapist) to address the root causes of their symptoms. The goal of this treatment is to correct limitations and implement strategies for coping that align with the person's everyday life.
In addition to teaching clients to recognize unhelpful thoughts, those who specialize in adult ADHD CBT help them develop 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 are unable to feel enough relief from their medication.
In a recent RCT that was conducted, it was discovered that cognitive behavior therapy in combination with medication is superior to cognitive behavior therapy alone in terms of improving the core symptoms, emotional symptoms, self-esteem, and social functioning in adults suffering from ADHD (Clarke and co. 2017). The combination of CBT and methylphenidate is especially effective for those who have more severe underlying problems.
Therapists who provide this kind of treatment work with clients to devise an action plan to address their specific issues. They typically teach them the fundamentals of therapy that are easy to apply and have a high chance of being successful. A chart system is often used to monitor progress, and reward positive behaviors. This could be an everyday report for children that lists the tasks they have to complete in school or the positive behaviors that need to be exhibited, and an approach to tracking and rewarding rewards. The therapists could also consider introducing negative consequences when a child does not finish their tasks. This can be done in a very sensitive and supportive manner.
Metacognitive Therapy
A more recent form of therapy, metacognitive therapy, assists individuals in changing how they think. This kind of therapy is effective for those who suffer from a variety of mental health issues, including depression. It is a type of cognitive behavioral therapy that helps people learn to recognize negative thought patterns and their impact on their emotions. This type of therapy helps them develop mental tools that are versatile and useful.
The goal of this study was to examine the relationship between metacognitive abilities and daily functioning in adults with ADHD. To accomplish this we compared self and informant-rated daily functioning impairments with predictors of Metacognition (comprehensive Knowledge, Regulation of Cognition, Debugging Information Management, and Evaluation). It was observed that comprehensive knowledge was related to daily functioning in adults with ADHD however, the regulatory processes were not. The predictive ability of a model incorporating metacognition predictors was moderate, indicating that they can explain an important portion of the variation in daily functioning for people with ADHD.
Metacognitive Therapy (MCT) is an intervention that focuses on changing metacognitive beliefs that are dysfunctional and perpetuate states such as worry, rumination, or attention fixation. Adrian Wells developed MCT based on the model of information processing by Wells and Gerald Matthews. Iam Psychiatry has been shown to be effective in treating anxiety disorders. However, it is still an emerging treatment and more research is needed to determine whether it can help with other disorders.
This study was conceived to evaluate the efficacy of MCT to alleviate symptoms of illness anxiety disorder. However, it can be used to treat a variety disorders and is more effective than any other therapy. It is important to keep in mind that this is not an effective treatment for ADHD however it can be utilized as an adjunctive therapy.
Family Therapy
In family therapy, the therapist collaborates with all family members. Everyone is able to better understand the client's issues and learn how to help their loved ones. It also assists them in finding ways to deal with their own anxieties and improve their communication skills. This type of counseling can also be used to address other comorbidities, such as substance abuse and depression that are commonly associated as part of ADHD.
The therapist will start with an intake session in order to gain an understanding of the family's perception of the issue and determine their potential for intervention by the family. This can be conducted in person or online. The counselor will explain to each participant the purpose of therapy and the rules and regulations for family therapy.
A therapist with experience treating adults with ADHD asks a lot questions to gain insight into the current symptoms as well as their history and the impact that they have on their family, work and personal relationships. They will also ask whether there are other mental health issues that are present, such as depression or anxiety.
Cognitive behavioral therapy (CBT) is a structured form of counseling that helps you change your negative thinking patterns and manage your behavior. It concentrates on improving self-esteem and self-control by teaching methods to deal with stress and anger. It is a short-term treatment that can be paired with other types of psychotherapy.
Individual therapy can help people with ADHD deal with emotional trauma from a long-running pattern of underachievement, failure academic issues, frequent job changes and conflicts in relationships. It can help you learn coping and stress reduction techniques and help you manage your time and money more efficiently. It can also address the comorbidity of disorders like depression and anxiety, which are often seen as a result of ADHD.