Adult ADHD and Comorbid Disorders
Many adults with ADHD also have comorbid disorders, such as major depression (Kessler and colleagues, 2006). Many patients who are depressed are not able to respond well to medication and may get better results from therapy.
Medications that most effectively improve the symptoms of ADHD appear to increase and regulate levels of certain brain chemicals called neurotransmitters. The most commonly prescribed stimulants are amphetamine, methylphenidate and similar medications.
Medicines
A variety of medications used to treat ADHD in children can be used on adults. The dosages and the side effects are different. A doctor will take into consideration the medical history of the patient, family history and other health issues to determine what medication is best for him or her.
The most commonly used kind of ADHD medication is a stimulant. It works by adjusting levels of two chemical messengers in the brain, norepinephrine as well as dopamine. Stimulants such as methylphenidate or dextro-amphe (commonly called Adderall) increase the availability of these neurotransmitters, which help improve focus and reduce aggression and impulsivity. These stimulants are available in different forms, such as liquids, skin patches and chewable tablets. Long-acting versions of these stimulants are preferred because they provide greater patient compliance and a longer lasting and smoother improvement in symptoms.
It is crucial to remember that co-occurring disorders like depression or anxiety disorders can affect the response to ADHD medication. Therefore, it is recommended that these psychiatric issues be treated first, and then medication utilized as a secondary measure. The drugs that can be used for comorbid mood disorders are atomoxetine (Bupropion) tricyclic antidepressants as well as bupropion (Wilens 2004).
Certain patients might experience a "rebound effect" in which their ADHD symptoms become 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 cannot tolerate stimulant medications or are in a position to not take them due to addiction or other health conditions, for example, heart problems that are severe or hypertension. In these cases, non-stimulant drugs like atomoxetine or viloxazine are effective. These drugs do not have the same level of side effects as stimulants, and are a lower risk for misuse and diversion.
Psychotherapy
Psychotherapy (talk therapy) can be helpful for people with ADHD. It can help them learn strategies to improve their lives manage anxiety and stress, resolve conflicts, and deal with problems in relationships or at work. It can also assist with co-existing mental disorders like depression and addiction disorders.
Talk therapies include cognitive behavior therapy (CBT), mind-body cognitive therapy and schema therapy. These therapies are based on the notion that thoughts and beliefs influence how a person feels, thinks and acts. CBT assists individuals in identifying negative behaviors and thought patterns and then formulate and implement positive strategies to change them. Mindfulness-based cognitive therapy uses techniques of meditation to teach people how to concentrate on their thoughts and emotions, manage their impulses and improve their executive functioning. Schema therapy, along with other forms of psychotherapy that focus on a person’s family history could be beneficial for those suffering from ADHD.
In addition to medication psychotherapy can assist in addressing the particular issues caused by ADHD problems, like having trouble staying on track with schoolwork, resolving conflicts, getting together with others, losing important dates or responsibilities and making impulsive choices that result in legal or financial issues. It can also help individuals to address and overcome underlying issues that could contribute to their ADHD symptoms, like anxiety or depression.
Psychotherapy can assist a person develop healthy coping strategies and reduce stress, for example exercises, sleep improvement and healthy eating habits. It can also provide support to a spouse or family member who may be dealing with the effects of ADHD on their relationship. Family therapy and marriage counseling can help families and couples learn to communicate better and manage ADHD symptoms together.
Cognitive Behavioral Therapy (CBT)
CBT is a kind of psychotherapy which focuses on helping clients to change their negative patterns of thinking. It involves a skill-based dialog with a mental health professional to identify the root causes of the symptoms. This treatment aims to assist clients overcome their impairments and develop coping skills that are in line with their everyday lives.
In addition to teaching clients how to identify unhelpful thoughts, those who specialize in adult ADHD CBT aid them in developing abilities that enable them to replace unhelpful thinking with more productive ones. This process can take a while. However, it is a viable option for adults who aren't getting enough relief from medication.
In a recent RCT that was conducted, it was discovered that cognitive behavioral therapy paired with medication is superior to cognitive behavior therapy on its own in terms of improving the core symptoms, emotional symptom, self-esteem, and social performance in adults with ADHD (Clarke, et al. 2017). The combination of CBT and methylphenidate is particularly beneficial for those suffering from more severe underlying issues.
The therapists that provide this treatment usually work with the client to develop a detailed action plan for addressing their problems. They train them in a series of practical skills that are easy to learn and have a high probability of success. Charts are typically used to monitor progress, and to reward positive behavior. This could include an everyday report for a child that outlines the tasks they have to finish at school or the positive behaviors that need to be demonstrated, and an organized system for recording and rewarding. Therapists can also talk about the possibility that negative consequences could be inflicted upon a child who does not complete their task. This can be done in a sensitive and calming manner.
Metacognitive Therapy
Metacognitive therapy is a newer type of psychotherapy that assists people to change their thinking. This type of therapy can be beneficial to those who suffer from various mental health issues, such as depression. It is a form of cognitive behavioral therapy that helps people learn to recognize negative thinking patterns and their impact on their emotions. This kind of therapy can help them develop psychological tools that are adaptable and beneficial.
The aim of this study was to explore the relationship between metacognitive abilities and daily functioning in adults with ADHD. To do this we compared self- and informant-rated impairments in daily functioning with predictors of Metacognition (comprehensive Knowledge, Regulation of Cognition, Debugging, Information Management and Evaluation). It was found that comprehensive knowledge was related to daily functioning in adults with ADHD however, the regulatory processes were not. Metacognition predictors 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 dysfunctional metacognitive belief patterns that perpetuate mental states such as worry, rumination and attention fixation. MCT was created by Adrian Wells based on an information processing model developed by Wells and Gerald Matthews. MCT has been proven to be effective in treating anxiety disorders. However, it is still a relatively new treatment, and further research is required to determine if it could help with other disorders.
adhd untreated in adults of this study was to determine the efficacy of MCT in reducing symptoms of illness anxiety disorder, however it can be applied to a variety of disorders, and may be more effective than other therapies. It's important to keep in mind that this isn't an effective treatment for ADHD but it could be utilized as an alternative therapy.
Family Therapy
In family therapy the Therapist works with the entire family. This allows everyone to learn about the client's issues and learn how to support their loved ones better. It also helps them cope with their anger and develop more effective communication skills. This kind of counseling can be utilized to treat the underlying conditions, like substance abuse and depression which are frequently associated with ADHD.
The therapist will start with an intake session in order to better understand the family's views and determine if they're appropriate for family intervention. The session can be conducted in person or via the internet. The therapist will explain to each participant the nature of treatment and the do's & don'ts for family therapy.
A therapist who has experience in treating adults with 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 as well as their family and social life. They will also inquire if any other mental problems are present, for example anxiety or depression.
Cognitive behavioral therapy (CBT) is an organized form of counseling that helps you change your negative thinking patterns and manage your behavior. It is focused on improving your self esteem and self-control by teaching you techniques to cope with anxiety and stress. This is a temporary option that can be used alongside other types of psychotherapy.
Individual talk therapy can help people with ADHD deal with emotional baggage from longstanding patterns of underachievement and failure, academic difficulties frequent job changes, and conflict in relationships. It can teach strategies for coping with stress and stress reduction, and how to manage your finances and time. It can also be used to address the comorbidities, like mood and anxiety disorders, which are often seen alongside ADHD.