Adult ADHD and Comorbid Disorders
Many adults with ADHD have comorbid conditions like 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.
Neurotransmitters are brain chemicals that regulate and boost levels of certain brain chemicals. The most frequently prescribed stimulants include amphetamine, methylphenidate, and similar medications.
Medications
Adults are able to take many different drugs that are prescribed for ADHD in children. The dosages and the side effects are different. The doctor will take a look at the medical history, family health history and other factors of the individual to determine which medicine is the best for them.
The most common type of ADHD medication is stimulant and is used to regulate levels of two chemical messengers in the brain called norepinephrine and dopamine. The stimulants methylphenidate and dextroamphetamine (commonly called Adderall) boost the supply of these neurotransmitters. They help improve focus and reduce aggression and impulsivity. These stimulants are available in different forms, including skin patches, liquids, and chewable tablets. These long-acting stimulants are favored due to their improved patient compliance, as well as an easier, longer-lasting improvement of symptoms.
It is important to remember that co-occurring disorders like depression or anxiety disorders can influence the response to ADHD medication. It is therefore recommended that these psychiatric problems be treated first, and medication used as secondary measure. The medications that can be used to treat comorbid disorders of mood are atomoxetine (Bupropion), tricyclic antidepressants and bupropion (Wilens 2004).).
Certain patients may experience some patients may experience a "rebound" effect where they experience an increase in ADHD symptoms after stopping stimulant medications. In these instances, a short trial of a lower dose of stimulant medication could be beneficial.
Certain people are not able to take stimulant medication or take it due to addiction to drugs or other health conditions such as severe hypertension or heart problems. In these cases, nonstimulant medications like atomoxetine (Strattera) and viloxazine (Qelbree) can be effective. These medications do not cause the same high rates of adverse effects as stimulants, and are a lower risk for misuse and diversion.
Psychotherapy
People suffering from ADHD can benefit from psychotherapy (talk therapy). It can help people who suffer from ADHD learn to improve their lives, deal with stress and anxiety, resolve conflicts, or manage problems in their relationships or at work. It can also help with co-occurring mental illnesses such as depression and substance use disorders.
Talk therapies include cognitive behavior therapy (CBT) and mind-body cognitive therapy and schema therapy. These therapies are based upon the idea that beliefs and thoughts can influence how someone behaves, thinks and feels. CBT helps an individual identify negative patterns of behavior and thoughts and then develop and implement strategies to change these. Mindfulness-based cognitive therapy utilizes meditation techniques to help a person learn to focus on their thoughts and emotions, control impulses, and improve their executive functioning. Schema therapy, as well as other forms of psychotherapy that focus on a person's history with their family could be beneficial for those who suffer from ADHD with significant secondary issues.
Psychotherapy, in addition to medication, can help with specific ADHD issues, like difficulty keeping up with schoolwork or interacting with others. It can also help in avoiding important dates and obligations and making impulsive decisions that can lead to financial and legal problems. It can help a person overcome issues of the underlying nature, such as depression and anxiety that may contribute to their ADHD symptoms.
Psychotherapy can help people discover healthy coping techniques and reduce stress. For instance exercise, sleep improvement, and healthy eating habits. It can also provide support to an individual in the family or with a spouse who is struggling with the effects ADHD can have on their relationship. Marriage and family therapy can help families and couples communicate better and understand how to manage ADHD symptoms together.
Cognitive Behavioral Therapy
CBT is a form of psychotherapy which focuses on helping clients overcome their negative thinking patterns. It uses skill-based dialogue with a trained mental health professional (a therapist) to address the underlying causes of their symptoms. The goal of this treatment is to overcome the limitations and implement coping strategies that align with the client's daily life.
Therapists who specialize in adult ADHD-CBT show clients how to identify unhelpful thinking patterns and assist them to build the skills to replace them with more productive thoughts. This process can be lengthy. It's a possibility for adults who do not feel enough relief from their medications.
In a recent RCT, it was found that cognitive behavior therapy in combination with medication is superior to cognitive behavior therapy alone when it comes to improving the core symptoms, emotional symptoms, self-esteem and social functioning for adults with ADHD (Clarke and colleagues. 2017). CBT combined with methylphenidate can be particularly effective for people with more severe underlying problems.
The therapists who offer this type of treatment typically work with the client to devise an action plan specific to solving their issues. They usually teach clients a series of practical skills that are simple to implement and have a high chance of being successful. Often a chart system is utilized to track the progress of a child and reward positive behavior. adults adhd treatment could include an everyday report for a child that outlines the tasks they are required to finish at school or the positive behavior that must be demonstrated, and an approach to recording and rewarding. The therapists may also consider introducing negative consequences when the child fails to complete their work. This can be done with care and support.
Metacognitive Therapy
Metacognitive therapy is an innovative kind of psychotherapy that helps people to change their thinking. This kind of therapy is effective for those suffering from a range of mental health issues which include depression. It is a form of cognitive behavioral therapy that helps people learn to recognize negative thinking patterns and their effects on their moods. This kind of therapy can also help them acquire psychological tools that are able and beneficial.
The goal of this study was to examine 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 predictors of Metacognition (comprehensive Knowledge, Regulation of Cognition, Debugging, Information Management, and Evaluation). The results showed that complete knowledge was associated with daily functioning in adults with ADHD but not with the processes that regulate. The predictive power of a model with metacognition predictors was moderate, which suggests that they can account for an important portion of the variation in daily functioning for adults with ADHD.
Metacognitive Therapy (MCT) is an intervention which focuses on reversing metacognitive beliefs that are dysfunctional and perpetuate states such as worry, rumination and attention fixation. MCT was created by Adrian Wells based on an information processing model created by Wells and Gerald Matthews. One case series has demonstrated the effectiveness of MCT in managing illness anxiety disorder, but it's still relatively in its infancy and more research is required to determine its effectiveness for other disorders.
This study was created to determine the efficacy of MCT in the reduction of symptoms of illness anxiety disorder, however it can be applied to a range of disorders and could be more effective than other treatments. It is important to keep in mind that this is not a cure for ADHD but it could be utilized as an alternative therapy.
Family Therapy
In family therapy the therapist works with the whole family. This allows all members to learn about the client's issues and to understand how to help their loved one better. It also helps them deal with their frustrations and build more effective communication skills. This type of counseling can be utilized to treat the underlying conditions, like substance abuse and depression, which are often seen as part of ADHD.
The therapist will commence with an intake session to get a better understanding of the family's perspective of the problem and evaluate their suitability for family intervention. This can be done in person or via the internet. The therapist will explain to each participant the nature of treatment and the rules and regulations for family therapy.
A therapist with experience in treating adults with ADHD will ask a lot of questions to gain an understanding of the client's current symptoms, their past and their impact on their work, family life and relationships. They will also inquire if any other mental 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 concentrates on improving your self-esteem and self-control by teaching you strategies to manage anger and stress. It is a treatment option for short-term use that can be paired with other forms of psychotherapy.
Individual talk therapy can help those with ADHD overcome emotional baggage from longstanding patterns of underachievement and failure academic issues, frequent job changes and relationship conflict. It can teach stress reduction and coping techniques as well as how to manage your finances and time. It can also address comorbid disorders such as depression and anxiety, which are often seen with ADHD.