Adult ADHD and Comorbid Disorders
Many people suffering from ADHD suffer from comorbid disorders, like major depression (Kessler and colleagues, 2006). Many depressed patients do not respond well to medication and could benefit from therapy.
Neurotransmitters are brain chemicals that regulate and increase levels of certain brain chemicals. The most frequently prescribed stimulants include amphetamine, methylphenidate, and similar medications.
Medications
A variety of medications used to treat ADHD in children can be used in adults. However the dosages are different and the medications can cause side effects that are not typical of children. A doctor will take into consideration the individual's medical history, family history, and other health issues to determine which medication is the best for them.
The most commonly used ADHD medication is a stimulant. It works by altering the levels of norepinephrine and dopamine in the brain. Stimulants like methylphenidate (also known as Adderall) and dextroamphetamine enhance the supply of neurotransmitters that help improve focus, reduce impulsivity, and decrease aggression. They come in many forms, including chewable tablets, liquids, and skin patches. Long-acting versions of these stimulants are preferred because they lead to better patient compliance and longer lasting, smoother improvement in symptoms.
It is crucial to keep in mind that co-existing conditions like anxiety and depression can alter the effectiveness of ADHD medications. Therefore, it is recommended that these psychiatric issues be treated first, with medication be used as a second measure. The drugs that can be used for comorbidity disorders include atomoxetine (Bupropion) tricyclic antidepressants, and bupropion (Wilens, 2004).
Certain patients may experience some patients may experience a "rebound" effect, where they experience a worsening of ADHD symptoms after discontinuing stimulant medications. In these cases a short trial of a low dosage of stimulant medication can be helpful.
Some people cannot tolerate stimulant medicines or are not able to take them due to drug abuse or other health issues, like heart issues that are severe or hypertension. In these cases, nonstimulant medications like atomoxetine (Strattera) and viloxazine (Qelbree) can be effective. These drugs don't have the same adverse effects as stimulants and are less likely to be abused or diverted.
Psychotherapy
Psychotherapy (talk therapy) can be beneficial for those with ADHD. It can help people who suffer from ADHD learn to improve their lives, deal with stress and anxiety, manage conflicts, or manage problems at work or in relationships. It can also aid in the treatment of those suffering from mental illness that are co-existing, like addiction and depression disorders.
Talk therapies include cognitive behavior therapy (CBT), mind-body cognitive therapy and schema therapy. These treatments are based on the idea that thoughts and beliefs can affect how a person feels, thinks and acts. CBT helps individuals identify negative patterns of behavior and thoughts and then develop and implement positive strategies to change these. Meditation techniques are used in mindfulness-based cognitive therapy to help someone focus on their thoughts and emotions, control impulses, and improve executive functioning. Schema therapy, as well as other forms of psychotherapy focused on a person's family history may be useful for people with ADHD who suffer from significant secondary problems.
In addition to medicines, psychotherapy can help address the particular issues caused by ADHD like difficulty getting through schoolwork, resolving conflict and getting together with others, losing important dates or responsibilities and making impulsive choices that can lead to legal or financial problems. It can also help individuals to address and resolve issues that may cause ADHD symptoms, such as depression or anxiety.
Psychotherapy can help people discover healthy strategies for coping and decrease stress. For example, exercise, sleep improvement, and healthy eating habits. It can also provide 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 type of psychotherapy which focuses on changing the client's 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 aim of this therapy is to correct the limitations and implement coping strategies that are compatible with the client's daily life.
In addition to teaching clients to recognize harmful thoughts, those who specialize in adult ADHD CBT help them develop abilities that enable clients to replace their negative thoughts with more productive ones. This process can take time. However, it is a viable option for adults who aren't getting enough relief from medications.
A recent RCT study concluded that when paired with medication, CBT is superior to cognitive behavioral therapy alone in reducing the severity of the emotional symptoms, core symptoms as well as self-esteem and social functioning of adults with ADHD (Clarke and co., 2017). CBT coupled with methylphenidate could be particularly effective for people with more serious underlying issues.
The therapists that provide this treatment usually collaborate with the client to devise a detailed action plan for solving their issues. They train them in a series of practical skills which are simple to master and have a high chance of success. A chart system is often utilized to track the progress of a child and reward positive behaviour. For a child, this might be a daily journal which outlines the school tasks or positive behaviors they need to accomplish and a method of monitoring and gaining rewards. The therapists could consider introducing negative consequences when children fail to complete their tasks. This can be done in a very sensitive and supportive manner.
Metacognitive Therapy
A newer form of therapy, metacognitive therapy helps individuals change how they think. This kind of therapy can be beneficial for people who suffer from a range of mental health problems, such as depression. I Am Psychiatry 's a kind of cognitive behavioral therapy that assists people to identify their negative thoughts and how they affect their moods. This kind of therapy can assist them in acquiring psychological tools that are able and useful.
This study was designed to investigate the relationship between metacognitive capabilities and daily functioning among adults with ADHD. To accomplish this we evaluated the self- and informant-rated impairments in daily functioning with indicators of metacognition (comprehensive knowledge, regulation of cognition debugging, management of information, and evaluation). The results showed that comprehensive knowledge was associated with daily functioning in adults with ADHD, but not the processes that regulate. The predictors of metacognition had moderate predictive power, which suggests they could explain an important amount of variance in daily functioning of adults with ADHD.
Metacognitive Therapy (MCT) is an treatment which focuses on reversing metacognitive beliefs that cause dysfunction and perpetuate states like worry, rumination, or attention fixation. MCT was created by Adrian Wells based on an information processing model by Wells and Gerald Matthews. A case series has proven the effectiveness of MCT in managing illness anxiety, 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 assess the effectiveness of MCT in decreasing symptoms of anxiety disorder, however it can be applied to a range of disorders, and may be more effective than other therapies. It is not a cure, but it could be utilized to treat ADHD.
Family Therapy
In family therapy, therapists work with all members of the family. This helps all family members understand the client's problems and to understand how to help their loved one better. It also assists them in dealing with their frustrations and build better communication skills. This type of counseling can be utilized to treat comorbid conditions, such as addiction and depression that are commonly associated as part of ADHD.
The therapist will begin with an intake session to gain a better understanding of the family's perspective and determine if they're appropriate for family intervention. The session can be conducted in person or online. The therapist will discuss the nature of the therapy with each individual and set out the rules and guidelines of family therapy.
A therapist with worked with adults suffering from ADHD asks a lot questions to gain an understanding of the current symptoms as well as their past and the impact they've had on their family, work and relationships. They will also ask if there are any other mental health issues present, such as depression or anxiety.
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 teaching you how to cope with stress and anger. It is a short-term treatment option that can be used in conjunction with other forms of psychotherapy.
Individual therapy helps those with ADHD to overcome the emotional baggage that comes from failing and underachievement. It can also assist them in dealing problems with relationships, job changes, and academic difficulties. It can help you learn ways to reduce stress and cope and also how to better manage your finances and time. It can also be used to address comorbid conditions, such as anxiety and mood disorders which are often associated with ADHD.