Adult ADHD and Comorbid Disorders
Many people suffering from ADHD have comorbid conditions such as major depression (Kessler and co., 2006). Many depressed patients are not able to respond well to medication and may be able to benefit from therapy.
Medications that most effectively improve core symptoms of ADHD seem to boost and regulate levels of certain neurotransmitters in the brain. Stimulants such as methylphenidate and amphetamine are frequently prescribed.
Medicines
Adults can use many medications that are used for ADHD in children. However, the dosages are different and the drugs may cause adverse effects that aren't typical of children. A doctor will look at the individual's medical history as well as family history and other health issues to determine what medication is the best for them.
The most commonly used ADHD medication is a stimulant. It works by adjusting the levels of norepinephrine and dopamine in the brain. The stimulants like methylphenidate (also called Adderall), and dextroamphetamine increase the availability of neurotransmitters, which help improve concentration, decrease impulsivity, and reduce aggression. They come in many forms like chewable tablets, liquids and skin patches. These long-acting stimulants are favored because they improve patient compliance, as well as a smoother, longer-lasting improvement of symptoms.
It is crucial to keep in mind that co-existing conditions like anxiety and depression may influence the response to ADHD medication. It is therefore recommended that these psychiatric problems be treated first, with medications be used as a secondary measure. The medications that are used to treat comorbid psychiatric disorders include bupropion, atomoxetine and tricyclic antidepressants (Wilens 2004).
Some patients may experience a "rebound effect" where their ADHD symptoms worsen after discontinuing stimulant medication. In these instances, a short trial of a low dose of stimulant medication could be helpful.
Certain people are not able to take stimulant medications or are in a position to not take them due to drug abuse or other health issues, for example, heart problems that are severe or hypertension. In these situations, nonstimulant drugs like atomoxetine or viloxazine can be effective. These drugs don't have the same adverse effects as stimulants, and they are less likely to be abused or diverted.
Psychotherapy
People with ADHD are able to benefit from psychotherapy (talk therapy). It can help them learn strategies to improve their lives, deal with stress and anxiety, resolve conflicts, and manage issues in relationships or at work. It can also assist those suffering from mental illness that are co-existing such as depression and substance use disorders.
Talk therapies include cognitive behavior therapy (CBT) and mind-body cognitive therapy, as well as schema therapy. These treatments are based on the idea that thoughts and beliefs can influence how a person is feeling, thinks and behaves. CBT helps individuals identify negative behaviors and thought patterns and then formulate and implement positive strategies to change these. Meditation techniques are used in mindfulness-based cognitive therapy to help a person focus on their emotions and thoughts, control impulses, and improve executive functioning. Schema therapy, along with other forms of psychotherapy that concentrate on the family history of a person can be beneficial for people suffering from ADHD.
In addition to medicines psychotherapy can assist in addressing the specific issues that arise from ADHD, such as trouble getting through schoolwork, resolving conflict and being able to get together with others, losing important dates or responsibilities and making impulsive choices that result in financial or legal troubles. It can also help people to identify and overcome underlying issues that may be contributing to their ADHD symptoms, like depression or anxiety.
Psychotherapy can assist people in finding healthy ways to cope and reduce stress. For example exercise, sleep improvement and healthy eating habits. It can also offer support to a spouse or family member who is struggling with the effects of ADHD on their relationship. Therapy for families and marriage can assist families and couples communicate better and understand how to manage ADHD symptoms together.
Cognitive Behavioral Therapy
CBT is a type of psychotherapy that focuses on helping clients to change their negative thinking patterns. It utilizes skill-based dialogue with a skilled mental health professional (a therapist) to address the underlying causes of their symptoms. The goal of this treatment is to correct the limitations and implement coping strategies that align with the daily routine of the client.
Therapists who specialize in adult ADHD-CBT teach clients to recognize unhelpful thoughts and help them develop skills to replace them with more productive thoughts. This process can take some time. But it is an effective option for those 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, self-esteem and social functioning of adults suffering from ADHD (Clarke and colleagues. 2017). The combination of CBT and methylphenidate is particularly effective for those with more severe underlying problems.
treating add in adults that provide this kind of treatment usually work with the client to devise an action plan that is specific to solving their issues. They teach them a set of practical skills which are easy to master and have a good chance of success. A chart system is often utilized to track progress and to reward positive behavior. This could be an everyday report for children that lists the tasks they have to complete in school or the positive behavior that must be exhibited, and an approach to tracking and rewarding. The therapists could also consider introducing negative consequences when the child fails to complete their work. This can be done with sensitivity and encouragement.
Metacognitive Therapy
A newer type of therapy, metacognitive therapy, assists individuals in changing how they think. This type of therapy can be beneficial for those who suffer from a variety mental health problems, such as depression. It is a type of cognitive behavior therapy that assists people in recognizing negative thinking patterns and their impact on their emotions. This type of therapy can also assist in the acquisition of psychological tools that are adaptable and useful.
The aim of this study was to explore the relationship between metacognitive capabilities and daily functioning in adults suffering from ADHD. To achieve this, we examined the relationship between self- and informant-rated impairments in daily functioning to the indicators of metacognition (comprehensive knowledge, regulation of cognition, debugging, information management and evaluation). It was found that the comprehensive knowledge of people was linked to daily functioning in adults with ADHD however, the regulatory processes were not. The predictors of metacognition had moderate predictive power, which indicates that they can be the cause of significant variations in the daily functioning of adults with ADHD.
Metacognitive Therapy (MCT) is an treatment that focuses on transforming metacognitive beliefs that cause dysfunction 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. MCT has been proven to be effective in treating anxiety disorders. However, it's still a relatively new treatment and more research is required to determine if it can aid in other disorders.
This study was created to evaluate the effectiveness of MCT in reducing symptoms of illness anxiety disorder, but it can be applied to a range of disorders and could be more effective than other treatments. This isn't an effective treatment, but it can be used to treat ADHD.
Family Therapy
In family therapy, the Therapist works with the entire family. This allows everyone to be aware of the issues facing the client and to understand how to help their loved ones better. It also helps them cope with their anger and develop better communication skills. This type of counseling can be used to tackle other comorbidities, such as substance abuse and depression which are frequently associated with ADHD.
The therapist will start with an intake session in order to gain a better understanding of the family's views and determine if they're suitable for family intervention. It can be done either in person or online. The therapist will explain to each client the nature of treatment and the rules for family therapy.
A therapist with worked with adults suffering from ADHD will ask a lot of questions to gain insight into their current symptoms, their past, and the impact they have on their work, family and personal relationships. They will also inquire whether any other mental problems are present, for example anxiety or depression.
Cognitive behavioral therapy is a structured kind of counseling that teaches you how to manage your behavior and change negative patterns of thinking to positive ones. It focuses on boosting self-esteem and self-control by educating you on how to handle stress and anger. It is a short-term treatment option that can be combined with other forms of psychotherapy.
Individual therapy can help people suffering from ADHD deal with emotional baggage from longstanding patterns of failure, underachievement academic struggles as well as frequent job changes and relationship conflict. It can teach you ways to manage stress and cope and help you manage your time and money more efficiently. It can also be used to address other comorbid conditions like anxiety and mood disorders, which are often seen alongside ADHD.