Adult ADHD and Comorbid Disorders
Many people suffering from ADHD have comorbid disorders such as major depression (Kessler et al 2006). Many patients do not respond to medication for depression and may be able to benefit from psychotherapy.
Neurotransmitters are brain chemicals that regulate and boost levels of certain brain chemicals. The most commonly prescribed stimulants are methylphenidate, amphetamine and other similar medications.
Medicines
A variety of medications used to treat ADHD in children can also be used in adults. However, the dosages are different and the drugs can cause adverse effects that aren't typical of children. A doctor will consider the individual's medical history as well as family history and other health conditions to determine which medicine is the best for him or her.
The most popular type of ADHD medication is a stimulant. It works by adjusting levels of two chemical messengers within the brain called norepinephrine and dopamine. Stimulants such as methylphenidate or dextro-amphe (commonly called Adderall) boost the supply of these neurotransmitters. They aid in improving focus and reducing aggression and impulsivity. They are available in a variety of forms such as chewable tablets, liquids and skin patches. These long-acting stimulants are preferred as they lead to better patient compliance and more consistent, long-lasting improvement of symptoms.
It is important to remember that co-existing conditions like anxiety and depression can affect the response to ADHD medication. Therefore, it is recommended that psychiatric disorders be treated first, and medications be used as a 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 might suffer from an "rebound effect" where their ADHD symptoms get worse after stopping stimulant medications. In these instances an experiment of a short duration with an atypical stimulant drug could be beneficial.
Some people are unable to tolerate stimulant medicines or are in a position to not take them due to addiction or other health issues, for example, heart problems that are severe or hypertension. In these situations, nonstimulant medications such as atomoxetine and viloxazine can be effective. These drugs do not have the same high rates of side effects as stimulants and carry a a lower risk for misuse and diversion.
Psychotherapy
Psychotherapy (talk therapy) can be helpful for people with ADHD. It can help those who suffer from ADHD learn to improve their lives, deal with stress and anxiety, manage conflicts, or cope with problems at work or in relationships. It can also assist with co-occurring mental illnesses like depression and substance abuse disorders.
Talk therapies include cognitive behavior therapy (CBT) and mind-body cognitive therapy, and schema therapy. These therapies are based upon the notion that beliefs and thoughts can influence how someone is feeling, thinks and behaves. CBT assists individuals in identifying negative behaviors and thought patterns and then devise and implement strategies to change them. Mindfulness-based cognitive therapy utilizes meditation techniques to teach people how to focus on their thoughts and emotions, manage their impulses, and improve their executive functioning. Schema therapy, and other forms of psychotherapy that focus on a person’s family history can be beneficial for people with ADHD.
Psychotherapy, along with medication, can aid with specific ADHD issues, like difficulties with schoolwork or getting along with others. treating add in adults can also assist in avoiding important dates and obligations and making decisions that are impulsive and result in legal and financial problems. It can also help individuals to address and overcome issues that cause ADHD symptoms, like anxiety or depression.
Psychotherapy can help people find healthy coping techniques and reduce stress. For instance exercise, sleep improvement and healthy eating habits. It can also offer support to a partner or family 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 form of psychotherapy that focuses on changing the negative patterns of thinking that clients have. It involves a dialog based on skill with a mental health professional to address the root causes of the symptoms. This treatment aims to help patients overcome impairments and develop coping skills that are appropriate to their everyday lives.
Therapists who specialize in adult ADHD-CBT show clients to recognize unhelpful thought patterns and help them learn to replace them with more productive thoughts. This process can take some time. However, it is a viable option for those who aren't getting enough relief from medication.
A recent RCT study concluded that when combined with medication, CBT is superior to cognitive behavioral therapy alone in reducing the emotional symptoms, core symptoms, self-esteem and social functioning in adults with ADHD (Clarke et al., 2017). CBT combined with methylphenidate can be particularly effective for people who have more severe underlying issues.
The therapists who provide this type of treatment typically collaborate with the client to devise a detailed action plan for solving their issues. They will teach them a set of practical skills which are easy to learn and have a high chance of success. Charts are often used to monitor progress, and to reward positive behavior. This might include an everyday report for children that lists the tasks they have to finish at school or the positive behavior that must be displayed, as well as an approach to recording and earning rewards. The therapists could also discuss the possibility of creating negative consequences if children fail to complete their work. This can be done with sensitivity and encouragement.
Metacognitive Therapy
A newer type of therapy, metacognitive therapy helps people change the way they think. This kind of therapy can be beneficial to those who suffer from a variety mental health issues like depression. It is a kind of cognitive behavioral therapy which assists people in recognizing negative thoughts and their effects on their moods. This type of therapy may also help them acquire psychological tools that are flexible and beneficial.
The goal of this study was to examine the relationship between metacognitive capabilities and daily functioning in adults with ADHD. To do this, we compared self and informant-rated impairments in daily functioning with the 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 but that regulatory processes were not. Metacognition predictors had a moderate predictive power, which suggests they could explain an important amount of variance in daily functioning of people with ADHD.
Metacognitive Therapy (MCT) is an treatment which focuses on reversing metacognitive beliefs that are dysfunctional and perpetuate states like worry, rumination, or attention fixation. MCT was developed 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, however it's still relatively in its infancy and more research is needed to determine its effectiveness 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 may be more effective than other treatments. It's important to keep in mind that this isn't an effective treatment for ADHD, but it can be utilized as an alternative therapy.
Family Therapy
In family therapy, therapists work with all members of the family. Everyone is able to better understand the client's needs and learn to assist their loved family members. It also assists them in finding ways to deal with their own feelings of frustration and improve their communication skills. This kind of counseling can also be used to address other comorbidities, such as substance abuse and depression, which are often seen as a result of ADHD.
The therapist will commence with an intake session to gain a better understanding of the family's perspective of the problem and evaluate their potential for intervention by the family. It can be done in person or online. The Therapist will discuss the nature of treatment with each person and spell out the do's and don'ts of family therapy.
A therapist who has experience in treating adults suffering from ADHD will ask lots of questions to gain insight into the client's current symptoms, their history, and their impacts on their work, family life and relationships. They will also inquire whether there are any other mental health issues that are present, such as anxiety or depression.
Cognitive behavioral therapy (CBT) is a method of counseling that is structured that helps you change your negative patterns of thinking and to manage your behavior. It focuses on boosting self-esteem and self control by teaching you how to handle 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 to manage the emotional baggage that comes from underachievement and failure. It can also assist them in dealing problems with relationships as well as job changes and academic difficulties. It can help you develop ways to manage stress and cope and teach you how to manage your time and finances more effectively. It can also help with comorbid disorders such as depression and anxiety that are commonly associated as a result of ADHD.