Adult ADHD and Comorbid Disorders
Many adults with ADHD have comorbid disorders like major depression (Kessler and colleagues, 2006). Many patients are not responsive to medications for depression and may be able to benefit from psychotherapy.
Neurotransmitters are brain chemicals that regulate and boost levels of certain brain chemicals. Drugs that stimulate the brain such as methylphenidate or amphetamine are frequently prescribed.
Medicines
Many medications that are used to treat ADHD in children can be used for adults. However the dosages differ and the medications can cause side effects that are not present in children. The doctor will take a look at the medical history, the family health history, and other conditions of an individual to determine which drug is best.
The most well-known ADHD medication is a stimulant. It works by altering the levels of norepinephrine and dopamine in the brain. The stimulants like methylphenidate (also called Adderall), and dextroamphetamine boost the supply of neurotransmitters that help improve concentration, decrease impulsivity, and decrease aggression. They are available in a variety of forms such as chewable tablets, liquids and skin patches. These long-acting stimulants are favored due to their improved patient compliance, and a smoother, longer-lasting improvement in symptoms.
It is important to remember that comorbid conditions like anxiety or depression can affect the response to ADHD medication. Therefore, it is recommended that these mental health issues be treated first before medication is 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 may experience an "rebound effect" in which their ADHD symptoms become worse after stopping stimulant medication. In these cases it is possible to try a short-term trial of a low-dose stimulant medication may be beneficial.
Certain people are not able to take stimulant drugs or are unable to take them due to drug abuse or other health conditions like heart issues that are severe or hypertension. In these instances, non-stimulant medications like atomoxetine (Strattera) and viloxazine (Qelbree) can be effective. These medications don't have the same negative side effects as stimulants, and they are less likely to be misused or diverted.
Psychotherapy
People with ADHD can benefit from psychotherapy (talk therapy). It can help people with ADHD learn how to improve their lives, manage anxiety and stress, resolve conflicts, or deal with issues in their relationships or at work. It can also help those suffering from mental illness that are co-existing like depression and substance use disorders.
Talk therapies include cognitive behavior therapy (CBT), mind-body cognitive therapy, as well as schema therapy. These therapies are based on belief that one's beliefs and thoughts influence how they behave, think and feel. CBT assists a person to identify negative behaviors and thinking patterns, then develops and implements strategies to change them. Mindfulness-based cognitive therapy employs techniques for meditation to teach people how to concentrate on their thoughts and emotions, control impulses, and improve their executive functioning. Schema therapy, and other forms of psychotherapy that focus on a person's family history could be beneficial for people suffering from ADHD.
Psychotherapy, as well as medication, can aid with specific ADHD issues, like difficulty keeping up with schoolwork or interacting with other people. It can also assist with forgetting important dates and responsibilities, and making impulsive decisions that can result in legal and financial problems. Psychotherapy can help someone overcome the root issues like depression and anxiety that may contribute to their ADHD symptoms.
Psychotherapy can help people find healthy coping techniques and reduce stress. For instance exercise, sleep improvement and healthy eating habits. It can also provide assistance to an individual in the family or with a spouse who is struggling with the effects ADHD has on their relationship. Family therapy and marriage counseling can help couples and families learn how to communicate better and manage ADHD symptoms together.
Cognitive Behavioral Therapy (CBT)
CBT is a type of psychotherapy that focuses on helping clients 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 aim of this treatment is to eliminate the limitations and implement coping strategies that fit with the daily routine of the client.
In addition to teaching clients how to identify unhelpful thoughts, the therapists 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 be lengthy. It is a viable option for those who cannot get enough relief from their medication.
In an upcoming RCT, it was found that cognitive behavior therapy in combination with medication is superior to cognitive behavior therapy on its own in terms of improving the core symptoms, emotional symptom, self-esteem, and social functioning for adults with ADHD (Clarke and co. 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 devise a detailed action plan for addressing their problems. They typically teach them a series of practical skills that are easy to implement and have a high likelihood of success. Often a chart system is used to track the progress of a child and reward positive behaviour. For an infant, this could involve a daily report which outlines the school-related tasks or positive behavior they must perform and a method of monitoring and gaining rewards. The therapists could also discuss the possibility of the introduction of negative consequences if the child fails to complete their tasks. This can be done in a sensitive and supportive way.
Metacognitive Therapy
Metacognitive therapy is a newer form of psychotherapy that helps people to change their thinking. This kind of treatment can be beneficial for people with a variety of mental health issues such as depression. It is a type of cognitive behavior therapy that assists people in recognizing negative thought patterns and their effects on their emotions. This type of therapy may also help them acquire psychological tools that are adaptable and useful.
This study was designed to investigate the relationship between metacognitive skills and daily functioning among 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). It was discovered that comprehensive knowledge was connected to daily functioning in adults with ADHD but that regulatory processes were not. The predictors of metacognition 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 a type of psychotherapy which focuses on changing dysfunctional metacognitive beliefs that perpetuate states of worry or rumination as well as attention fixation. MCT was created by Adrian Wells based on an information processing model created by Wells and Gerald Matthews. A case series has proven the effectiveness of MCT in reducing anxiety disorder, however it's still a relatively new concept and more research is required to determine its effectiveness in other disorders.
This study was created to assess the effectiveness of MCT to alleviate symptoms of anxiety disorder. However, it can be used to treat a variety disorders and is more effective than other therapy. This is not an effective treatment, but it can be utilized to treat ADHD.
Family Therapy
In family therapy, the therapist collaborates with all members of the family. All members can better understand the issues of the client and learn how they can help their loved family members. It also helps them find ways to cope with their own anxieties and improve their communication skills. This kind of counseling can be utilized to treat the underlying conditions, like addiction and depression that are commonly associated with ADHD.
The therapist will begin with an intake session to gain a better understanding of the family's perspective and determine whether they are appropriate for family intervention. This can be done in person or via the internet. The Therapist will discuss the nature of treatment with each individual and set out the rules and guidelines of family therapy.
A therapist who has experience in treating adults with ADHD will ask lots of questions to gain an understanding of the client's present symptoms, their history and their impacts on their work as well as their family and social life. They will also ask if any other mental issues are present, such depression or anxiety.
Cognitive behavioral therapy (CBT) is a structured form of counseling 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. This is a short-term option that can be used alongside other types of psychotherapy.
Individual talk therapy can help people with ADHD overcome emotional baggage from longstanding patterns of underachievement, failure, academic difficulties frequent job changes, and relationship conflict. It can help you learn ways to manage stress and cope and help you manage your time and money more efficiently. It can also help with the comorbidity of disorders like depression and anxiety that are commonly associated as a result of ADHD.