Adult ADHD and Comorbid Disorders
Many people with ADHD suffer from comorbid disorders, like major depression (Kessler and colleagues, 2006). Many patients are not responsive to medication for depression and may be able to benefit from psychotherapy.
Neurotransmitters are brain chemicals that regulate and increase levels of certain brain chemicals. The stimulants methylphenidate and amphetamine are commonly prescribed.
Medications
Many of the medications used to treat ADHD in children can also be used on adults. However the dosages are different and the medications can cause side effects that are not common in children. The doctor will look at the medical history, the family health history and other health conditions of the patient to determine which drug is the best for them.
The most common ADHD medication is a stimulant. It works by adjusting the levels of norepinephrine and dopamine in the brain. Stimulants like methylphenidate and dextro-amphetamine (commonly called Adderall) increase the amount of these neurotransmitters, which can improve focus and decrease aggression and impulsivity. They come in various forms such as chewable tablets, liquids, and skin patches. Long-acting versions of these stimulants are preferable because they provide better patient compliance and longer lasting and smoother improvement of symptoms.
It is important to remember that comorbid disorders such as anxiety or depression may influence the response to ADHD medication. It is therefore recommended that these psychiatric issues be treated first, with medication used as secondary measure. The medications that are used to treat comorbid mood disorders include atomoxetine and bupropion and tricyclic antidepressants (Wilens 2004).).
Some patients might suffer from some patients may experience a "rebound effect" where their ADHD symptoms get worse after stopping stimulant medication. In these cases it is possible to try a short-term trial of a low-dose stimulant medication may prove beneficial.
Some people are unable to tolerate stimulant medication or cannot use it due to the misuse of drugs or other health conditions such as heart or hypertension problems that are severe. In these cases, non-stimulant drugs like atomoxetine or viloxazine are effective. These medications do not cause the same level of side effects as stimulants and carry a a lower risk for misuse and diversion.
Psychotherapy
People with ADHD can benefit from psychotherapy (talk therapy). It can help them develop strategies to improve their lives, deal with stress and anxiety, resolve conflicts, and manage problems in relationships and at work. It can also assist with co-occurring mental illnesses like depression and substance use disorders.
Talk therapies include cognitive behavior therapy (CBT), mind-body cognitive therapy, and schema therapy. These treatments are based on the idea that beliefs and thoughts can influence how someone is feeling, thinks and behaves. CBT helps a person recognize negative behaviors and thinking patterns, and then develops and implements strategies to change these patterns. Mindfulness-based cognitive therapy uses techniques for meditation to help a person learn to focus on their thoughts and emotions, manage their impulses and improve their executive functioning. Schema therapy, and other forms psychotherapy that focus on a person's family history could be beneficial for people suffering from ADHD.
Psychotherapy, along with medication, can aid with specific ADHD issues, like difficulties with schoolwork or getting along with others. It can also assist with forgetting important dates and obligations and making decisions that are impulsive and result in legal and financial issues. Psychotherapy can also help people to identify and overcome issues that be contributing to their ADHD symptoms, such as depression or anxiety.
Psychotherapy can help people find healthy strategies for coping and decrease stress. For example exercising, improving sleep and healthy eating habits. It can also provide assistance to the family member or spouse who is struggling with the effects ADHD has on their relationship. Family therapy and marriage counseling can help couples and families communicate better and learn how to manage ADHD symptoms together.
treating adult add (CBT)
CBT is a kind of psychotherapy that focuses on helping clients change their negative patterns of thinking. It employs dialogue based on skill with a skilled mental health professional (a therapist) to address the underlying causes of their symptoms. The goal of this treatment is to eliminate limitations and implement strategies for coping that align with the person's everyday life.
Therapists who specialize in adult ADHD-CBT instruct clients to recognize harmful thinking patterns and assist them to build the skills to replace them with more productive thoughts. This process can take a while. But it is an effective option for adults who are not getting adequate relief from medications.
A recent RCT study concluded that when combined with medication, CBT is superior to cognitive behavioral therapy alone in reducing core symptoms, emotional symptoms, self-esteem and social functioning in adults with ADHD (Clarke and co., 2017). The combination of CBT and methylphenidate is especially effective for those with more severe underlying problems.
The therapists that provide this type of treatment typically collaborate with the client to create a detailed action plan for solving their issues. They train them in a series of practical skills which are easy to learn and have a high chance of success. Typically, a chart system is used to track progress and reward positive behaviour. This could include the daily report of children that lists the tasks they must finish at school or the positive behavior that must be displayed, as well as a system of monitoring and rewarding rewards. The therapists could also consider creating negative consequences if children fail to complete their work. This can be done in a very sensitive and supportive manner.
Metacognitive Therapy
Metacognitive therapy is a brand new kind of psychotherapy that helps people change their mindset. This kind of therapy is effective for those with a variety of mental health problems which include depression. It is a kind of cognitive behavioral therapy that assists people in recognizing negative thoughts and their effects on their moods. This kind of therapy helps to develop mental tools that are versatile and useful.
This study was designed to investigate the relationship between metacognitive capabilities and daily functioning in adults suffering from ADHD. To accomplish this we compared self and informant-rated daily functioning impairments with predictors of Metacognition (comprehensive Knowledge, Regulation of Cognition, Debugging, Information Management, and Evaluation). The results indicated that comprehensive knowledge was associated with daily functioning among adults suffering from ADHD however, it was not associated with the processes that regulate. The predictors of metacognition had moderate predictive power which suggests that they could be the cause of significant variance in daily functioning of adults with ADHD.
Metacognitive Therapy (MCT) is an treatment that focuses on changing dysfunctional metacognitive belief patterns that perpetuate states like worry, rumination and attention fixation. Adrian Wells developed MCT based on an idea of information processing by Wells and Gerald Matthews. One case series has demonstrated the effectiveness of MCT in tackling anxiety disorder, but it's still relatively new and more research is needed to determine its efficacy for other disorders.
This study was designed to determine the efficacy of MCT in the reduction of symptoms of illness anxiety disorder, however it can be applied to a variety of disorders and may even be more effective than other therapies. It is important to keep in mind that this is not a cure for ADHD but it could be used as an adjunctive therapy.
Family Therapy
In family therapy, the therapist works with all family members. This helps all family members be aware of the issues facing the client and to understand how to help their loved one better. It also helps them find ways to cope with their own anxieties and improve their communication skills. Additionally, this kind of therapy is helpful in dealing with comorbid disorders such as depression or substance misuse which are often seen alongside ADHD.
The therapist will commence with an intake session to get a better understanding of the family's perception of the problem and evaluate their potential for intervention by the family. This can be conducted online or in person. treating adhd in adults will go over the details of the therapy with each client and lay out the rules and guidelines of family therapy.
A therapist who has experience in treating adults with ADHD will ask a variety of questions to gain understanding of the client's current symptoms, their history and their impacts on their work as well as their family and social life. They will also ask whether any other mental problems are present, for example anxiety or depression.
Cognitive behavioral therapy (CBT) is a structured form of counseling which teaches you to change your negative patterns of thinking and to manage your behavior. It focuses on improving self-esteem and self control by teaching you how to manage anger and stress. It is a short-term treatment option that can be paired with other types of psychotherapy.
Individual therapy can help people with ADHD to manage the emotional baggage that comes from failure and underachievement. It can also assist them in dealing with conflicts in relationships as well as job changes and academic issues. It can teach you ways to reduce stress and cope, and how to better manage your time and finances. It can also be used to tackle other comorbid conditions like mood and anxiety disorders, which are often associated with ADHD.