Adult ADHD and Comorbid Disorders
Many people with ADHD also suffer from comorbid disorders such as major depression (Kessler and colleagues, 2006). Many patients are not responsive to medication for depression and may benefit from psychotherapy.
Medications that most effectively improve core symptoms of ADHD seem to boost and balance levels of specific brain chemicals called neurotransmitters. Commonly prescribed stimulants include methylphenidate, amphetamine and other similar drugs.
Medicines
Adults can use many medications that are used for ADHD in children. The dosages and effects differ. The doctor will look at the medical history, the family health history, and other conditions of an individual to determine which drug is best.
The most common kind of ADHD medication is a stimulant. It adjusts levels of two chemical messengers in the brain called norepinephrine and dopamine. Stimulants like methylphenidate and dextro-amphetamine (commonly known as Adderall) increase the availability of these neurotransmitters. They help improve focus and reduce aggression and impulsivity. They come in various forms such as chewable tablets, liquids and skin patches. These stimulants that last longer are popular due to their improved patient compliance, and more consistent, long-lasting improvement in symptoms.
It is crucial to be aware that co-occurring disorders like anxiety or depression may influence the response to ADHD medication. Therefore it is recommended that these disorders be treated first and medication utilized as a secondary measure. Some medications that are used to treat comorbid mood disorders include atomoxetine and bupropion and tricyclic antidepressants (Wilens 2004).).
Certain patients may experience an "rebound effect" where their ADHD symptoms worsen after discontinuing stimulant medication. In these instances, a brief trial of a low dosage of stimulant medication may be beneficial.
Some people are unable to take stimulant medication or use it due to the misuse of drugs or other health issues such as severe hypertension or heart issues. In these cases, nonstimulant medications such as atomoxetine (Strattera) and viloxazine (Qelbree) can be effective. These medications do not cause the same high rates of side effects as stimulants and have lower risks of abuse and diversion.
Psychotherapy
People with ADHD can benefit from psychotherapy (talk therapy). It can help those who suffer from ADHD learn to improve their lives, manage anxiety and stress, resolve conflicts, or deal with problems at work or in relationships. It can also assist with co-existing mental illnesses such as depression and substance use disorders.
Talk therapies include cognitive-behavioral therapy (CBT) as well as mindfulness-based cognitive therapy and schema therapy. These therapies are based upon the idea that thoughts and beliefs influence how someone feels, thinks and acts. CBT helps individuals identify negative thoughts and behaviors and then formulate and implement strategies to change them. Meditation techniques are used in mindfulness-based cognitive therapy to help someone concentrate on their thoughts and emotions as well as control their impulses and improve executive functioning. Schema therapy and other types of psychotherapy focused on the family history of a person can be beneficial for those with ADHD with significant secondary problems.
In addition to medicines, psychotherapy can help address the specific issues that arise from ADHD, such as trouble getting through schoolwork, resolving conflicts, getting together with others, losing important dates or responsibilities, and impulsive decisions that lead to legal or financial issues. Psychotherapy can help someone overcome underlying issues such as anxiety and depression that could be contributing to their ADHD symptoms.
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 member or partner who is dealing with the effects ADHD has on their relationship. Therapy for families and marriage can assist families and couples improve communication and learn to manage ADHD symptoms together.
Cognitive Behavioral Therapy
CBT is a kind of psychotherapy that is focused on changing the negative patterns of thinking that clients have. It involves a skill-based dialog with an expert in mental health to address the underlying reason for the symptoms. This therapy aims to help clients overcome difficulties and develop coping skills that are in line with their daily routines.
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 be lengthy. But it is an effective option for adults who aren't getting enough relief from medications.
In a recent RCT, it was found that cognitive behavioral therapy paired with medication is superior over cognitive behavior therapy by itself when it comes to improving the core symptoms, emotional symptoms, self-esteem and social functioning in adults with ADHD (Clarke, et al. 2017). CBT coupled with methylphenidate could be particularly effective for people who suffer from more serious underlying issues.
Therapists who provide this kind of treatment work with clients to develop an action plan that addresses their specific problems. They usually teach clients a set of practical skills that are simple 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 behavior. This might include a daily report for children that lists the tasks they are required to complete in school or the positive behavior that must be displayed, as well as a system of monitoring and earning rewards. Therapists can also talk about the possibility that negative consequences might be introduced when a child fails to complete their tasks. I Am Psychiatry can be done in a sensitive and calming manner.
Metacognitive Therapy
A newer form of therapy, metacognitive therapy, helps individuals change how they think. This type of treatment can be beneficial for people with a variety of mental health problems, including depression. It's a kind of cognitive behavioral therapy that assists individuals learn to recognize their negative thoughts and how they affect their moods. This kind of therapy can also help them acquire psychological tools that are adaptable 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 daily functioning impairments with predictors of Metacognition (comprehensive knowledge, regulation of Cognition, Debugging, Information Management and Evaluation). The results showed that complete knowledge was associated with daily functioning among adults suffering from ADHD but not with regulation processes. The predictors of metacognition had a moderate predictive power, which indicates that they can be the cause of significant variations in the daily functioning of adults suffering from ADHD.
Metacognitive therapy (MCT) is a psychotherapy which focuses on changing metacognitive beliefs that are dysfunctional and perpetuate states of worry or rumination as well as attention fixation. MCT was created by Adrian Wells based on an information processing model developed by Wells and Gerald Matthews. One case series has demonstrated the effectiveness of MCT in tackling anxiety disorder, however it's still relatively in its infancy and more research is needed to determine its effectiveness for other disorders.
This study was created to assess the effectiveness of MCT to reduce symptoms of anxiety disorder. However it is also able to treat a variety of disorders and is more effective than other treatment. It is not a cure, but it could be utilized to treat ADHD.
Family Therapy
In family therapy, the therapist collaborates with all members of the family. This allows everyone to be aware of the issues facing the client and to learn how they can support their loved one more effectively. It also assists them in dealing with their frustrations and build more effective communication skills. In addition, this type of therapy is helpful in addressing comorbid conditions such as depression and substance misuse which are often found in conjunction with ADHD.
The therapist will commence with an intake session to gain a clearer understanding of the family's view of the problem and evaluate their potential for intervention by the family. This can be done in person or via the internet. The counselor will explain to each person the purpose of therapy and the do's & don'ts for family therapy.
A therapist with experience treating adults suffering from ADHD will ask a lot of questions to gain insight into the client's current symptoms, their past 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 is a type of counseling that helps you learn how to manage your behavior and change negative patterns of thinking to positive ones. It concentrates on improving your self-esteem and self-control through teaching strategies to manage stress and anger. This is a short-term solution that can be utilized alongside other types of psychotherapy.
Individual talk therapy helps people with ADHD to manage the emotional baggage that results from failure and underachievement. It can also help them deal with conflicts in relationships, job changes, and academic issues. It can teach you ways to manage stress and cope and help you manage your time and finances more efficiently. It can also address comorbid disorders such as anxiety and mood disorders, which are often seen as a result of ADHD.