Adult ADHD and Comorbid Disorders
Many adults with ADHD also have comorbid disorders like major depression (Kessler and colleagues 2006). Many patients who are depressed aren't able to take medication and could be able to benefit from therapy.
Treatments that are most effective in reducing the most fundamental symptoms of ADHD appear to increase and balance levels of certain brain chemicals called neurotransmitters. The most commonly prescribed stimulants are amphetamine, methylphenidate and similar drugs.
Medicines
A variety of medications used to treat ADHD in children can also be used on adults. The dosages and effects are different. A doctor will consider the individual's medical history as well as family history and other health conditions to determine what medication is best for them.
The most common ADHD medication is a stimulant. It works by adjusting the levels of norepinephrine and dopamine in the brain. The stimulants methylphenidate and dextroamphetamine (commonly known as Adderall) increase the availability of these neurotransmitters. They aid in improving focus and reducing aggression and impulsivity. They come in various forms like chewable tablets, liquids, and skin patches. These long-acting stimulants are preferred due to their improved patient compliance, and an easier, longer-lasting improvement in symptoms.
It is important to keep in mind that comorbid conditions like depression or anxiety disorders can influence the response to ADHD medication. It is therefore recommended that psychiatric disorders be treated first, and medication be used as a second measure. treating add in adults that can be used to treat comorbid mood disorders include atomoxetine, bupropion and tricyclic antidepressants (Wilens 2004).).
Some patients might have an "rebound effect" in which their ADHD symptoms get worse after stopping stimulant medications. In these instances, a brief trial of a low dose of stimulant medication can be beneficial.
Certain people are not able to tolerate stimulant medication or cannot take it because of drug misuse or other health conditions such as severe hypertension or heart issues. In these cases, non-stimulant drugs like atomoxetine or viloxazine are effective. These drugs don't have the same negative side effects as stimulants and are less likely to be abused or diverted.
Psychotherapy
Psychotherapy (talk therapy) can be beneficial for those with ADHD. It can help them develop skills to improve their life, deal with stress and anxiety, resolve conflicts, and manage problems in relationships or at work. It can also aid with co-occurring mental illnesses like depression and substance use disorders.
Talk therapies include cognitive-behavioral therapy (CBT), mindfulness-based cognitive therapy and schema therapy. These therapies are based upon the idea that thoughts and beliefs affect how a person is feeling, thinks and behaves. CBT helps people identify negative behaviors and thinking patterns, then develops and implements positive strategies to change these patterns. Mindfulness-based cognitive therapy employs techniques for meditation to help a person learn to focus on their emotions and thoughts, manage their impulses, and improve their executive functioning. Schema therapy, as well as other forms of psychotherapy focusing on a person's family history can be beneficial for those who suffer from ADHD with significant secondary issues.
In addition to medications psychotherapy can also help with the specific issues that arise from ADHD like difficulty getting through schoolwork, resolving conflicts and being able to get along with others, forgetting important dates or responsibilities and making impulsive choices that result in financial or legal troubles. It can assist a person overcome issues of the underlying nature, such as anxiety and depression that could be contributing to their ADHD symptoms.
Psychotherapy can help people find 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 affects their relationship. Therapy for families and marriage can help couples and families communicate better and learn how to manage ADHD symptoms together.
Cognitive Behavioral Therapy
CBT is a type of psychotherapy that is focused on changing the negative patterns of thinking that clients have. It involves a dialogue based on skills with an expert in mental health to identify the root causes of the symptoms. This treatment is designed to help patients overcome difficulties and develop coping skills that are compatible with their daily routines.
In addition to educating clients to recognize harmful thoughts, the therapists who specialize in adult ADHD CBT help them develop skills that allow them to replace unhelpful thinking with more productive ones. This process can take time. It's a possibility for adults who do not receive enough relief from their medications.
A recent RCT study has found 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 with ADHD (Clarke and colleagues., 2017). The combination of CBT and methylphenidate is especially effective for those who have more severe underlying problems.
Therapists who offer this kind of treatment work with their clients to devise an action plan that addresses their specific problems. They usually teach them the fundamentals of therapy that are simple to implement and have a high likelihood of being successful. A chart system is often used to track the progress of a child and reward positive behavior. This could be an everyday report for children that lists the tasks they have to finish at school or the positive behaviors that need to be displayed, as well as a system of tracking and rewarding. The therapists could also discuss the possibility of introducing negative consequences when children fail to complete their work. This can be done in a sensitive and supportive manner.
Metacognitive Therapy
A more recent form of therapy, metacognitive therapy helps people change the way they think. This type of treatment can be effective for people suffering from a range of mental health issues such as depression. It is a type of cognitive behavior therapy that helps people recognize negative thinking patterns and their effect on their emotions. This kind of therapy can also help them acquire psychological tools that are flexible and effective.
The purpose of this study was to examine the relationship between metacognitive capabilities and daily functioning in adults suffering from ADHD. To this end, we examined the relationship between self- and informant-rated impairments in daily functioning to indicators of metacognition (comprehensive knowledge as well as regulation of cognition, debugging, management of information, and evaluation). The results showed that complete knowledge was linked to daily functioning in adults with ADHD, but not the processes that regulate. The predictive power of a model with predictors of metacognition was moderate, suggesting that they can account for an important portion of the variance in daily functioning for people with ADHD.
Metacognitive Therapy (MCT) is an intervention that focuses on transforming metacognitive beliefs that are dysfunctional and perpetuate mental states such as worry, rumination and attention fixation. Adrian Wells developed MCT based on the model of information processing by Wells and Gerald Matthews. MCT has been proven to be effective in treating illness anxiety disorders. However, it is still a relatively new treatment and more research is required to determine if it could help with other disorders.
This study was designed to assess the effectiveness of MCT in the reduction of symptoms of illness anxiety disorder, but it can be applied to a variety of disorders and could be more effective than other therapies. This is not a cure, but can be employed to treat ADHD.
Family Therapy
In family therapy the Therapist works with the entire family. This allows everyone to understand the client's problems and learn how to support their loved ones better. It also helps them cope with their frustrations and develop better communication skills. Additionally, this type of counseling is useful in addressing comorbid conditions such as depression or alcohol abuse, which are commonly associated with ADHD.
The therapist will start with an intake session to better understand the family's perception and determine whether they are suitable for intervention with the family. It can be done in person or online. The Therapist will explain to each client the nature of treatment as well as the rules and regulations for family therapy.
A therapist who has experience in treating adults suffering from ADHD will ask a lot of questions to gain understanding of the client's present symptoms, their past and their impact on their work life, family life and relationships. They will also ask whether there are other mental health issues like depression or anxiety.
Cognitive behavioral therapy is a structured kind of counseling that teaches you how to manage your behavior and change negative thinking patterns into positive ones. It focuses on improving self-esteem and self-control by teaching strategies to manage anger and stress. It is a short-term treatment option that can be paired with other types of psychotherapy.
Individual talk therapy can help those with ADHD overcome emotional burdens resulting from long-standing patterns of underachievement, failure academic struggles, frequent job changes and relationship conflict. It can teach you coping and stress reduction techniques and teach you how to manage your time and money more efficiently. It can also help with problems that are comorbid, such as anxiety and mood disorders which are frequently associated as a result of ADHD.