Adult ADHD and Comorbid Disorders
Many adults suffering from ADHD also have comorbid disorders, such as major depression (Kessler and colleagues 2006). Many patients do not respond to medication for depression and may benefit from psychotherapy.
Neurotransmitters are brain chemicals that regulate and boost levels of certain brain chemicals. The most frequently prescribed stimulants include methylphenidate, amphetamine and other similar medications.
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 take into consideration the medical history of the patient as well as family history and other health issues to determine which medicine is most suitable for him or her.
The most common ADHD medication is a stimulant. It works by adjusting the levels of norepinephrine and dopamine in the brain. Stimulants such as methylphenidate or dextro-amphe (commonly called Adderall) boost the supply of these neurotransmitters. They aid in improving focus and reducing impulsivity and aggression. 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 a smoother, longer-lasting improvement of symptoms.
It is important to remember that co-existing conditions like anxiety and depression can alter the effectiveness of ADHD medications. Therefore it is recommended that disorders be treated first and medication used as a secondary measure. Some medications that can be used to treat comorbid mood disorders include atomoxetine, bupropion and tricyclic antidepressants (Wilens 2004).
Certain patients may experience a "rebound" effect, where they experience worsening of ADHD symptoms after discontinuing stimulant medication. In these cases, a short-term trial of the use of a low dose stimulant medication could be helpful.
Certain people are not able to take stimulant medications or are unable to take them due to addiction or other health issues, like heart issues that are severe or hypertension. In these cases, nonstimulant medication such as atomoxetine (Strattera) and viloxazine (Qelbree) can be effective. These medications don't cause the same amount of side effects as stimulants and have a lower risk for misuse and diversion.
Psychotherapy
People with ADHD are able to benefit from psychotherapy (talk therapy). It can help them develop skills to improve their life to manage stress and anxiety, resolve conflicts, and deal with problems in relationships or at work. It can also aid those suffering from mental illness that are co-existing like depression and substance abuse disorders.
Talk therapies include cognitive-behavioral therapy (CBT) and mindfulness-based cognitive therapy, and schema therapy. These therapies are based upon the idea that thoughts and beliefs influence how someone is feeling, thinks and behaves. CBT helps individuals identify negative thoughts and behaviors and then formulate and implement positive strategies to change these. Meditation techniques are used in mindfulness-based cognitive therapy to help a person focus on their emotions and thoughts as well as control their impulses and improve executive functioning. Schema therapy and other forms of psychotherapy focused on the family history of a person could be beneficial for those with ADHD who have significant secondary problems.
In addition to medications psychotherapy can also help with the specific problems caused by ADHD, such as trouble staying on track with schoolwork, resolving conflicts, being able to get along with others, ignoring important dates or obligations, and impulsive decisions that lead to financial or legal troubles. Psychotherapy can help someone overcome underlying issues such as anxiety and depression that could contribute to their ADHD symptoms.
Psychotherapy can help people discover healthy coping techniques and reduce stress. For example, exercise, sleep improvement and healthy eating habits. It can also offer support to a spouse or family member who may be dealing with the effects of ADHD on their relationship. Family therapy and marriage counseling can help couples and families communicate better and understand how to manage ADHD symptoms together.
Discover More Here is a type of psychotherapy which focuses on helping clients to change their negative thinking patterns. It involves a dialog based on skill with an expert in mental health to address the root causes of the symptoms. The aim of this therapy is to correct limitations and implement strategies for coping that align with the daily routine of the client.
Therapists who specialize in adult ADHD-CBT teach clients how to identify unhelpful thoughts and help them learn to replace them with more productive thoughts. This process can be lengthy. But it is an effective option for those who are not getting adequate relief from their medication.
In the course of a recent RCT, it was found that cognitive behavioral therapy combined with medication is superior to cognitive behavior therapy alone in terms of improving core symptoms, emotional symptoms, self-esteem, and social performance in adults with ADHD (Clarke and colleagues. 2017). The combination of CBT and methylphenidate is especially effective for those who have more severe underlying issues.
The therapists that provide this type of treatment typically collaborate with the client to develop a detailed action plan for solving their issues. They usually teach clients a set of practical skills that are easy to apply and have a high chance of being successful. Typically, a chart system is used to monitor progress and reward positive behaviour. For children, this could be a daily journal that lists all the in-school tasks or positive behaviors they need to accomplish and a system for monitoring and gaining rewards. Therapists can also talk about the possibility that negative consequences may be imposed if a child fails to complete their tasks. This can be done with sensitivity and encouragement.
Metacognitive Therapy
A newer type of therapy, metacognitive therapy, helps individuals change how they think. This type of therapy can be beneficial for those who suffer from a range of mental health problems like depression. It's a kind of cognitive behavioral therapy that helps individuals learn to recognize their negative thought patterns and how they impact their moods. This kind of therapy helps them develop mental tools that are flexible and useful.
The aim of this study was to explore the relationship between metacognitive capabilities and daily functioning in adults with ADHD. To this end, we examined the relationship between the self- and informant-rated impairments in daily functioning to predictors of metacognition (comprehensive knowledge and cognition regulation, debugging, management of information, and evaluation). It was discovered that the comprehensive knowledge of people was linked to daily functioning in adults with ADHD but that the processes of regulation were not. Metacognition predictors had moderate predictive power which suggests that they could explain an important amount of variation in the daily functioning of adults suffering from 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. Adrian Wells developed MCT based on a model of information processing by Wells and Gerald Matthews. One case series has demonstrated the effectiveness of MCT in tackling anxiety, but it's still relatively new and more research is required to determine its effectiveness in other disorders.
This study was designed to evaluate the efficacy of MCT to alleviate symptoms of anxiety disorder. However, it can be used to treat various disorders and is more effective than other therapy. It is not a cure, but it could be employed to treat ADHD.
Family Therapy
In family therapy, the therapist works with the whole family. This allows all members to learn about the client's issues and learn how to support their loved one more effectively. It also assists them in finding ways to deal with their own frustrations and develop healthier communication skills. This type of counseling can be utilized to treat other comorbidities, such as depression and substance abuse, which are often seen as part of ADHD.
The therapist will begin with an intake session to get a better understanding of the family's view of the problem and evaluate their potential for intervention by the family. This can be conducted online or in person. The counselor will go over the details of the treatment with each individual and set out the do's and don'ts of family therapy.
A therapist with experience treating adults suffering from ADHD will ask a lot of questions to gain an insight into the client's current symptoms, their history, and their impact on their work life, family life and relationships. They will also inquire whether there are any other mental health issues present, such as anxiety or depression.
Cognitive behavioral therapy is a structured type of counseling that helps you learn how to control your behavior and change negative patterns of thinking into positive ones. It focuses on boosting self-esteem and self-control by teaching you how to manage anger and stress. It is a short-term treatment option that can be used in conjunction with other types of psychotherapy.
Individual therapy can help people with ADHD to overcome the emotional baggage that comes from failure and underachievement. It can also help them deal problems with relationships as well as job changes and academic difficulties. It can help you learn ways to reduce stress and cope and also how to better manage your financial and time management. It can also help with the comorbidity of disorders like mood and anxiety disorders which are frequently associated as a result of ADHD.