Adult ADHD and Comorbid Disorders
Many adults suffering from ADHD also suffer from comorbid disorders like major depression (Kessler and colleagues 2006). Many depressed patients do not respond well to medications and may benefit from therapy.
Treatments that are most effective in reducing the most fundamental symptoms of ADHD seem to boost and balance levels of certain neurotransmitters, which are brain chemicals. Commonly 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. However the dosages are different and the medications can cause adverse effects that aren't typical of children. A doctor will take into consideration the individual's medical history, family history and other health conditions to determine which medicine is most suitable for them.
The most well-known ADHD medication is a stimulant. It works by altering the levels of norepinephrine and dopamine in the brain. Stimulants like methylphenidate and dextro-amphetamine (commonly known as Adderall) increase the availability of these neurotransmitters, which aid in improving focus and reducing impulsivity and aggression. These stimulants are available in various forms, including skin patches, liquids and chewable tablets. Long-acting versions of these stimulants are more effective as they result in more patient compliance and lasting and smoother improvement in symptoms.
It is crucial to keep in mind that co-existing conditions like depression and anxiety disorders can affect the response to ADHD medication. Therefore it is recommended that psychiatric issues be treated first and medication used as a secondary measure. The drugs that can be used for comorbidity disorders include atomoxetine (Bupropion) tricyclic antidepressants as well as bupropion (Wilens 2004).).
Certain patients may experience an "rebound" effect, where they experience worsening of ADHD symptoms after discontinuing stimulant medication. In these instances it is possible to try a short-term trial of the use of a low dose stimulant medication could be helpful.
Some people cannot tolerate stimulant medications or are not able to take them due to drug abuse or other health conditions, for example, heart problems that are severe or hypertension. In these cases, non-stimulant drugs like atomoxetine or viloxazine can be effective. These drugs don't have the same 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, deal with anxiety and stress, resolve conflicts, or cope with problems in their relationships or at work. It can also help co-existing mental disorders such as depression and addiction disorders.
Talk therapies include cognitive behavior therapy (CBT) and mindfulness-based cognitive therapy and schema therapy. These treatments are based on the notion that a person's beliefs and thoughts influence how they think, feel and behave. CBT helps individuals identify negative patterns of behavior and thoughts and then devise and implement positive strategies to change them. The use of meditation techniques in mindfulness-based cognitive therapy to help a person concentrate on their emotions and thoughts to control their impulses and improve executive functioning. Schema therapy and other forms of psychotherapy that focus on the family history of a person may be useful for people suffering from ADHD who suffer from significant secondary problems.
In addition to medicines psychotherapy can assist in addressing the particular issues caused by ADHD like difficulty getting through schoolwork, resolving conflict and getting together with others, losing important dates or obligations and making impulsive choices that result in legal or financial problems. It can assist a person overcome underlying issues such as anxiety and depression that could contribute to their ADHD symptoms.
Psychotherapy can help someone to develop healthy coping methods and reduce stress, for example exercising, improving sleep and healthy eating habits. It can also provide support 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 is a type of psychotherapy that is focused on helping clients overcome their negative patterns of thinking. It uses skill-based dialogue with an experienced mental health professional (a therapist) to address the underlying causes of their symptoms. The aim of this therapy is to overcome the limitations and implement coping strategies that align with the person's everyday life.
Therapists who specialize in adult ADHD-CBT teach clients to recognize unhelpful thoughts and help them develop skills to replace them with more productive thoughts. This process can take a while. It is an option for those who cannot get enough relief from their medication.
A recent RCT study concluded that when combined with medication, CBT is superior to CBT on its own in reducing the severity of core symptoms, emotional symptoms as well as self-esteem and social functioning of adults with ADHD (Clarke and colleagues. 2017). CBT coupled with methylphenidate could be particularly effective for those who have more serious underlying issues.
The therapists who provide this type of treatment typically collaborate with the client to develop an action plan specific to solving their issues. They usually teach clients a series of practical skills that are easy to apply and have a high likelihood of success. Charts are typically used to track progress and reward positive behaviors. For a child, this might involve a daily report that outlines all of the school-related tasks or positive behaviors they need to accomplish and an approach to recording and earning rewards. The therapists may consider introducing negative consequences when the child fails to complete their tasks. This can be done with sensitivity and support.
Metacognitive Therapy
Metacognitive therapy is a newer type of psychotherapy that assists people change their mindset. This type of therapy can be beneficial for those who suffer from a variety mental health problems, such as depression. It is a type of cognitive behavioral therapy which helps people recognize negative thoughts and their impact on their moods. This type of therapy may assist them in acquiring psychological tools that are adaptable and beneficial.
The aim of this study was to examine the relationship between metacognitive abilities and daily functioning in adults with ADHD. To this end we compared self- and informant-rated deficits in daily functioning to indicators of metacognition (comprehensive knowledge, regulation of cognition, debugging, information management and evaluation). It was found that the comprehensive knowledge of people was linked to daily functioning in adults with ADHD but that the processes of regulation were not. The predictive ability of a model incorporating predictors of metacognition was moderate, suggesting that they could explain a significant amount of the variance in daily functioning for people with ADHD.
Metacognitive Therapy (MCT) is an intervention that focuses on transforming metacognitive beliefs that cause dysfunction and perpetuate states like worry, rumination, or attention fixation. Adrian Wells developed MCT based on the model of information processing by Wells and Gerald Matthews. One case series has demonstrated the effectiveness of MCT in reducing anxiety disorder, however it's still relatively new and more research is required to determine its efficacy for other disorders.
This study was conceived to evaluate the efficacy of MCT to alleviate symptoms of illness anxiety disorder. However it could be used to treat a variety of disorders and is more effective than any other therapy. It is important to keep it in mind that this is not a cure for ADHD, but it can be used as an alternative therapy.
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In family therapy, the therapist works with the whole family. This helps all family members understand the client's problems and learn how to support their loved one more effectively. It also assists them in dealing with their anger and develop more effective communication skills. This type of counseling could be utilized to treat the underlying conditions, like substance abuse and depression that are commonly associated with ADHD.
The therapist will start with an intake session to better understand the family's perception and determine if they're suitable for family intervention. This can be conducted either in person or online. The Therapist will discuss the nature of treatment with each person and spell out the guidelines and rules of family therapy.
A therapist with experience treating adults with ADHD will ask a lot of questions to gain an understanding of the current symptoms as well as their past and the impact they've had on their family, work, and relationships. They will also inquire if any other mental issues are present, such depression or anxiety.
Cognitive behavioral therapy is a kind of counseling that helps you learn how to manage your behavior and change negative thinking patterns to positive ones. It focuses on improving self-esteem and self control by teaching you how to cope with anger and stress. It is a short-term treatment that can be used in conjunction with other forms of psychotherapy.
Individual therapy helps those with ADHD to deal with the emotional baggage that comes from failure and underachievement. It can also assist them in dealing with relationship conflicts or job changes as well as academic challenges. It can teach you strategies for coping with stress and stress reduction as well as how to better manage your financial and time management. It can also be used to tackle comorbid conditions, such as anxiety and mood disorders, which are often associated with ADHD.