treating adult adhd and Comorbid Disorders
Many people with ADHD also have comorbid disorders such as major depressive disorder (Kessler and colleagues 2006). Many patients do not respond to medications for depression and may be able to benefit from psychotherapy.
Neurotransmitters are brain chemicals that regulate and increase levels of certain brain chemicals. Stimulants such as methylphenidate and amphetamine are often prescribed.
Medicines
Adults can take a variety of medications to treat ADHD in children. However the dosages are different and the drugs may cause negative side effects that aren't typical of children. The doctor will take a look at the medical history, the family health history, and other medical health conditions of the patient to determine which medication is most appropriate for the patient.
The most commonly used kind of ADHD medication is stimulant and is used to regulate levels of two chemical messengers within the brain, namely norepinephrine and dopamine. Stimulants such as methylphenidate or dextro-amphe (commonly known as Adderall) increase the amount of these neurotransmitters. They help improve focus and reduce aggression and impulsivity. These stimulants are available in different forms, including liquids, skin patches and chewable tablets. These long-acting stimulants are preferred due to their improved patient compliance, and an easier, longer-lasting improvement of symptoms.
It is crucial to be aware that co-occurring disorders like depression or anxiety disorders can influence the response to ADHD medication. Therefore, it is recommended that psychiatric disorders be treated first before medication used as secondary measure. The medications that can be used to treat comorbid disorders of mood are atomoxetine (Bupropion) tricyclic antidepressants and bupropion (Wilens, 2004).).
Certain patients may experience a "rebound" effect in which they experience an increase in ADHD symptoms after stopping stimulant medication. In these instances, a brief trial of a low dosage of stimulant medication may be helpful.
Certain people are not able to take stimulant drugs or are unable to take them due to addiction or other health conditions, such as severe heart problems or hypertension. In these cases, nonstimulant medications like atomoxetine (Strattera) and viloxazine (Qelbree) can be effective. These medications don't have the same adverse effects as stimulants, and are less likely to be misused or diverted.
Psychotherapy
People suffering from ADHD can benefit from psychotherapy (talk therapy). It can help those with ADHD to improve their lives, manage anxiety and stress, resolve conflicts, or deal with issues at work or in relationships. It can also assist with co-existing mental illnesses like depression and substance abuse disorders.
Talk therapies include cognitive behavior therapy (CBT), mind-body cognitive therapy and schema therapy. These therapies are based on the notion that thoughts and beliefs influence how someone behaves, thinks and feels. CBT helps people recognize negative behavior and thought 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 emotions and thoughts, manage their impulses, and improve their executive functioning. Schema therapy, as well as other forms of psychotherapy focused on a person's family history can be beneficial for those suffering from ADHD who suffer from significant secondary issues.
In addition to medications psychotherapy can also help with the specific issues that arise from ADHD problems, like having trouble keeping up with schoolwork, resolving conflicts and being able to get together with others, losing important dates or responsibilities as well as impulsive decisions that can lead to legal or financial problems. It can assist a person overcome the root issues like anxiety and depression that could be contributing to their ADHD symptoms.
Psychotherapy can help a person develop healthy coping strategies and reduce stress through exercise, sleep improvement and healthy eating habits. It can also provide support to a partner or family member who may be dealing with the effects of ADHD on their relationship. Therapy for families and marriage can help families and couples improve communication and learn to manage ADHD symptoms together.
Cognitive Behavioral Therapy
CBT is a kind of psychotherapy that focuses on helping clients to change their negative thoughts. It employs dialogue based on skill with a skilled mental health professional (a therapist) to address the root causes of their symptoms. This therapy aims to assist clients overcome their impairments and develop coping skills that are compatible with their daily lives.
Therapists who specialize in adult ADHD-CBT show clients to recognize harmful thought patterns and help them develop skills to replace them with more productive thoughts. This process can take a long time. However, it is a viable alternative for adults who do not receive enough relief from their medication.
A recent RCT study found that when paired with medication, CBT is superior to cognitive behavioral therapy on its own in reducing the severity of the core symptoms, emotional symptoms, self-esteem and social functioning of adults with ADHD (Clarke and co., 2017). The combination of CBT and methylphenidate is especially effective for those who have more severe underlying problems.
The therapists who offer this kind of treatment usually collaborate with the client to develop an action plan specific to solving their issues. They train them in a series of practical skills which are easy to learn and have a high probability of success. Charts are typically utilized to track progress and reward positive behaviors. This could be the daily report of children that lists the tasks they have to complete at school, or the positive behaviors that need to be exhibited, and a system of monitoring and earning rewards. Therapists may also discuss the possibility that negative consequences might be imposed if a child isn't able to finish their work. This can be done in a very sensitive and supportive way.
Metacognitive Therapy
Metacognitive therapy is a newer kind of psychotherapy that helps people change their thinking. This type of treatment is effective for those suffering from a range of mental health issues, including depression. It's a form of cognitive behavioral therapy that helps individuals learn to recognize their negative thought patterns and how they impact their emotions. This kind of therapy helps individuals develop psychological tools that are versatile and useful.
The aim of this study was to explore the relationship between metacognitive abilities and daily functioning in adults suffering from ADHD. In order to do this, we compared self and informant-rated impairments in daily functioning with the predictors of metacognition (comprehensive knowledge, regulation of Cognition, Debugging, Information Management, and Evaluation). The results indicated that comprehensive knowledge was linked to daily functioning among adults suffering from ADHD, but not regulation processes. The predictive power of a model with metacognition predictors was moderate, suggesting that they could explain significant proportions of the variance in daily functioning for adults with ADHD.
Metacognitive Therapy (MCT) is an intervention that focuses on transforming metacognitive beliefs that are dysfunctional and perpetuate states such as worry, rumination, and attention fixation. Adrian Wells developed MCT based on an idea of information processing created by Wells and Gerald Matthews. MCT has been shown to be effective in treating illness anxiety disorder. However, it is still an in-development treatment and more research is needed to determine whether it can help with other disorders.
This study was designed to evaluate the effectiveness of MCT in the reduction of symptoms of illness anxiety disorder, however it can be applied to a variety of disorders, and may be more effective than other treatments. It is important to keep in mind that this isn't an effective treatment for ADHD however it can be used as an adjunctive therapy.
Family Therapy
In family therapy, the therapist works with all family members. Everyone can gain a better understanding of the client's issues and learn to assist their loved family members. It also helps them find ways to cope with their own frustrations and improve their communication skills. This type of counseling could be used to tackle the underlying conditions, like substance abuse and depression, which are often seen with ADHD.
The therapist will commence with an intake session to gain an understanding of the family's perception of the problem and evaluate their ability to intervene with the family. The session can be conducted in person or via the internet. The therapist will explain to each client the nature of treatment as well as the do's & don'ts for family therapy.
A therapist with experience treating adults suffering from ADHD will ask a variety of questions in order 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 inquire whether any other mental health issues are present, like anxiety or depression.
Cognitive behavioral therapy (CBT) is a structured form of counseling that teaches you how to change your negative patterns of thinking and to manage your behavior. It focuses on improving self-esteem and self-control through teaching techniques to cope with anger and stress. It is a treatment option for short-term use that can be paired with other types of psychotherapy.
Individual therapy can help those with ADHD overcome emotional baggage from longstanding patterns of underachievement and failure academic struggles, frequent job changes and relationship conflict. It can teach strategies for coping with stress and stress reduction as well as how to better manage your time and finances. It can be used to treat comorbid conditions, such as mood and anxiety disorders, that are often associated with ADHD.