Adult ADHD and Comorbid Disorders
Many adults with ADHD also have comorbid disorders like major depression (Kessler and colleagues, 2006). Many depressed patients are not able to respond well to medication and may benefit from therapy.
The most effective medications to treat core symptoms of ADHD seem to boost and regulate levels of certain neurotransmitters, which are brain chemicals. Drugs that stimulate the brain such as methylphenidate or amphetamine are often prescribed.
Medicines
A variety of medications used to treat ADHD in children can be used in adults. The dosages and effects are different. A doctor will take into consideration the medical history of the patient, family history and other health conditions to determine which medication is the best for them.
The most commonly used kind of ADHD medication is stimulant. It works by adjusting levels of two chemical messengers in the brain, norepinephrine as well as dopamine. The stimulants like methylphenidate (also called Adderall) and dextroamphetamine enhance the supply of neurotransmitters, which help improve concentration, decrease impulsivity, and decrease aggression. They come in many forms, including chewable tablets, liquids and skin patches. These stimulants that last longer are popular as they lead to better patient compliance and an easier, longer-lasting improvement of symptoms.
It is crucial to keep in mind that comorbid disorders such as anxiety or depression can influence the response to ADHD medication. Therefore it is recommended that disorders be treated first and medication used as a second measure. Medications that can be used to treat comorbid psychiatric disorders include bupropion, atomoxetine and tricyclic antidepressants (Wilens 2004).).
Some patients may experience an "rebound" effect where they experience an increase in ADHD symptoms after stopping stimulant medication. In these instances, a short trial of a low dose of stimulant medication could be beneficial.
Some people are unable tolerate stimulant medication or cannot take it due to addiction to drugs or other health conditions such as heart or hypertension problems that are severe. In these instances, non-stimulant drugs such as atomoxetine and viloxazine may be beneficial. These drugs don't have the same negative side effects as stimulants, and they are less likely to be misused or diverted.
Psychotherapy
People suffering from ADHD can benefit from psychotherapy (talk therapy). It can help them gain strategies to improve their lives manage anxiety and stress, resolve conflicts, and cope with problems in relationships or at work. It can also assist with co-existing mental illnesses such as depression and substance use disorders.
Talk therapies include cognitive behavior therapy (CBT), mindfulness-based cognitive therapy, and schema therapy. These therapies are based upon the notion that thoughts and beliefs can influence how a person behaves, thinks and feels. CBT helps a person recognize negative behaviors and thinking patterns, and then develops and implements strategies to alter them. Meditation techniques are used in mindfulness-based cognitive therapy to help people concentrate on their emotions and thoughts as well as control their impulses and improve executive functioning. Schema therapy, and other forms of psychotherapy that concentrate on the family history of a person can be beneficial for people suffering from ADHD.
Psychotherapy, as well as medication, can assist with specific ADHD problems, such as difficulty keeping up with schoolwork or getting along with other people. It can also assist in forgetting important dates and responsibilities and making impulsive choices that result in legal and financial issues. It can help a person overcome the root issues like depression and anxiety that may contribute to their ADHD symptoms.
Psychotherapy can assist a person find healthy coping skills and reduce stress, such as exercising, improving sleep and healthy eating habits. It can also offer support to a family or partner member who is struggling with the effects of ADHD on their relationship. Marriage and family therapy can help families and couples improve communication and learn to manage ADHD symptoms together.
Cognitive Behavioral Therapy
CBT is a type of psychotherapy which focuses on changing the client's negative thinking patterns. It utilizes skill-based dialogue with a skilled mental health professional (a therapist) to address the underlying causes of their symptoms. This treatment aims to assist clients overcome their limitations and develop coping strategies that are appropriate to their everyday lives.
Therapists who specialize in adult ADHD-CBT teach clients how to identify unhelpful thought patterns and help them develop skills to replace them with more productive thoughts. This process can take some time. It is a viable option for those who are unable to receive enough relief from their medications.
A recent RCT study concluded that when combined with medication, CBT is superior to cognitive behavioral therapy 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 et al., 2017). The combination of CBT and methylphenidate is especially effective for those who have more severe underlying issues.
The therapists who provide this type of treatment typically collaborate with the client to develop an action plan specific to addressing their problems. They train them in a series of skills that are easy to learn and have a high probability of success. Often a chart system is utilized to track the progress of a child and reward positive behavior. For children, this could include a daily report which outlines the school tasks or positive behaviors they have to perform, as well as an approach to recording and earning rewards. Therapists may also discuss the possibility that negative consequences might be inflicted upon a child who does not complete their task. This can be done with care and encouragement.
Metacognitive Therapy
Metacognitive therapy is a brand new form of psychotherapy that helps people to change their thinking. This type of therapy can be beneficial for those who suffer from various mental health issues, such as depression. It is a form of cognitive behavior therapy that helps people recognize negative thoughts and their effects on their moods. This kind of therapy can assist them in acquiring psychological tools that are able and effective.
The purpose of this study was to explore the relationship between metacognitive skills and daily functioning among adults suffering from ADHD. To achieve this we examined the relationship between the self- and informant-rated impairments in daily functioning to the indicators of metacognition (comprehensive knowledge as well as regulation of cognition debugging, management of information, and evaluation). iampsychiatry.uk was observed that comprehensive knowledge was related to daily functioning in adults with ADHD however, the regulatory processes were not. The predictive effectiveness of a model that includes metacognition predictors was moderate, suggesting that they can account for an important portion of the variance in daily functioning of people with ADHD.
Metacognitive therapy (MCT) is a psychotherapy that focuses on changing metacognitive beliefs that cause states of anxiety and rumination, as well as attention fixation. Adrian Wells developed MCT based on the model of information processing created by Wells and Gerald Matthews. One case series has demonstrated the effectiveness of MCT in managing illness 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 conceived to assess the effectiveness of MCT to treat symptoms of illness anxiety disorder. However it is also able to treat a variety disorders and may be more effective than other therapy. It is important to keep it in mind that this is not an effective treatment for ADHD however it can be utilized as an alternative therapy.
Family Therapy
In family therapy, therapists work with all family members. Everyone is able to better understand the issues of the client and learn how to help their loved family members. It also assists them in finding ways to cope with their own feelings of frustration and develop healthier communication skills. This type of counseling can be used to tackle other comorbidities, such as depression and substance abuse which are frequently associated with ADHD.
The therapist will begin with an intake session in order to understand the family's perspective and determine if they are appropriate for family intervention. This can be conducted in person or online. The therapist will discuss the nature of the therapy with each client and lay out the rules and guidelines of family therapy.
A therapist with experience treating adults with ADHD asks a lot questions to gain an understanding of their present symptoms, their past, and the impact they have on their family, work and personal relationships. They will also ask whether there are any other mental health issues present like anxiety or depression.
Cognitive behavioral therapy is a kind of counseling that teaches you how to manage your behavior and change negative thinking patterns to positive ones. It is focused on improving your self esteem and self-control by teaching you strategies to manage anxiety and stress. It is a treatment option for short-term use that can be used in conjunction with other forms of psychotherapy.
Individual therapy can help people with ADHD to deal with the emotional baggage that results from underachievement and failure. It can also assist them in dealing problems with relationships as well as job changes and academic difficulties. It can teach you stress reduction and coping techniques as well as how to manage your time and finances. It can also address problems that are comorbid, such as mood and anxiety disorders, which are often seen with ADHD.