Adult ADHD and Comorbid Disorders
Many people suffering from ADHD have comorbid disorders such as major depression (Kessler and co., 2006). Many patients are not responsive to medications for depression and may be able to benefit from psychotherapy.
Medications that most effectively improve core symptoms of ADHD appear to increase and balance levels of specific neurotransmitters in the brain. Stimulants such as methylphenidate and amphetamine are often prescribed.
Medications
Adults can use many medications to treat ADHD in children. However the dosages are different and the medications can cause negative side effects that aren't common in children. A doctor will look at the medical history of the patient, 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. Stimulants like methylphenidate and dextro-amphetamine (commonly called Adderall) increase the amount of these neurotransmitters. They aid in improving focus and reducing impulsivity and aggression. These stimulants are available in different forms, including skin patches, liquids and chewable tablets. Long-acting versions of these stimulants are preferred because they provide more patient compliance and lasting more smooth improvement in symptoms.
It is important to keep in mind that co-existing conditions like depression and anxiety disorders can affect the response to ADHD medications. Therefore it is recommended that these disorders be treated first and medication utilized as a secondary measure. The medications that are used to treat comorbid mood disorders include bupropion, atomoxetine and tricyclic antidepressants (Wilens 2004).
Certain patients may have some patients may experience a "rebound effect" in which their ADHD symptoms become worse after stopping stimulant medications. In these instances it is possible to try a short-term trial of the use of a low dose stimulant medication could be beneficial.
Some people are unable to tolerate stimulant medication or cannot take it due to drug misuse or other health issues such as heart or hypertension problems that are severe. In these instances, non-stimulant medication such as atomoxetine (Strattera) and viloxazine (Qelbree) can be effective. These drugs do not have the same high rates of adverse effects as stimulants, and are less risk of misuse and diversion.
Psychotherapy
People suffering from ADHD may benefit from psychotherapy (talk therapy). It can help them develop techniques to improve their lives manage stress and anxiety, resolve conflicts, and manage issues in relationships or at work. It can also help with co-existing mental illnesses like depression and addiction disorders.
Talk therapies include cognitive behavior therapy (CBT) and mind-body cognitive therapy and schema therapy. These therapies are based on the idea that thoughts and beliefs can affect how a person behaves, thinks and feels. CBT helps individuals identify negative thoughts and behaviors and then devise and implement positive strategies to change these. Mindfulness-based cognitive therapy utilizes techniques of meditation to help a person learn to focus on their thoughts and emotions, control impulses, and improve their executive functioning. Schema therapy, and other forms of psychotherapy that focus on a person’s family history could be beneficial for people suffering from ADHD.
In addition to medication psychotherapy can also help with the specific issues that arise from ADHD like difficulty staying on track with schoolwork, resolving conflicts and being able to get together with others, losing important dates or obligations as well as impulsive decisions that can lead to legal or financial problems. It can also assist people to identify and overcome issues that could contribute to their ADHD symptoms, like depression or anxiety.
Psychotherapy can help people discover healthy coping techniques and reduce stress. For example, exercise, sleep improvement and healthy eating habits. It can also provide assistance to the family member or partner who is dealing with the negative effects ADHD can have 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)
CBT is a kind of psychotherapy which focuses on helping clients overcome their negative patterns of thinking. It utilizes skill-based dialogue with a trained mental health professional (a therapist) to address the underlying causes of their symptoms. The aim of this treatment is to eliminate the limitations and implement coping strategies that are compatible with the daily routine of the client.
In addition, they teach clients to recognize harmful thoughts, therapists who specialize in adult ADHD CBT assist them in developing skills that allow them to replace negative thoughts with more productive ones. This process can take time. However, it's a good option for adults who are not getting adequate relief from medication.
A recent RCT study concluded that when paired with medication, CBT is superior to cognitive behavioral therapy on its own in reducing core symptoms, emotional symptoms, self-esteem and social functioning in adults with ADHD (Clarke and colleagues. 2017). CBT when combined with methylphenidate may be particularly effective for people who have more serious underlying issues.
The therapists who offer this kind of treatment usually work with the client to devise a detailed action plan for solving their issues. They typically teach them a set of practical skills that are simple to implement and have a high chance of success. A chart system is often used to track the progress of a child and reward positive behavior. For children, this could be a daily journal which outlines the school activities or positive behaviors they need to accomplish and an approach to tracking and earning rewards. Therapists can also talk about the possibility that negative consequences might be inflicted upon a child who isn't able to finish their work. This can be done in a very sensitive and calming manner.
Metacognitive Therapy
Metacognitive therapy is a newer type of psychotherapy that assists people change their thinking. This kind of therapy can be beneficial for people who suffer from various mental health issues like depression. It's a form of cognitive behavioral therapy that assists people recognize their negative thought patterns and how they impact their moods. This type of therapy may assist them in acquiring psychological tools that are able and useful.
This study was designed to investigate the relationship between metacognitive skills and daily functioning in adults with ADHD. To achieve this, we compared self- and informant-rated impairments in daily functioning to the indicators of metacognition (comprehensive knowledge, regulation of cognition debugging, information management, and evaluation). It was observed that the comprehensive knowledge of people was linked to daily functioning in adults with ADHD but that regulatory processes were not. The predictors of metacognition had moderate predictive power, which suggests that they could explain an important amount of variations in the daily functioning of adults suffering from ADHD.
Metacognitive Therapy (MCT) is an intervention that focuses on changing dysfunctional metacognitive belief patterns that perpetuate mental states such as worry, rumination and attention fixation. MCT was created by Adrian Wells based on an information processing model by Wells and Gerald Matthews. A case series has proven the effectiveness of MCT in tackling anxiety disorder, but it's still a relatively new concept and more research is required to determine its effectiveness in other disorders.
This study was conceived for evaluating the effectiveness of MCT to treat symptoms of illness anxiety disorder. However it is also able to treat a variety of disorders and is more effective than other treatment. It is important to keep in mind that this isn't a cure for ADHD, but it can be used as an adjunctive therapy.
adhd untreated in adults
In family therapy, the Therapist works with the entire family. This helps all family members be aware of the issues facing the client and to understand how to help their loved ones better. It also helps them deal with their frustrations and develop better communication skills. Additionally, this type of counseling is useful in dealing with comorbid disorders such as depression or substance misuse which are often associated with ADHD.
The therapist will commence with an intake session to get a clearer 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 Therapist will discuss the nature of treatment with each person and spell out the guidelines and rules of family therapy.
A therapist who has experience treating adults with ADHD asks a lot questions to gain an understanding of their present symptoms as well as their past and the impact they have on their work, family, and relationships. They will also inquire if there are any other mental health issues that are present like depression or anxiety.
Cognitive behavioral therapy is a structured type of counseling that teaches you to manage your behavior and change negative thinking patterns into positive ones. It focuses on boosting self-esteem and self control by educating you on how to handle anger and stress. It is a treatment option for short-term use that can be used in conjunction with other types of psychotherapy.
Individual therapy can help those with ADHD deal with emotional burdens resulting from long-standing patterns of underachievement and failure academic issues as well as frequent job changes and relationship conflict. It can teach strategies for coping with stress and stress reduction, and how to better manage your financial and time management. It can also address comorbid disorders such as anxiety and mood disorders that are commonly associated with ADHD.
