Adult ADHD and Comorbid Disorders
Many people with ADHD also suffer from comorbid conditions like major depression (Kessler and colleagues, 2006). Many people who suffer from depression do not respond well to medication and may be able to benefit from therapy.
The most effective medications to treat the most fundamental symptoms of ADHD are those that boost and regulate levels of certain neurotransmitters in the brain. Stimulants such as methylphenidate and amphetamine are often prescribed.
Medications
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 side effects that are not common in children. A doctor will consider the medical history of the patient, family history and other health conditions to determine what medication is the best for them.
The most commonly used ADHD medication is a stimulant. It works by adjusting the levels of norepinephrine, and dopamine in the brain. The stimulants like methylphenidate (also called Adderall) and dextroamphetamine increase the availability of neurotransmitters that help improve concentration, decrease impulsivity, and reduce aggression. These stimulants are available in a variety of forms, including skin patches, liquids, and chewable tablets. These stimulants that last longer are popular because they improve patient compliance, as well as more consistent, long-lasting improvement in symptoms.
It is crucial to keep in mind that co-existing conditions like anxiety and depression may influence the response to ADHD medications. It is therefore recommended that these psychiatric issues be treated first, and 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).).
Some patients may experience a "rebound" effect, where they experience worsening of ADHD symptoms after discontinuing stimulant medication. In these cases an experiment of a short duration with an atypical stimulant drug could be helpful.
Certain people are not able to take stimulant medications or take it because of addiction to drugs or other health conditions like severe hypertension or heart problems. In these instances, non-stimulant drugs such as atomoxetine and viloxazine may be beneficial. These drugs do not have the same high rates of side effects as stimulants and have a lower risk for misuse and diversion.
Psychotherapy
People suffering from ADHD are able to benefit from psychotherapy (talk therapy). It can help those with ADHD learn how to improve their lives, manage anxiety and stress, resolve conflicts, or cope with issues at work or in relationships. It can also aid those suffering from mental illness that are co-existing like depression and addiction disorders.
Talk therapies include cognitive behavior therapy (CBT) as well as mindfulness-based cognitive therapy and schema therapy. These treatments are based on the belief that one's beliefs and thoughts influence how they feel, think and act. CBT helps individuals identify negative behaviors and thought patterns and then develop and implement strategies to change them. 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, as well as other forms of psychotherapy that concentrate on a person’s family history can be beneficial for people with ADHD.
In adult adhd treatments to medications psychotherapy can assist in addressing the specific issues that arise from ADHD like difficulty getting through schoolwork, resolving conflict and getting along with others, forgetting important dates or obligations, and impulsive decisions that result in legal or financial problems. Psychotherapy can help someone overcome underlying issues such as depression and anxiety that may be contributing to their ADHD symptoms.
Psychotherapy can assist people in finding healthy ways to cope and reduce stress. For example exercise, sleep improvement, and healthy eating habits. It can also provide 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 communicate better and understand how to manage ADHD symptoms together.
Cognitive Behavioral Therapy (CBT)
CBT is a kind of psychotherapy that focuses on helping clients change their negative thinking patterns. It involves a dialogue based on skills with a mental health professional to identify the root reason for the symptoms. This therapy aims to help patients overcome limitations and develop coping strategies that are appropriate to their daily lives.
Therapists who specialize in adult ADHD-CBT instruct clients to recognize harmful thinking patterns and assist them to build the skills to replace them with more productive thoughts. The process can be long. But it is an effective option for those who do not receive enough relief from their medication.
In an upcoming RCT, it was found that cognitive behavior therapy in combination with medication is superior to cognitive behavior therapy alone when it comes to improving the core symptoms, emotional symptoms, self-esteem, and social functioning in adults with ADHD (Clarke, et al. 2017). The combination of CBT and methylphenidate is particularly beneficial for those suffering from more severe underlying issues.
The therapists who provide this type of treatment typically work with the client to devise an action plan that is specific to addressing their problems. They usually teach them a set of practical skills that are simple to implement and have a good chance of being successful. Often a chart system is utilized to track progress and reward positive behavior. In the case of an infant, this could include a daily report which outlines the school-related tasks or positive behaviors they have to perform, as well as a method of monitoring and gaining rewards. Therapists can also talk about the possibility that negative consequences could be inflicted upon a child who fails to complete their tasks. This can be done in a very sensitive and supportive manner.
Metacognitive Therapy
Metacognitive therapy is an innovative kind of psychotherapy that helps people change their thinking. This kind of therapy can be beneficial for people who suffer from a variety of mental health issues, including depression. It's a type 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 goal of this study was to investigate the relationship between metacognitive capabilities and daily functioning in adults suffering from ADHD. To this end we examined the relationship between the self- and informant-rated impairments in daily functioning with the indicators 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 with regulatory processes. The predictors of metacognition had moderate predictive power which suggests they could explain an important amount of variations in the daily functioning of people with ADHD.
Metacognitive Therapy (MCT) is an intervention which focuses on reversing metacognitive beliefs that are dysfunctional and perpetuate states such as worry, rumination, and attention fixation. MCT was created by Adrian Wells based on an information processing model developed by Wells and Gerald Matthews. MCT has been proven to be effective in treating illness anxiety disorders. However, it is still a relatively new treatment and further research is required to determine if it can aid in other disorders.
This study was conceived for evaluating the effectiveness of MCT to reduce symptoms of illness anxiety disorder. However it is also able to treat a variety of disorders and may be more effective than any other therapy. It's important to keep in mind that this isn't a cure for ADHD but it could be used as an adjunctive therapy.
Family Therapy
In family therapy, the therapist works with all family members. This allows all members to be aware of the issues facing the client and learn how to support their loved one more effectively. It also helps them find ways to deal with their own anxieties and develop healthier communication skills. Additionally, this type of counseling can be helpful for addressing comorbidities such as depression and alcohol abuse, which are commonly found in conjunction with ADHD.
The therapist will commence with an intake session to get an understanding of the family's perspective of the problem and evaluate their suitability for family intervention. This can be conducted online or in person. The therapist will explain to each client the purpose of therapy and the rules and regulations for family therapy.
A therapist who has experience treating adults with ADHD asks lots of questions to gain an understanding of the current symptoms as well as their past and the impact they have on their family, work and relationships. They will also inquire whether there are any other mental health issues that are present, such as depression or anxiety.
Cognitive behavioral therapy is a kind of counseling that teaches you how to manage your behavior and transform negative patterns of thinking to positive ones. It is focused on improving your self esteem and self-control by teaching strategies to manage anger and stress. It is a short-term treatment that can be used in conjunction with other forms of psychotherapy.
Individual talk therapy helps people with ADHD to manage the emotional baggage that results from failing and underachievement. It can also assist them in dealing with conflicts in relationships, job changes, and academic issues. It can teach you ways to manage stress and cope and teach you how to manage your time and money more efficiently. It can also address the comorbidity of disorders like depression and anxiety, which are often seen with ADHD.