Adult ADHD and Comorbid Disorders
Many people with ADHD have comorbid disorders such as major depression (Kessler et al 2006). Many patients do not respond to medication for depression and may be able to benefit from psychotherapy.
Neurotransmitters are brain chemicals that regulate and boost levels of certain brain chemicals. The most commonly prescribed stimulants are amphetamine, methylphenidate, and similar medications.
Medicines
Adults are able to take many different medications that are used for ADHD in children. The dosages and side effects differ. A doctor will look at the individual's medical history as well as family history and other health issues to determine which medication is best for him or her.
The most commonly used ADHD medication is a stimulant. It works by altering the levels of norepinephrine, and dopamine in the brain. The stimulants methylphenidate and dextroamphetamine (commonly called Adderall) boost the supply of these neurotransmitters. They can improve focus and decrease aggression and impulsivity. They come in various forms, including chewable tablets, liquids and skin patches. Long-acting versions of these stimulants are preferable because they lead to more patient compliance and lasting more smooth improvement in symptoms.
It is important to remember that comorbid conditions such as anxiety and depression may alter the effectiveness of ADHD medications. It is therefore recommended that these psychiatric problems be treated first, and medication used as secondary measure. The medications that can be utilized for comorbidity disorders include atomoxetine (Bupropion), tricyclic antidepressants and bupropion (Wilens 2004).).
Some patients might experience a "rebound effect" in which their ADHD symptoms get worse after stopping stimulant medications. In these instances, a short trial of a low dosage of stimulant medication can be beneficial.
Some people are unable take stimulant medications or take it because of drug misuse or other health issues like severe hypertension or heart problems. In these situations, non-stimulant medications like atomoxetine (Strattera) and viloxazine (Qelbree) can be effective. These drugs do not have the same high rates of side effects as stimulants and carry a less risk of misuse and diversion.
Psychotherapy
People suffering from ADHD may benefit from psychotherapy (talk therapy). It can help people with ADHD to improve their lives, manage stress and anxiety, manage conflicts, or deal with issues at work or in relationships. It can also assist with those suffering from mental illness that are co-existing, like depression and addiction disorders.
Talk therapies include cognitive behavior therapy (CBT), mind-body cognitive therapy, and schema therapy. These therapies are based on the idea that a person's beliefs and thoughts influence how they think, feel and behave. CBT assists individuals in identifying negative behaviors and thought patterns and then devise and implement positive strategies to alter these. The use of meditation techniques in mindfulness-based cognitive therapy to help someone focus on their emotions and thoughts, control impulses, and improve executive functioning. Schema therapy and other forms of psychotherapy focused on a person's history with their family can be beneficial for those suffering from ADHD who have significant secondary problems.
In addition to medications, psychotherapy can help address the specific issues that arise from ADHD problems, like having trouble getting through schoolwork, resolving conflict and getting along with others, forgetting important dates or obligations as well as impulsive decisions that can lead to legal or financial problems. It can also help people to identify and overcome underlying issues that could be contributing to their ADHD symptoms, such as depression or anxiety.
Psychotherapy can help someone find healthy coping skills and reduce stress through exercising, improving sleep and healthy eating habits. It can also offer support to a family member or spouse who is struggling with the negative effects ADHD has on their relationship. Marriage and family therapy helps couples and families learn how to communicate better and manage ADHD symptoms together.
Cognitive Behavioral Therapy (CBT)
CBT is a type of psychotherapy that is focused on transforming the patterns of negative thinking of the client. It employs dialogue based on skill with a skilled mental health professional (a therapist) to address the root causes of their symptoms. The aim of this therapy is to correct impairments and implement coping strategies that fit with the daily routine of the client.
Therapists who specialize in adult ADHD-CBT teach clients how to identify unhelpful thoughts and help them learn to replace them with more productive thoughts. The process can be long. It's a possibility for those who cannot receive enough relief from their medications.
In the course of a recent RCT, it was found that cognitive behavioral therapy combined with medication is superior to cognitive behavior therapy on its own in terms of improving the core symptoms, emotional symptoms, self-esteem and social functioning in adults with ADHD (Clarke and colleagues. 2017). CBT coupled with methylphenidate could be particularly effective for people with more severe underlying issues.
Therapists who offer this kind of treatment work with clients to develop an action plan that addresses the specific issues they face. They usually teach them a set of practical skills that are easy to apply and have a high chance of success. A chart system is often used to monitor progress, and to reward positive behavior. For children, this could be a daily journal which outlines the in-school activities or positive behaviors they need to accomplish and a system for recording and earning rewards. The therapists may also consider introducing negative consequences when children fail to finish their tasks. This can be done in a very sensitive and supportive way.
Metacognitive Therapy
Metacognitive therapy is an innovative type of psychotherapy that assists people to change their thinking. This type of treatment can be effective for people who suffer from a variety of mental health issues, including depression. It's a kind of cognitive behavioral therapy that helps people recognize their negative thoughts and how they affect their emotions. This kind of therapy can help them develop psychological tools that can be adaptable and beneficial.
The goal of this study was to explore the relationship between metacognitive abilities and daily functioning in adults with ADHD. In order to do this we compared self- and informant-rated daily functioning impairments with the predictors of metacognition (comprehensive knowledge, regulation of Cognition, Debugging, Information Management and Evaluation). The results showed that comprehensive knowledge was associated with daily functioning among adults suffering from ADHD but not with the processes that regulate. Metacognition predictors had moderate predictive power, which suggests that they could be the cause of significant variance in daily functioning of adults suffering from ADHD.
Metacognitive therapy (MCT) is a psychotherapy which focuses on changing dysfunctional metacognitive beliefs that perpetuate states of anxiety and rumination, as well as attention fixation. MCT was developed by Adrian Wells based on an information processing model developed by Wells and Gerald Matthews. A case series has proven the effectiveness of MCT in reducing anxiety disorder, however it's still relatively in its infancy and more research is needed to determine its effectiveness in other disorders.
This study was conceived to evaluate the efficacy of MCT to alleviate symptoms of illness anxiety disorder. However treatment for adults with add is also able to treat a variety disorders and could be more effective than any other treatment. It's important to keep in mind that this is not a cure for ADHD, but it can be utilized as an adjunctive therapy.
Family Therapy
In family therapy, the therapist collaborates with all members of the family. Everyone is able to better understand the issues of the client and learn how they can help their loved family members. It also helps them cope with their frustrations and develop better communication skills. This type of counseling could also be used to address comorbid conditions, such as depression and substance abuse which are frequently associated with ADHD.
The therapist will start with an intake session in order to gain an understanding of the family's perspective of the problem and evaluate their ability to intervene with the family. This can be done in person or online. The Therapist will explain to each participant the nature of treatment as well as the rules and regulations for family therapy.
A therapist with had experience working with adults suffering from ADHD will ask a lot of questions to gain insight into their current symptoms as well as their history and the impact they've had on their family, work and personal relationships. They will also ask if there are any other mental health issues like anxiety or depression.
Cognitive behavioral therapy is a kind of counseling that helps you learn how to manage your behavior and change negative patterns of thinking to positive ones. It focuses on improving self-esteem and self-control by educating you on how to manage stress and anger. This is a short-term option that can be used in conjunction with other types psychotherapy.
Individual therapy can help people suffering from ADHD deal with emotional burdens resulting from long-standing patterns of underachievement, failure academic issues as well as frequent job changes and conflict in relationships. It can help you learn strategies for managing stress and coping and help you manage your time and finances more efficiently. It can also help with problems that are comorbid, such as mood and anxiety disorders that are commonly associated as a result of ADHD.