Adult ADHD and Comorbid Disorders
Many people suffering from ADHD have comorbid disorders such as major depression (Kessler and co., 2006). Many patients do not respond to medications for depression and may benefit from psychotherapy.
The most effective medications to treat the symptoms of ADHD are those that boost and balance levels of certain brain chemicals called neurotransmitters. 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 also be used in adults. The dosages and effects are different. The doctor will look at the medical history, the family health history, and other medical factors of the individual to determine which drug is most appropriate for the patient.
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 known as Adderall) boost the supply of these neurotransmitters. They can improve focus and decrease aggression and impulsivity. They are available in a variety of forms such as chewable tablets, liquids, and skin patches. These stimulants that last longer are popular as they lead to better patient compliance, as well as a smoother, longer-lasting improvement in symptoms.
It is important to remember that comorbid conditions such as anxiety and depression can affect the response to ADHD medication. It is therefore recommended that these psychiatric issues be treated first before medication be used as a second measure. The medications that are used to treat comorbid mood disorders include atomoxetine and bupropion and tricyclic antidepressants (Wilens 2004).
Some patients may exhibit some patients may experience a "rebound" effect, where they experience a worsening of ADHD symptoms after discontinuing stimulant medication. In these instances, a short trial of a low dosage of stimulant medication could be beneficial.
Some people are unable take stimulant medication or use it due to drug misuse or other health issues such as heart or hypertension problems that are severe. In these situations, nonstimulant drugs like atomoxetine or viloxazine may be beneficial. These medications don't cause the same negative side effects as stimulants, and are less likely to be abused or misused.
Psychotherapy
People with ADHD are able to benefit from psychotherapy (talk therapy). It can help those who suffer from ADHD learn to improve their lives, manage stress and anxiety, resolve conflicts, or deal with issues in their relationships or at work. It can also assist with co-occurring mental illnesses like depression and addiction disorders.
Talk therapies include cognitive behavior therapy (CBT), mind-body cognitive therapy, as well as schema therapy. These treatments are based on the notion that thoughts and beliefs can affect how a person behaves, thinks and feels. CBT helps individuals identify negative patterns of behavior and thoughts and then formulate and implement strategies to alter these. Mindfulness-based cognitive therapy uses techniques for meditation to teach people how to focus on their thoughts and emotions, control impulses, and improve their executive functioning. Schema therapy and other forms of psychotherapy focusing on the family history of a person could be beneficial for those suffering from ADHD who suffer from significant secondary problems.
In addition to medications psychotherapy can assist in addressing the particular issues caused by ADHD like difficulty staying on track with schoolwork, resolving conflict and being able to get along with others, ignoring important dates or obligations, and impulsive decisions that result in financial or legal troubles. It can also help people to identify and resolve issues that be contributing to their ADHD symptoms, like depression or anxiety.
Psychotherapy can assist a person to develop healthy coping methods and reduce stress through exercises, sleep improvement and healthy eating habits. It can also offer support to a family or partner member who may be dealing with the effects of ADHD on their relationship. Family therapy and marriage counseling can help couples and families learn how to communicate better and manage ADHD symptoms together.
Read the Full Write-up (CBT)
CBT is a form of psychotherapy that is focused on changing the client's negative thinking patterns. It involves a dialog based on skill with a mental health professional to address the root causes of the symptoms. This treatment is designed to help patients overcome impairments and develop coping skills that are appropriate to their daily lives.
In addition to educating clients to recognize unhelpful thoughts, therapists who specialize in adult ADHD CBT help them develop abilities that enable them to replace negative thoughts with more productive ones. This process can be lengthy. However, it is a viable option for adults who do not receive enough relief from medications.
A recent RCT study concluded that when paired with medication, CBT is superior to cognitive behavioral therapy alone in reducing the severity of the emotional symptoms, core symptoms, self-esteem and social functioning of adults suffering from ADHD (Clarke and co. 2017). The combination of CBT and methylphenidate is especially effective for those with more severe underlying problems.
Therapists who provide this type of treatment work with their clients to create an action plan that addresses the specific issues they face. They typically teach them the fundamentals of therapy that are simple to implement and have a good chance of success. Typically, a chart system is utilized to track progress and reward positive behavior. This could include the daily report of children that lists the tasks they have to finish at school or the positive behaviors that need to be exhibited, and a system of monitoring and rewarding. The therapists may consider the introduction of negative consequences if children fail to complete their tasks. This can be done in a sensitive and supportive manner.
Metacognitive Therapy
Metacognitive therapy is an innovative form of psychotherapy that helps people to change their thinking. This kind of therapy could be beneficial for those who suffer from various mental health issues, such as depression. It is a form of cognitive behavioral therapy that helps people recognize negative thought patterns and their effects on their emotions. This type of therapy may also assist in the acquisition of psychological tools that are able and effective.
The goal of this study was to investigate the relationship between metacognitive capabilities and daily functioning in adults suffering from ADHD. To achieve this we compared self- and informant-rated deficits in daily functioning with the indicators of metacognition (comprehensive knowledge as well as regulation of cognition, debugging, information management and evaluation). The results indicated that comprehensive knowledge was associated with daily functioning among adults with ADHD, but not regulation processes. The predictive effectiveness of a model that includes metacognition predictors was moderate, suggesting that they could explain a significant amount of the variation in daily functioning for people with ADHD.
Metacognitive Therapy (MCT) is an intervention which focuses on reversing metacognitive beliefs that cause dysfunction and perpetuate states such as worry, rumination, and attention fixation. MCT was developed by Adrian Wells based on an information processing model created by Wells and Gerald Matthews. MCT has been shown to be effective in treating anxiety disorder. However, it's still a relatively new treatment and more research is required to determine if it could aid in other disorders.
This study was created to assess the effectiveness of MCT in the reduction of symptoms of illness anxiety disorder, but it can be applied to a range of disorders and may even be more effective than other treatments. It is not a cure, but can be utilized to treat ADHD.
Family Therapy
In family therapy, the therapist works with the whole family. This helps all family members be aware of the issues facing the client and to learn how they can support their loved one more effectively. It also helps them deal with their frustrations and develop better communication skills. In addition, this type of therapy is helpful for addressing comorbidities like depression or alcohol abuse, which are commonly found in conjunction with ADHD.
The therapist will start with an intake session in order to gain a better understanding of the family's views and determine if they're suitable for intervention with the family. This can be done in person or online. The therapist will explain to each person the nature of treatment as well as the rules and regulations for family therapy.
A therapist who has experience in treating adults with ADHD will ask a lot of questions to gain insight into the client's current symptoms, their history and their impact on their work life as well as their family and social life. They will also ask whether there are other mental health issues that are present like anxiety or depression.
Cognitive behavioral therapy (CBT) is an organized form of counseling which teaches you to change your negative thoughts patterns and control your behavior. It concentrates on improving self-esteem and self-control by teaching you methods to deal with anger and stress. It is a short-term treatment option that can be used in conjunction with other forms of psychotherapy.
Individual therapy helps those with ADHD to deal with the emotional baggage that comes from failure and underachievement. It can also assist them in dealing with conflicts in relationships, job changes, and academic issues. It can help you learn strategies for coping with stress and stress reduction and also how to manage your time and finances. It can also help with problems that are comorbid, such as mood and anxiety disorders which are frequently associated with ADHD.