Adult ADHD and Comorbid Disorders
Many people with ADHD also suffer from comorbid conditions, such as major depression (Kessler and colleagues, 2006). Many depressed patients do not respond well to medication and could benefit from therapy.
Neurotransmitters are brain chemicals that regulate and increase levels of certain brain chemicals. The most commonly prescribed stimulants are amphetamine, methylphenidate, and similar drugs.
Medicines
A variety of medications used to treat ADHD in children can be used in adults. The dosages and the side effects can be different. A doctor will consider the individual's medical history as well as family history and other health issues to determine which medication is most suitable for him or her.
The most popular kind of ADHD medication is stimulant. It adjusts levels of two chemical messengers in the brain called norepinephrine and dopamine. Stimulants such as methylphenidate (also called Adderall) and dextroamphetamine increase the availability of neurotransmitters that help improve focus, reduce impulsivity and reduce aggression. They come in many forms such as chewable tablets, liquids, and skin patches. These long-acting stimulants are favored because they improve patient compliance, as well as an easier, longer-lasting improvement of symptoms.
It is important to keep in mind that co-existing conditions like anxiety and depression may alter the effectiveness of ADHD medication. It is therefore recommended that these psychiatric problems be treated first before medication used as secondary measure. Some medications that are used to treat comorbid mood disorders include bupropion, atomoxetine and tricyclic antidepressants (Wilens 2004).).
Certain patients might have a "rebound effect" where their ADHD symptoms become worse after stopping 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 medicines or are not able to take them due to drug abuse or other health conditions, like heart issues that are severe or hypertension. In these situations, non-stimulant medication such as atomoxetine (Strattera) and viloxazine (Qelbree) can be effective. These medications don't have the same side effects as stimulants, and are less likely to be abused or misused.
Psychotherapy
People suffering from ADHD may benefit from psychotherapy (talk therapy). It can help them gain strategies to improve their lives to manage anxiety and stress, resolve conflicts, and cope with problems in relationships or at work. It can also aid with co-occurring mental illnesses such as depression and substance use disorders.
Talk therapies include cognitive behavioral therapy (CBT) as well as mindfulness-based cognitive therapy as well as schema therapy. These therapies are based on the notion that thoughts and beliefs can influence how a person feels, thinks and acts. CBT helps a person recognize negative behaviors and thinking patterns, and then formulates and implements strategies to alter these patterns. Mindfulness-based cognitive therapy uses meditation techniques to help a person learn to concentrate on their emotions and thoughts, manage their impulses, and improve their executive functioning. Schema therapy, and other forms of psychotherapy that focus on a person’s family history can be beneficial for people suffering from ADHD.
In addition to medication, psychotherapy can help address the specific problems caused by ADHD like difficulty getting through schoolwork, resolving conflict and getting along with others, ignoring important dates or responsibilities and making impulsive choices that result in legal or financial issues. Psychotherapy can also help people to identify and resolve issues that may contribute to their ADHD symptoms, like anxiety or depression.
Psychotherapy can help people discover healthy coping techniques and reduce stress. For example exercising, improving sleep, and healthy eating habits. It can also provide assistance to a family member or partner who is dealing with the negative effects ADHD has 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 type of psychotherapy that focuses on transforming the client's negative thinking patterns. It involves a dialog based on skill with a mental health professional to address the underlying reason for the symptoms. This therapy aims to help clients overcome limitations and develop coping strategies that are appropriate to their daily lives.
Therapists who specialize in adult ADHD-CBT instruct clients to recognize unhelpful thought patterns and help them build the skills to replace them with more productive thoughts. This process can take a while. However, it is a viable alternative for adults who do not receive enough relief from medication.
A recent RCT study found that when paired with medication, CBT is superior to cognitive behavioral therapy on its own in reducing the severity of core symptoms, emotional symptoms, self-esteem and social functioning of adults suffering from ADHD (Clarke and colleagues., 2017). The combination of CBT and methylphenidate is particularly beneficial for those suffering from more severe underlying issues.
Therapists who offer this kind of treatment work with their clients to create an action plan to address the specific issues they face. They usually teach them a set of practical skills that are simple to implement and have a good chance of being successful. A chart system is often used to track progress and reward positive behaviors. For an infant, this could involve a daily report which outlines the in-school tasks or positive behavior they need to accomplish and a method of tracking and earning rewards. Therapists can also consider creating negative consequences if the child fails to complete their work. This can be done in a sensitive and supportive manner.
Metacognitive Therapy
A more recent form of therapy, metacognitive therapy, helps individuals change how they think. This kind of therapy can be beneficial to those who suffer from various mental health issues, such as depression. It's a form of cognitive behavioral therapy that assists individuals learn to recognize their negative thinking patterns and how they affect their moods. This type of therapy can also help them acquire psychological tools that are flexible and useful.
The goal of this study was to examine the relationship between metacognitive abilities and daily functioning in adults with ADHD. To accomplish this we examined the relationship between self- and informant-rated impairments in daily functioning to predictors of metacognition (comprehensive knowledge as well as regulation of cognition, debugging, information management and evaluation). The results showed that complete knowledge was associated with daily functioning in adults with ADHD but not with regulation processes. adult adhd treatment of a model incorporating metacognition predictors was moderate, which suggests that they can explain an important portion of the variance in daily functioning of people with ADHD.
Metacognitive Therapy (MCT) is an treatment which focuses on reversing dysfunctional metacognitive belief patterns that perpetuate states like worry, rumination, or attention fixation. MCT was developed by Adrian Wells based on an information processing model by Wells and Gerald Matthews. One case series has demonstrated the effectiveness of MCT in tackling anxiety disorder, but it's still relatively new and more research is needed to determine its effectiveness for other disorders.
This study was created to assess the effectiveness of MCT in the reduction of symptoms of illness anxiety disorder, however it can be applied to a range of disorders, and may be more effective than other treatments. It is important to keep it in mind that this is not a cure for ADHD but it could be employed as an adjunctive therapy.
Family Therapy
In family therapy, the therapist collaborates with all family members. Everyone can gain a better understanding of the issues of the client and learn to assist their loved ones. It also helps them deal with their anger and develop better communication skills. This type of counseling could be used to tackle the underlying conditions, like substance abuse and depression that are commonly associated with ADHD.
The therapist will start with an intake session to better understand the family's views and determine if they are suitable for family intervention. This can be done in person or via the internet. The Therapist will discuss the nature of the therapy with each individual and set out the do's and don'ts of family therapy.
A therapist with experience in treating adults with ADHD will ask lots of questions in order to gain insight into the client's current symptoms, their history and their impact on their work, family life and relationships. They will also inquire whether any other mental health problems are present, for example depression or anxiety.
Cognitive behavioral therapy (CBT) is a structured form of counseling that teaches you how to change your negative thinking patterns and manage your behavior. It is focused on improving your self-esteem and self-control by teaching you techniques to cope with anxiety and stress. It is a short-term treatment that can be used in conjunction with other types of psychotherapy.
Individual therapy helps those with ADHD to manage the emotional baggage that results from failing and underachievement. It can also help them deal problems with relationships, job changes, and academic challenges. It can teach you coping and stress reduction techniques and help you manage your time and money more efficiently. It can be used to treat other comorbid conditions like mood and anxiety disorders, which are often seen alongside ADHD.