Adult ADHD and Comorbid Disorders
Many adults suffering from ADHD also suffer from comorbid conditions, such as major depressive disorder (Kessler and colleagues, 2006). Many patients do not respond to medication for depression and may benefit from psychotherapy.
Neurotransmitters are brain chemicals that regulate and increase levels of certain brain chemicals. Commonly prescribed stimulants include methylphenidate, amphetamine and other similar drugs.
Medications
Adults can use many medications to treat ADHD in children. However, made my day are different and the medications can cause side effects that are not typical of 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 type of ADHD medication is a stimulant. It adjusts levels of two chemical messengers within the brain, norepinephrine as well as dopamine. Stimulants like methylphenidate and dextro-amphetamine (commonly known as Adderall) boost the supply of these neurotransmitters, which 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 preferable as they result in better patient compliance and longer lasting more smooth improvement in symptoms.
It is important to remember that co-existing conditions like anxiety and depression can alter the effectiveness of ADHD medication. Therefore, it is recommended that psychiatric disorders be treated first, with medication used as secondary measure. The medications that can be utilized for comorbidity disorders include atomoxetine (Bupropion), tricyclic antidepressants, and bupropion (Wilens 2004).
Certain patients may have some patients may experience a "rebound effect" where their ADHD symptoms worsen after discontinuing stimulant medication. In these instances, a brief trial of a lower dose of stimulant medication can be beneficial.
Certain people are not able to take stimulant medicines or are in a position to not take them due to drug abuse or other health issues, such as severe heart problems or hypertension. In these instances, non-stimulant drugs such as atomoxetine and viloxazine can be effective. These medications do not cause the same high rates of side effects as stimulants and carry a less risk of abuse and diversion.
Psychotherapy
People suffering from ADHD can benefit from psychotherapy (talk therapy). It can help them develop skills to improve their life manage anxiety and stress, work out conflicts, and deal with problems in relationships or at work. It can also assist with those suffering from mental illness that are co-existing, such as depression and addiction disorders.
Talk therapies include cognitive behavior therapy (CBT) and mindfulness-based cognitive therapy, and schema therapy. These therapies are based on idea that a person's beliefs and thoughts affect how they feel, think and act. CBT assists individuals in identifying negative patterns of behavior and thoughts and then formulate and implement strategies to alter these. Mindfulness-based cognitive therapy employs meditation techniques to teach people how to focus on their thoughts and emotions, manage their impulses and improve their executive functioning. Schema therapy, as well as other forms psychotherapy that focus on a person's family history could be beneficial for people with ADHD.
Psychotherapy, along with medication, can aid with specific ADHD issues, such as difficulties with schoolwork or getting along with other people. It can also assist in forgetting important dates and obligations and making decisions that are impulsive and lead to financial and legal issues. It can also help people to identify and resolve issues that could cause ADHD symptoms, like depression or anxiety.
Psychotherapy can assist people in finding healthy coping techniques and reduce stress. For example exercise, sleep improvement and healthy eating habits. It can also provide support to a family member or spouse who is struggling with the negative effects ADHD can have on their relationship. Therapy for families and marriage can help couples and families communicate better and learn how to manage ADHD symptoms together.
Cognitive Behavioral Therapy (CBT)
CBT is a form of psychotherapy that is focused on changing 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 goal of this treatment is to eliminate limitations and implement strategies for coping that are compatible with the client's daily life.
In addition to teaching clients to recognize harmful 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 take time. It is an option for those who cannot feel enough relief from their medications.
In a recent RCT study, it was concluded that cognitive behavior therapy in combination with medication is superior to cognitive behavior therapy on its own in terms of improving the core symptoms, emotional symptom self-esteem and social functioning in adults suffering from ADHD (Clarke, et al. 2017). CBT combined with methylphenidate can be particularly effective for those who have more severe underlying problems.
Therapists who provide this type of treatment work with their clients to devise an action plan to address their specific problems. They usually teach them a series of practical skills that are easy to apply and have a high likelihood of success. Typically, a chart system is used to track the progress of a child and reward positive behaviour. In the case of an infant, this could include a daily report which outlines the school tasks or positive behavior they need to accomplish and a method of monitoring and gaining rewards. The therapists may also discuss the possibility of creating negative consequences if the child fails to finish their tasks. This can be done with care and encouragement.
Metacognitive Therapy
A more recent form of therapy, metacognitive therapy, helps individuals change how they think. This type of therapy can be beneficial for people who suffer from various mental health issues, such as depression. It is a type of cognitive behavioral therapy that helps people learn to recognize negative thinking patterns and their effect on their moods. This type of therapy may also help them acquire psychological tools that are adaptable and effective.
The aim of this study was to explore the relationship between metacognitive abilities and daily functioning in adults with ADHD. To accomplish 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). It was discovered that comprehensive knowledge was connected to daily functioning in adults with ADHD but that the processes of regulation were not. Metacognition predictors had a moderate predictive power, which suggests that they could explain a significant amount of 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, and attention fixation. Adrian Wells developed MCT based on a model of information processing created by Wells and Gerald Matthews. A case series has proven the effectiveness of MCT in reducing anxiety disorder, but it's still a relatively new concept and more research is required to determine its effectiveness for other disorders.
This study was designed to assess the effectiveness of MCT in reducing 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 not a cure, but it could be utilized to treat ADHD.
Family Therapy
In family therapy, the therapist works with all family members. Everyone is able to better understand the client's issues and learn how to help their loved ones. It also assists them in finding ways to cope with their own frustrations and develop healthier communication skills. In addition, this type of counseling can be helpful in addressing comorbid conditions like depression or substance misuse which are often associated with ADHD.
The therapist will start with an intake session in order to understand the family's perception and determine whether they are suitable for intervention with the family. This can be done in person or via the internet. The therapist will discuss the nature of treatment with each client and lay out the rules and guidelines of family therapy.
A therapist who has experience in treating adults with ADHD will ask a lot of questions to gain an understanding of the client's present symptoms, their past and their impacts on their work and family life as well as relationships. They will also ask if any other mental issues are present, like depression or anxiety.
Cognitive behavioral therapy is a structured kind of counseling that teaches you to manage your behavior and change negative patterns of thinking to positive ones. It focuses on improving your self esteem and self-control by teaching you strategies to manage anger and stress. It is a short-term treatment that can be used in conjunction with other types of psychotherapy.
Individual talk therapy can help people suffering from ADHD deal with emotional trauma from a long-running pattern of failure, underachievement academic issues frequent job changes, and conflicts in relationships. It can teach ways to reduce stress and cope, and how to better manage your financial and time management. It can be used to treat the comorbidities, like anxiety and mood disorders that are often associated with ADHD.