Adult ADHD and Comorbid Disorders
Many people with ADHD have comorbid conditions like major depression (Kessler and co., 2006). Many people who suffer from depression aren't able to take medication and may be able to benefit from therapy.
Neurotransmitters are brain chemicals that regulate and increase levels of certain brain chemicals. Commonly prescribed stimulants include amphetamine, methylphenidate, and similar drugs.
Medicines
Many of the medications used to treat ADHD in children can be used in adults. However, the dosages are different and the drugs may cause side effects that are not typical of children. A doctor will look at the medical history of the patient as well as family history and other health issues to determine which medicine is most suitable for them.
The most well-known 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) increase the amount of these neurotransmitters, which help improve focus and reduce aggression and impulsivity. These stimulants are available in different forms, such as skin patches, liquids and chewable tablets. Long-acting versions of these stimulants are more effective because they provide better patient compliance and longer lasting more smooth improvement of symptoms.
It is crucial to keep in mind that comorbid disorders such as anxiety or depression can affect the response to ADHD medication. It is therefore recommended that these psychiatric issues be treated first, and medication be used as a second measure. Medications that can be used to treat comorbid mood disorders include atomoxetine, bupropion and tricyclic antidepressants (Wilens 2004).).
Some patients might suffer from some patients may experience a "rebound effect" in which their ADHD symptoms become worse after stopping stimulant medications. In these instances, a short trial of a low dosage of stimulant medication may be helpful.
Some people are unable to take stimulant medications or take it due to addiction to drugs or other health conditions such as severe hypertension or heart problems. In these situations, nonstimulant medications such as atomoxetine and viloxazine are effective. These medications do not cause the same high rates of adverse effects as stimulants and have a lower risk for misuse and diversion.
Psychotherapy
People with ADHD may benefit from psychotherapy (talk therapy). It can help people with ADHD to improve their lives, deal with stress and anxiety, manage conflicts, or deal with problems in their relationships or at work. It can also assist with co-existing mental disorders such as depression and addiction disorders.
Talk therapies include cognitive-behavioral therapy (CBT), mindfulness-based cognitive therapy and schema therapy. These therapies are based upon the notion that thoughts and beliefs influence how a person is feeling, thinks and behaves. CBT helps an individual identify negative patterns of behavior and thoughts and then develop and implement strategies to change them. Mindfulness-based cognitive therapy uses techniques for meditation to teach people how to concentrate on their thoughts and emotions, manage their impulses, and improve their executive functioning. Schema therapy, along with other forms psychotherapy that focus on a person’s family history could be beneficial for people with ADHD.
In addition to medicines psychotherapy can also help with the specific problems caused by ADHD problems, like having trouble keeping up with schoolwork, resolving conflict and being able to get along with others, forgetting important dates or obligations, and impulsive decisions that result in legal or financial problems. Psychotherapy can also help individuals to address and resolve issues that cause ADHD symptoms, such as anxiety or depression.
Psychotherapy can help people find healthy coping techniques and reduce stress. For example exercise, sleep improvement and healthy eating habits. It can also provide support to a spouse or family member who is struggling with the effects of ADHD on their relationship. Marriage and family therapy can help couples and families improve communication and learn to manage ADHD symptoms together.
Cognitive Behavioral Therapy
CBT is a type of psychotherapy that is focused on helping clients overcome their negative patterns of thinking. It involves a skill-based dialog with a mental health professional to address the underlying cause of symptoms. The aim of this treatment is to correct impairments and implement coping strategies that align with the daily routine of the client.
In addition to educating clients to recognize unhelpful thoughts, therapists who specialize in adult ADHD CBT aid them in developing skills that allow them to replace negative thoughts with more productive ones. This process can be lengthy. It is a viable option for those who are unable to feel enough relief from their medications.
A recent RCT study concluded that when paired with medication, CBT is superior to CBT on its own in improving core symptoms, emotional symptoms, self-esteem and social functioning of adults with ADHD (Clarke and colleagues., 2017). The combination of CBT and methylphenidate is particularly effective for those who have more severe underlying problems.
Therapists who offer this kind of treatment work with their clients to devise an action plan to address their specific problems. They train them in a series of practical skills that are simple to master and have a high probability of success. A chart system is often used to track progress and reward positive behaviors. In the case of a child, this might include a daily report that lists all the in-school tasks or positive behaviors they have to perform, as well as a system for monitoring and gaining rewards. Therapists can also talk about the possibility that negative consequences might be inflicted upon a child who fails to complete their tasks. This can be done in a very sensitive and supportive manner.
Metacognitive Therapy
A more recent form of therapy, metacognitive therapy, assists individuals in changing how they think. This kind of therapy can be beneficial for people who suffer from a variety of mental health issues which include depression. It's a type of cognitive behavioral therapy that helps individuals learn to recognize their negative thoughts and how they affect their moods. This kind of therapy helps to develop mental tools that are versatile and useful.
This study aimed to examine the relationship between metacognitive capabilities and daily functioning among adults with ADHD. To do this we compared self and informant-rated impairments in daily functioning with predictors of Metacognition (comprehensive Knowledge, Regulation of Cognition, Debugging Information Management and Evaluation). It was observed that the comprehensive knowledge of people was linked to daily functioning in adults with ADHD but that the processes of regulation were not. Metacognition predictors had moderate predictive power which indicates that they can be the cause of significant variation in the daily functioning of adults with ADHD.
Metacognitive Therapy (MCT) is an treatment that focuses on changing metacognitive beliefs that are dysfunctional and perpetuate states such as worry, rumination, and attention fixation. Adrian Wells developed MCT based on the model of information processing by Wells and Gerald Matthews. One case series has demonstrated the effectiveness of MCT in managing illness 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 it is also able to treat various disorders and could be more effective than any other therapy. It is important to keep it in mind that this is not a cure for ADHD however it can be utilized as an adjunctive therapy.
Family Therapy
In family therapy, the therapy therapist works with the entire family. This allows everyone to understand the client's problems and learn how to support their loved ones better. It also helps them find ways to cope with their own anxieties and develop healthier communication skills. This kind of counseling can be used to tackle the underlying conditions, like addiction and depression, which are often seen as part of ADHD.
The therapist will begin with an intake session in order to understand the family's perception and determine if they're suitable for intervention with the family. This can be done in person or via the internet. The therapist will discuss the nature of the therapy with each client and lay out the do's and don'ts of family therapy.
A therapist who has had experience working with adults suffering from ADHD asks lots of questions to get a better understanding of their present symptoms, their past, and the impact they have on their family, work and personal relationships. They will also ask whether any other mental problems are present, for example depression or anxiety.
Cognitive behavioral therapy (CBT) is a structured form of counseling which teaches you to change your negative thinking patterns and manage your behavior. It focuses on improving self-esteem and self-control by teaching you strategies to manage stress and anger. It is a short-term treatment option 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 strategies for coping with stress and stress reduction and also how to better manage your finances and time. It can also help with comorbid disorders such as anxiety and mood disorders which are frequently associated as a result of ADHD.