Adult ADHD and Comorbid Disorders
Many people with ADHD also have comorbid disorders like major depressive disorder (Kessler and colleagues, 2006). Many patients do not respond to medications for depression and may benefit from psychotherapy.
Medications that most effectively improve the most fundamental symptoms of ADHD appear to increase and balance levels of specific neurotransmitters, which are brain chemicals. Stimulants such as methylphenidate and amphetamine are commonly prescribed.
Medications
Many medications that are used to treat ADHD in children can also be used for adults. adult add treatments and side effects are different. The doctor will examine the medical history, the family health history, and other conditions of an individual to determine which drug is best.
The most popular type of ADHD medication is a stimulant. It is used to regulate levels of two chemical messengers in the brain, namely norepinephrine and dopamine. The stimulants methylphenidate and dextroamphetamine (commonly called Adderall) increase the amount of these neurotransmitters. They aid in improving focus and reducing impulsivity and aggression. They are available in a variety of forms, including chewable tablets, liquids and skin patches. Long-acting versions of these stimulants are preferable because they provide more patient compliance and lasting and smoother improvement in symptoms.
It is crucial to keep in mind that comorbid conditions like anxiety or depression may affect the response to ADHD medication. Therefore, it is recommended that these psychiatric issues be treated first, and medication be used as a second measure. The drugs that can be used for comorbid mood disorders are atomoxetine (Bupropion) tricyclic antidepressants as well as bupropion (Wilens, 2004).
Certain patients may experience a "rebound" effect where they experience worsening of ADHD symptoms after stopping stimulant medication. In these instances, a short trial of a low dosage of stimulant medication can be beneficial.
Some people cannot tolerate stimulant medicines or are unable to take them due to addiction or other health conditions such as severe heart problems or hypertension. In these cases, nonstimulant medication such as atomoxetine (Strattera) and viloxazine (Qelbree) can be effective. These drugs do not have the same amount of adverse effects as stimulants and have less risk of abuse and diversion.
Psychotherapy
People suffering from ADHD may benefit from psychotherapy (talk therapy). It can help people who suffer from ADHD learn to improve their lives, manage anxiety and stress, resolve conflicts, or cope with issues at work or in relationships. It can also assist with co-occurring mental illnesses like depression and substance use disorders.
Talk therapies include cognitive behavior therapy (CBT) and mind-body cognitive therapy, and schema therapy. These therapies are based upon the notion that thoughts and beliefs can influence how a person is feeling, thinks and behaves. CBT helps individuals identify negative patterns of behavior and thoughts and then devise and implement positive strategies to change them. Mindfulness-based cognitive therapy uses techniques for meditation to teach a person how to focus on their thoughts and emotions, manage their impulses, and improve their executive functioning. Schema therapy and other forms of psychotherapy focused on a person's family history could be beneficial for those who suffer from ADHD who have significant secondary issues.
In addition to medications psychotherapy can assist in addressing the particular issues caused by ADHD like difficulty staying on track with schoolwork, resolving conflicts, being able to get together with others, losing important dates or responsibilities and making impulsive choices that lead to legal or financial problems. It can also assist people to identify and overcome underlying issues that may cause ADHD symptoms, like anxiety or depression.
Psychotherapy can help a person develop healthy coping strategies and reduce stress, for example exercising, improving sleep and healthy eating habits. It can also offer support to a spouse or family member who may be dealing with the effects of ADHD on their relationship. Marriage and family therapy can help families and couples communicate better and learn how to manage ADHD symptoms together.
Cognitive Behavioral Therapy (CBT)
CBT is a type of psychotherapy that focuses on helping clients change their negative thinking patterns. It involves a dialogue based on skills with a mental health professional to identify the root cause of symptoms. This treatment aims to help clients overcome impairments and develop coping skills that are in line with their everyday lives.
In addition to teaching clients to recognize harmful thoughts, therapists who specialize in adult ADHD CBT assist them in developing skills that allow them to replace negative thoughts with more productive ones. This process can take time. It's a possibility for those who cannot get enough relief from their medications.
A recent RCT study concluded that when paired with medication, CBT is superior to cognitive behavioral therapy alone in reducing core symptoms, emotional symptoms self-esteem, and social functioning of adults suffering from ADHD (Clarke and co. 2017). The combination of CBT and methylphenidate is especially beneficial for those suffering from more severe underlying issues.
Therapists who offer this kind of treatment work with their clients to develop an action plan to address the specific issues they face. They will teach them a set of skills that are easy to master and have a high probability of success. Typically, a chart system is used to monitor the progress of a child and reward positive behavior. For an infant, this could involve a daily report which outlines the school activities or positive behaviors they must perform and a method of tracking and earning rewards. Therapists can also talk about the possibility that negative consequences could be imposed if a child isn't able to finish their work. This can be done in a very sensitive and supportive way.
Metacognitive Therapy
Metacognitive therapy is an innovative form of psychotherapy that helps people to change their thinking. This kind of therapy can be effective for people suffering from a range of mental health issues which include depression. It is a type of cognitive behavioral therapy which assists people in recognizing negative thinking patterns and their effects on their moods. This kind of therapy helps individuals develop psychological tools that are versatile and useful.
This study was designed to investigate the relationship between metacognitive abilities and daily functioning in adults suffering from ADHD. In order to do this, we compared self and informant-rated impairments in daily functioning with the 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 regulatory processes were not. The predictive ability of a model incorporating metacognition predictors was moderate, which suggests that they can explain significant proportions of the variation in daily functioning for adults with ADHD.
Metacognitive Therapy (MCT) is an intervention which focuses on reversing metacognitive beliefs that cause dysfunction and perpetuate states such as worry, rumination, or attention fixation. MCT was developed by Adrian Wells based on an information processing model 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 efficacy for other disorders.
This study was conceived for evaluating the effectiveness of MCT to alleviate symptoms of illness anxiety disorder. However it could be used 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 but it could be employed as an alternative therapy.
Family Therapy
In family therapy, the therapist works with all family members. Everyone is able to better understand the client's issues and learn to assist their loved family members. It also helps them find ways to cope with their own anxieties and develop healthier communication skills. Additionally, this type of counseling can be helpful for addressing comorbidities like depression or substance misuse which are often seen alongside ADHD.
The therapist will commence with an intake session to gain a clearer understanding of the family's perspective of the problem and evaluate their ability to intervene with the family. It can be done either in person or online. The Therapist will explain to each participant the purpose of therapy and the do's & don'ts for family therapy.
A therapist who has experience in treating adults suffering from ADHD will ask lots of questions to gain understanding of 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 issues are present, like anxiety or depression.
Cognitive behavioral therapy is a structured kind of counseling that teaches you how to control your behavior and change negative thinking patterns to positive ones. It focuses on improving your self esteem and self-control by teaching techniques to cope with stress and anger. It is a treatment option for short-term use that can be paired with other types of psychotherapy.
Individual therapy can help people suffering from ADHD overcome emotional burdens resulting from long-standing patterns of underachievement, failure academic issues frequent job changes, and conflicts in relationships. It can help you develop coping and stress reduction techniques and help you manage your time and finances more effectively. It can also be used to address comorbid conditions, such as anxiety and mood disorders, that are often associated with ADHD.