Adult ADHD and Comorbid Disorders
Many people suffering from ADHD suffer from comorbid disorders, such as major depression (Kessler et al 2006). Many depressed patients are not able to respond well to medication and could benefit from therapy.
Treatments that are most effective in reducing core symptoms of ADHD are those that boost and regulate levels of certain brain chemicals called neurotransmitters. The most frequently prescribed stimulants include amphetamine, methylphenidate, and similar drugs.
Medicines
Adults are able to take many different medications to treat ADHD in children. The dosages and the side effects can be different. The doctor will look at the medical history, the family health history and other conditions of an individual to determine which medication 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 called Adderall) increase the amount of these neurotransmitters, which aid in improving focus and reducing aggression and impulsivity. They come in various forms such as chewable tablets, liquids, and skin patches. Long-acting versions of these stimulants are preferred because they lead to better patient compliance and longer lasting, smoother improvement in symptoms.
It is important to remember that comorbidities like depression and anxiety disorders can influence the response to ADHD medications. Therefore, it is recommended that these psychiatric issues be treated first, with medications be used as a secondary measure. The medications that can be used for comorbidity disorders include atomoxetine (Bupropion) tricyclic antidepressants as well as bupropion (Wilens 2004).).
Some patients may suffer from an "rebound effect" in which their ADHD symptoms worsen after discontinuing stimulant medication. In these cases, a short-term trial of a low-dose stimulant medication may be beneficial.
Some people cannot tolerate stimulant medications or are in a position to not take them due to abuse of drugs or other health issues, like heart issues that are severe or hypertension. In these cases, non-stimulant drugs such as atomoxetine and viloxazine are effective. These drugs do not have the same amount of side effects as stimulants, and are lower risks of misuse and diversion.
Psychotherapy
People suffering from ADHD are able to benefit from psychotherapy (talk therapy). It can help people with ADHD learn how to improve their lives, deal with stress and anxiety, resolve conflicts, or manage issues at work or in relationships. It can also assist with people with mental disorders that coexist, like depression and addiction disorders.
Talk therapies include cognitive-behavioral therapy (CBT) and mindfulness-based cognitive therapy and schema therapy. These therapies are based upon the idea that thoughts and beliefs can influence how a person is feeling, thinks and behaves. CBT helps an individual identify negative thoughts and behaviors and then formulate and implement strategies to alter these. Meditation techniques are used in mindfulness-based cognitive therapy to help a person focus on their thoughts and emotions as well as control their impulses and improve executive functioning. Schema therapy and other types of psychotherapy that focus on a person's family history could be beneficial for those with ADHD with significant secondary problems.
Psychotherapy, as well as medication, can help with specific ADHD issues, such as difficulty completing schoolwork or getting along with other people. It can also help in avoiding important dates and obligations and making decisions that are impulsive and result in legal and financial problems. It can help a person overcome underlying issues such as depression and anxiety that may be contributing to their ADHD symptoms.
Psychotherapy can help people find healthy coping techniques and reduce stress. For example exercising, improving sleep and healthy eating habits. It can also provide support to an individual in the family or with a partner who is dealing with the effects ADHD has on their relationship. Marriage and family therapy can assist families and couples communicate better and understand how to manage ADHD symptoms together.
Cognitive Behavioral Therapy (CBT)
CBT is a type of psychotherapy that focuses on helping clients change their negative thoughts. It involves a dialog based on skill with a mental health professional to address the underlying cause of symptoms. The goal of this treatment is to correct the limitations and implement coping strategies that align with the client's daily life.
In treating add in adults , they teach clients to recognize harmful thoughts, those who specialize in adult ADHD CBT aid them in developing abilities that enable them to replace unhelpful thinking with more productive ones. This process can take a long time. It's a possibility for adults who do not receive 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 the emotional symptoms, core symptoms as well as self-esteem and social functioning in adults with ADHD (Clarke et al., 2017). The combination of CBT and methylphenidate is particularly effective for those who have more severe underlying problems.
The therapists who provide this type of treatment typically work with the client to develop an action plan that is specific to solving their issues. They train them in a series of skills that are easy to learn and have a high probability of success. Charts are typically utilized to track progress and to reward positive behavior. For children, this could be a daily journal which outlines the school activities or positive behaviors they need to accomplish and a system for monitoring and gaining rewards. Therapists can also consider creating negative consequences if children fail to finish their tasks. This can be done with sensitivity and encouragement.
Metacognitive Therapy
A newer form of therapy, metacognitive therapy, helps individuals change how they think. This kind of therapy can be beneficial for people suffering from a range of mental health issues which include depression. It's a type of cognitive behavioral therapy that helps people to identify their negative thoughts and how they impact their moods. This type of therapy can also assist in the acquisition of psychological tools that are able and effective.
The goal of this study was to examine the relationship between metacognitive abilities and daily functioning in adults with ADHD. To achieve this, we examined the relationship between the self- and informant-rated impairments in daily functioning to the indicators of metacognition (comprehensive knowledge, regulation of cognition debugging, management of information, and evaluation). It was found that the comprehensive knowledge of people was linked to daily functioning in adults with ADHD but that regulatory processes were not. The predictors of metacognition had a moderate predictive power, which suggests they could explain a significant amount of variation in the daily functioning of people with ADHD.
Metacognitive therapy (MCT) is a form of psychotherapy which focuses on changing metacognitive beliefs that cause states of worry and rumination, as well as attention fixation. Adrian Wells developed MCT based on the model of information processing by Wells and Gerald Matthews. A case series has proven the effectiveness of MCT in tackling anxiety disorder, however it's still relatively new and more research is required to determine its effectiveness in other disorders.
This study was designed to assess the effectiveness of MCT to alleviate symptoms of anxiety disorder. However it could be used to treat a variety of disorders and may be more effective than any other treatment. It is important to keep in mind that this isn't an effective treatment for ADHD but it could be employed as an adjunctive therapy.
Family Therapy
In family therapy, therapists work with all family members. Everyone is able to better understand the client's needs and learn to assist their loved family members. It also assists them in finding ways to deal with their own frustrations and improve their communication skills. Additionally, this type of therapy is helpful for addressing comorbidities like depression or addiction to drugs, which are typically seen alongside ADHD.
The therapist will begin with an intake session to understand the family's views and determine if they're suitable for intervention with the family. The session can be conducted in person or online. The Therapist will discuss the nature of treatment with each individual and set out the guidelines and rules of family therapy.
A therapist who has experience treating adults with ADHD asks lots of questions to gain insight into the current symptoms as well as their past and the impact that they have on their work, family and relationships. They will also inquire whether any other mental health issues are present, such anxiety or depression.
Cognitive behavioral therapy is a type of counseling that teaches you to manage your behavior and transform negative thinking patterns to positive ones. It focuses on boosting self-esteem and self-control by teaching you how to cope with anger and stress. This is a short-term solution that can be utilized alongside other types of psychotherapy.
Individual talk therapy can help people with ADHD deal with emotional burdens resulting from long-standing patterns of failure, underachievement academic struggles frequent job changes, and conflict in relationships. It can help you learn coping and stress reduction techniques and teach you how to manage your time and money more efficiently. It can also help with the comorbidity of disorders like depression and anxiety, which are often seen as a result of ADHD.