Adult ADHD and Comorbid Disorders
Many adults with ADHD have comorbid disorders such as major depression (Kessler and colleagues, 2006). Many depressed patients are not able to respond well to medication and may get better results from therapy.
Neurotransmitters are brain chemicals that regulate and increase levels of certain brain chemicals. The most frequently prescribed stimulants include methylphenidate, amphetamine and other similar medications.
Medications
Adults are able to take many different medications that are used for ADHD in children. The dosages and effects differ. The doctor will look at the medical history, family health history, and other medical conditions of an individual to determine which medication is best.
The most commonly used type of ADHD medication is stimulant and is used to regulate levels of two chemical messengers within the brain, namely norepinephrine and dopamine. Stimulants like methylphenidate and dextro-amphetamine (commonly called Adderall) increase the availability of these neurotransmitters, which help improve focus and reduce impulsivity and aggression. These stimulants are available in various forms, including skin patches, liquids, and chewable tablets. These long-acting stimulants are preferred due to their improved patient compliance, and a smoother, longer-lasting improvement in symptoms.
It is important to be aware that comorbid disorders such as depression or anxiety disorders can influence the response to ADHD medication. Therefore, it is recommended that these psychiatric problems be treated first, and medication be used as a second measure. The medications that are used to treat comorbid psychiatric disorders include atomoxetine, bupropion and tricyclic antidepressants (Wilens 2004).
Some patients may exhibit an "rebound" effect, where they experience an increase in ADHD symptoms after stopping stimulant medication. In these instances, a short-term trial of an atypical stimulant drug could be beneficial.
Some people are unable to tolerate stimulant medicines or are in a position to not take them due to abuse of drugs or other health conditions like heart issues that are severe or hypertension. In these situations, non-stimulant medications like atomoxetine (Strattera) and viloxazine (Qelbree) can be effective. These medications don't cause the same negative side effects as stimulants and are less likely to be abused or misused.
Psychotherapy
People with 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 deal with issues at work or in relationships. It can also aid those suffering from mental illness that are co-existing such as depression and substance abuse disorders.
Talk therapies include cognitive-behavioral therapy (CBT) and mindfulness-based cognitive therapy, and schema therapy. These therapies are based on belief that one's beliefs and thoughts affect how they think, feel and behave. CBT helps an individual identify negative behaviors and thought patterns and then devise and implement positive strategies to change them. The use of meditation techniques in mindfulness-based cognitive therapy to help people concentrate on their thoughts and emotions as well as control their impulses and improve executive functioning. Schema therapy, along with other forms of psychotherapy that focus on the family history of a person can be beneficial for people with ADHD.
In addition to medications psychotherapy can assist in addressing the specific issues that arise from ADHD, such as trouble keeping up with schoolwork, resolving conflict and being able to get along with others, ignoring important dates or obligations and making impulsive choices that lead to legal or financial problems. It can also assist a person explore and overcome underlying issues that be contributing to their ADHD symptoms, such as anxiety or depression.
Psychotherapy can help someone find healthy coping skills and reduce stress, such as exercising, improving sleep 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. Therapy for families and marriage helps couples and families learn how to communicate better and manage ADHD symptoms together.
Cognitive Behavioral Therapy
CBT is a form of psychotherapy that is focused on helping clients overcome their negative thinking patterns. It involves a skill-based dialog with an expert in mental health to address the root reason for the symptoms. The aim of this treatment is to overcome impairments and implement coping strategies that fit with the client's daily life.
In addition to educating clients to recognize unhelpful thoughts, therapists who specialize in adult ADHD CBT assist them in developing abilities that enable clients to replace their negative thoughts with more productive ones. This process can take some time. However, it's a good option for those who do not receive enough relief from medications.
In an upcoming RCT that was conducted, it was discovered that cognitive behavioral therapy combined with medication is superior to cognitive behavior therapy alone when it comes to improving the core symptoms, emotional symptoms, self-esteem, and social performance for adults with ADHD (Clarke, et al. 2017). CBT combined with methylphenidate can be particularly effective for those who suffer from more serious underlying issues.
Therapists who offer this kind of treatment work with clients to develop an action plan that addresses their specific issues. They usually teach them a series of practical skills that are easy to apply and have a high chance of being successful. A chart system is often used to monitor progress, and reward positive behaviors. In the case of a child, this might involve a daily report that outlines all of the school tasks or positive behavior they need to accomplish and a method of tracking and earning rewards. The therapists can also discuss the possibility that negative consequences might be introduced when a child does not complete their task. This can be done in a sensitive and supportive manner.
Metacognitive Therapy
Metacognitive therapy is a newer form of psychotherapy that helps people to change their thinking. This kind of therapy can be beneficial for people with a variety of mental health issues which include depression. It is a kind of cognitive behavioral therapy which helps people recognize negative thought patterns and their effect on their emotions. This kind of therapy can help to develop mental tools that are adaptable and beneficial.
The purpose of this study was to explore the relationship between metacognitive skills 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). The results showed that comprehensive knowledge was associated with daily functioning among adults suffering from ADHD but not with regulation processes. Metacognition predictors had a moderate predictive power, which indicates that they can explain an important amount of variation in the daily functioning of adults with ADHD.
Metacognitive therapy (MCT) is a psychotherapy that focuses on modifying dysfunctional metacognitive beliefs that perpetuate states of anxiety, rumination and attention fixation. MCT was created by Adrian Wells based on an information processing model developed by Wells and Gerald Matthews. One case series has demonstrated the effectiveness of MCT in managing illness anxiety disorder, however it's still relatively new and more research is required to determine its effectiveness for other disorders.
This study was designed to assess the effectiveness of MCT in decreasing symptoms of anxiety disorder, but it can be applied to a variety of disorders and could be more effective than other therapies. It's important to keep in mind that this is not a cure for ADHD however it can be employed as an alternative therapy.
I Am Psychiatry
In family therapy, the therapist works with all members of the family. All members can better understand the client's issues and learn to assist their loved ones. It also assists them in finding ways to deal with their own frustrations and develop healthier communication skills. Additionally, this type of counseling is useful in addressing comorbid conditions such as depression and alcohol abuse, which are commonly associated with ADHD.
The therapist will start with an intake session to gain a better understanding of the family's perspective and determine if they are suitable for intervention with the family. It can be done in person or online. The therapist will explain to each participant the nature of treatment and the rules for family therapy.
A therapist with had experience working with adults suffering from ADHD asks a lot questions to get a better understanding of their present symptoms as well as their past and the impact that they have on their family, work, and relationships. They will also inquire whether there are any other mental health issues that are present like depression or anxiety.
Cognitive behavioral therapy is a structured kind of counseling that teaches you how to manage your behavior and transform negative patterns of thinking to positive ones. It focuses on improving self-esteem and self-control by educating you on how to handle stress and anger. It is a short-term treatment that can be used in conjunction with other types of psychotherapy.
Individual therapy can help those with ADHD deal with emotional burdens resulting from long-standing patterns of underachievement, failure academic issues, frequent job changes and conflict in relationships. It can help you develop strategies for managing stress and coping and teach you how to manage your time and money more effectively. It can also help with the comorbidity of disorders like depression and anxiety which are frequently associated as a result of ADHD.