From All Over The Web: 20 Fabulous Infographics About Treatment Adult ADHD
Adult ADHD and Comorbid Disorders
Many people with ADHD also have comorbid disorders like major depression (Kessler and colleagues 2006). Many patients do not respond to medication for depression and may be able to benefit from psychotherapy.
Medications that most effectively improve core symptoms of ADHD are those that boost and balance levels of specific brain chemicals called neurotransmitters. Commonly prescribed stimulants include amphetamine, methylphenidate, and similar drugs.
Medicines
Adults are able to take many different drugs that are prescribed for ADHD in children. However the dosages are different and the medications can cause adverse effects that aren't common in children. A doctor will consider the individual's medical history, family history and other health issues to determine which medicine is the best for them.
The most commonly used ADHD medication is a stimulant. It works by altering the levels of norepinephrine and dopamine in the brain. The stimulants like methylphenidate (also called Adderall) and dextroamphetamine increase the availability of neurotransmitters that help improve focus, reduce impulsivity, and reduce aggression. They come in various forms, including chewable tablets, liquids, and skin patches. These long-acting stimulants are favored as they lead to better patient compliance and an easier, longer-lasting improvement in symptoms.
It is crucial to remember that comorbid disorders such as anxiety or depression can influence the response to ADHD medication. It is therefore recommended that these psychiatric problems be treated first, and medications be used as a secondary measure. Medications that can be used to treat comorbid mood disorders include bupropion, atomoxetine and tricyclic antidepressants (Wilens 2004).
Some patients may exhibit some patients may experience a "rebound" effect, where they experience a worsening of ADHD symptoms after discontinuing stimulant medications. In these instances it is possible to try a short-term trial of an atypical stimulant drug could be beneficial.
Certain people are not able to take stimulant medications or are in a position to not take them due to drug abuse or other health conditions, for example, heart problems that are severe or hypertension. In these situations, nonstimulant drugs like atomoxetine or viloxazine may be beneficial. These medications don't cause the same adverse 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 them gain techniques to improve their lives, deal with stress and anxiety, resolve conflicts, and manage problems in relationships or at work. It can also assist those suffering from mental illness that are co-existing like depression and substance abuse disorders.
Talk therapies include cognitive behavioral therapy (CBT), mindfulness-based cognitive therapy, and schema therapy. These treatments are based on the notion that a person's beliefs and attitudes affect how they feel, think and act. CBT helps individuals identify negative behaviors and thought patterns and then develop and implement positive strategies to alter these. Meditation techniques are employed in mindfulness-based cognitive therapy to help a person concentrate on their emotions and thoughts, control impulses, and improve executive functioning. Schema therapy, as well as other forms of psychotherapy focusing on a person's history with their family may be useful for people with ADHD with significant secondary problems.
In addition to medications psychotherapy can assist in addressing the specific problems caused by ADHD problems, like having trouble getting through schoolwork, resolving conflicts and getting together with others, losing important dates or obligations, and impulsive decisions that lead to legal or financial issues. It can also assist a person explore and overcome issues that may contribute to their ADHD symptoms, such as anxiety or depression.
Psychotherapy can help people find healthy strategies for coping and decrease stress. For example, exercise, sleep improvement, and healthy eating habits. It can also provide support to a partner or family member who may be dealing with the effects of ADHD on their relationship. Family therapy and marriage counseling can help couples and families learn how to communicate better and manage ADHD symptoms together.
Cognitive Behavioral Therapy (CBT)
CBT is a type of psychotherapy that focuses on transforming the negative patterns of thinking that clients have. It involves a skill-based dialog with an expert in mental health to address the root causes of the symptoms. This treatment is designed to help patients overcome impairments and develop coping skills that are appropriate to their everyday lives.
Therapists who specialize in adult ADHD-CBT instruct clients to recognize harmful thinking patterns and assist them to build the skills to replace them with more productive thoughts. This process can take some time. But it is an effective alternative for adults who do not receive enough relief from medication.
In an upcoming RCT, it was found that cognitive behavior therapy in combination with medication is superior over cognitive behavior therapy by itself when it comes to improving core symptoms, emotional symptoms, self-esteem, and social functioning in adults suffering from ADHD (Clarke and co. 2017). CBT coupled with methylphenidate could be particularly effective for those who have more severe underlying issues.
The therapists who provide this type of treatment typically work with the client to develop an action plan specific to addressing their problems. They will teach them a set of skills that are easy to master and have a high chance of success. A chart system is often utilized to track progress and reward positive behaviors. In the case of children, this could involve a daily report which outlines the school-related tasks or positive behavior they have to perform, as well as an approach to monitoring and gaining rewards. The therapists may also discuss the possibility of the introduction of negative consequences if children fail to finish their tasks. This can be done in a very sensitive and supportive manner.
Metacognitive Therapy
A newer type of therapy, metacognitive therapy helps individuals change how they think. This kind of therapy could be beneficial for people who suffer from a range of mental health problems, such as depression. It is a kind of cognitive behavioral therapy which helps people learn to recognize negative thoughts and their effects on their moods. This type of therapy can also help them acquire psychological tools that are flexible and useful.
This study was designed to investigate the relationship between metacognitive abilities and daily functioning among adults with ADHD. To do 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 complete knowledge was linked to daily functioning among adults with ADHD but not with the processes that regulate. Metacognition predictors had moderate predictive power which indicates that they can explain a significant amount of variations in the daily functioning of adults suffering from ADHD.
Metacognitive therapy (MCT) is a form of psychotherapy which focuses on changing dysfunctional metacognitive beliefs that perpetuate states of worry, rumination and attention fixation. MCT was developed by Adrian Wells based on an information processing model created by Wells and Gerald Matthews. A case series has proven the effectiveness of MCT in tackling anxiety, but it's still relatively in its infancy and more research is needed to determine its effectiveness in other disorders.
treatment of add 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 even be more effective than other therapies. This isn't an effective treatment, but it can be employed to treat ADHD.
Family Therapy
In family therapy the therapy therapist works with the entire family. Everyone can gain a better understanding of the client's needs and learn how to help their loved family members. It also helps them find ways to deal with their own frustrations and develop healthier communication skills. Additionally, this kind of therapy is helpful for addressing comorbidities such as depression or alcohol abuse, which are commonly seen alongside ADHD.
The therapist will begin with an intake session to better understand the family's perception and determine whether they are appropriate for family intervention. This can be conducted in person or online. 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 lots of questions to gain an understanding of the client's current symptoms, their history and their impacts on their work and family life as well as relationships. They will also ask whether any other mental health issues are present, such depression or anxiety.
Cognitive behavioral therapy is a structured kind of counseling that teaches you how to control your behavior and change negative patterns of thinking to positive ones. It focuses on boosting self-esteem and self-control by educating you on how to handle stress and anger. This is a short-term option that can be used in conjunction with other forms of psychotherapy.
Individual talk therapy helps people with ADHD to manage the emotional baggage that results from failing and underachievement. It can also help them deal with relationship conflicts or job changes as well as academic issues. It can help you learn ways to reduce stress and cope, and how to manage your finances and time. It can also help with the comorbidity of disorders like anxiety and mood disorders that are commonly associated with ADHD.