ADHD in Adults - Treatment Options
ADHD is a common neurobiological disorder that affects 4.4 percent of the general population. It is accompanied by high levels of co-morbidity (depression anxiety, anxiety, and substance abuse) and significant emotional, social and occupational impairments.
Psychotherapy and medication are both effective treatments for adults with ADHD. The most commonly prescribed medications are stimulants such as methylphenidate or amphetamine.
Medications
Many adults with ADHD notice significant improvements in their symptoms and functioning in response to medications. Because of the different ways that people react to medications, it is important for individuals with ADHD to discover a combination that works best.
Stimulants, like methylphenidate and amphetamines, are the most commonly prescribed drugs for adults suffering from ADHD. They are available in tablets or liquids in an immediate-release (short acting) formulation. They can be taken every three to four hour. Some adults can supplement their immediate-release dose with an extended-release or long-acting medicine taken once a day to decrease the need for frequent dosing throughout the day.
Antidepressants like desipramine have also been found to be effective in the treatment of adults with ADHD. This class of medications can be employed in conjunction with stimulants or alone to enhance their effects. They can also increase the risk of serious adverse consequences, like rapid heartbeats, EKG changes and orthostatic hypotension.
Alpha-2 adrenergic antagonists like alprazolam and clonidine can also be utilized to treat adults suffering from ADHD. These medications, originally developed to treat high blood pressure, possess an calming effect and are able to increase focus and reduce hyperactivity and impulsivity in certain adults. These medications can lead to very low blood pressure when they are suddenly stopped, or the dosage is reduced.
Psychotherapy is also beneficial for adults suffering from ADHD. Individual talk therapy can help them cope with feelings of shame and embarrassment over their ADHD and anger towards supervisors, coworkers teachers, and family members who may nag or criticize them. Family and marriage counseling is also a great way to help couples with ADHD improve their understanding of each other and improve communication.
Behavioral Therapy
Psychosocial therapy for adults with ADHD aims to improve daily functioning by educating people on strategies and skills. Psychotherapy can help individuals who suffer from ADHD overcome their self-esteem problems and the feeling of failure they often feel.
Cognitive behavioral therapy (CBT) helps people change the negative thoughts that create difficulties in their lives and to develop new ways of thinking and feeling, as well as acting. This short-term, goal-oriented type of psychotherapy has been found to be effective for many disorders, including depression and anxiety. It can be used in conjunction with other treatments or by itself.
CBT could include group therapy, which is particularly beneficial for people with ADHD because it gives the opportunity to meet others who are facing similar issues and discover how other people manage their ADHD symptoms. CBT can be offered in person or via the phone. One study examined the effects of CBT with that of traditional therapy for adults with ADHD and found that both treatments led to improvements in self-report measures of functioning, symptoms and quality of life.
A number of studies have compared CBT with other psychosocial treatments for people with ADHD, and all show significant reductions in self-reported ADHD symptoms with medium to large effect size. look at these guys were associated with a variety of modalities that include cognitive and interpersonal behavioral therapy, social skill training, problem-solving training and mindfulness meditation.
However, caution is advised in comparing the efficacy of different therapies for adult ADHD. It is likely that differences in the results of treatment result from a variety of factors, such as treatment characteristics and measures used. A few studies have looked into the effectiveness of neurofeedback, an approach that involves wearing an electrode-lined cap while doing cognitive tasks to pinpoint areas of the brain where there is too much or little activity. Then, teaching the individual to control these patterns.
Counseling
Many people with ADHD also suffer from anxiety or mood disorders that need treatment. Counseling can help address these issues, which could be contributing to ADHD symptoms. Some psychotherapy approaches include interpersonal therapy to improve the capacity of individuals to establish meaningful relationships and to resolve conflicts. Cognitive behavioral therapy seeks to alter negative behaviors and assist in managing self-destructive and impulsive behavior which can lead to issues at work or school.
In certain cases psychotherapy can be utilized as an adjunct to the medication used for adhd in adults treatment. Patients with comorbid disorders like bipolar disorder, and substance abuse must be assessed carefully to ensure they do not have symptoms that are not improved by the medication used to treat ADHD. Patients with certain medical conditions, including thyroid disorders, lead poisoning, and seizures in the past, need to be treated more aggressively as they are more at risk of developing complications from the medications.
Intensive outpatient programs might be recommended if the person's ADHD is such that it hinders their daily functioning and quality of life. These programs provide structured treatment that is more intense than conventional outpatient psychotherapy.
Cognitive behavioral therapy (CBT) helps adults with ADHD improve their abilities to manage time management, impulse control, executive function, and planning. It helps them understand and express emotions and uses worksheets and activities to make the learning interesting. The training in mindfulness meditation improves CBT and improves the ability of a person's ability to concentrate and manage emotions. It enhances the capacity of a person to tolerate the effects of stress and arousal. It can assist them in dealing with anger, sadness and other emotions which could be contributing to their ADHD.
Occupational Therapy
Adults with ADHD experience difficulties at work and at home. In addition to impacting work performance, these symptoms interfere with relationships and can result in financial issues. Therapy that addresses these issues can help you boost your self-esteem, solve the root causes of your issues and develop healthy coping mechanisms.
Cognitive-behavioral therapy is a useful treatment for adults with ADHD because it helps you change your negative beliefs and behavior. It is focused on teaching time management techniques and overcoming thinking distortions that contribute to negative moods, and the perception of limited options.
Many people with ADHD have depression or anxiety disorders that are comorbid. These psychiatric disorders can exacerbate or decrease the effectiveness of some treatments for ADHD. It is recommended to treat the most severe comorbidity and then observe its response to the medication prior to treating the other condition.
Occupational therapy can help you organize your life and work and establish routines that are predictable to control your time and money, and develop a positive image of yourself. It can help you master ways to relax that could reduce impulsivity and hyperactivity. In the same way, yoga and other exercise can help you focus better by stabilizing the body in various poses.
Family and marriage counseling can address the issues adults with ADHD frequently cause their children, spouses, and other family members. They often complain of being erratic and unorganized. They often forget things or make impulsive decisions. You can strengthen relationships by informing your spouses and family members about ADHD. It can help you and your family members to understand that the problems are due to ADHD and not a lack in caring or refusing to cooperate.
Clinical Trials
Adult ADHD is a neurobiological disorder which is extremely frequent. It is accompanied by high levels of comorbidity. This includes depression, anxiety and addiction disorders. Treatment options include psychosocial and medical interventions. There are a variety of medications available to adults suffering from ADHD, and some of them have been evaluated in clinical trials. These studies have exposed the strengths and drawbacks of the medications.
Adults suffering from ADHD may experience the same symptoms as children do, but it can be difficult to determine because childhood symptoms might not persist in adulthood. Adults who suffer from ADHD might not have a family background of the disorder or may not remember symptoms. A thorough medical history is important to determine if the symptoms are caused by an illness such as a thyroid problem, sleep apnea, vision and hearing problems or lead poisoning.
Medications for adults with ADHD generally fall into two categories: stimulants and nonstimulant medications. Stimulants are the most effective medications for treating adults with ADHD and their responsiveness rates are within the 70-80 percentage range. Amphetamine and methylphenidate are the most commonly prescribed stimulants. Methylphenidate is also administered through a transdermal system. This allows for continuous medication delivery during the daytime.
Nonstimulant medicines for adults suffering from ADHD are primarily tricyclic antidepressants which work on dopamine and norepinephrine. Desipramine, which is the most researched tricyclic, has shown to be effective in adult ADHD patients. It is a low dose medicine and is recommended to increase the dose by 50 mg every seven days until the desired response is observed.
Bupropion XL is a different antidepressant that has been proven to be effective in adults suffering from ADHD. It is a dopamine agonist that blocks the reuptake of norepinephrine at the presynaptic transporter, increasing its availability in brain. The drug is known to improve the mood of adults and reduce hyperactivity, however, it's not as effective at improving concentration or cognitive functions as stimulants.