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ADHD in Adults - Treatment Options
ADHD is a common neurological disorder that affects 4,4% of the population. It is associated by high rates of comorbidity, including anxiety, depression and addiction to drugs, and significant social, emotional and occupational impairments.
Psychotherapy and medications are both effective treatments for adults with ADHD. The most frequently prescribed drugs are stimulants like methylphenidate or amphetamine.
Medicines
Many people who suffer from ADHD notice significant improvements in their symptoms and functioning in response to medications. Due to the various ways that people react to medications, it is important for individuals with ADHD to find a combination that is most effective.
Adults suffering from ADHD are prescribed stimulants such as amphetamines or methylphenidate. These stimulants are available in tablets or liquids in an immediate-release (short acting) formulation. They can be taken every three to four hours. Some adults can supplement their immediate-release dose with an extended-release or long-acting medicine that is taken daily to reduce the need for frequent dosing throughout the day.
Adults with ADHD can be treated effectively with antidepressants, like desipramine. This class of drugs may be employed in conjunction with stimulants or in isolation to boost their effects. However, they could increase the risk of serious cardiovascular side effects such as an increased heart rate, EKG changes, and orthostatic hypotension.
Alpha-2 adrenergic agonists such as alprazolam as well as clonidine are used for the treatment of adults suffering from ADHD. These drugs were initially developed to treat hypertension. They are calming and may improve focus and reduce the amount of hyperactivity and impulsivity in certain adults. These medications can lead to extremely low blood pressure if they suddenly stop, or the dosage is reduced.
Adults suffering from ADHD may also benefit from psychotherapy. Individual talk therapy can help them cope with feelings of shame and embarrassment over their ADHD, as well as anger toward supervisors, colleagues teachers, and family members who might nag or criticize them. Counseling for families and marriage is a great method to help couples suffering from ADHD improve their understanding of each other and improve communication.
Behavioral Therapy
Psychosocial therapy for adults with ADHD is designed 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 inadequacy they feel frequently.
Cognitive behavioral therapy (CBT) is also referred to as cognitive behavioral therapy helps people change their negative thoughts and emotions that are causing difficulties in their lives. It teaches them new ways to think, feel and act. This short-term, goal-oriented form of psychotherapy has been found to be effective for many disorders, including depression and anxiety. It can be used by itself or in combination with other treatments.
CBT may also include group therapy. This is especially beneficial for those suffering from ADHD as it allows them to connect with others who have similar struggles and learn about how they manage their ADHD symptoms. It can be delivered in person or by phone. One study examined the effects of CBT in comparison to standard therapy for adults with ADHD and discovered that both treatments resulted in improvement in self-report assessments of functioning, symptoms, and quality of life.
A number of studies have compared CBT with other psychosocial treatments for people with ADHD and all have shown significant reductions in self-reported ADHD symptoms, with medium to large effect size. These improvements were linked to a variety of modalities that include cognitive and interpersonal behavioral therapy, social skills training, problem-solving and mindfulness meditation.
However, caution is warranted in comparing the effectiveness of various treatments for adult ADHD. It is possible that the different outcomes of the treatments are due to a variety of variables, including treatment characteristics, measures used and the background of the patient. There are few studies that have investigated the effectiveness neurofeedback. This method involves wearing an electrode-lined hat while performing cognitive tasks to determine brain regions where there is a lack or excess of activity. The person is then taught to regulate these patterns.
Counseling
Many people suffering from ADHD also suffer from anxiety or mood disorders that need treatment. Counseling can help address these problems, which may be contributing to the ADHD symptoms. Some psychotherapy approaches include interpersonal therapy to enhance the ability of a person to form meaningful relationships and resolve conflicts. Cognitive behavioral therapy aims to change negative behavior and assist in reducing self-destructive and impulsive behaviors that can cause problems at school or at work.
In some cases, psychotherapy is used as an alternative to the medication used for ADHD treatment for adults. Patients suffering from co-occurring disorders like depression, substance abuse and bipolar disorder need to be assessed to ensure that their symptoms are not worsened by medications used to treat ADHD. Certain medical conditions, like thyroid disorders, lead poisoning, and a history of seizures, need to be treated with more vigor.
In-depth outpatient programs could be recommended if the person's ADHD is so severe that it significantly affects their daily functioning and quality of life. These programs provide an organized therapy that is more intense than the traditional outpatient psychotherapy.
Cognitive behavioral therapy (CBT) is a type of cognitive therapy, assists adults with ADHD to improve their ability to manage time, impulse control, planning and executive functioning. It helps them understand and express their emotions and utilizes activities and worksheets to make the lessons interesting. Meditation training that is mindful enhances CBT and improves a person's ability to focus and manage their emotions. It enhances the capacity of a person to manage stress and arousal. It helps them deal with sadness, anger and other difficult emotions which could be contributing to their ADHD.
Occupational Therapy
Adults with ADHD often have difficulties functioning at home and at work. In addition to affecting work performance, these conditions can cause problems with relationships and can cause financial problems. Therapy that addresses these issues can help 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 teaches you how to modify your negative beliefs and behavior. It focuses on teaching you to employ strategies to manage your time and eliminate mental distortions that lead to negative moods and the perception of a limited range of choices.
Many people suffering from ADHD suffer from anxiety or depression disorders as comorbid conditions. These psychiatric illnesses may aggravate or diminish the effectiveness of some drugs used to treat ADHD. Therefore untreated adhd in adults relationships is recommended you treat the most severe comorbidity first and observe its response to medication before proceeding to treatment of the other disorder.
Occupational therapy can help you learn methods to organize your life and your work, establish regular routines, manage your money and time and develop an optimistic self-image. It can also help you master relaxation techniques that could decrease your impulsivity and hyperactivity. Yoga and other exercises can also aid in improving your concentration by stabilizing your body during various postures.
Family and marriage counseling can address the issues adults suffering from ADHD often cause their children, spouses, and others. They often complain about being unreliable, disorganized, forgetful and often prone to making impulsive choices. Therapy and classes in which spouses and other family members are educated about ADHD can help you establish more harmonious relationships. Additionally it can help you and your loved ones to understand that these problems are related to the patient's ADHD rather than an absence of care or a willful refusal to cooperate.
Clinical Trials
Adult ADHD is a neurobiological disorder that is highly common. It is accompanied by a high rate of comorbidity. This includes anxiety, depression and substance abuse disorders. Psychosocial and medication interventions are available as treatments. There are a variety of medications available for adults with ADHD, and some of them have been evaluated in clinical trials. These studies have revealed the strengths and weaknesses of the drugs.
Adults with ADHD experience the same symptoms as children, however it can be difficult to identify them since childhood symptoms may not persist until adulthood. Additionally, people with ADHD might not have a history of the disorder in their family or they may not remember experiencing symptoms. A thorough medical history is essential to determine if the symptoms are caused by a medical condition such as thyroid issues or sleep apnea, hearing and vision problems or lead poisoning.
Treatments for adults suffering from ADHD generally fall into two categories: stimulants and nonstimulant medications. Stimulants have the highest reaction rates for people suffering from ADHD. Their responsiveness rates vary from 70 to 80%. Amphetamine and methylphenidate are among the most frequently prescribed stimulants. Methylphenidate may also be administered through a transdermal system. This allows for continuous medication delivery throughout the day.
Adults with ADHD are able to take nonstimulant medication that are based on norepinephrine, or dopamine. Desipramine, the most studied tricyclic, has been proven 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 and is able to block the reuptake process of norepinephrine by the presynaptic transporter, thereby increasing its availability in the brain. This drug has been proven to improve the mood of adults and reduce hyperactivity, however, it's not as effective in improving concentration or cognitive function as stimulants.