ADHD in Adults - Treatment Options
ADHD is a common disorder of the nervous system that affects around 4,4% of the population. It is accompanied with high rates of comorbidity, including anxiety, depression, and substance abuse, and significant social, emotional and occupational impairments.
Both psychotherapy and medication are effective treatments for adults with ADHD. The most commonly prescribed medications are stimulants like methylphenidate or amphetamine.
Medicines
Many people who suffer from ADHD notice significant improvement in their symptoms and functioning in response to medication. It is essential that those who suffer from ADHD find the combination of medications that is effective for them.
Adults with ADHD are prescribed stimulants, such as amphetamines or methylphenidate. They are available in immediate-release (short-acting) tablet or liquid form, and can be taken as frequently as every three to four hours. Adults can supplement their immediate-release medicine with an extended-release, long-acting medicine once a week to reduce the necessity to take it often throughout the day.
Adults suffering from ADHD can be treated effectively with antidepressants, such as desipramine. This class of drugs may be used together with stimulants or alone to enhance their effects. However, they could increase the risk of serious cardiovascular adverse effects like rapid heartbeat, EKG changes, and orthostatic hypotension.
Alpha-2 adrenergic agonists such as alprazolam and clonidine are also used to treat people suffering from ADHD. These medications were originally developed to treat hypertension. They are calming and can improve focus, and decrease hyperactivity and impulseivity in certain adults. However, these medications can cause a very low blood pressure when they are suddenly removed or reduced in dosage.
Psychotherapy is also useful for adults with ADHD. Individual therapy can help people deal with feelings of embarrassment, shame, and resentment toward coworkers, teachers, supervisors, and family members that might nitpick or criticize them. Additionally, marriage and family counseling can help couples with ADHD to understand each other's issues 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 low self-esteem, and the feeling of inadequacy they often feel.
Cognitive behavioral therapy (CBT) helps people change the negative thoughts that create problems in their lives and to learn new ways of thinking, feeling and doing. This short-term, goal-oriented kind of psychotherapy has been found to be effective for a variety of illnesses such as anxiety and depression. It can be used alone or in conjunction with other therapies.
CBT could involve group therapy, which is particularly beneficial for people with ADHD because it gives the opportunity to meet others who have similar struggles and to learn from others how they manage their ADHD symptoms. CBT can be provided in person or via phone. In one study, CBT was compared to standard therapy for adults suffering from ADHD. Both treatments helped improve self-reporting measures like symptoms, functioning 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 sizes. These improvements were associated with a variety of modalities, including interpersonal and cognitive behavioral therapy, social skills training, problem-solving exercises, and mindfulness meditation.
Recommended Looking at is important to compare the effectiveness of various treatment options for adults with ADHD with caution. It is likely that the variations in the outcomes reflect a number of variables, including treatment characteristics, measures used, and patient backgrounds. Few studies have examined the effectiveness of neurofeedback. This technique involves wearing an electrode-lined hat while performing cognitive tasks to pinpoint brain areas in which there is excessive or insufficient activity. The person is then taught to regulate these patterns.
Counseling
Many people suffering from ADHD suffer from anxiety or mood disorders that require treatment. Counseling can help to address these issues, which may contribute to ADHD symptoms. Some psychotherapy approaches include interpersonal therapy to enhance the capacity of individuals to establish meaningful relationships and to resolve conflicts. Cognitive behavioral therapy is designed to change negative behavior and help manage impulsive and self-destructive behaviors that can cause problems at school or work.
In certain cases psychotherapy can be used as an alternative to medications for adult adhd treatment for adults. Patients suffering from multiple disorders like depression, substance abuse and bipolar disorder should be assessed to ensure their symptoms aren't made worse by medications used to treat ADHD. People who suffer from certain medical issues, including thyroid disorders, lead poisoning, and a history of seizures, need to be treated more aggressively because they are more at risk for complications from the medications.
In-depth outpatient programs could be recommended if the person's ADHD is such that it affects their daily functioning and quality of life. These programs offer structured treatment that is more intensive than traditional outpatient psychotherapy.
Cognitive behavioral therapy (CBT), which is a form of cognitive therapy, helps adults with ADHD to improve their ability to manage time planning, impulse control and executive function. It helps them understand and express their feelings and uses worksheets and activities to make the learning more interesting. The practice of mindfulness meditation enhances CBT and enhances the capacity of a person to focus and manage emotions. It enhances the capacity of a person's ability to handle anxiety and stress. It can assist them in dealing with anger, sadness and other emotions that could be causing their ADHD.
Occupational Therapy
Adults suffering from ADHD often have difficulties functioning at home and at work. These issues can also impact relationships and can lead to financial difficulties. Therapy that addresses these issues will allow you to improve your self-esteem and address the root of the issue. It will also help you develop healthy coping strategies.
Cognitive-behavioral therapy can be a beneficial treatment for adults suffering from ADHD because it helps you change your negative beliefs and behavior. It focuses on teaching time management techniques and overcoming the distortions in your thinking that contribute to negative moods, and the perception of a limited number of options.
Many adults with ADHD also have comorbid anxiety or depression. These psychiatric conditions can decrease or exacerbate the effectiveness of certain medications used to treat ADHD. Therefore it is recommended you treat the most severe comorbid disorder first and then monitor the response to treatment prior to attempting treatment for the other disorder.
Occupational therapy can help you learn ways to organize your life and your work, establish regular routines, manage your money and time and develop a positive self-image. It can also help you learn relaxation techniques that can decrease your impulsivity and hyperactivity. Yoga and other exercises can aid in improving your focus by ensuring your body is stable in different poses.
Family and marriage counseling can assist adults suffering from ADHD to resolve the issues they create for their spouses, kids and other family members. They often complain about being erratic and unorganized. They are also prone to forget things or make impulsive choices. You can strengthen your relationships by informing your spouses and family members about ADHD. It can aid you and your family members to understand that the problems are caused by ADHD instead of the lack of care or a refusal to cooperate.
Clinical Trials
Adult ADHD is a neurobiological disorder that is very frequent. It is accompanied by a high rate of comorbidity. This includes depression, anxiety and substance abuse disorders. The use of medication and psychosocial interventions is available as treatment options. A wide range of medications are available for adults with ADHD, and some of them have been evaluated in clinical trials. These studies have exposed the strengths and drawbacks of the drugs.
Adults with ADHD experience the same symptoms as children, but it can be difficult to diagnose them because childhood symptoms may not persist throughout adulthood. Adults who suffer from ADHD may not have a family history of the disorder, or may not remember symptoms. It is essential to take a thorough medical history to determine whether the symptoms are caused by an illness, like thyroid issues, sleep apnea or hearing and vision problems.
Adults with ADHD are treated with stimulants or non-stimulants. Stimulants are the most effective medications for treating adults with ADHD and their response rates are in the 70%-80% range. Amphetamine as well as methylphenidate are the most commonly prescribed stimulants. Methylphenidate is also accessible in a transdermal system that allows for continuous medication delivery throughout the day.
Nonstimulant drugs for adults with ADHD are primarily tricyclic antidepressants which work on dopamine and norepinephrine. Desipramine, which is the most researched tricyclic, has been proven to work in adult ADHD patients. It is a low dose drug and is recommended to increase the dose by 50 mg every 7 days until the desired effect is observed.
Bupropion XL another antidepressant, was shown to be effective in adults suffering from ADHD. It is a dopamine-agonist which is effective in blocking the reuptake of norepinephrine at the presynaptic transporter which increases its accessibility to the brain. This drug has been shown to improve mood and reduce hyperactivity in adults, however it isn't as effective as stimulants in improving cognitive performance or concentration.