ADHD in Adults - Treatment Options
ADHD is a prevalent condition of the nervous system that affects around 4,4 percent of the population. It is accompanied with high rates of comorbidity. This includes depression, anxiety, and substance abuse, as well as significant emotional, social and occupational impairments.
Psychotherapy and medication are both effective treatments for adults with ADHD. Stimulants like methylphenidate or amphetamine are among the most frequently prescribed drugs.
Medications
Many people who suffer from ADHD notice significant improvement in their symptoms and functioning when they take medication. Due to the many different ways that people react to medications, it is essential for those with ADHD to discover a combination that is effective.
Stimulants, such as methylphenidate and amphetamines, are the most frequently prescribed medications for adults with ADHD. They are available in immediate-release (short-acting) tablet or liquid form, and can be taken as often as every three to four hours. Some adults supplement an immediate-release dose with an extended-release or long-acting medication used once per day to decrease the need for frequent dosing throughout the day.
Adults suffering from ADHD can be treated successfully with antidepressants like desipramine. This class of medications can be employed in conjunction with stimulants or alone to enhance their effects. However, they can increase the risk of serious cardiovascular side effects, such as an increased heart rate, EKG changes, and orthostatic hypotension.
Adults with ADHD can also be treated with alprazolam or clonidine, which are both Alpha-2 antagonists of the adrenergic system. These drugs, initially developed to treat high blood pressure, possess an calming effect and are able to enhance focus and decrease the level of hyperactivity and impulsivity among some adults. However, these drugs can result in a drop in blood pressure if they are suddenly removed or reduced in dosage.
Psychotherapy is also beneficial for adults with ADHD. Individual therapy can help people to overcome feelings of shame, embarrassment, and resentment toward coworkers, teachers, supervisors and family members who might criticize or nag them. Additionally counseling for marriage and families can help couples with ADHD to understand each other's issues and improve communication.
Behavioral Therapy
Psychosocial therapy for adults suffering from ADHD is designed to improve daily functioning by teaching strategies and skills. Psychotherapy can also assist people with ADHD to overcome the low self-esteem and feeling of failure that is often associated with this condition.
Cognitive behavioral therapy (CBT) helps people change the negative thoughts that cause problems in their lives and to learn new ways of thinking, feeling and acting. This short-term, goal-oriented type of psychotherapy has been found to be effective for many conditions including anxiety and depression. It can be used in conjunction with other treatments or alone.
I Am Psychiatry could involve group therapy, which can be particularly helpful for adults with ADHD, as it provides the chance to connect with others who are facing similar issues and discover how other people manage their ADHD symptoms. CBT can be provided in person or over the phone. In one study, CBT was compared to the standard treatment for adults with ADHD. Both treatments improved self-report measures like symptoms, functioning and quality of life.
CBT has been compared with other psychosocial treatments for adults suffering from ADHD. All of these studies have shown significant reductions in ADHD symptoms with effects between medium and large. These improvements were linked to a variety of modalities, including interpersonal and cognitive behavioral therapy, social skill training, problem-solving exercises, and mindfulness meditation.
However, caution is warranted in comparing the effectiveness of different treatments for adults with ADHD. It is likely that differences in the outcomes are due to a variety of factors, including the treatment characteristics and the measures used. A few studies have looked into the effectiveness of neurofeedback. This technique involves wearing a hat with electrodes while doing cognitive tasks to determine brain regions where there is a lack or excess of activity. The individual is then taught to regulate these patterns.
Counseling
Many people with ADHD also have comorbid mood or anxiety disorders that require treatment. Counseling can help to address these issues, which may be contributing to the ADHD symptoms. Interpersonal therapy is among the psychotherapy approaches that can help improve the ability of a person to resolve conflicts and develop lasting relationships. Cognitive behavioral therapy is designed to help manage impulsive, self-destructive, and negative behavior that can create problems at school or work.
In certain cases, psychotherapy can be used in conjunction with medication for adults with adhd treatment. Patients suffering from multiple disorders like substance abuse, depression, and bipolar disorder must be assessed to ensure their symptoms aren't made worse through the use of medications to treat ADHD. Certain medical conditions, like thyroid disorders, lead poisoning and a history or seizures, must be treated more aggressively.
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 offer structured therapy that is more intense than the traditional outpatient psychotherapy.
Cognitive behavioral therapy (CBT) is a type of cognitive therapy, helps adults suffering from ADHD to improve their ability to manage time planning, impulse control and executive functioning. It helps them understand and express emotions and utilizes worksheets and activities to make the lessons interesting. Mindfulness meditation training enhances CBT and improves the ability of a person to concentrate and regulate their emotions. It increases the capacity of a person to manage the effects of stress and arousal. It can assist them in dealing with sadness, anger, and other emotional issues that may be contributing towards their ADHD.
Occupational Therapy
Adults with ADHD often report difficulty functioning at home and at work. In addition to impacting work performance, these issues can interfere with relationships and may lead to financial difficulties. Therapy that addresses these issues will allow you improve your self-esteem and address the root of the issue. It can also help you develop healthy ways of coping.
Cognitive-behavioral therapy is a useful treatment for adults with ADHD because it helps you modify your negative beliefs and behavior. It concentrates on teaching time management techniques and overcoming thinking distortions that can lead to negative moods and the perception of a limited number of possibilities.
Many people with ADHD have anxiety or depression disorders that are comorbid. These psychiatric conditions can decrease or exacerbate the effectiveness of certain medications used to treat ADHD. Therefore it is recommended that you treat the most severe comorbid disorder first and monitor the response to treatment prior to attempting treatment for the other condition.
Occupational therapy can help you manage your life and work, establish predictable routines that help you manage your time and money, and develop an optimistic image of yourself. It can also help you master relaxation techniques that could decrease your impulsivity and hyperactivity. In the same way yoga and other exercises can help you focus better by ensuring your body is stable in different postures.
Family and marriage counseling can address the problems that adults suffering from ADHD often cause their spouses, children and other family members. They often complain of being unreliable and disorganized. They also tend to forget things or make impulsive decisions. Therapy and classes in which spouses and other family members are educated on ADHD can help you establish healthier relationships. Moreover, it can help you and your loved ones understand that these problems are related to the patient's ADHD rather than to a lack of caring or a willful refusal to cooperate.
Clinical Trials
Adult ADHD is a frequent neurobiological disorder. It is accompanied by a high rate of comorbidity, including anxiety, depression and substance abuse disorders. Psychosocial and medication treatments are available as treatment options. There are a variety of medications available for adults with ADHD and a few of these have been evaluated in clinical trials. These studies have exposed the advantages and drawbacks of the drugs.
Adults with ADHD may experience the same symptoms that children have, but it's difficult to diagnose since childhood symptoms may not persist in adulthood. Adults with ADHD may also not have any family background of the disorder or might not remember the symptoms. It is crucial to take an extensive medical history to determine whether the symptoms are caused by a medical condition, like thyroid issues or sleep apnea, and vision issues.
Adults with ADHD are treated with stimulants or nonstimulants. Stimulants are the most effective drugs for adults suffering from ADHD and their responsiveness rates are in the 70 - 80% range. The most commonly used stimulants are amphetamine and methylphenidate compounds. Methylphenidate is also available as a transdermal solution, that allows for continuous medication delivery throughout the day.
Adults suffering from ADHD can take nonstimulant medications that work by affecting norepinephrine or dopamine. Desipramine, which is the most researched tricyclic, has shown to work in adult ADHD patients. It is a low dose drug and should be increased by 50 mg every seven days until the desired response is observed.
Bupropion XL another antidepressant, was shown to work in adults with ADHD. It is a dopamine-agonist that is effective in blocking the reuptake of norepinephrine at the presynaptic transporter which increases its accessibility to the brain. This drug is known to boost mood in adults and reduce hyperactivity, but it's not as effective in improving concentration or cognitive functions as stimulants.