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 by high levels of comorbidity (depression, anxiety, substance abuse) and significant emotional, social, and occupational impairments.
Both psychotherapy and medication are effective treatments for adults with ADHD. The stimulants methylphenidate and amphetamine are the most commonly prescribed medications.
Medicines
Many adults with ADHD experience significant improvements in their symptoms and functioning due to medications. It is essential that those who suffer from ADHD find the combination of medication that works for them.
Adults suffering from ADHD are prescribed stimulants like amphetamines and 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. Some adults may supplement an immediate-release dose with an extended-release or longer-acting drug taken once a day to decrease the requirement for frequent doses throughout the day.
Adults suffering from ADHD can also be treated effectively with antidepressants, such as desipramine. This class of medications can be used in conjunction with stimulants, or in isolation to boost their effects. However, they can increase the risk of serious cardiovascular side effects, such as a rapid heartbeat, EKG changes, and orthostatic hypotension.
Adults suffering from ADHD can also be treated with alprazolam and clonidine, which are both Alpha-2 antagonists of the adrenergic system. These drugs were initially developed to treat hypertension. They have a calming affect and can improve focus, and decrease hyperactivity and impulseivity in some adults. However, these medications could cause a very low blood pressure if they are suddenly removed or reduced in dosage.
Psychotherapy can also be beneficial for adults suffering from ADHD. Individual talk therapy helps those with ADHD to overcome feelings of embarrassment, shame, and resentment towards co-workers and teachers, supervisors and family members who might nitpick or criticize them. Counseling for families and marriage is also a great way to help couples with ADHD improve their understanding of each other and improve communication.
Behavioral Therapy
One of the main goals of psychosocial therapy for adult ADHD is to impart skills and strategies that improve function in everyday life. Psychotherapy can also assist people with ADHD to overcome the low self-esteem and feelings of inadequacy that can be a result of this condition.
Cognitive behavioral therapy (CBT) assists individuals in changing the negative thoughts that create problems in their lives. It also helps to develop new ways of thinking and feeling, as well as doing. This short-term, goal-oriented kind of psychotherapy has proven to be effective for many disorders, including depression and anxiety. It can be used alone or in conjunction with other therapies.
CBT could involve group therapy, which is especially beneficial for adults suffering from ADHD, as it provides the chance to connect with others with similar challenges and to learn from others how they manage their ADHD symptoms. CBT can be provided in person or via phone. In signs of untreated adhd in adults , CBT was compared to the standard treatment for adults suffering from ADHD. Both treatments improved self-report indicators like symptoms, functioning, and quality of life.
A number of studies have compared CBT with other psychosocial treatments for adults suffering from ADHD, and all show significant reductions in self-reported ADHD symptoms, with medium to large effect size. These improvements were attributed to various modalities that include cognitive and interpersonal behavioral therapy, social skill training, problem-solving exercises and mindfulness meditation.
It is crucial to evaluate the effectiveness of various treatments for adults with ADHD with caution. It is likely that differences in the results of treatment are due to a range of factors, including treatment characteristics and the measures employed. A few studies have looked into the effectiveness of neurofeedback, a technique that involves wearing an electrode-lined cap when performing cognitive tasks to identify areas of the brain where there is too much or little activity. Then, instructing the person to manage these patterns.
Counseling
Many people suffering from ADHD also have comorbid mood or anxiety disorders that need treatment. Counseling can help with these issues which may be causing ADHD symptoms. Certain psychotherapy strategies include interpersonal therapy to enhance a person's ability to build meaningful relationships and resolve conflicts. Cognitive behavioral therapy is designed to help manage self-destructive, impulsive, and negative behaviors that can cause difficulties at school or at work.
In some instances psychotherapy may be utilized as an adjunct to medications for adult ADHD treatment for adults. Patients with multiple disorders like substance abuse, depression, and bipolar disorder should be evaluated to ensure that their symptoms aren't aggravated by the medications used to treat ADHD. Patients with certain medical conditions such as thyroid disorders, lead poisoning and seizures in the past, have to be treated more aggressively as they are at a higher risk of developing complications from the medications.
In-depth outpatient programs could be recommended when the person's ADHD is such that it interferes with their daily functioning and quality of life. These programs provide an organized treatment that is more intensive than traditional outpatient psychotherapy.
Cognitive behavioral therapy (CBT) is a form of cognitive therapy, assists people with ADHD to improve their ability to manage time planning, impulse control and executive function. It teaches them to recognize and express their emotions and utilizes worksheets and activities to make the lessons interesting. Meditation training that is mindful enhances CBT and enhances the ability of people to concentrate and manage their emotions. It enhances the capacity of a person to manage the effects of stress and arousal. It can help them deal with anger, sadness and other emotional issues that could be causing their ADHD.
Occupational Therapy
Adults suffering from ADHD experience difficulties at work and at home. These symptoms can also affect relationships and cause financial issues. Therapy that addresses these issues will help you build confidence in yourself and resolve underlying problems. It will also help you develop healthy coping strategies.
Cognitive-behavioral therapy can be a beneficial treatment for adults with ADHD because it helps you modify your negative beliefs and behaviors. It is focused on teaching you how to employ strategies to manage your time and eliminate the distortions in your thinking that cause negative moods and the perception of limited choices.
Many people who suffer from ADHD also suffer from anxiety or depression. These psychiatric conditions can decrease or even increase the effectiveness of certain medications that are used to treat ADHD. Therefore, it is recommended that you first treat the most severe comorbidity and then observe its reaction to the medication prior treating the other condition.
Occupational therapy can help you learn methods to organize your life and your work, create predictable routines, manage time and money, and create confidence in yourself. It can also help you master relaxation techniques that can decrease your impulsivity and hyperactivity. In the same way yoga and other exercises can help you improve your focus by stabilizing your body in different poses.
Counseling for families and marriage can address the issues adults suffering from ADHD often cause their children, spouses, and their families. They often complain about being unreliable and disorganized. They are also prone to forget things or make impulsive decisions. Therapy and classes where spouses and other family members are taught about ADHD can help you develop more harmonious relationships. Furthermore, it can aid you and your loved ones realize that these issues are linked to the patient's ADHD rather than to an absence of care or refusing to cooperate.
Clinical Trials
Adult ADHD is a highly common neurobiological disorder. It is accompanied by a high rate of comorbidity, such as anxiety, depression and substance abuse disorders. Psychosocial and medication treatments are available as treatments. There are many medications available for adults with ADHD. Certain of these medications have been evaluated in clinical trials. These studies have highlighted the strengths and weaknesses of the drugs.
Adults suffering from ADHD may have the same symptoms as children have, but it's difficult to identify because the symptoms of childhood may not last into adulthood. Adults with ADHD may not have any family background of the disorder or may not be aware of symptoms. A thorough medical history is important to determine if the symptoms are caused by medical conditions like thyroid problems, sleep apnea, issues with vision and hearing or lead poisoning.
Adult medications for ADHD generally fall into two categories: stimulants and nonstimulant medications. The stimulants have the highest response rates for adults suffering from ADHD. Their rates of responsiveness range between 70 and 80%. Amphetamine as well as methylphenidate are the most commonly prescribed stimulants. Methylphenidate is also accessible in a transdermal system that allows for continuous supply of medication throughout the day.
Nonstimulant drugs for adults with ADHD are mostly tricyclic antidepressants that target norepinephrine and dopamine. Desipramine is the most researched tricyclic drug and has been proven to be effective in adult patients with ADHD. It is a low-dose medication that should be increased every seven days by 50mg until the desired effect is noticed.
Bupropion XL another antidepressant, was shown to work in adults with ADHD. It is a dopamine agonist that works by blocking norepinephrine reuptake in the presynaptic cellular transporter which increases its accessibility to the brain. The drug is known to improve mood in adults and reduce hyperactivity, but it's not as effective in improving concentration or cognitive function as stimulants.