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 rates of comorbidity (depression, anxiety, alcohol abuse) and significant emotional, social, and occupational impairments.
Psychotherapy and medication are both effective treatments for adults suffering from ADHD. The most commonly prescribed medications are stimulants, such as methylphenidate and amphetamine.
Medicines
Many people with ADHD experience significant improvement in their symptoms and performance due to medications. Due to the various ways that people respond to medication, it is important for individuals with ADHD to determine a mix that is effective.
Stimulants, like 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 frequently as every three to four hours. Some adults may supplement an immediate-release dose with an extended-release or longer-acting drug used once per day to decrease the requirement for frequent doses throughout the day.
Desipramine and other antidepressants have also been proven to be effective in treatment of adults with ADHD. This class of drugs can be utilized in conjunction with stimulants or on their own to boost their effects. However, they could increase the risk of serious cardiovascular side effects such as a rapid heartbeat, EKG changes, and orthostatic hypotension.
Alpha-2 adrenergic antagonists like alprazolam and clonidine are also used to treat people suffering from ADHD. These drugs were initially developed to treat hypertension. They have a calming effect and may improve focus and decrease hyperactivity and impulseivity in some adults. However, these medications can result in a drop in blood pressure when they are abruptly cut off or reduced in dosage.
Adults suffering from ADHD are also able to benefit from psychotherapy. Individual therapy helps people to overcome feelings of embarrassment, shame, and resentment towards co-workers and supervisors, teachers, and family members that may criticize or nag them. Marriage and family counseling can be a great option to help couples with ADHD to better understand each other and improve communication.
Behavioral Therapy
Psychosocial therapy for adults suffering from ADHD seeks to improve everyday functioning by teaching strategies and skills. Psychotherapy can also assist people with ADHD to overcome the low self-esteem and feelings of failure that is often associated with this condition.
Cognitive behavioral therapy (CBT), also known as cognitive behavioral therapy helps people change their negative thoughts and feelings that are causing problems in their lives. It teaches them new ways to think, feel and behave. This short-term and goal-oriented therapy has been proven to be effective in treating many illnesses, such as anxiety and depression. It can be used in conjunction with other therapies or on its own.
CBT may include group therapy, which is particularly beneficial for people with ADHD because it gives the opportunity to interact with other people with similar challenges and to discover how other people manage their ADHD symptoms. It can be delivered in person or over the phone. In one study, CBT was compared to standard therapy for adults suffering from ADHD. Both treatments improved self-report indicators like symptoms, functioning, and quality of life.
CBT has been compared to other psychosocial treatments for adults suffering from ADHD. All of these studies have shown significant reductions in ADHD symptoms and effects, with sizes between medium and large. These improvements were attributed to various modalities that include cognitive and interpersonal behavioral therapy, social skill training, problem-solving training and mindfulness meditation.
However, caution is warranted in comparing the efficacy of different therapies for adult ADHD. It is likely that the differences in the outcomes are due to a variety of factors, including treatment characteristics and measures used. There are few studies that have investigated the effectiveness of neurofeedback. This method involves wearing an electrode-lined hat while doing cognitive tasks to determine brain regions where there is excessive or inadequate activity. The person then learns to control these patterns.
Counseling
Many people who suffer from ADHD also have anxiety or mood disorders that need treatment. Counseling can help address these issues that may be contributing ADHD symptoms. Interpersonal therapy is among the psychotherapy methods which can improve the ability of a person to manage conflicts and create meaningful relationships. Cognitive behavioral therapy is designed to help people manage self-destructive, impulsive and negative behavior that can create problems at school or work.
In some cases, psychotherapy can be used in conjunction with medication for adults with adhd treatment. People with comorbid conditions like bipolar disorder and substance abuse need to be evaluated carefully to make sure they don't have symptoms that are not improved by the medications that are prescribed to treat ADHD. Certain medical conditions, such as thyroid disorders, lead poisoning, and a history or seizures, must be treated more aggressively.
If ADHD is serious enough to affect the quality of life and daily functioning intensive outpatient programs could be recommended. These programs offer structured treatment that is more intensive than traditional outpatient psychotherapy.
Cognitive behavioral therapy (CBT), which is a type of cognitive therapy, aids adults with ADHD to improve their ability to manage time planning, impulse control and executive function. It helps them identify and express their feelings and utilizes worksheets and activities to make the lessons more interesting. The training in mindfulness meditation enhances CBT and enhances the capacity of a person's ability to concentrate and manage emotions. It increases the capacity of a person's ability to handle the effects of stress and arousal. It helps them deal with sadness, anger and other emotions that may be contributing towards their ADHD.
Occupational Therapy
Adults with ADHD often report difficulty functioning at home and at work. These symptoms can also affect relationships and cause financial issues. Therapy that addresses these issues can help increase self-esteem, address underlying problems and establish healthy coping mechanisms.
Cognitive-behavioral therapy is an effective treatment for adults with ADHD because it helps them change their negative attitudes and behavior. It is focused on teaching time management techniques and overcoming thinking distortions that can cause negative moods, and the perception of limited possibilities.
Many adults with ADHD also have comorbid anxiety or depression. These psychiatric disorders can diminish or exacerbate the effectiveness of some medications used to treat ADHD. Therefore it is recommended you treat the most severe comorbidity first and observe its response to medication before proceeding to treatment of the other condition.
Occupational therapy can help you manage your work and life and establish routines that are predictable that help you manage your time and money and build 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 exercises can help you focus better by ensuring your body is stable in different poses.
Counseling for families and marriage can help adults with ADHD to solve the problems they create for their spouses, kids and friends. They frequently complain that they are unreliable, disorganized, forgetful and often prone to making impulsive choices. You can strengthen relationships by educating your spouses and family members about ADHD. It can aid you and your family members to understand that the problem is due to ADHD and not an inability to care or a refusal to cooperate.
Clinical Trials
Adult ADHD is a neurobiological disorder that is highly prevalent. It is often accompanied by other disorders that are comorbid, such as anxiety, depression and abuse disorders. Psychosocial and medication treatments are available as treatment options. There are many treatments for adults suffering from ADHD. Certain of these medications have been tested in trials. These studies have highlighted the strengths and limitations of the various medications.
Adults suffering from ADHD may have the same symptoms as children have, but it's difficult to determine because the symptoms of childhood may not last into adulthood. Adults suffering from ADHD may not have an ancestral background of the disorder or may not remember symptoms. It is essential to take a thorough medical history in order to determine whether the symptoms are related to an illness like thyroid issues such as sleep apnea, sleep apnea and vision problems.
Adults with ADHD are treated with stimulants or nonstimulants. Stimulants are the most effective medications for treating adults with ADHD, and their responsiveness rates are in the 70 - 80 percent range. Amphetamine as well as methylphenidate are the most commonly prescribed stimulants. Methylphenidate can also be administered via a transdermal device. This permits continuous medication delivery during the daytime.
I Am Psychiatry suffering from ADHD can take non-stimulant drugs that act on norepinephrine or dopamine. Desipramine, the most studied tricyclic, has been proven to be effective in adult ADHD patients. It is a medication with a low dose that is recommended to be increased every seven days by 50mg until the desired effect is observed.
Bupropion XL another antidepressant, has been proven to work in adults with ADHD. It is a dopamine agonist that works by blocking the reuptake process of norepinephrine by the presynaptic transporter, thereby increasing its presence in the brain. This drug has been proven to improve the mood of adults and reduce hyperactivity but it's not as effective at improving concentration or cognitive functions as stimulants.