ADHD in Adults - Treatment Options
ADHD is a common neurological disorder that affects 44% of the population. It is associated by high rates of comorbidity, including anxiety, depression, and substance abuse, and significant social, emotional and occupational impairments.
Psychotherapy and medications are both effective treatments for adults suffering from ADHD. The stimulants methylphenidate and amphetamine are the most commonly prescribed medications.
Medications
Many adults with ADHD have significant improvement in their symptoms and performance as a result of medication. It is crucial that people who suffer from ADHD find the combination of medication that works for them.
Stimulants, such as amphetamines and methylphenidate, are the most commonly prescribed medications for adults with ADHD. These stimulants are available as liquid or tablet form in an immediate-release (short acting) formulation. They can be taken every three to four hours. Some adults supplement an immediate-release dose with an extended-release or longer-acting drug used once per day to reduce the requirement for frequent doses throughout the day.
Adults with ADHD are also treated successfully with antidepressants like desipramine. This class of drugs can be used in conjunction with stimulants or on their own to boost their effects. They can also increase the risk of serious side effects, including rapid heartbeats, EKG changes and orthostatic hypotension.
Alpha-2 adrenergic agonists like alprazolam and clonidine are also used for the treatment of adults with ADHD. These medications were originally developed to treat hypertension. They have a calming effect and can improve focus, and reduce the amount of hyperactivity and impulsivity in certain adults. These medications can lead to extremely low blood pressure if they are suddenly stopped, or the dosage is reduced.
Adults with ADHD may also benefit from psychotherapy. Individual therapy can help people deal with feelings of embarrassment, shame, and resentment against coworkers, supervisors, teachers, and family members that might nitpick or criticize them. Marriage and family counseling is also a great way to help couples with ADHD to better understand each other and improve communication.
Behavioral Therapy
Psychosocial therapy for adults with ADHD seeks to improve everyday functioning by teaching skills and strategies. Psychotherapy can help people who suffer from ADHD overcome their self-esteem problems and the feeling of failure they often feel.
Cognitive behavioral therapy (CBT) helps people change the negative thoughts that cause problems in their lives and to develop new ways of thinking, feeling and acting. This short-term, goal-oriented psychotherapy has been shown to be effective in treating many conditions, including anxiety and depression. It can be used by itself or in combination with other treatments.
CBT can include group therapy. This is particularly beneficial for those suffering from ADHD because it allows them to connect with others who face similar challenges and discover how they deal with their ADHD symptoms. CBT can be provided in person or over the phone. In one study, CBT was compared to standard therapy for adults who have ADHD. Both treatments helped improve self-reporting indicators like symptoms, functioning and quality of life.
Numerous studies have evaluated 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 sizes. These improvements were associated with a variety modalities including interpersonal and cognitive behavior therapy, social skills training, problem solving training, and mindfulness meditation.
However, caution is required in comparing the effectiveness of different therapies for adult ADHD. It is possible that the differences in the outcomes are due to a range of factors, including the treatment features and the methods used. Few studies have examined the effectiveness of neurofeedback. This method involves wearing a hat with electrodes while performing cognitive tasks in order to pinpoint brain areas in which there is excessive or inadequate activity. The person then learns to control these patterns.
Counseling
Many people suffering from ADHD also suffer from comorbid mood or anxiety disorders that need treatment. Counseling can help with these problems, which may be contributing to ADHD symptoms. Some psychotherapy approaches include interpersonal therapy to improve 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 could create difficulties at school or at work.
In adhd treatment for older adults is sometimes used in combination with medication for adults with adhd treatment. Patients suffering from multiple disorders like depression, substance abuse and bipolar disorder should be evaluated to ensure that their symptoms are not worsened by medications used to treat ADHD. Patients with certain medical conditions such as thyroid disorders, lead poisoning and an history of seizures need to be treated more aggressively because they are at a higher risk of developing complications from the medications.
When ADHD is serious enough to affect everyday functioning and quality of life intensive outpatient programs might be recommended. These programs offer structured treatment that is more intense than conventional outpatient psychotherapy.
Cognitive behavioral therapy (CBT) helps adults suffering from ADHD enhance their ability to manage time management, impulse control, executive function, and planning. It helps them understand and express emotions and uses activities and worksheets to make the learning interesting. The practice of mindfulness meditation enhances CBT and improves the ability of a person to concentrate and manage emotions. It improves the ability of a person's ability to handle 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 have issues functioning at work and at home. In addition to affecting their work performance, these symptoms interfere with relationships and may result in financial issues. Therapy that addresses these issues will help you to improve your self-esteem and solve the underlying issues. It can also help you develop healthy ways of coping.
Cognitive-behavioral Therapy is a great treatment for adults suffering from ADHD because it helps you change your negative thoughts and behaviors. Particularly, it focuses on teaching you to employ time management strategies and overcome mental distortions that lead to negative moods and a perception of limited choices.
Many people with ADHD suffer from anxiety or depression disorders as comorbid conditions. 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 treat the most severe comorbidity first and monitor its response to medication prior to attempting treatment for the other condition.
Occupational therapy can help you manage your life and work by establishing predictable routines that help you manage your time and money, and develop a positive image of yourself. It can also help you master relaxation techniques that could reduce your impulsivity and hyperactivity. Yoga and other exercises can also aid in improving your focus by ensuring your body is stable in various poses.
Family and marriage counseling can help address the issues that people with ADHD frequently cause their spouses, children and others. They frequently complain of being erratic and unorganized. They also tend to forget things or make decisions impulsively. Classes and therapy in which spouses and other family members are educated on ADHD can help you establish more harmonious relationships. It can also help you and your family members understand that the problems are caused by ADHD instead of an inability to care or a refusal to cooperate.
Clinical Trials
Adult ADHD is a neurobiological disorder which is highly prevalent. It is often associated with other disorders that are comorbid, such as depression, anxiety and substance abuse disorders. Psychosocial and medication interventions are available as treatment options. A wide range of medications are available to adults suffering from ADHD and some of them have been tested in clinical trials. These studies have exposed the strengths and weaknesses of the drugs.
Adults suffering from ADHD may have the same symptoms as children do, but it is difficult to determine since childhood symptoms may not persist in adulthood. In addition, adults who suffer from ADHD may not have a family history of the disorder in their families or they may not even remember experiencing symptoms. It is essential to take an extensive medical history to determine if the symptoms are due to a medical condition, like thyroid issues such as sleep apnea, sleep apnea and vision issues.
Treatments for adults suffering from ADHD generally fall into two categories: stimulants and nonstimulant medications. The stimulants have the highest response rates for adults with ADHD. Their rates of responsiveness vary from 70% to 80%. Amphetamine and methylphenidate are the most frequently prescribed stimulants. Methylphenidate may also be administered via a transdermal device. This allows for continuous medication delivery throughout the daytime.
Adults suffering from ADHD can take non-stimulant drugs that act on norepinephrine or dopamine. Desipramine, which is the most researched tricyclic, has been shown to work in adult ADHD patients. It is a low dose drug 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 shown to be effective in adults suffering from ADHD. It is a dopamine-agonist that blocks the reuptake of norepinephrine at the presynaptic transportationer, increasing its availability in brain. The drug is known to improve mood in adults and reduce hyperactivity but it's not as effective in improving cognitive function or concentration as stimulants.