ADHD in Adults - Treatment Options
ADHD is a well-known neurobiological disorder that affects 4.4% of the general population. It is associated by high rates of comorbidity, including depression, anxiety, and substance abuse, as well as significant emotional, social and occupational impairments.
Psychotherapy and medication are both effective treatments for adults suffering from ADHD. Stimulants such as methylphenidate and amphetamine are the most commonly prescribed drugs.
Medicines
Many adults with ADHD experience significant improvements in their symptoms and performance due to medications. Due to the various ways that people react to medications, it is important for individuals with ADHD to find a combination that is most effective.
Stimulants, like methylphenidate and amphetamines, are the most frequently prescribed drugs for adults suffering from 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. Adults can augment an immediate-release medicine with an extended-release, long-acting medicine every week to decrease the need to take it regularly throughout the day.
Adults with ADHD can also be treated successfully with antidepressants such as desipramine. This class of drugs can be used by itself or in conjunction with stimulants 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 as well as clonidine are used to treat people suffering from ADHD. These medications were initially created to treat hypertension. They are calming and can help improve focus and reduce the amount of hyperactivity and impulsivity in certain adults. However, these medications could cause a very low blood pressure if they are abruptly cut off or reduced in dosage.
Adults suffering from ADHD may also benefit from psychotherapy. Individual therapy can help them cope with their feelings of shame and embarrassment regarding their ADHD, as well as resentment toward co-workers, supervisors teachers, family members and others who may nag or criticize them. In addition counseling for marriage and families can help couples suffering from ADHD to understand each other's issues and improve communication.
Behavioral Therapy
Psychosocial therapy for adults with ADHD seeks to improve everyday functioning by educating people on strategies and skills. Psychotherapy can help individuals with ADHD overcome their self-esteem problems and the feeling of failure they often feel.
Cognitive behavioral therapy (CBT), also known as cognitive behavior therapy, assists people to change negative thoughts and feelings that are causing problems in their lives. It teaches them new ways to think, feel and behave. This short-term, goal-oriented form of psychotherapy has proven to be effective for many conditions, including depression and anxiety. It can be used in conjunction with other treatments or on its own.
CBT can involve group therapy, which can be particularly beneficial for people with ADHD because it gives the chance to connect with others who are facing similar issues and learn how other people manage their ADHD symptoms. It can be provided in person or via the phone. In one study, CBT was compared to standard therapy for adults who have ADHD. Both treatments improved self-report measures such as symptoms, functioning and quality of life.
Several studies have compared CBT with other psychosocial treatments for adults with ADHD, and all show significant reductions in self-reported ADHD symptoms, with medium to large effect sizes. These improvements were linked to a variety of modalities, including interpersonal and cognitive behavioral therapy, social skills training, problem-solving training and mindfulness meditation.
However, caution is required in comparing the effectiveness of various treatments for adult ADHD. It is possible that the differences in outcomes results result from a variety of factors, such as treatment characteristics and measures employed. A few studies have investigated the effectiveness of neurofeedback, a technique that involves wearing an electrode-lined cap when performing cognitive tasks to identify areas in the brain that there is too much or too little activity, and instructing the person to manage these patterns.
Counseling
Many people suffering from ADHD suffer from anxiety or mood disorders that require treatment. Counseling can help address these issues that could be contributing to ADHD symptoms. Interpersonal therapy is among the psychotherapy methods that can help improve a person’s ability to manage conflicts and create lasting relationships. Cognitive behavioral therapy is designed to help people manage self-destructive, impulsive, and negative behaviors that can create problems at work or school.
In some cases psychotherapy may be utilized in conjunction with medication for adults who are seeking treatment for adhd. Patients with comorbid disorders such as depression, bipolar disorder and substance abuse need to be evaluated carefully to make sure they don't have symptoms that cannot be improved by the medications used to treat ADHD. Certain medical conditions, like thyroid disorders, lead poisoning, and a history or seizures, need to be treated with more vigor.
If ADHD is severe enough to interfere with the quality of life and daily functioning, intensive outpatient programs may be recommended. These programs offer an organized therapy that is more intense than the traditional outpatient psychotherapy.
Cognitive behavioral therapy (CBT) helps adults with ADHD improve their abilities to manage their time, impulse control, planning, and executive function. It helps them understand and express their feelings. iampsychiatry uses worksheets and activities to make the lessons more interesting. Mindfulness meditation training enhances CBT, and it improves the ability of a person to concentrate and manage their emotions. It enhances the capacity of a person's ability to handle stress and arousal. It helps them deal with sadness, anger and other difficult emotions that could be causing their ADHD.
Occupational Therapy
Adults with ADHD frequently have difficulty functioning at home and at work. In addition to affecting work performance, these symptoms interfere with relationships and could cause financial problems. Therapy that addresses these issues will allow you improve your self-esteem and resolve underlying problems. It can also assist you in developing healthy coping strategies.
Cognitive-behavioral therapy is a useful treatment for adults with ADHD because it helps you modify your negative beliefs and behaviors. In particular, it concentrates on teaching you to utilize strategies for managing time and overcoming thinking distortions that contribute to negative moods and the perception of limited choices.
Many people suffering from ADHD have anxiety or depression disorders as comorbid conditions. These psychiatric illnesses may aggravate or decrease the effectiveness of some drugs used to treat ADHD. It is recommended that you first treat the most severe comorbid condition and then monitor the response to the medication prior to treating the other disorder.
Occupational therapy can help you learn how to manage your life and work, create predictable routines, manage time and money, and create a positive self-image. It can also help you master relaxation techniques that could decrease your impulsivity and hyperactivity. Similarly, yoga and other exercise can help you focus better by stabilizing the body in different postures.
Family and marriage counseling can assist adults suffering from ADHD to resolve the issues they cause their children, spouses and others. They frequently complain of being unreliable and disorganized. They often forget things or make decisions impulsively. Therapy and classes in which spouses and other family members are educated about ADHD can help you develop healthier relationships. It can help you and your family members 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 prevalent neurobiological disorder. It is often associated with co-occurring conditions like anxiety, depression and substance abuse disorders. Psychosocial and medication treatments are available as treatments. There are many medication options for adults suffering from ADHD. Certain of these medications have been tested in studies. These studies have highlighted both the strengths and the limitations of the drugs.
Adults suffering from ADHD may experience the same symptoms that children do, but it is difficult to determine because the symptoms of childhood may not persist in adulthood. Adults with ADHD may also not have any family history of the disorder, or may not be aware of symptoms. It is important to have an extensive medical history to determine if the symptoms are due to an illness like thyroid issues, sleep apnea or hearing and vision problems.
Adults with ADHD are treated with stimulants or nonstimulants. Stimulants are the most effective drugs for adults suffering from ADHD and their response rates are in the 70%-80% range. The most popular stimulants are amphetamine and methylphenidate compounds. Methylphenidate is also accessible in a transdermal system, that allows for continuous drug delivery throughout the day.
Nonstimulant medicines for adults suffering from ADHD are mostly tricyclic antidepressants which work on dopamine and norepinephrine. Desipramine, the most researched tricyclic, has shown to be effective in adult ADHD patients. It is a low-dose medication that should be increased every seven days by 50mg until the desired effect is seen.
Bupropion XL is a different antidepressant that has been shown to be effective in adults with ADHD. It is a dopamine agonist and works by blocking the reuptake of norepinephrine at the presynaptic receptor, thereby increasing its availability in the brain. This drug is known to boost mood in adults and reduce hyperactivity but it's not as effective at improving cognitive function or concentration as stimulants.