ADHD in Adults - Treatment Options
ADHD is a common neurobiological disorder that affects 4.4% of the general population. It is accompanied with high rates of comorbidity, including anxiety, depression and addiction to drugs, as well as significant emotional, social and occupational impairments.
Both psychotherapy and medication are effective treatments for adults suffering from ADHD. The most commonly prescribed medications are stimulants like methylphenidate or amphetamine.
Medicines
Many people with ADHD have significant improvements in symptoms and functioning due to medication. Due to the many different ways that people react to medications, it is essential for those with ADHD to find a combination that works best.
Adults with ADHD are prescribed stimulants, such as amphetamines and methylphenidate. These stimulants are available as liquid or tablet form in an immediate-release (short acting) formulation. They can be taken every three to four hour. Adults may supplement an immediate-release medicine with an extended release long-acting medication once a week to reduce the need to take it often throughout the day.
Adults suffering from ADHD can be successfully treated with antidepressants, like desipramine. This class of medications can be used in conjunction with stimulants, or alone to enhance their effects. They can also increase the risk of serious side consequences, like rapid heartbeats, EKG changes and orthostatic hypotension.
Adults with ADHD can also be treated with alprazolam and clonidine, which are both Alpha-2 antagonists of the adrenergic system. These medications, originally developed to treat high blood pressure, have an calming effect and are able to improve focus and decrease hyperactivity and impulsivity in some adults. These medications can result in very low blood pressure if they are suddenly stopped, or the dosage is reduced.
Adults with ADHD are also able to benefit from psychotherapy. Individual talk therapy helps them overcome feelings of embarrassment, shame, and resentment toward coworkers, supervisors, teachers and family members who might nitpick or criticize them. Additionally counseling for families and marriages can help couples with ADHD to understand each other's issues and improve communication.
Behavioral Therapy
One of the main goals of psychosocial therapy for adults with ADHD is to teach strategies and skills that help improve functioning in daily life. Psychotherapy can help individuals who suffer from ADHD overcome their self-esteem issues and the sense of failure they feel frequently.
Cognitive behavioral therapy (CBT) assists individuals in changing the negative thoughts that create problems in their lives. It also helps to discover new ways of thinking and feeling, as well as doing. This short-term, goal-oriented kind of psychotherapy has been found to be effective for a variety of disorders, including depression and anxiety. It can be used on its own or in combination with other treatments.
CBT may also include group therapy. This is particularly beneficial for people with ADHD as it allows them to connect with others who face similar challenges and discover how they deal with their ADHD symptoms. CBT can be offered in person or via 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 have all shown significant reductions in self-reported ADHD symptoms, with medium to large effect size. These improvements were attributed to various modalities, including interpersonal and cognitive behavior therapy and social skills training. problem solving training, as well as mindfulness mediation.
However, caution is required in comparing the effectiveness of different treatments for adults with ADHD. It is likely that different outcomes of the treatments reflect a number of variables such as the characteristics of the treatment, the measures used, and patient backgrounds. A few studies have looked into the effectiveness of neurofeedback. This technique involves wearing a hat with electrodes while doing cognitive tasks to pinpoint brain areas in which there is excessive or insufficient activity. The individual is then taught to regulate these patterns.
Counseling
Many people with ADHD also suffer from anxiety or mood disorders that require treatment. Counseling can help with these issues that may be contributing ADHD symptoms. Certain psychotherapy strategies include the use of interpersonal therapy to improve the ability of a person to form meaningful relationships and resolve conflicts. Cognitive behavioral therapy is designed to help manage self-destructive, impulsive and negative behaviors that can create difficulties at school or at work.
In certain situations psychotherapy is sometimes used in combination with medication for adults adhd treatment. Patients with co-occurring disorders like depression, substance abuse and bipolar disorder should be evaluated to ensure that their symptoms are not worsened by the medications used to treat ADHD. Patients with certain medical conditions like thyroid disorders, lead poisoning, and a history of seizures, need to be treated more aggressively because they are more at risk of complications from medications.
Outpatient intensive programs may be recommended when the person's ADHD is so severe that it interferes with their daily functioning and quality of life. These programs offer more intense and structured treatment than traditional outpatient therapy.
Cognitive behavioral therapy (CBT) helps adults suffering from ADHD enhance their ability to manage their time, impulse control, organizing, and executive function. It helps them understand and express their emotions and utilizes activities and worksheets to make the learning interesting. The training in mindfulness meditation improves CBT and enhances the capacity of a person to concentrate and manage emotions. It also improves 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 to their ADHD.
Occupational Therapy
Adults suffering from ADHD often have difficulties functioning at home and at work. These symptoms can also affect relationships and cause financial difficulties. Therapy that addresses these issues can help you boost your self-esteem, solve underlying problems and establish healthy coping mechanisms.
Cognitive-behavioral therapy can be a beneficial treatment for adults suffering from ADHD because it teaches you how to change your negative thoughts and behaviors. It focuses on teaching time management techniques and overcoming thinking distortions that contribute to negative moods, and the perception of limited options.
Many people who suffer from ADHD also have comorbid anxiety or depression. These psychiatric disorders can diminish or even increase the effectiveness of some medications used to treat ADHD. Therefore, it is recommended to first treat the most severe comorbidity and then monitor its reaction to the medication prior treating the other disorder.
Occupational therapy can help you learn how to manage your life and your work, establish predictable routines, manage time and money, and create a positive self-image. It can help you master ways to relax that could reduce hyperactivity and impulsivity. Additionally yoga and other exercises can help you improve your focus by stabilizing your body in different postures.
Marriage and family counseling can address the issues adults suffering from ADHD frequently cause their spouses, children and others. They often complain about being unreliable, disorganized, forgetful and susceptible to making decisions based on impulsivity. Therapy and classes where spouses and other family members are educated on ADHD can help you establish better relationships. Moreover, it can aid you and your loved ones realize that these problems are related to the patient's ADHD instead of the lack of compassion or a willful refusal to cooperate.
Clinical Trials
Adult ADHD is an neurobiological disorder that is extremely prevalent. It is often accompanied by comorbid conditions such as anxiety, depression and abuse disorders. Psychosocial and medication interventions are available as treatments. There are a range of treatments for adults suffering from ADHD. Some of these medications have been evaluated in clinical trials. These studies have revealed the strengths and the limitations of the medication.
Adults suffering from ADHD have the same symptoms as children, however it can be difficult to identify them since childhood symptoms might not last throughout adulthood. Adults who suffer from ADHD may also not have any family history of the disorder, or might not remember the symptoms. A thorough medical history is necessary to help determine whether the symptoms are caused by medical conditions like thyroid problems or sleep apnea, issues with vision and hearing or lead poisoning.
Adults suffering from ADHD are treated with stimulants or non-stimulants. Stimulants are the most effective drugs to treat adults suffering from ADHD, and their responsiveness rates are in the 70 - 80% range. The most popular stimulants are amphetamine and methylphenidate compounds. Methylphenidate is also available in a transdermal system which allows for a continuous drug delivery throughout the day.
adhd treatment adults with ADHD can take non-stimulant drugs that are based on norepinephrine, or dopamine. Desipramine, which is the most researched tricyclic, has been proven to work in adult ADHD patients. It is a medication with a low dose that should be increased every seven days by 50mg until the desired effect is noticed.
Bupropion XL is a different antidepressant, has been shown to work in adults with ADHD. It is a dopamine agonist that blocks the reuptake of norepinephrine at the presynaptic transporter, thereby increasing its presence in the brain. This drug has been shown to improve mood and decrease hyperactivity in adults, but it is not as effective as stimulants when it comes to improving concentration or cognitive function.