ADHD in Adults - Treatment Options
ADHD is a common neurological disorder that affects 44% of the population. It is accompanied by high levels of comorbidity (depression anxiety, anxiety, addiction to drugs) and significant social, emotional, and occupational impairments.
Both psychotherapy and medication are effective treatments for adults with ADHD. Stimulants like methylphenidate or amphetamine are the most commonly prescribed drugs.
Medications
Many adults with ADHD experience significant improvements in their symptoms and functioning as a result of medication. It is crucial that people who suffer from ADHD discover the right combination of medications that works for them.
Adults with ADHD are prescribed stimulants like methylphenidate or amphetamines. They are available in liquid or tablet form in an immediate-release (short acting) formulation. They can be taken every three to four hours. Adults can augment an immediate-release medicine with an extended-release long-acting medicine at least once a week to reduce the necessity to take it frequently throughout the day.
Adults suffering from ADHD can be successfully treated with antidepressants, like desipramine. This class of drugs may be used in conjunction with stimulants or on their own to boost their effects. They can also increase the risk of serious adverse effects, such as rapid heartbeats, EKG changes and orthostatic hypotension.
Adults with ADHD can also be treated with alprazolam or clonidine. They are both Alpha-2 antagonists of the adrenergic system. These medications were initially created to treat hypertension. They have a calming effect and can improve focus, and decrease hyperactivity and impulseivity in certain adults. However, these drugs can cause a drop in blood pressure if they are suddenly removed or reduced in dosage.
Adults with ADHD may also benefit from psychotherapy. Individual therapy can help them deal with their feelings of shame and embarrassment about their ADHD, as well as anger towards supervisors, coworkers, teachers and family members who may nag or criticize them. Counseling for families and marriage is also a great way to help couples with ADHD to better understand each other and improve their communication.
Behavioral Therapy
The primary goal of psychosocial therapy for adults with ADHD is to impart strategies and skills that help improve performance in everyday life. Psychotherapy can help people with ADHD overcome their self-esteem problems and the sense of failure they often feel.
Cognitive behavioral therapy (CBT) helps individuals change the negative thoughts that create problems in their lives and to develop 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 anxiety and depression. It can be used by itself or in combination with other therapies.
CBT may also include group therapy. This is especially beneficial for people with ADHD because it enables them to meet others who face similar challenges and discover how they deal with their ADHD symptoms. It can be provided in person or over the phone. One study compared the effects of CBT in comparison to standard therapy for adults with ADHD and found that both treatments produced improvements in self-report measures of functioning, symptoms and quality of life.
Numerous studies have evaluated CBT with other psychosocial treatments for adults with ADHD and all have shown significant reductions in self-reported ADHD symptoms, with medium to large effect sizes. These improvements were attributed to a variety of modalities that include cognitive and interpersonal behavioral therapy, social skills training, problem-solving exercises, and mindfulness meditation.
However, caution is warranted in comparing the effectiveness of various treatments for adult ADHD. It is likely that differences in outcome results depend on a variety of factors such as the characteristics of the treatment, the measures used as well as the backgrounds of the patients. There are few studies that have investigated the effectiveness neurofeedback. This technique involves wearing a hat with electrodes while performing cognitive tasks in order to identify brain areas where there is excessive or insufficient activity. The individual then learns to control these patterns.
Counseling
Many people who suffer from ADHD also have comorbid mood or anxiety disorders that need treatment. Counseling can help to address these issues, which could be contributing to ADHD symptoms. Interpersonal therapy is one of the psychotherapy methods that can aid in improving the ability of a person to resolve conflicts and develop meaningful relationships. Cognitive behavioral therapy is designed to help manage self-destructive, impulsive and negative behaviors that can cause difficulties at school or at work.
In certain situations psychotherapy may be utilized in combination with medication for adults adhd treatment. People with comorbid disorders such as depression, substance abuse and bipolar disorder need to be assessed to ensure their symptoms are not worsened through the use of medications to treat ADHD. People who suffer from certain medical issues, including thyroid disorders, lead poisoning, and a history of seizures, have to be treated more aggressively because they are at higher risk for complications from the medications.
When ADHD is serious enough to affect daily functioning and quality-of-life intensive outpatient programs might be recommended. These programs offer a more thorough and controlled treatment than standard outpatient therapy.
Cognitive behavioral therapy (CBT), which is a form of cognitive therapy, assists people with ADHD to improve their ability to manage time and impulse control, as well as planning and executive function. It helps them recognize and express their feelings. It utilizes worksheets and activities to make the learning more interesting. Meditation training that is mindful enhances CBT and improves the ability of people to concentrate and manage their emotions. It also improves a person's ability to handle the effects of stress and arousal. It helps them deal with anger, sadness and other emotions which could be contributing to their ADHD.
Occupational Therapy
Adults suffering from ADHD report difficulties functioning at work and at home. In addition to affecting work performance, these issues can interfere with relationships and may cause financial problems. Therapy that addresses these issues will help you improve your self-esteem and resolve underlying problems. It will also help you develop healthy ways of coping.
Cognitive-behavioral therapy is a successful treatment for adults with ADHD, as it teaches them how to change their negative thoughts and behaviors. It focuses on teaching time management techniques and overcoming thinking distortions that can lead to negative moods and the perception that there are only a few options.
Many people who suffer from ADHD also suffer from comorbid anxiety or depression. These psychiatric disorders can exacerbate or decrease the effectiveness of certain medications used to treat ADHD. It is therefore recommended to first treat the most severe comorbidity and then monitor the response to the medication before treating the other condition.
Occupational therapy can teach you methods to organize your life and work, create routines that are predictable, manage time and money, and create confidence in yourself. It can help you learn ways to relax that could reduce hyperactivity and impulsivity. Yoga and other exercises can also help you focus by stabilizing your body in various poses.
Counseling for families and marriage can assist adults suffering from ADHD to resolve the issues they create for their children, spouses and friends. adhd treatment adults complain of being unreliable, disorganized, forgetful and prone to making impulsive decisions. Classes and therapy in which spouses and other family members are educated about ADHD can help you establish healthier relationships. It can also help you and your family members realize that the problems are due to ADHD and not a lack in caring or refusing to cooperate.
Clinical Trials
Adult ADHD is a neurobiological disorder that is highly prevalent. It is accompanied by high rates of comorbidity, such as depression, anxiety and substance abuse disorders. Treatment options include medication and psychosocial interventions. A wide range of medications are available for adults suffering from ADHD and some of them have been tested in clinical trials. These studies have highlighted the strengths and weaknesses of the drugs.
Adults suffering from ADHD may experience the same symptoms that children do, but it is difficult to diagnose because the symptoms of childhood may not persist in adulthood. Additionally, people with ADHD may not have a history of the disorder in their families or they may not even remember experiencing symptoms. A thorough medical history is important to help determine whether the symptoms are caused by a medical condition such as a thyroid problem or sleep apnea. It could also be due to vision and hearing problems or lead poisoning.
Adults suffering from ADHD are treated with stimulants or nonstimulants. Stimulants are the most effective medications to treat adults suffering from ADHD and their response rates are in the 70%-80% range. The most popular stimulants are amphetamine and methylphenidate compounds. Methylphenidate may also be administered through a transdermal system. This permits continuous medication delivery during the day.
Nonstimulant drugs for adults with ADHD are mostly tricyclic antidepressants that target norepinephrine and dopamine. Desipramine, the most researched tricyclic, has been proven to be effective in adult ADHD patients. It is a low dose medicine and is recommended to increase the dose by 50 mg every seven days until the desired response is observed.
Bupropion XL is another antidepressant that has been proven to be effective for adults suffering from ADHD. It is a dopamine-agonist which is effective in blocking the reuptake of norepinephrine at the presynaptic transporter and increasing its presence in the brain. This drug has been found to improve mood and reduce hyperactivity in adults, but it is not as effective as stimulants in improving concentration or cognitive function.