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 levels of co-morbidity (depression anxiety, anxiety, alcohol abuse) and significant social, emotional, and occupational impairments.
Both psychotherapy and medication are effective treatments for adults suffering from ADHD. The most frequently prescribed medications are stimulants, such as methylphenidate and amphetamine.
Medicines
Many adults with ADHD have significant improvements in symptoms and performance due to medication. It is crucial that people who suffer from ADHD discover the right combination of medications that works for them.
Adults suffering from ADHD are prescribed stimulants like methylphenidate or amphetamines. These stimulants are available as tablets or liquids in an immediate-release (short acting) formulation. They can be taken every three to four hour. Adults can augment an immediate-release medicine with an extended-release long-acting medicine at least once a week to reduce the requirement to take it regularly throughout the day.
Adults suffering from ADHD can also be successfully treated with antidepressants, like desipramine. This class of drugs can be used in conjunction with stimulants or alone to enhance their effects. However, they can increase the risk of serious cardiovascular side effects, such as a rapid heartbeat, EKG changes, and orthostatic hypotension.
Adults with ADHD can also be treated with alprazolam or clonidine, which are both Alpha-2 adrenergic antagonists. These medications were initially created to treat hypertension. They have a calming affect and may improve focus and reduce the amount of hyperactivity and impulsivity in some adults. These medications can result in very low blood pressure when they are abruptly stopped or the dosage is reduced.
Adults with ADHD can also benefit from psychotherapy. Individual therapy can help them cope with their feelings of shame and embarrassment over their ADHD, as well as anger toward supervisors, colleagues teachers, family members and others who might be a source of criticism or nagging them. Marriage and family counseling is a great method 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 skills and strategies. Psychotherapy can help individuals with ADHD overcome their low self-esteem, and the sense of failure they often feel.
Cognitive behavioral therapy (CBT) helps individuals change the negative thoughts that cause difficulties in their lives and to develop new ways of thinking and feeling, as well as acting. This short-term, goal-oriented psychotherapy has been proven effective in treating many conditions, including depression and anxiety. It can be used in conjunction with other treatments or on its own.
CBT could involve group therapy, which can be 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 via phone. In one study, CBT was compared to the standard treatment for adults with ADHD. Both treatments improved self-report indicators like symptoms, functioning, and quality of life.
Several studies have compared 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 linked to various modalities, including interpersonal and cognitive behavioral therapy, social skills training, problem-solving training and mindfulness meditation.
However, caution is required when comparing the effectiveness of different treatments for adults with ADHD. It is likely that different outcomes of the treatments are due to a variety of variables that include treatment characteristics, 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 doing cognitive tasks to identify brain areas where there is excessive or insufficient activity. The person is then taught to regulate these patterns.
Counseling
Many people with ADHD have anxiety or mood disorders that require treatment. Counseling can help with these issues, which may contribute to ADHD symptoms. Interpersonal therapy is among the psychotherapy techniques which can improve the ability of individuals to manage conflicts and create lasting relationships. Cognitive behavioral therapy aims to transform negative behaviors and help manage self-destructive and impulsive behaviors that can lead to problems at school or at work.
In certain cases, psychotherapy can be used in combination with medication for adults adhd treatment. People with comorbid disorders such as substance abuse, depression, and bipolar disorder need to be assessed to ensure their symptoms aren't aggravated through the use of medications to treat ADHD. People who suffer from certain medical issues like thyroid disorders, lead poisoning, and seizures in the past, must be treated with more vigor because they are at higher risk for complications from the medications.
In-depth outpatient programs could be suggested if the individual's ADHD is so severe that it significantly interferes with their daily functioning and quality of life. These programs provide structured therapy that is more intense than conventional outpatient psychotherapy.
Cognitive behavioral therapy (CBT) helps adults with ADHD improve their abilities to manage their time and impulse control, as well as executive function, and planning. It helps them understand and express their feelings. It uses worksheets and activities to make the lessons more enjoyable. Meditation training that is mindful enhances CBT, and it improves the ability of people to concentrate and regulate their emotions. It also enhances an individual's ability to tolerate the effects of stress and arousal. It helps them deal with sadness, anger and other difficult feelings 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 conditions can cause problems with relationships and can cause financial problems. first line treatment for adhd in adults that addresses these issues can help boost your self-esteem, solve the root of your issue and establish healthy coping mechanisms.
Cognitive-behavioral therapy can be a beneficial treatment for adults with ADHD because it helps you modify your negative beliefs and behavior. It is focused on teaching techniques for managing time and overcoming thinking distortions which can cause negative moods, and the perception that there are only a few choices.
Many people who suffer from ADHD also suffer from depression or anxiety disorders. These psychiatric conditions can decrease or increase the effectiveness of certain medications that are used to treat ADHD. Therefore it is recommended that you treat the most severe comorbid disorder first and monitor the response to treatment prior to beginning treatment for the other disorder.
Occupational therapy can help you manage your work and life, establish predictable routines that help you control your time and money and build confidence in yourself. It can help you learn techniques for relaxation that can reduce hyperactivity and impulsivity. Similarly yoga and other exercises can help you improve your focus by stabilizing your body in different postures.
Counseling for families and marriage can help adults with ADHD to overcome the problems they create for their children, spouses and friends. They frequently complain that they are unstable, unorganized, forgetful and prone to making impulsive decisions. You can strengthen your relationships by informing your spouses and family members about ADHD. Furthermore it can help you and your loved ones understand that these issues are linked to the patient's ADHD rather than to an absence of care or a willful refusal to cooperate.
Clinical Trials
Adult ADHD is a neurobiological disorder that is extremely common. It is accompanied by high levels of comorbidity. This includes anxiety, depression and addiction disorders. The use of medication and psychosocial interventions is available as treatment options. There are many medications available for adults with ADHD. Some of these medications have been tested in clinical trials. These studies have revealed the strengths and weaknesses of the various medications.
Adults suffering from ADHD may experience the same symptoms as children do, but it is difficult to identify because the symptoms of childhood may not persist in adulthood. In addition, adults who suffer from ADHD might 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 whether the symptoms are related to a medical condition, like thyroid issues such as sleep apnea, sleep apnea and vision problems.
Adults with ADHD are treated with stimulants or non-stimulants. Stimulants have the highest reaction rates for people suffering from ADHD. Their rates of responsiveness vary from 70 to 80%. Amphetamine as well as methylphenidate are the most commonly prescribed stimulants. Methylphenidate can also be found as a transdermal solution, that allows for continuous drug delivery throughout the day.
Nonstimulant drugs for adults with ADHD are primarily tricyclic antidepressants which work on dopamine and norepinephrine. Desipramine, the most studied tricyclic, has been proven to work in adult ADHD patients. It is a low dose medication which should be increased each 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 is able to block the reuptake of norepinephrine in 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 function as stimulants.