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 rates of co-morbidity (depression anxiety, anxiety, and substance abuse) and significant emotional, social and occupational impairments.
Psychotherapy and medication are both effective treatments for adults with ADHD. Stimulants like methylphenidate or amphetamine are the most frequently prescribed drugs.
Medicines
Many adults suffering from ADHD experience significant improvements in their symptoms and functioning due to medication. It is essential that those who suffer from ADHD find the combination of medications that is effective for them.
Adults suffering from ADHD are prescribed stimulants like amphetamines or methylphenidate. They are available in immediate-release (short-acting) tablet or liquid forms and can be taken as often as every three to four hours. Adults may supplement an immediate-release medication with an extended-release long-acting medication once a week to reduce the need to take it frequently throughout the day.
Adults suffering from ADHD can also be treated successfully with antidepressants like desipramine. This class of drugs may be used in conjunction with stimulants or on their own to boost their effects. However, they can increase the risk of serious cardiovascular side effects such as rapid heartbeat, EKG changes, and orthostatic hypotension.
Alpha-2 adrenergic agonists like alprazolam and clonidine can also be utilized to treat adults suffering from ADHD. These drugs were initially developed to treat hypertension. They have a calming effect and may improve focus and reduce hyperactivity and impulse control in certain adults. These medications can lead to very low blood pressure when they suddenly stop, or the dosage is reduced.
Adults with ADHD are also able to benefit from psychotherapy. Individual therapy can help them deal with feelings of shame, embarrassment and resentment against coworkers, teachers, supervisors and family members who might criticize or nag them. Counseling for families and marriage is a great method to help couples suffering from ADHD to better understand each other and improve their communication.
Behavioral Therapy
The primary goal of psychosocial therapy for adult ADHD is to teach skills and strategies that improve performance in everyday life. Psychotherapy can also help people who suffer from ADHD overcome their low self-esteem and feelings of failure that is often associated with this condition.
Cognitive behavioral therapy (CBT) helps individuals change the negative thoughts that cause problems in their lives. It also helps to develop new ways of thinking, feeling and doing. This short-term, goal-oriented kind of psychotherapy has been found to be effective for many illnesses such as anxiety and depression. It can be utilized in conjunction with other therapies or by itself.
CBT may also include group therapy. This is especially beneficial for adults with ADHD because it enables them to connect with others who have similar struggles and learn how they manage their ADHD symptoms. CBT can be provided in person or via phone. In one study, CBT was compared to conventional therapy for adults with 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 with ADHD and have all shown significant reductions in self-reported ADHD symptoms, with medium to large effect sizes. These improvements were linked to various modalities, including interpersonal and cognitive behavior therapy as well as social skills training, problem solving training, as well as mindfulness meditation.
However, caution is required in comparing the effectiveness of different therapies for adult ADHD. It is possible that the different outcomes of the treatments are due to a variety of variables, including treatment characteristics, measures used, and patient backgrounds. Few studies have examined the effectiveness neurofeedback. This method 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 who suffer from ADHD have mood or anxiety disorders that require treatment. Counseling can help address these issues which may be causing ADHD symptoms. Some psychotherapy approaches include interpersonal therapy to improve the ability of a person to form meaningful relationships and to resolve conflicts. Cognitive behavioral therapy aims to change negative behavior and assist in reducing self-destructive and impulsive behaviors that can lead to problems at school or at work.
In some instances psychotherapy can be utilized as an adjunct to medication for adult ADHD treatment for adults. Patients with comorbid disorders such as addiction to substances, depression and bipolar disorder should be assessed to ensure that their symptoms aren't made worse by the medications used to treat ADHD. Certain medical conditions, like thyroid disorders, lead poisoning, and a history of seizures, should be treated with more vigor.
When ADHD is serious enough to affect everyday functioning and quality of life, intensive outpatient programs may be suggested. These programs provide more intensive and organized treatment than traditional outpatient therapy.
Cognitive behavioral therapy (CBT) helps adults with ADHD improve their ability to manage time and impulse control, executive function, and planning. It helps them understand and express their feelings and employs worksheets and exercises to make the learning more engaging. Mindfulness meditation training improves CBT, and it improves the ability of people to concentrate and control their emotions. It enhances the capacity of a person to tolerate stress and arousal. It can assist them in dealing with anger, sadness and other emotional issues that could be causing their ADHD.
Occupational Therapy
Adults with ADHD experience difficulties at work and at home. These issues can also impact relationships and lead to financial difficulties. Therapy that addresses these issues can help you increase self-esteem, address the root causes of your issues and develop healthy coping mechanisms.
Cognitive-behavioral therapy can be a beneficial treatment for adults with ADHD because it teaches you how to change your negative beliefs and behaviors. In particular, it concentrates on teaching you to employ strategies for managing time and overcoming mental distortions that lead to negative moods and the perception of limited choices.
Many adults with ADHD have depression or anxiety disorders as comorbid conditions. These psychiatric disorders can diminish or exacerbate the effectiveness of certain medications used to treat ADHD. It is therefore recommended to first treat the most severe comorbid condition and then observe its reaction to the medication prior treating the other disorder.
Occupational therapy can help you manage your life and work by establishing predictable routines, manage your time and money, and develop a positive image of yourself. It can also help you master relaxation techniques that may reduce your hyperactivity and impulsivity. Yoga and other workouts can help you improve concentration by stabilizing your body in various poses.
Counseling for families and marriage can help address the issues that people with ADHD frequently cause their spouses, children and others. They often complain about being erratic and unorganized. They are also prone to forget things or make impulsive decisions. Therapy and classes where spouses and other family members are educated on ADHD can help you build better relationships. It can also help you and your family members understand that the issues are due to ADHD instead of a lack in caring or a refusal to cooperate.
Clinical Trials
Adult ADHD is a prevalent neurobiological disorder. It is often accompanied by other disorders that are comorbid, such as anxiety, depression and substance abuse disorders. The use of medication and psychosocial interventions is available as treatments. There are doctors who treat adhd in adults of medications available for adults with ADHD. Some of these medications have been tested in studies. These studies have exposed the strengths and weaknesses of the drugs.
Adults with ADHD may experience the same symptoms that children do, but it can be difficult to determine because childhood symptoms might not persist in adulthood. Adults suffering from ADHD might not have an ancestral history of the disorder, or might not remember the symptoms. A thorough medical history is important to help determine whether the symptoms are due to a medical condition like thyroid problems, sleep apnea, issues with vision and hearing or lead poisoning.
Adult medications for ADHD generally fall into two categories: stimulants and nonstimulant medications. Stimulants are the most effective drugs for treating adults with ADHD and their responsiveness rates are within the 70-80 percent range. The most frequently used stimulants are amphetamine and methylphenidate compounds. Methylphenidate is also available in a transdermal system that allows for continuous drug delivery throughout the day.
Adults suffering from ADHD can take nonstimulant medications that work by affecting norepinephrine or dopamine. Desipramine, the most studied tricyclic, has been proven to be effective 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 observed.
Bupropion XL is a second antidepressant that has been proven to be effective in adults with ADHD. It is a dopamine agonist that blocks the reuptake of norepinephrine in the presynaptic cellular transporter which increases its accessibility to the brain. This drug has been proven to boost mood in adults and decrease hyperactivity, however it's not as effective in improving concentration or cognitive functions as stimulants.