ADHD in Adults - Treatment Options
ADHD is a well-known disorder of the nervous system that affects 44% of the population. It is accompanied by high levels of co-morbidity (depression anxiety, anxiety, and addiction to drugs) and 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 such as methylphenidate or amphetamine.
Medicines
Many people with ADHD notice significant improvements in their symptoms and functioning when they take medication. Due to the many different ways that people respond to medication, it is crucial for people with ADHD to determine a mix that is most effective.
Stimulants, including amphetamines and methylphenidate are the most frequently prescribed drugs for adults suffering from ADHD. These stimulants are available in tablets or liquids in an immediate-release (short acting) formulation. They can be taken every three to four hour. Some adults may supplement an immediate-release dose with an extended-release or longer-acting drug used once per day to reduce the requirement for frequent doses throughout the day.
Antidepressants like desipramine have also been proven to be effective in treatment of adults with ADHD. This class of drugs can be utilized in conjunction with stimulants, or on their own to boost their effects. However, they may increase the risk of serious cardiovascular side effects such as a rapid heartbeat, EKG changes, and orthostatic hypotension.
Alpha-2 adrenergic agonists such as alprazolam and clonidine can also be used to treat adults with ADHD. These medications, originally designed to treat high blood pressure, possess the ability to calm and improve focus and decrease the level of hyperactivity and impulsivity among certain adults. These medications can cause very low blood pressure when they suddenly stop, or the dosage is reduced.
Adults with ADHD can also benefit from psychotherapy. Individual talk therapy can help them cope with their feelings of shame and embarrassment about their ADHD and anger towards supervisors, coworkers teachers, and family members who may nag or criticize them. Counseling for families and marriage is a great method to help couples with ADHD better understand each other and improve communication.
Behavioral Therapy
A key goal of psychosocial therapy for adults with ADHD is to teach skills and strategies that improve performance in everyday life. Psychotherapy can help those who suffer from 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 create problems in their lives and to learn new ways of thinking and feeling, as well as doing. This short-term, goal-oriented psychotherapy has been shown to be effective in treating various disorders, such as anxiety and depression. It can be used on its own or in conjunction with other therapies.
CBT may also include group therapy. This is especially beneficial for adults with ADHD as it allows them to meet others who have similar struggles and discover how they deal with their ADHD symptoms. CBT can be provided in person or by phone. One study compared the results of CBT with that of traditional therapy for adults with ADHD and found that both treatments produced improvement in self-report measures of functioning, symptoms and quality of life.
Several studies have compared CBT with other psychosocial treatments for people with ADHD, and all show significant reductions in self-reported ADHD symptoms with medium to large effect size. These improvements were attributed to a variety of modalities that include cognitive and interpersonal behavioral therapy, social skills training, problem-solving training and mindfulness meditation.
It is essential to assess the efficacy between different treatments for adult ADHD with caution. It is possible that the differences in the outcomes result from a variety of factors, including treatment features and the methods used. A few studies have examined the effectiveness of neurofeedback, a technique that involves wearing an electrode-lined cap while doing 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 who suffer from ADHD also suffer from comorbid mood or anxiety disorders that require treatment. Counseling can help with these problems, which may contribute to ADHD symptoms. Interpersonal therapy is one of the psychotherapy methods that can aid in improving the ability of a person to manage conflicts and create meaningful relationships. Cognitive behavioral therapy aims to alter negative behaviors and help manage self-destructive and impulsive behavior that can lead to problems at school or work.
In some cases psychotherapy is sometimes used in conjunction with medications for adults who are seeking treatment for adhd. People with comorbid conditions such as depression, bipolar disorder, and substance abuse must be assessed carefully to ensure they do not have symptoms that cannot be improved by the medication that are prescribed to treat ADHD. Patients with certain medical conditions, including thyroid disorders, lead poisoning, and a history of seizures, have to be treated more aggressively as they are at higher risk of developing complications from the medication.
Outpatient intensive programs may be recommended if the person's ADHD is such that it hinders their daily functioning and quality of life. These programs offer more thorough and controlled treatment than standard outpatient therapy.
Cognitive behavioral therapy (CBT), which is a type of cognitive therapy, aids people with ADHD to improve their ability to manage time and impulse control, as well as planning and executive functioning. It helps them recognize and express their feelings and uses worksheets and activities to make the lessons more engaging. The practice of mindfulness meditation improves CBT and enhances the capacity of a person to focus and manage emotions. It also increases a person's capacity to manage the effects of stress and arousal. It can help them cope with sadness, anger and other emotions that may be contributing towards their ADHD.
Occupational Therapy
Adults suffering from ADHD report difficulties functioning at work and at home. These symptoms can also affect relationships and cause financial difficulties. Therapy that addresses these issues can help boost your self-esteem, solve underlying problems and establish healthy coping mechanisms.
Cognitive-behavioral therapy is a successful treatment for adults with ADHD because it teaches them how to change their negative thoughts and behavior. It is focused on teaching you how to employ time management strategies and overcome mental distortions that lead to negative moods and the perception of a limited selection.
Many people suffering from ADHD have anxiety or depression disorders that are comorbid. These psychiatric illnesses may aggravate or reduce the effectiveness of certain treatments for ADHD. Therefore, it is recommended that you treat the most severe comorbidity first and monitor the effect of medication prior to attempting treatment for the other disorder.
Occupational therapy can help you learn methods to organize your life and your work, create regular routines, manage your time and money and build a positive self-image. It can help you master techniques for relaxation that can reduce impulsivity and hyperactivity. Yoga and other exercises can aid in improving your concentration by stabilizing your body in different poses.
Family and marriage counseling can help address the issues that people with ADHD often create for their spouses, children and other family members. They often complain about being unstable, unorganized, forgetful and susceptible to making decisions based on impulsivity. You can strengthen your relationships by educating your spouses and family members about ADHD. It can help you and your family members to understand that the issues are due to ADHD and not the lack of care or an unwillingness to cooperate.
Clinical Trials
Adult ADHD is a highly common neurobiological disorder. It is accompanied by high levels of comorbidity. This includes depression, anxiety and addiction disorders. Psychosocial and medication interventions are available as treatment options. A variety of medications are available for adults suffering from ADHD and a few of them have been tested in clinical trials. These studies have exposed the strengths and weaknesses of the drugs.
Adults who suffer from ADHD suffer from the same issues as children, however it can be difficult to diagnose them because childhood symptoms might not last until adulthood. Adults suffering from ADHD might not have any family background of the disorder or might not remember the symptoms. A thorough medical history is necessary to help determine whether the symptoms are due to medical conditions like thyroid problems or sleep apnea. It could also be due to vision and hearing problems or lead poisoning.
Treatments for adults suffering from ADHD generally fall into two categories: stimulants and non-stimulant medications. adhd treatment for older adults are the most effective medications for adults suffering from ADHD, and their responsiveness rates are in the 70%-80 percent range. The most commonly used stimulants are amphetamine and methylphenidate compounds. Methylphenidate is also available in a transdermal system, that allows for continuous supply of medication throughout the day.
Nonstimulant medicines for adults suffering from ADHD are primarily tricyclic antidepressants that work on norepinephrine and dopamine. Desipramine, the most researched tricyclic, has been proven to work in adult ADHD patients. It is a low dose medication and should be increased by 50 mg every seven days until the desired effect is observed.
Bupropion XL another antidepressant, has been shown to work in adults with ADHD. It is a dopamine agonist and is able to block the reuptake of norepinephrine in the presynaptic transporter, thereby increasing its availability in the brain. This drug is known to boost mood in adults and decrease hyperactivity, but it's not as effective at improving concentration or cognitive function as stimulants.