ADHD in Adults - Treatment Options
ADHD is a prevalent neurological disorder that affects around 4,4% of the population. It is accompanied by high rates of comorbidity, including anxiety, depression, and substance abuse, and significant emotional, social and occupational impairments.
Both medication and psychotherapy are effective treatments for adults suffering from ADHD. The most frequently prescribed drugs are stimulants like methylphenidate or amphetamine.
Medications
Many people with ADHD have significant improvement in their symptoms and functioning due to medication. Due to the various ways people respond to medications it is crucial for people with ADHD to determine a mix that is effective.
Stimulants, such as methylphenidate and amphetamines, are the most frequently prescribed medication for adults suffering from ADHD. These stimulants are available in liquid or tablet form in an immediate-release (short acting) formulation. They can be taken every three to four hours. Some adults can supplement their immediate-release dose with an extended-release or longer-acting drug that is taken daily to decrease the need for frequent dosing throughout the day.
Adults suffering from ADHD are also treated successfully with antidepressants such as desipramine. This class of drugs may be employed in conjunction with stimulants or alone to enhance 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 as well as clonidine are used for the treatment of adults suffering from ADHD. These medications were originally developed to treat hypertension. They have a calming affect and can improve focus, and decrease hyperactivity and impulseivity in some adults. However, these medications can result in a drop in blood pressure if they are suddenly removed or reduced in dosage.
Adults suffering from ADHD are also able to benefit from psychotherapy. Individual therapy can help them to overcome feelings of shame, embarrassment, and resentment towards co-workers and teachers, supervisors, and family members that might criticize or nag them. Counseling for families and marriage is also a great way to help couples with ADHD better understand each other and improve communication.
Behavioral Therapy
Psychosocial therapy for adults suffering from ADHD is designed to improve daily functioning by educating people on strategies and skills. Psychotherapy can also help people who suffer from ADHD overcome low self-esteem and feelings of failure that is often associated with this condition.
Cognitive behavioral therapy (CBT), also known as cognitive behavioral therapy assists people to change negative thoughts and feelings that cause difficulties in their lives. It teaches them new ways to think, feel and act. This short-term, goal-oriented psychotherapy has been shown to be effective in treating a variety of illnesses, such as depression and anxiety. It can be used on its own or in conjunction with other treatments.
CBT may involve group therapy, which can be particularly helpful for adults with ADHD as it offers the opportunity to meet others who are facing similar issues and learn how other people manage their ADHD symptoms. It can be delivered in person or by phone. One study compared the effects of CBT with that of standard therapy for adults with ADHD and found that both treatments led to 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. adhd in adults symptoms and treatment were associated with various modalities such as cognitive and interpersonal behavioral therapy, social skills training, problem-solving, and mindfulness meditation.
It is essential to assess the efficacy between different treatments for adult ADHD with caution. It is likely that different outcomes of the treatments depend on a variety of factors, including treatment characteristics, measures employed, and patient backgrounds. Few studies have examined the effectiveness neurofeedback. This method involves wearing an electrode-lined hat while performing cognitive tasks to pinpoint brain areas in which there is excessive or insufficient activity. The individual then learns to control these patterns.
Counseling
Many people with ADHD also suffer from anxiety or mood disorders that require treatment. Counseling can help with these issues that could be contributing to ADHD symptoms. Some psychotherapy approaches include the use of interpersonal therapy to improve a person's ability to build meaningful relationships and to resolve conflicts. Cognitive behavioral therapy is designed to help control self-destructive, impulsive and negative behaviors that can create difficulties at school or at work.
In some cases, psychotherapy can be used in conjunction with medications for adults who are seeking treatment for adhd. People with multiple disorders like addiction to substances, depression and bipolar disorder need to be evaluated to ensure that their symptoms aren't made worse by medications used to treat ADHD. People with certain medical issues, including thyroid disorders, lead poisoning, and a history of seizures, need to be treated more aggressively as they are at higher risk for complications from the medications.
If ADHD is severe enough to interfere with daily functioning and quality-of-life intensive outpatient programs might be recommended. These programs provide an organized treatment that is more intense than traditional outpatient psychotherapy.
Cognitive behavioral therapy (CBT) assists adults suffering from ADHD improve their abilities to manage time management and impulse control, as well as organizing, and executive function. It helps them identify and express their feelings and employs worksheets and exercises to make the learning more engaging. Mindfulness meditation training improves CBT and improves the ability of people to concentrate and regulate their emotions. It increases the capacity of a person to manage stress and arousal. It helps them deal with sadness, anger and other emotional issues that may be contributing towards their ADHD.
Occupational Therapy
Adults suffering from ADHD have issues functioning at work and at home. In addition to affecting work performance, these issues can interfere with relationships and can result in financial issues. Therapy that addresses these issues will help you to improve your self-esteem and solve the underlying issues. It can also assist you in developing healthy coping strategies.
Cognitive-behavioral Therapy is a great treatment for adults suffering from ADHD because it helps you change your negative beliefs and behaviors. It focuses on teaching techniques for managing time and overcoming thinking distortions which can cause negative moods, and the perception of a limited number of possibilities.
Many people who suffer from ADHD also suffer from comorbid depression or anxiety disorders. These psychiatric conditions can cause or decrease the effectiveness of certain medications used to treat ADHD. Therefore it is recommended you treat the most severe comorbidity first and monitor its response to medication prior to beginning treatment for the other disorder.
Occupational therapy can teach you ways to organize your life and your work, establish routines that are predictable, manage time and money, and create an optimistic self-image. It can also help you learn relaxation techniques that can reduce your impulsivity and hyperactivity. Additionally yoga and other forms of exercise can help you focus better by stabilizing the body in different postures.
Marriage and family counseling can help adults with ADHD to overcome the problems they create for their spouses, kids and others. They frequently complain that they are insecure, unorganized, and prone to making impulsive decisions. You can build stronger relationships by educating your spouses and family members about ADHD. It can also help you and your family members understand that the issues are due to ADHD instead of a lack in caring or an unwillingness to cooperate.
Clinical Trials
Adult ADHD is a frequent neurobiological disorder. It is accompanied by high rates of comorbidity. This includes anxiety, depression, and substance abuse disorders. Psychosocial and medication treatments are available as treatment options. A wide range of medications are available for adults with ADHD and a few of them have been evaluated in clinical trials. These studies have highlighted both the advantages and drawbacks of the medications.
Adults who suffer from ADHD suffer from the same issues as children, however it isn't always easy to recognize them since the symptoms of childhood may not persist throughout adulthood. Additionally, people with ADHD may not have a family history of the disorder in their family or may not be aware of having symptoms. A thorough medical history is important to help determine whether the symptoms are due to a medical condition such as thyroid issues or sleep apnea, hearing and vision problems or lead poisoning.
Adults with ADHD are treated with stimulants or non-stimulants. Stimulants are the most effective drugs for adults suffering from ADHD and their response rates are in the 70 - 80 percent range. The most commonly used stimulants are amphetamine and methylphenidate compounds. Methylphenidate may also be administered via a transdermal system. This allows for continuous medication delivery during the day.
Nonstimulant medications for adults with ADHD are mostly tricyclic antidepressants which work on norepinephrine and dopamine. Desipramine, the most studied tricyclic, has shown 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 different antidepressant, has been proven to work in adults with ADHD. It is a dopamine agonist and is able to block the reuptake of norepinephrine at the presynaptic receptor, thereby increasing its availability in the brain. This drug has been proven to improve the mood of adults and reduce hyperactivity however it's not as effective at improving concentration or cognitive functions as stimulants.