ADHD in Adults - Treatment Options
ADHD is a common neurobiological disorder that affects 4.4% of the general population. It is accompanied by high levels of comorbidity (depression, anxiety, substance abuse) and significant social, emotional, and occupational impairments.
Psychotherapy and medication are both effective treatments for adults suffering from ADHD. The stimulants methylphenidate and amphetamine are the most commonly prescribed drugs.
Medications
Many people with ADHD notice significant improvement in their symptoms and functioning as a result of medication. It is essential that those who suffer from ADHD find the combination of medication that works for them.
Stimulants, like amphetamines and methylphenidate, 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 hour. Adults may supplement an immediate-release medication with an extended-release long-acting medication every week to decrease the need to take it frequently throughout the day.
Adults suffering from ADHD can also be treated successfully with antidepressants such as desipramine. This class of drugs may be utilized in conjunction with stimulants or in isolation 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 antagonists like alprazolam and clonidine are also used for the treatment of adults with ADHD. These medications, originally developed to treat high blood pressure, can have a calming effect and can enhance focus and decrease hyperactivity and impulsivity in some adults. These medications can lead to very low blood pressure if they are suddenly stopped, or the dosage is reduced.
Psychotherapy can also be beneficial for adults with ADHD. Individual therapy can help them deal with their feelings of shame and embarrassment regarding their ADHD, as well as anger towards supervisors, coworkers teachers, family members and others who might be a source of criticism or nagging them. Additionally, marriage and family counseling can help couples with ADHD be able to recognize each other's challenges and improve communication.
Behavioral Therapy
Psychosocial therapy for adults with ADHD aims to improve daily functioning by teaching skills and strategies. Psychotherapy can help those who suffer from 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. It also helps to develop new ways of thinking, feeling and acting. This short-term, goal-oriented form of psychotherapy has been proven to be effective for many conditions including anxiety and depression. It can be used by itself or in conjunction with other therapies.
CBT may include group therapy, which can be particularly helpful for adults with ADHD as it offers the opportunity to meet others with similar challenges and to discover how other people manage their ADHD symptoms. CBT can be offered in person or via the phone. In one study, CBT was compared to standard therapy for adults who have ADHD. Both treatments helped improve self-reporting measures such as 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 associated with various modalities that include cognitive and interpersonal behavioral therapy, social skill training, problem-solving exercises, and mindfulness meditation.
It is important to compare the effectiveness of various treatments for adult ADHD with caution. It is possible that the differences in outcome results are due to a variety of variables such as treatment characteristics, measures used and the background of the patient. A few studies have investigated the effectiveness of neurofeedback, a technique that involves wearing an electrode-lined cap while doing cognitive tasks to identify areas of the brain where there is too much or little activity - and then instructing the person to manage these patterns.
Counseling
Many people who suffer from ADHD also suffer from anxiety or mood disorders that require treatment. This Web-site can help with these issues which may be causing ADHD symptoms. Some psychotherapy approaches include interpersonal therapy to improve a person's ability to build meaningful relationships and resolve conflicts. Cognitive behavioral therapy is designed to help control self-destructive, impulsive and negative behaviors that could create problems at school or work.
In some cases psychotherapy may be used as an alternative to the medication used for ADHD treatment for adults. People with multiple disorders like depression, substance abuse and bipolar disorder should be evaluated to ensure that their symptoms are not worsened through the use of medications to treat ADHD. Patients with certain medical conditions like thyroid disorders, lead poisoning, and a history of seizures, need to be treated more aggressively as they are at a higher risk for complications from the medication.
If ADHD is sufficient to cause problems with the quality of life and daily functioning intensive outpatient programs could be recommended. These programs offer more thorough and structured treatment than traditional outpatient therapy.
Cognitive behavioral therapy (CBT), which is a form of cognitive therapy, aids people with ADHD to improve their ability to manage time, impulse control, planning and executive functioning. It helps them understand and express their feelings and utilizes worksheets and activities to make the learning more engaging. The training in mindfulness meditation improves CBT and improves the ability of a person to focus and regulate emotions. It also increases a person's ability to tolerate the effects of stress and arousal. It helps them deal with sadness, anger, and other emotions which could be contributing to their ADHD.
Occupational Therapy
Adults suffering from ADHD often have difficulties functioning at home and at work. In addition to affecting their work performance, these issues can interfere with relationships and may result in financial issues. Therapy that addresses these issues can help you build confidence in yourself and solve the underlying issues. It can also assist you in developing healthy ways of coping.
Cognitive-behavioral therapy can be a beneficial treatment for adults with ADHD because it teaches you how to modify your negative thoughts and behaviors. It focuses on teaching techniques for managing time and overcoming thinking distortions that can lead to negative moods and the perception that there are only a few options.
Many adults with ADHD also suffer from depression or anxiety disorders. These psychiatric disorders can exacerbate or decrease the effectiveness of certain treatments for ADHD. Therefore, it is recommended that you first treat the most severe comorbidity and then observe its reaction to the medication prior treating the other condition.
Occupational therapy can teach you how to manage your life and your work, establish regular routines, manage your money and time and develop confidence in yourself. It can also help you learn ways to relax that could reduce hyperactivity and impulsivity. Yoga and other exercises can help you concentration by stabilizing your body in various postures.
Marriage and family counseling can address the problems that people with ADHD frequently cause their spouses, children and others. They often complain about being undependable and unorganized. They also tend to forget things or make impulsive choices. Therapy and classes in which spouses and other family members are educated on ADHD can help you develop healthier relationships. Furthermore it can help you and your loved ones to understand that these problems are related to the patient's ADHD rather than a lack of caring or an unwillingness to cooperate.
Clinical Trials
Adult ADHD is a highly prevalent neurobiological disorder. It is accompanied by high levels of comorbidity. This includes depression, anxiety and addiction 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 exposed the strengths and the limitations of the medication.
Adults who suffer from ADHD may experience the same symptoms as children do, but it can be difficult to determine because childhood symptoms might not persist in adulthood. Adults suffering from ADHD may also not have any family history of the disorder, or might not remember the symptoms. It is crucial to take a thorough medical history in order to determine whether the symptoms are due to an illness, such as thyroid problems or sleep apnea, and vision problems.
Adult medications for ADHD generally fall into two categories: stimulants and non-stimulant medications. Stimulants have the highest response rates for people suffering from ADHD. Their response rates range from 70% to 80%. The most popular stimulants are methylphenidate and amphetamine compounds. Methylphenidate is also administered via a transdermal device. This permits continuous medication delivery throughout the daytime.
Adults with ADHD can take non-stimulant drugs that act on norepinephrine or dopamine. Desipramine is the most studied tricyclic, and has been proven to be effective in adult patients suffering from ADHD. It is a low-dose medication that should be increased every seven days by 50mg until the desired effect is observed.
Bupropion XL is another antidepressant which has been proven to be effective in adults with ADHD. It is a dopamine agonist that blocks the reuptake process of norepinephrine by the presynaptic receptor, thereby increasing its presence in the brain. This drug has been found to improve mood and decrease hyperactivity in adults. However, it isn't as effective as stimulants when it comes to improving concentration or cognitive function.