ADHD in Adults - Treatment Options
ADHD is a common condition of the nervous system that affects 44% of the population. It is associated with a high rate of comorbidity, including depression, anxiety and substance abuse and significant emotional, social and occupational impairments.
Medications and psychotherapy are both effective treatments for adults with ADHD. The most frequently prescribed drugs are stimulants like methylphenidate or amphetamine.
Medicines
Many adults suffering from ADHD have significant improvements in symptoms and performance due to medications. Because of the different ways people respond to medications it is important for individuals with ADHD to find a combination that is effective.
Stimulants, such as amphetamines and methylphenidate, are the most commonly prescribed medications for adults with 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. Adults can augment an immediate-release medicine with an extended release long-acting medication once a week to reduce the requirement to take it frequently throughout the day.
Adults suffering from ADHD are also successfully treated with antidepressants, like desipramine. This class of drugs can be used alone or in combination with stimulants to boost their effects. They may also increase the danger of serious side effects, including rapid heartbeats, EKG changes and orthostatic hypotension.
Alpha-2 adrenergic antagonists like alprazolam and clonidine are also used for the treatment of people suffering from ADHD. These medications, originally developed to treat high blood pressure, have an calming effect and are able to increase focus and reduce the amount of impulsivity and hyperactivity in some adults. However, these drugs can cause a very low blood pressure if they are suddenly cut off or reduced in dosage.
Adults with ADHD are also able to benefit from psychotherapy. Individual therapy can help them to overcome feelings of embarrassment, shame, and resentment toward coworkers, teachers, supervisors, and family members that might nitpick or criticize them. Counseling for families and marriage is a great method to help couples with ADHD to better understand each other and improve communication.
Behavioral Therapy
The primary goal of psychosocial therapy for adults with ADHD is to impart skills and strategies that improve function in everyday life. Psychotherapy can help individuals with ADHD overcome their self-esteem problems and the feeling of failure they often feel.
Cognitive behavioral therapy (CBT) helps people change the negative thoughts that create difficulties in their lives and to learn new ways of thinking and feeling, as well as acting. This short-term, goal-oriented psychotherapy has been proven effective in treating various illnesses, such as depression and anxiety. It can be used alone or in combination with other therapies.
CBT can 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 about how they manage their ADHD symptoms. CBT can be provided in person or via phone. One study compared the results of CBT against conventional therapy for adults suffering from ADHD and discovered that both treatments resulted in improvement in self-report measures of symptoms, functioning, and quality of life.
CBT has been compared with other psychosocial treatments for adults suffering from ADHD. All of these studies demonstrate significant reductions in ADHD symptoms and effects, with sizes ranging from medium to large. These improvements were associated with various modalities that include cognitive and interpersonal behavioral therapy, social skill training, problem-solving exercises, and mindfulness meditation.
However, caution is warranted in comparing the effectiveness of various treatments for adult ADHD. It is likely that the differences in outcome results are due to a variety of variables that include treatment characteristics, measures employed and the background of the patient. There are few studies that have investigated the effectiveness of neurofeedback. This technique involves wearing an electrode-lined hat while doing cognitive tasks to pinpoint brain areas in which there is excessive or inadequate activity. The individual is then taught to regulate these patterns.
Counseling
Many people suffering from ADHD also suffer from comorbid mood or anxiety disorders that require treatment. Counseling can help address these issues that could be contributing to ADHD symptoms. Interpersonal therapy is one of the psychotherapy approaches that can help improve a person’s ability to resolve conflicts and develop lasting relationships. Cognitive behavioral therapy is designed to help manage self-destructive, impulsive and negative behaviors that could cause difficulties at school or at work.
In some cases psychotherapy is sometimes used in conjunction with medications for adults adhd treatment. People who have comorbid conditions like bipolar disorder, and addiction to drugs need to be evaluated carefully to make sure they don't have symptoms that are not ameliorated by the medications used to treat ADHD. Certain medical conditions, such as thyroid disorders, lead poisoning, and a history or seizures, need to be treated with more vigor.
Intensive outpatient programs might be suggested if the individual's ADHD is so severe that it significantly affects their daily functioning and quality of life. These programs provide an organized therapy that is more intense than traditional outpatient psychotherapy.
Cognitive behavioral therapy (CBT), which is a type of cognitive therapy, assists people with ADHD to improve their ability to manage time, impulse control, planning and executive functioning. It helps them understand and express emotions, and it uses activities and worksheets to make the lessons engaging. Mindfulness meditation training enhances CBT and improves the ability of people to concentrate and regulate their emotions. It also enhances an individual's ability to tolerate stress and arousal. It can assist them in dealing with sadness, anger and other emotional issues that could be contributing to their ADHD.
Occupational Therapy
Adults suffering from ADHD frequently have difficulty functioning at home and at work. In addition to affecting their work performance, these issues can interfere with relationships and may lead to financial difficulties. Therapy that addresses these issues will allow you improve your self-esteem and address the root of the issue. It can also assist you in developing healthy coping strategies.
Cognitive-behavioral therapy is an effective treatment for adults suffering from ADHD, as it teaches them how to change their negative thoughts and behaviors. It is focused on teaching you how to utilize strategies to manage your time and eliminate mental distortions that lead to negative moods and perceptions of a limited selection.
Many adults with ADHD have depression or anxiety disorders that are comorbid. These psychiatric illnesses may aggravate or decrease the effectiveness of certain drugs used to treat ADHD. Therefore treatment for inattentive adhd in adults is recommended you treat the most severe comorbid disorder first and then monitor its response to medication before proceeding to treatment of the other disorder.
Occupational therapy can help you learn ways to organize your life and work, establish predictable routines, manage time and money and build confidence in yourself. It can also help you learn relaxation techniques that can reduce your impulsivity and hyperactivity. In the same way yoga and other exercises can help you focus better by stabilizing the body in various poses.
Family and marriage counseling can help adults with ADHD to overcome the problems they create for their spouses, kids and other family members. They frequently complain of being unreliable, disorganized, forgetful and susceptible to making decisions based on impulsivity. You can strengthen relationships by informing your spouses and family members about ADHD. It can also help you and your family members understand that the problem is due to ADHD instead of a lack in caring or a refusal to cooperate.
Clinical Trials
Adult ADHD is a neurobiological disorder which is extremely common. It is often accompanied by comorbid conditions such as depression, anxiety and substance abuse disorders. Treatment options include medication and psychosocial interventions. A wide range of medications are available for adults suffering from ADHD and a few of these have been evaluated in clinical trials. These studies have revealed the strengths and the limitations of the medication.
Adults suffering from ADHD may experience the same symptoms that children do, but it can be difficult to determine because the symptoms of childhood may not last into adulthood. In addition, adults with ADHD may not have a family history of the disorder in their families or may not be aware of experiencing symptoms. A thorough medical history is important to help determine whether the symptoms are due to medical conditions such as a thyroid problem, sleep apnea, hearing and vision problems or lead poisoning.
Adults suffering from ADHD are treated with stimulants or non-stimulants. Stimulants have the highest reaction rates for people suffering from ADHD. Their response rates vary from 70 to 70% to 80%. The most frequently used stimulants are amphetamine and methylphenidate compounds. Methylphenidate can also be found as a transdermal solution, which permits continuous supply of medication throughout the day.
Nonstimulant drugs for adults with ADHD are primarily tricyclic antidepressants that target dopamine and norepinephrine. Desipramine, the most researched tricyclic, has been shown to work in adult ADHD patients. It is a low dose drug and should be increased by 50 mg every seven days until the desired effect is observed.
Bupropion XL another antidepressant, has been proven to be effective in adults suffering from ADHD. It is a dopamine receptor agonist and works by blocking the reuptake of norepinephrine at the presynaptic receptor, thereby increasing its availability in the brain. This drug is known to improve mood in adults and decrease hyperactivity, however it's not as effective at improving concentration or cognitive function as stimulants.