Treatment of ADHD in Adults
Treatment for adults with adhd is based on therapy, medication and family support. Clinical trials are available to test the effectiveness of new treatments for ADHD.
The stimulant medications are the most effective treatment for adults with ADHD. However, they must be monitored regularly. This includes regular clinical appointments, and frequent reviews of symptoms and side effects.
Medicines
Many medications can be used to reduce the symptoms of ADHD in adults. They are known as psychostimulants and they alter the levels of certain chemicals in your brain (neurotransmitters) that pass messages between nerve cells. Your doctor will select the best medication for you and will decide the most effective dose and time to take it. It may take a while to determine the appropriate medication and dosage that controls your symptoms.
Stimulants are often the first medication doctors prescribe for adults with ADHD. They increase the amount of dopamine and norepinephrine that are present in your brain, which enhances your ability to focus and control impulses. They come in short-, intermediate-- and long-acting forms. Short-acting stimulants can last up to up to 6 hours. Intermediate-acting drugs last between 8 and 10 hours. Long-acting drugs can last up to 16. Long-acting stimulants are less likely to cause adverse reactions than intermediate or shorter-acting medications. However, they can cause sleepiness and changes in appetite.
Non-stimulant medications like atomoxetine, (Strattera) are used to treat adult ADHD if stimulants do not perform or cause unwanted adverse effects. These medicines don't affect your dopamine or norepinephrine however they increase the amount of norepinephrine available to your brain, and improve your ability to concentrate. These medicines come in capsules and can be taken twice or once every day.
Some adults with ADHD also have other psychiatric disorders, including depression and anxiety. These are referred to as comorbid conditions and they can impact how you react to treatment for ADHD. Before beginning treatment for ADHD it is essential to address any comorbid issues. For instance, those who have an addiction history to drugs or disorder are more likely to use psychostimulants. It's best to wait until a person has stopped using drugs before taking them on with stimulants.
Psychotherapy
Psychotherapy involves discussing and talking about topics that are troubling or disturbing for a person. The therapist gives advice based upon his or her education, experience, credentials and therapeutic philosophy. Psychotherapy can be short-term, (a few weeks or even months) or addressing more immediate issues, or longer-term. The therapist and patient determine the length and frequency of treatment.
The combination of psychotherapy and medication together is an extremely effective treatment option for adults suffering from ADHD. Behavioral therapy assists people in improving their ability to manage their time, organize and prioritizing. It can also teach methods for managing emotions like anger and frustration. Medication can reduce symptoms, improve focus and lead to better academic and work performance.
Adults who suffer from ADHD have a higher risk of co-existing illnesses. This is particularly true for mood disorders like anxiety and depression. It is crucial that any co-existing condition be treated prior to starting treatment for ADHD. The treatment of co-existing conditions might require different kinds of medications and dosages than the medications prescribed to treat ADHD.
A person suffering from ADHD may also suffer from hypertension. To select a medication to treat the ADHD symptoms without destabilizing the patient's hypertension it is essential to know how different medications affect people over time as well as the interactions between the medications.
It is important to choose a therapist with whom you have a good relationship, and who has experience treating adults suffering from ADHD. It is crucial to schedule your initial sessions at a time that you will not be distracted by family or work obligations.
Counseling
Adults with ADHD have many difficulties in their lives, such as problems in their relationships and at work. A person with ADHD may also experience anger, frustration and blame that have been accumulated over time. A variety of psychosocial treatments have been proven to aid them and their families develop new skills, attitudes and ways of connecting.
Cognitive behavioral therapy is a form of psychotherapy that assists people in changing their thinking and behavior. It includes goal-setting, skill training and practice, and methods of teaching to increase self-esteem and organizational skills. It can be done in a private or in a group. Metacognitive therapy has been shown to significantly reduce symptoms among adults suffering from ADHD and improve their performance (Stevenson, et al. 2002).
In addition to psychotherapy, some individuals with ADHD also require counseling to address specific issues. These may include family conflict, impulsive or aggressive behavior, or difficulties managing failures and disappointments. Counseling can teach strategies to help manage these situations and improve communication and problem-solving abilities. It can also help improve relationships, especially in marriages and other long-term relationships.
Family therapy and supportive group therapy are also types of psychotherapy that could be utilized to treat ADHD. These can help families cope with the anxiety of having a child who has ADHD and develop skills to improve communication and reduce conflict. It can aid parents understand the condition and develop parenting strategies that encourage positive outcomes in their children.
It is crucial for people with ADHD to discuss their medication with their healthcare providers regularly, and to reveal all other medications they are taking, including prescription drugs. Certain medications can trigger adverse reactions or interact with other medications.
Medication Monitoring
After a thorough examination and diagnosis is made, it is crucial that the patient be monitored to ensure that they are receiving the benefits of the medication and not experiencing side effects. It is recommended to visit a patient for the initial clinical assessment within 30 days of beginning treatment and every month following that. In the case of psychostimulants (methylphenidate amphetamines) this allows for a thorough titration to an effective and well-tolerated dose. This allows accurate registration of the patient's response and helps avoid keeping patients who are sensitive to doses that are too low.
For adults who are unable to respond well to stimulant medication or suffer from uncontrollable side effects, the use of non-stimulant drugs may be indicated. Typically this involves the use of atomoxetine or other alternatives to methylphenidate.
Adults with ADHD are frequently affected by comorbid conditions, such as depression or substance abuse. They might also be suffering from medical problems like hearing and vision problems or chronic sleep disorders. As part of the initial assessment for ADHD it is essential to identify these conditions and assess them. These conditions can have a significant impact on functional impairments for adults.
Marital therapy can be helpful in the treatment of ADHD. Couples often say that they feel overburdened by the caretaking responsibilities of their spouses who have ADHD and can become resentful and angry as a result. increasing the awareness of the patient about the signs of their condition and helping them understand that these aren't willful actions or a lack of affection can help to reduce resentment and marital difficulties. Couples who undergo this type of therapy usually experience improved family functioning.
Behavioral Therapy
For those who suffer from ADHD, psychotherapy is generally recommended and should incorporate a cognitive-behavioral component. Behavioral therapy helps patients improve their organizational skills, focus and manage impulsive behavior. It teaches patients to manage their home, work and social interactions in more productive ways. Psychotherapy can also help patients understand how their condition affects various aspects of their lives and relationships. This can help reduce the stigma and feelings of shame that are commonly seen in people with ADHD. They could be perceived by others as being lazy or unintelligent.
ADHD symptoms can be mimicked by a variety of psychiatric disorders. For example anxiety disorders are seen at a higher rate in adults ADHD patients and depression is observed at increased levels in adults with the disorder. If needed, add natural treatment of other psychiatric disorders should be analyzed to determine whether ADHD symptoms are a result of them.
Adults with ADHD are usually treated using the combination of pharmacotherapy and psychotherapy. It has been proven that a combination of psychotherapy and medication can produce better results than either treatment alone. Future controlled studies will aim to measure and assess the effects of functional improvement, like improved functioning in school as well as in the workplace and interpersonal relationships.