![[PukiWiki]](image/pukiwiki.png "[PukiWiki]")
|
Adult ADHD and Comorbid Disorders Many adults with ADHD also have comorbid disorders such as major depression (Kessler and colleagues, 2006). Many patients do not respond to depression medications and may benefit from psychotherapy. Neurotransmitters are brain chemicals that regulate and increase levels of certain brain chemicals. Commonly prescribed stimulants include amphetamine, methylphenidate, and similar medications. Medications Adults can take a variety of drugs that are prescribed for ADHD in children. The dosages and the side effects are different. A doctor will take into consideration the individual's medical history, family history and other health issues to determine which medicine is best for them. The most commonly used ADHD medication is a stimulant. It works by altering the levels of norepinephrine, and dopamine in the brain. Stimulants such as methylphenidate (also called Adderall) and dextroamphetamine enhance the supply of neurotransmitters that help improve focus, reduce impulsivity, and decrease aggression. They come in various forms, including chewable tablets, liquids, and skin patches. Long-acting versions of these stimulants are more effective because they lead to more patient compliance and lasting and smoother improvement in symptoms. It is crucial to keep in mind that comorbid conditions such as depression and anxiety disorders can affect the response to ADHD medications. Therefore it is recommended that psychiatric issues be treated first and medication used as a second measure. Some medications that are used to treat comorbid mood disorders include atomoxetine, bupropion and tricyclic antidepressants (Wilens 2004). Some patients may suffer from a "rebound effect" in which their ADHD symptoms worsen after discontinuing stimulant medications. In these instances, a short trial of a lower dose of stimulant medication may be helpful. Certain people are not able to take stimulant medications or take it due to the misuse of drugs or other health conditions such as heart or hypertension problems that are severe. In these instances, non-stimulant medication such as atomoxetine (Strattera) and viloxazine (Qelbree) can be effective. These medications don't have the same negative side effects as stimulants, and they are less likely to be abused or diverted. Psychotherapy Psychotherapy (talk therapy) can be helpful for people with ADHD. It can help them develop skills to improve their life, deal with anxiety and stress, work out conflicts, and cope with issues in relationships or at work. It can also assist with co-occurring mental illnesses like depression and substance use disorders. Talk therapies include cognitive behavior therapy (CBT) and mind-body cognitive therapy and schema therapy. These treatments are based on the notion that a person's beliefs and thoughts influence how they behave, think and feel. CBT helps an individual identify negative patterns of behavior and thoughts and then formulate and implement strategies to change these. Meditation techniques are used in mindfulness-based cognitive therapy to help someone focus on their emotions and thoughts, control impulses, and improve executive functioning. Schema therapy, as well as other forms of psychotherapy that focus on the family history of a person could be beneficial for people with ADHD. Psychotherapy, as well as medication, can assist with specific ADHD problems, such as difficulty keeping up with schoolwork or interacting with other people. It can also help in avoiding important dates and obligations and making decisions that are impulsive and lead to financial and legal issues. It can also help individuals to address and overcome issues that may be contributing to their ADHD symptoms, such as anxiety or depression. Psychotherapy can help someone to develop healthy coping methods and reduce stress through exercising, improving sleep and healthy eating habits. It can also provide support to an individual in the family or with a partner who is dealing with the effects ADHD has on their relationship. Marriage and family therapy can help couples and families improve communication and learn to manage ADHD symptoms together. Cognitive Behavioral Therapy CBT is a kind of psychotherapy that is focused on changing the patterns of negative thinking of the client. It involves a dialogue based on skills with an expert in mental health to identify the root cause of symptoms. This treatment aims to assist clients overcome their impairments and develop coping skills that are compatible with their daily routines. Therapists who specialize in adult ADHD-CBT show clients how to identify unhelpful thinking patterns and assist them to develop skills to replace them with more productive thoughts. This process can take time. However, it is a viable option for those who aren't getting enough relief from medications. A recent RCT study found that when paired with medication, CBT is superior to CBT on its own in reducing the emotional symptoms, core symptoms as well as self-esteem and social functioning of adults with ADHD (Clarke and colleagues., 2017). The combination of CBT and methylphenidate is especially effective for those who have more severe underlying problems. Therapists who provide this type of treatment work with clients to develop an action plan to address the specific issues they face. They usually teach them the fundamentals of therapy that are easy to implement and have a high likelihood of being successful. Often a chart system is utilized to track progress and reward positive behavior. In the case of a child, this might include a daily report that outlines all of the school tasks or positive behavior they must perform and an approach to recording and earning rewards. Therapists can consider introducing negative consequences when the child fails to finish their tasks. This can be done in a sensitive and supportive manner. Metacognitive Therapy A newer type of therapy, metacognitive therapy helps people change the way they think. This kind of therapy could be beneficial for those who suffer from various mental health problems, such as depression. It's a form of cognitive behavioral therapy that helps people recognize their negative thoughts and how they impact their moods. This type of therapy helps them develop psychological tools that are versatile and useful. The aim of this study was to investigate the relationship between metacognitive abilities and daily functioning in adults with ADHD. In order to do this we compared self- and informant-rated impairments in daily functioning with predictors of Metacognition (comprehensive Knowledge, Regulation of Cognition, Debugging Information Management, and Evaluation). It was discovered that comprehensive knowledge was connected to daily functioning in adults with ADHD but that the processes of regulation were not. The predictive ability of a model incorporating metacognition predictors was moderate, indicating that they can account for an important portion of the variation in daily functioning of people with ADHD. Metacognitive therapy (MCT) is a psychotherapy that focuses on modifying metacognitive beliefs that cause states of worry and rumination, as well as attention fixation. MCT was developed by Adrian Wells based on an information processing model developed by Wells and Gerald Matthews. One case series has demonstrated the effectiveness of MCT in managing illness anxiety disorder, however it's still relatively new and more research is needed to determine its effectiveness in other disorders. This study was conceived to assess the effectiveness of MCT to treat symptoms of anxiety disorder. However it is also able to treat a variety of disorders and is more effective than any other treatment. This isn't a cure, but it could be utilized to treat ADHD. Family Therapy
The therapist will start with an intake session in order to gain an understanding of the family's perspective of the problem and assess their potential for intervention by the family. This can be done in person or online. The therapist will explain to each participant the nature of treatment as well as the do's & don'ts for family therapy. A therapist with had experience working with adults suffering from ADHD will ask a lot of questions to gain an understanding of their present symptoms as well as their past and the impact they have on their work, family, and relationships. They will also ask whether there are other mental health issues, such as depression or anxiety. Cognitive behavioral therapy (CBT) is an organized form of counseling which teaches you to change your negative patterns of thinking and to manage your behavior. It is focused on improving your self esteem and self-control through teaching strategies to manage anger and stress. This is a short-term option that can be utilized in conjunction with other forms of psychotherapy. Individual therapy can help people with ADHD to overcome the emotional baggage that comes from underachievement and failure. It can also help them deal problems with relationships as well as job changes and academic difficulties. It can teach you stress reduction and coping techniques, and how to better manage your finances and time. It can be used to treat other comorbid conditions like mood and anxiety disorders, that are often associated with ADHD. |
