![[PukiWiki]](image/pukiwiki.png "[PukiWiki]")
|
Adult ADHD and Comorbid Disorders Many people with ADHD also suffer from comorbid conditions such as major depressive disorder (Kessler and colleagues 2006). Many sufferers do not respond to medications for depression and may be able to benefit from psychotherapy. Medications that most effectively improve the most fundamental symptoms of ADHD seem to boost and balance levels of specific brain chemicals called neurotransmitters. Commonly prescribed stimulants include methylphenidate, amphetamine and other similar drugs. Medicines Adults can take a variety of drugs that are prescribed for ADHD in children. However the dosages are different and the drugs may cause adverse effects that aren't typical of children. A doctor will look at the individual's medical history, family history, and other health issues to determine which medication is the best for them. The most commonly used ADHD medication is a stimulant. It works by adjusting the levels of norepinephrine and dopamine in the brain. The stimulants like methylphenidate (also known as Adderall), and dextroamphetamine increase the availability of neurotransmitters that help improve focus, reduce impulsivity and reduce aggression. These stimulants are available in various forms, such as liquids, skin patches and chewable tablets. Long-acting versions of these stimulants are preferred because they lead to greater patient compliance and a longer lasting, smoother improvement in symptoms. It is crucial to keep in mind that co-existing conditions like anxiety and depression can influence the response to ADHD medications. Therefore, it is recommended that these disorders be treated first and medication used as a secondary measure. The medications that can be used for comorbid mood disorders are atomoxetine (Bupropion), tricyclic antidepressants as well as bupropion (Wilens 2004). Certain patients may have an "rebound effect" in which their ADHD symptoms worsen after discontinuing stimulant medications. In these instances an experiment of a short duration with an atypical stimulant drug could be beneficial. Some people are unable to tolerate stimulant medications or are unable to take them due to abuse of drugs or other health issues, like heart issues that are severe or hypertension. In these cases, nonstimulant medications such as atomoxetine (Strattera) and viloxazine (Qelbree) can be effective. These medications don't cause the same level of adverse effects as stimulants, and are less risk of misuse and diversion. Psychotherapy
Psychotherapy (talk therapy) can be beneficial for those suffering from ADHD. It can help people with ADHD learn how to improve their lives, deal with anxiety and stress, resolve conflicts, or cope with issues in their relationships or at work. It can also assist those suffering from mental illness that are co-existing like depression and addiction disorders. Talk therapies include cognitive-behavioral therapy (CBT) as well as mindfulness-based cognitive therapy and schema therapy. These treatments are based on the idea that beliefs and thoughts can influence how a person feels, thinks and acts. CBT assists a person to identify negative behaviors and thinking patterns, and then develops and implements strategies to alter these patterns. Mindfulness-based cognitive therapy uses techniques of meditation to teach a person how to focus on their emotions and thoughts, manage their impulses, and improve their executive functioning. Schema therapy and other types of psychotherapy focusing on a person's history with their family could be beneficial for those suffering from ADHD with significant secondary problems. In addition to medications, psychotherapy can help address the particular issues caused by ADHD, such as trouble getting through schoolwork, resolving conflict and being able to get together with others, losing important dates or obligations and making impulsive choices that lead to financial or legal troubles. It can also help a person explore and overcome underlying issues that could be contributing to their ADHD symptoms, like depression or anxiety. Psychotherapy can help someone find healthy coping skills and reduce stress, for example exercising, improving sleep and healthy eating habits. It can also provide assistance to a family or partner member who may be dealing with the effects of ADHD on their relationship. Family therapy and marriage counseling can help couples and families learn how to communicate better and manage ADHD symptoms together. Cognitive Behavioral Therapy (CBT) CBT is a kind of psychotherapy that focuses on helping clients change their negative thinking patterns. It involves a dialog based on skill with an expert in mental health to identify the root reason for the symptoms. This treatment is designed to assist clients overcome their difficulties and develop coping skills that are in line with their daily routines. Therapists who specialize in adult ADHD-CBT show clients to recognize unhelpful thinking patterns and assist them to learn to replace them with more productive thoughts. This process can take a long time. However, it is a viable option for those who aren't getting enough relief from medications. A recent RCT study found that when combined with medication, CBT is superior to CBT on its own in reducing the severity of the emotional symptoms, core symptoms, self-esteem and social functioning of adults suffering from ADHD (Clarke and colleagues., 2017). CBT coupled with methylphenidate could be particularly effective for those who suffer from more severe underlying issues. Therapists who provide this type of treatment work with clients to devise an action plan to address their specific issues. They typically teach them a series of practical skills that are easy to implement and have a good chance of being successful. A chart system is often used to track progress and reward positive behaviour. This could include a daily report for children that lists the tasks they are required to complete in school or the positive behaviors to be displayed, as well as an organized system for monitoring and earning rewards. The therapists may also discuss the possibility of creating negative consequences if a child does not complete their tasks. This can be done in a sensitive and calming manner. Metacognitive Therapy A newer type of therapy, metacognitive therapy assists individuals in changing how they think. This type of therapy can be beneficial for those who suffer from a variety mental health problems, such as depression. It's a form of cognitive behavioral therapy that helps individuals learn to recognize their negative thoughts and how they impact their moods. This kind of therapy can also assist in the acquisition of psychological tools that are able and useful. This study was designed to investigate the relationship between metacognitive capabilities and daily functioning among adults suffering from ADHD. To accomplish this, we compared self- and informant-rated deficits in daily functioning with the indicators of metacognition (comprehensive knowledge and cognition regulation debugging, information management and evaluation). It was found that comprehensive knowledge was related to daily functioning in adults with ADHD but that the processes of regulation were not. Metacognition predictors had moderate predictive power, which suggests that they could explain an important amount of variation in the daily functioning of adults suffering from ADHD. Metacognitive Therapy (MCT) is an intervention which focuses on reversing metacognitive beliefs that are dysfunctional and perpetuate states such as worry, rumination, or attention fixation. MCT was developed by Adrian Wells based on an information processing model created by Wells and Gerald Matthews. MCT has been proven to be effective in treating anxiety disorder. However, it is still an in-development treatment and further research is required to determine whether it can aid in other disorders. The purpose of this study was to determine the efficacy of MCT in reducing symptoms of illness anxiety disorder, however it can be applied to a variety of disorders and may even be more effective than other therapies. It is important to keep it in mind that this isn't a cure for ADHD however it can be used as an adjunctive therapy. Family Therapy In family therapy, the therapy therapist works with the entire family. All members can better understand the client's issues and learn how they can help their loved family members. It also assists them in finding ways to deal with their own anxieties and develop healthier communication skills. This type of counseling could be used to tackle the underlying conditions, like depression and substance abuse, which are often seen as a result of ADHD. The therapist will commence with an intake session to get an understanding of the family's perception of the problem and evaluate their ability to intervene with the family. This can be done in person or online. The counselor will explain to each client the nature of treatment as well as the rules and regulations for family therapy. Cognitive behavioral therapy is a kind of counseling that helps you learn how to manage your behavior and transform negative thinking patterns into positive ones. It focuses on improving your self-esteem and self-control through teaching strategies to manage anger and stress. It is a treatment option for short-term use that can be paired with other forms of psychotherapy. Individual talk therapy can help people suffering from ADHD overcome emotional trauma from a long-running pattern of underachievement, failure academic issues, frequent job changes and relationship conflict. It can help you learn ways to reduce stress and cope, and how to manage your time and finances. It can be used to treat the comorbidities, like anxiety and mood disorders, which are often associated with ADHD. |
