![[PukiWiki]](image/pukiwiki.png "[PukiWiki]")
|
Adult ADHD and Comorbid Disorders
Many adults with ADHD also suffer from comorbid disorders such as major depressive disorder (Kessler and colleagues 2006). Many patients who are depressed do not respond well to medication and could get better results from therapy. Neurotransmitters are brain chemicals that regulate and boost levels of certain brain chemicals. Drugs that stimulate the brain such as methylphenidate or amphetamine are often prescribed. Medications A variety of medications used to treat ADHD in children can also be used in adults. However, the dosages are different and the drugs may cause negative side effects that aren't present in children. The doctor will take a look at the medical history, family health history, and other health conditions of the patient to determine which medication is most appropriate for the patient. The most common type of ADHD medication is a stimulant. It is used to regulate levels of two chemical messengers in the brain called norepinephrine and dopamine. Stimulants like methylphenidate and dextro-amphetamine (commonly known as Adderall) boost the supply of these neurotransmitters. They can improve focus and decrease impulsivity and aggression. They come in many forms, including chewable tablets, liquids, and skin patches. These long-acting stimulants are favored because they improve patient compliance, and more consistent, long-lasting improvement of symptoms. It is crucial to keep in mind that comorbid conditions like depression or anxiety disorders can affect the response to ADHD medication. It is therefore recommended that these psychiatric issues be treated first, with medication used as secondary measure. The medications that can be used to treat comorbid disorders of mood are atomoxetine (Bupropion), tricyclic antidepressants, and bupropion (Wilens 2004). Certain patients may experience some patients may experience a "rebound" effect where they experience worsening of ADHD symptoms after stopping stimulant medications. In these instances, a brief trial of a lower dose of stimulant medication can be beneficial. Certain people are not able to take stimulant medication or take it because of the misuse of drugs or other health issues like severe hypertension or heart issues. In these situations, non-stimulant medications like atomoxetine (Strattera) and viloxazine (Qelbree) can be effective. These medications don't cause the same amount of side effects as stimulants, and are a lower risk for abuse and diversion. Psychotherapy Psychotherapy (talk therapy) can be helpful for those suffering from ADHD. It can help those with ADHD to improve their lives, manage stress and anxiety, resolve conflicts, or manage issues in their relationships or at work. It can also help co-existing mental disorders like depression and addiction disorders. Talk therapies include cognitive behavioral therapy (CBT) as well as mindfulness-based cognitive therapy, and schema therapy. These therapies are based upon the idea that thoughts and beliefs can affect how a person is feeling, thinks and behaves. CBT assists a person to recognize negative behaviors and thinking patterns, and then formulates and implements positive strategies to change them. Mindfulness-based cognitive therapy employs techniques for meditation to teach people how to focus on their thoughts and emotions, control impulses, and improve their executive functioning. Schema therapy and other types of psychotherapy that focus on a person's family history could be beneficial for those suffering from ADHD who suffer from significant secondary problems. In addition to medications psychotherapy can assist in addressing the specific issues that arise from ADHD, such as trouble keeping up with schoolwork, resolving conflict and being able to get along with others, ignoring important dates or obligations, and impulsive decisions that can lead to legal or financial issues. It can also help individuals to address and overcome underlying issues that may be contributing to their ADHD symptoms, such as depression or anxiety. Psychotherapy can help people discover healthy coping techniques and reduce stress. For instance exercise, sleep improvement, and healthy eating habits. It can also offer support to a partner or family member who is struggling with the effects of ADHD on their relationship. Marriage and family therapy helps couples and families learn how to communicate better and manage ADHD symptoms together. Cognitive Behavioral Therapy CBT is a kind of psychotherapy that focuses on changing the negative patterns of thinking that clients have. It uses skill-based dialogue with an experienced mental health professional (a therapist) to address the root causes of their symptoms. The goal of this treatment is to correct impairments and implement coping strategies that are compatible with the person's everyday life. Therapists who specialize in adult ADHD-CBT teach clients to recognize harmful thought patterns and help them develop skills to replace them with more productive thoughts. This process can take some time. It is a viable option for those who are unable to get enough relief from their medications. In the course of a recent RCT that was conducted, it was discovered that cognitive behavioral therapy combined with medication is superior to cognitive behavior therapy on its own in terms of improving the core symptoms, emotional symptom, self-esteem, and social performance in adults with ADHD (Clarke and co. 2017). The combination of CBT and methylphenidate is especially effective for those who have more severe underlying issues. Therapists who provide this type of treatment work with clients to create an action plan that addresses their specific issues. They teach them a set of practical skills which are easy to master and have a high chance of success. Often a chart system is utilized to track the progress of a child and reward positive behaviour. For an infant, this could include a daily report that outlines all of the school-related activities or positive behaviors they have to perform, as well as a system for recording and earning rewards. Therapists may also discuss the possibility that negative consequences could be introduced when a child fails to complete their tasks. This can be done with care and support. Metacognitive Therapy Metacognitive therapy is an innovative type of psychotherapy that assists people to change their thinking. This kind of therapy can be effective for people suffering from a range of mental health problems such as depression. It is a form of cognitive behavioral therapy which helps people learn to recognize negative thinking patterns and their effects on their emotions. This type of therapy helps them develop psychological tools that are flexible and useful. Metacognitive Therapy (MCT) is an intervention that focuses on transforming metacognitive beliefs that cause dysfunction and perpetuate states like worry, rumination and attention fixation. Adrian Wells developed MCT based on an idea of information processing created by Wells and Gerald Matthews. MCT has been proven to be effective in treating illness anxiety disorder. However, it is still an emerging treatment and more research is needed to determine whether it can help with other disorders. The purpose of this study was to determine the efficacy of MCT in decreasing symptoms of anxiety disorder, however it can be applied to a range of disorders, and may be more effective than other therapies. It is not a cure, but can be employed to treat ADHD. Family Therapy In family therapy, the therapist collaborates with all family members. This allows everyone to understand the client's problems and learn how to support their loved ones better. It also helps them cope with their anger and develop better communication skills. Additionally, this kind of therapy is helpful in addressing comorbid conditions such as depression or substance misuse which are often found in conjunction with ADHD. The therapist will start with an intake session to gain a better understanding of the family's perspective and determine if they are appropriate for family intervention. It can be done in person or online. The Therapist will discuss the nature of the therapy with each person and spell out the rules and guidelines of 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've had on their work, family, and relationships. They will also inquire whether any other mental health problems are present, for example anxiety or depression. Cognitive behavioral therapy is a kind of counseling that helps you learn how to manage your behavior and change negative thinking patterns into positive ones. It focuses on improving self-esteem and self-control by teaching you how to manage stress and anger. It is a short-term treatment that can be used in conjunction with other forms of psychotherapy. Individual therapy helps those with ADHD to overcome the emotional baggage that results from failure and underachievement. It can also assist them in dealing with relationship conflicts or job changes as well as academic difficulties. It can help you develop ways to manage stress and cope and help you manage your time and finances more efficiently. It can also be used to address other comorbid conditions like anxiety and mood disorders which are often seen alongside ADHD. |
