Treatment of ADHD in Adults
Adults with adhd are treated by therapy, medication and support from family members. People can also participate in clinical trials to try new approaches to treating ADHD.
Stimulant medications are the most effective medications for adults with ADHD. They need to be monitored regularly. That includes monthly clinical appointments as well as frequent reviews of side effects and symptoms.
Medicines
There are many drugs that can help to reduce the symptoms of ADHD in adults. They are known as psychostimulants and they affect the levels of certain chemicals in your brain (neurotransmitters) that pass messages between nerve cells. Your doctor will recommend the best medication for you and will decide the most effective dose and time to take it. It may take a while to find the right dosage and medication that will control your symptoms.
Stimulants are often the first medication doctors prescribe for adults with ADHD. These medications increase the levels of dopamine and norepinephrine that are present in your brain, which enhances your ability to focus and manage impulses. They are available in short-, intermediate- and long-acting forms. Short-acting stimulants last about 6 hours, intermediate-acting drugs last 8-10 hours, and long-acting medicines last up to 16 hours. Long-acting stimulants have less negative effects than shorter- or intermediate-acting drugs, however they still cause an increase in appetite and sleepiness.
Non-stimulant medications like atomoxetine (Strattera), are used to treat adults with ADHD when stimulants don't perform or cause undesirable side effects. These medicines don't affect the levels of norepinephrine or dopamine however they do increase the amount of norepinephrine available to your brain, and improve your ability to focus. These medications are in capsule form and are taken twice or once a day.
Some adults with ADHD have co-occurring disorders, such as depression or anxiety. These disorders are referred to as comorbidities, and they can affect how you respond to ADHD treatment. Before starting treatment for ADHD it is essential to address any comorbid issues. People who have a history of addiction to drugs are more likely to use psychostimulants. It's best to wait until someone has quit using drugs before treating them with stimulants.
Psychotherapy
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Psychotherapy is an interactive process of talking and discussing issues that may be disturbing or troubling to a person. The therapist listens and provides guidance based on his or his or her training, education and experience as well as professional qualifications and therapeutic philosophies. Psychotherapy can be short-term, (a few weeks or months) or addressing more immediate issues, or longer-term. The patient and therapist decide on the length and frequency of therapy.
The use of psychotherapy and drugs together is an extremely effective treatment for adults suffering from ADHD. Behavioral therapy can help individuals improve their time management, organizational skills, and prioritizing. It can also teach strategies to manage emotions like anger and frustration. The use of medication can help reduce symptoms, improve focus, and result in better work and academic performance.
Adults with ADHD have a higher likelihood of co-existing conditions. This is especially relevant for mood disorders such as anxiety and depression. It is essential that any co-existing disorders be addressed prior to beginning treatment for ADHD. Treatment for co-existing disorders might require different types and dosages of medication than the ones used to treat ADHD.
A person who suffers from ADHD may also suffer from hypertension. Selecting a medication that addresses the ADHD symptoms, but does not affect the patient's hypertension which is being controlled requires understanding how different medications affect individuals over time and an understanding of the interactions between various medications.
It's important to find an therapy provider with whom you have a good relations, and who has experience in treating adults suffering from ADHD. It's also important to schedule your first few sessions when you aren't distracted by family responsibilities or work obligations.
Counseling
Adults with ADHD typically face a variety of problems in their lives, such as relationships and work problems. They also may experience anger, blame, and frustration that have developed in their lives due to their symptoms. A variety of psychosocial treatments have been proven to help their families and patients learn new behaviors, skills, and ways of communicating.
Psychotherapy can include cognitive behavior therapy, a form of psychotherapy that helps individuals change their behavior and thinking. It involves goal-setting, skill training and practice, and methods to help improve self-esteem and organization. It may be done in individual or group sessions. Metacognitive therapy has proven to significantly reduce symptoms among adults suffering from ADHD and improve their functioning (Stevenson and colleagues., 2002).
Some people suffering from ADHD may also require therapy to help them overcome particular life issues. This could include family conflict, impulsive and aggressive behaviors, or difficulty coping with disappointments and failures. Counseling can help you develop the strategies to help manage these situations and improve the ability to communicate and solve problems. It can also help improve interpersonal relationships, particularly in long-term marriages or other partnerships.
https://www.iampsychiatry.uk/adhd-treatment-for-adults/ and supportive group therapy are two other types of psychotherapy that can be used to treat ADHD. These therapies can help families cope and learn skills to reduce conflict and improve communication when dealing with a child suffering from ADHD. It can also help parents understand the disorder and develop parenting strategies that promote positive outcomes for their children.
It is important for people with ADHD to discuss their medications with their health care professionals regularly, and to inform them of all other medications they're taking, including over-the-counter drugs. Certain medications can cause adverse effects or interact with other medications.
Medication Monitoring
After a comprehensive evaluation and diagnosis is made, it is essential to monitor the patient to ensure that they are receiving the benefits of the medication and not experiencing adverse effects. It is recommended that patients be referred for an initial medical check-up within 30 days of beginning treatment, and every month thereafter. This will allow for an accurate titration of psychostimulants such as amphetamines and methylphenidate, to a safe, effective dose. This allows for a precise registration of the patient's response. It also assists in avoiding keeping sensitive patients on doses that are not sufficient (slow metabolizers) or forcing those who require higher doses onto unnecessarily high levels (rapid metabolizers).
Adults who are not responding well to stimulant medications or have side effects that are intolerable may benefit from nonstimulant medications. Typically this involves the use of atomoxetine or other methylphenidate alternatives.
Adults who suffer from ADHD typically suffer from comorbid disorders like mood or anxiety disorder, substance abuse issues or depression. Moreover, they may have chronic sleep disturbances or medical issues such as hearing and vision disorders. As part of the initial evaluation for ADHD it is crucial to identify for these conditions and then evaluate their severity. These conditions could have a significant impact on functional impairments for adults.
Marital therapy can also be beneficial in managing ADHD. Spouses report feeling overburdened with the responsibilities of caring for their spouses who suffer from ADHD, and can become resentful or angry as a consequence. Reduced resentment can be achieved by enhancing the awareness of their condition, and helping them understand that the symptoms are not caused by an absence of love or willfulness. Couples who go through this type of therapy generally experience a better family functioning.
Behavioral Therapy
For adults with ADHD, psychotherapy is generally recommended and should include an element of cognitive-behavioral therapy. Behavioral therapy can help patients to improve their abilities to manage their time and focus and control their impulsive behavior. It helps patients learn to manage their work, social and home life more effectively. Psychotherapy helps patients to understand how their condition impacts various aspects of their lives and relationships. This can help reduce the feelings of shame and low self-esteem that are commonly seen in people suffering from ADHD. They could be perceived by others as lazy or inexperienced.
Many psychiatric disorders mimic ADHD symptoms. Adult ADHD patients are more likely to suffer from depression and anxiety disorders. If needed the presence of any other psychiatric disorders should be assessed to determine if ADHD symptoms are a result of them.
A combination of pharmacotherapy and psychotherapy is usually recommended for the treatment of ADHD in adults. It has been established that the combination of psychotherapy with medication yields better results than either therapy alone. Future controlled studies will aim to monitor and evaluate improvements in functional performance, for example, better functioning at school, the workplace, and interpersonal relations.
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