Treatment of ADHD in Adults
Treatment for adults with adhd is based on therapy, medication and family support. Clinical trials are being conducted to test new treatments for ADHD.
Adults suffering from ADHD are the most likely to benefit from stimulant medication. They must be monitored regularly. This includes regular appointments with a physician and regular review of symptoms.
Medications
Many medications can be used to treat symptoms of ADHD among adults. These are known as psychostimulants. They work by altering the levels of certain neurotransmitters (chemicals) in your brain that transmit messages between nerve cell. Your doctor will choose a medication that's right for you and will decide the most appropriate dosage and time to take it. It may take a while to find the right medication and dosage that controls your symptoms.
The first medication doctors prescribe to adults suffering from ADHD is stimulants. They increase the amount of dopamine that is present in your brain and norepinephrine which helps you to control your thoughts and focus. They are available in short-, intermediate-and long-acting versions. Short-acting stimulants last for up to 6 hours. Intermediate-acting drugs last between 8 and 10 hours. Long-acting drugs can last up to 16 hours. Long-acting stimulants have fewer side effects than shorter- or intermediate-acting medications, but they still cause sleepiness and changes in appetite.
Nonstimulant medicines, such as atomoxetine (Strattera), can be used to treat adult ADHD when stimulants don't work or cause unwanted adverse side effects. These medicines don't affect the levels of norepinephrine or dopamine however they do increase the amount of norepinephrine that's available to your brain, and improve your ability to concentrate. These capsules are taken once or two times a day.
Some people with ADHD have co-occurring disorders, such as depression or anxiety. These conditions are known as comorbidities and may affect your response to ADHD treatment. It is important to address any comorbid conditions before starting treatment for ADHD. For instance, those who have a history of substance use disorder may be more likely to use psychostimulants. For this reason, it is generally recommended to wait until a person has removed themselves from using substances before evaluating treatment with stimulants for ADHD.
Psychotherapy
Psychotherapy is an interactive process of discussing and talking about issues that may be disturbing or troubling to someone. The therapist listens to the person and provides guidance based on his or his or her training, education and experience, professional credentials and therapeutic theories. Psychotherapy can be short-term, (a couple of weeks or months) or addressing more immediate issues, or long-term. The therapist and patient decide on the duration and frequency of treatment.
The use of psychotherapy and medications together is an extremely effective treatment for adults suffering from ADHD. Behavioral therapy helps people improve their abilities to organize their lives, manage their time and prioritizing. It can also teach techniques for managing emotions like anger and frustration. Treatment can ease symptoms, improve focus and lead to better academic and work performance.
Adults suffering from ADHD have a higher likelihood of having co-existing disorders. This is particularly applicable to mood disorders like anxiety and depression. Before starting treatment for ADHD it is essential to treat any co-existing conditions. The treatment of co-existing disorders may require different types of medications and dosages than the medications prescribed to treat ADHD.
A person who suffers from ADHD can also have hypertension. Selecting a medication that addresses the ADHD symptoms, but does not affect the patient's tentatively controlled hypertension requires knowledge of how different medications affect people over time, as well as an understanding of the interactions between various medications.
It is important to choose the right therapy provider with whom you have a a good relationship, and who has experience treating adults with ADHD. It's also important to arrange your first few sessions when you aren't distracted by family obligations or work obligations.
Counseling
Adults suffering from ADHD have many difficulties in their lives, such as problems in their relationships and at work. They may also experience frustration, blame and anger that have accumulated in their lives because of their symptoms. A variety of psychosocial treatments have been proven effective in helping them and their families learn new attitudes, skills and ways of connecting.
Cognitive behavioral therapy is a type psychotherapy that helps people alter their behavior and thinking. It includes goal-setting, skill training and practice, and methods to help improve organization and self-esteem. It can be done in a private or in a group. Some studies have shown that metacognitive treatment can significantly reduce symptoms and improve functioning for adults suffering from ADHD (Stevenson and colleagues 2002).
Some people with ADHD may also require counseling to help them overcome specific life issues. These challenges may include family conflicts, aggressive or impulsive behaviors, or difficulty in dealing with failures and disappointments. Counseling can teach the strategies to manage these situations, improve communication, and increase problem-solving capabilities. It can also enhance relationships, particularly in marriages and other long-term relationships.
Family therapy and supportive group therapy are two other types of psychotherapy that could be utilized to treat ADHD. These can help families cope with the stress of having a child who has ADHD, as well as develop skills to improve communication and reduce conflict. It can assist parents understand the condition and develop parenting strategies that promote positive outcomes for their children.
It is essential for people suffering from ADHD to discuss their medications with their healthcare providers regularly, and to disclose all other medications they are taking, including any over-the-counter medications. Certain medications can trigger adverse effects or interact with other medications.
Medication Monitoring
After a thorough examination and diagnosis is established, it is crucial that the patient be monitored to ensure he/she is getting 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 initiating treatment and monthly afterward. For treatment for adult add (methylphenidate amphetamines, methylphenidate) this allows for a thorough titration to an effective and well-tolerated dose. This allows for accurate registration of the patient's reaction and helps to avoid keeping a the patient with a sensitive response on doses that are not sufficient.
For adults who do not respond well to stimulant medication or have intolerable side effects the use of nonstimulant medications may be indicated. This is usually the case with atomoxetine, or other methylphenidate-related alternatives.
Adults with ADHD often have comorbid disorders like mood disorder or anxiety disorder, substance abuse problems or depression. In addition, they may experience persistent sleep disturbances or medical issues such as hearing and vision problems. As part of the initial evaluation for ADHD it is crucial to detect for these conditions and then evaluate their severity. These conditions can have a significant effect on functional impairments in adults.
Marital therapy can also be beneficial in managing ADHD. treatment for add in adults report that they feel overwhelmed by the caretaking responsibilities of their spouses who have ADHD and may become resentful and angry as a result. Making the patient aware of the signs of their condition and helping to understand that these aren't willful actions or a lack of affection can help to reduce marital tensions and resentment. Couples who undergo this type of therapy are more likely to have better functioning families.
Behavioral Therapy
Psychotherapy for adults suffering from ADHD is usually advised. It should include a behavioral and cognitive component. Behavioral therapy can help patients to improve their abilities to manage their time and focus, as well as control the impulsive behavior. It helps patients manage their home, work, and social situations more effectively. Psychotherapy also helps patients understand how their condition affects different areas of their lives and relationships. This helps reduce the stigma and feelings of shame that are often felt by people with ADHD. They may be perceived by others as lazy or less intelligent.
ADHD symptoms can be mimicked by many psychiatric disorders. For example, anxiety disorders occur at high rates in adults ADHD patients and depression is observed in greater numbers among those suffering from the disorder. If it is necessary, the presence of other psychiatric disorders must be analyzed to determine if ADHD symptoms are caused by them.
Adults with ADHD are usually treated using the combination of pharmacotherapy and psychotherapy. It has been demonstrated that when a combination of medications and psychotherapy is used results are more favorable than the results of either treatment alone. Future controlled studies will aim to measure and assess improvements in functional performance, for example, improvement in school performance or at work, as well as interpersonal relations.