Treatment of ADHD in Adults
Adults who suffer from adhd are treated with medication, therapy and support from the family. Clinical trials are being conducted to test new treatments for ADHD.
Adults with ADHD are the most likely to benefit from stimulant medications. But they need to be monitored regularly. That includes monthly clinical appointments, and frequent reviews of side effects and symptoms.
Medications
There are many drugs that can help reduce the symptoms of ADHD in adults. These are called psychostimulants and they work by changing the levels of certain chemicals in your brain (neurotransmitters) which transmit messages between nerve cells. Your doctor will determine the most appropriate medication for your needs and will determine the most effective dosage and schedule. It could take some time to determine the appropriate dosage and medication that will control your symptoms.
The first medication doctors prescribe to adults suffering from ADHD is stimulants. These medications increase the levels of norepinephrine and dopamine in your brain, which improve your ability to concentrate and manage impulses. They are available in short-, intermediate-and long-acting varieties. Short-acting stimulants last around 6 hours, intermediate-acting medications last between 8 and 10 hours, while long-acting drugs last up to 16 hours. Long-acting stimulants have less adverse effects than shorter- or intermediate-acting medications, but they can still cause an increase in appetite and sleepiness.
Nonstimulant medications, like atomoxetine (Strattera) are used to treat adult ADHD when stimulants don't work or cause unwanted adverse side effects. These medications don't alter your norepinephrine or dopamine levels, but they increase the amount of norepinephrine that's available to your brain, and improve your ability to concentrate. These medicines come in capsules and can be taken either twice or three times a day.
Many people with ADHD also suffer from other mental disorders, such as depression and anxiety. These are called comorbid conditions and they can impact the way you respond to treatment for ADHD. Before starting treatment for ADHD, it's important to address any comorbidities. People with a history substance abuse disorder are more likely to use psychostimulants. Because of this, it is generally recommended to wait until the person has quit using substances before considering treatment with stimulants to treat ADHD.
Psychotherapy
Psychotherapy is a process that involves discussing and discussing issues that cause distress or anxiety for a person. The therapist provides guidance on the basis of his or her qualifications, experience, training and therapeutic philosophy. Psychotherapy could be short-term (a few weeks or months) dealing with issues that are more immediate, or long-term (months or years) in which a patient is working to address more complex and long-standing issues. The patient and therapist decide on the duration and frequency of therapy.
The use of psychotherapy and drugs together is an extremely effective treatment for adults with ADHD. Behavioral therapy can help people improve their organizational skills, time management and prioritizing. It can also teach techniques for managing emotions like anger and frustration. Medication can reduce symptoms and improve concentration, which results in more efficient and successful academic and work.
Adults who suffer from ADHD are more likely to be affected by co-existing conditions, particularly mood disorders such as depression and anxiety. Before beginning adhd adults treatment for ADHD it is crucial to treat any co-existing disorders. Treatment of co-existing disorders could require different forms and dosages of medication than that used to treat ADHD.
A person with ADHD may also suffer from hypertension. To pick a medication that can treat the ADHD symptoms without causing instability to the hypertension of the patient it is essential to understand how various medications affect people over time as well as the interactions between the medications.
It is essential to locate a therapist who has experience treating adults with ADHD and with whom you are comfortable. It's also important to arrange your initial sessions in a time when you won't be distracted by family responsibilities or work obligations.
Counseling
Adults with ADHD have many difficulties in their lives, including issues at work and with relationships. They may also experience frustration, blame and anger that have built up in their lives because of their symptoms. Several psychosocial treatments have been proven effective in helping their families and patients learn new skills, attitudes and ways of relating.
Psychotherapy may include cognitive behavioral therapy, which is a type of psychotherapy that helps individuals change their behavior and thinking. It includes goal-setting, skill training and practice, and methods of teaching to increase self-esteem and organizational skills. It can be done in a private or in a group. Metacognitive therapy has been proven to significantly reduce symptoms among adults suffering from ADHD and improve their performance (Stevenson et al. 2002).
In addition to psychotherapy, some individuals with ADHD also need counseling to address specific life challenges. These challenges may include family conflicts, aggressive or impulsive behavior, and difficulties in dealing with failures and disappointments. Counseling can help teach how to handle these situations, improve communication, and improve problem-solving skills. It can also help improve relationships, particularly in marriages and other long-term partnerships.
Family therapy and supportive groups therapy are other forms of psychotherapy that can be utilized to treat ADHD. These can help families deal with the anxiety of having a child who has ADHD and develop skills to improve communication and reduce conflicts. It can assist parents understand the disorder and develop parenting methods that encourage positive results in their children.
It is important for people suffering from ADHD to discuss their medications with their health care professionals regularly, and to inform them of all other medications they are taking, including prescription drugs. Certain medications can interact with specific medications or cause adverse effects that are exacerbated by other medications.
Medication Monitoring
After a thorough examination and diagnosis is made, it is crucial that the patient be monitored to ensure that he or she is receiving the benefits of the medication and is not experiencing side effects. It is recommended that a patient be examined for a first clinical examination within 30 days of starting treatment and then every month afterward. This allows for an accurate titration of psychostimulants such as amphetamines and methylphenidate, to a well-tolerated, effective dose. This allows for a precise registration of the patient's response and assists in avoiding keeping sensitive patients on doses that are not sufficient (slow metabolism) or forcing those who require higher doses on excessively high levels (rapid metabolizers).
For adults who are not responding effectively to stimulant medications or suffer from uncontrollable side effects, the use of nonstimulant medication may be indicated. This usually involves the use the methylphenidate based atomoxetine alternatives.
Adults with ADHD are frequently affected by comorbid disorders, like depression or drug abuse. They might also be suffering from medical issues like hearing and vision problems or chronic sleep disorders. As part of the initial assessment for ADHD it is crucial to detect these conditions and assess their severity. These conditions can have a significant effect on functional impairments in adults.
ADHD can also be treated through marital therapy. Couples often say that they are overwhelmed by the responsibilities of caring for their spouses with ADHD and may become resentful and angry due to this. Reducing resentment can be achieved by enhancing the awareness of their condition, and helping them to realize that the symptoms aren't caused by a lack in willfulness or love. Couples who undergo this kind of therapy tend to have better family functioning.
Behavioral Therapy
Psychotherapy for adults with ADHD is usually recommended. It should include a cognitive and behavioral component. Behavioral therapy assists patients in improving their organizational skills, focus and control their impulsive behaviors. It helps patients manage their work, home, and social situations more effectively. Psychotherapy helps patients to understand how their disorder impacts different areas of their life and relationships. This can help decrease the shame and low self-esteem that is commonly seen in those with ADHD, who may be thought of as lazy or insufficiently intelligent.
Many psychiatric disorders can mimic ADHD symptoms. For instance anxiety disorders are found at a high rate in adult ADHD patients, and depression is found in greater numbers among those suffering from the disorder. The presence of any other psychiatric problems should be evaluated according to the need, to determine whether or not the patient's ADHD symptoms are connected to them.
Adults suffering from ADHD are typically treated with an amalgamation of pharmacotherapy and psychotherapy. It has been proven that when a combination of medication and psychotherapy is employed the results are superior than the results of either treatment alone. Future controlled medication studies will attempt to measure and assess the effects of functional improvement, like improvement in school performance or at work, as well as interpersonal relations.