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Adult ADHD and Comorbid Disorders

Many people with ADHD have comorbid disorders such as major depression (Kessler and colleagues, 2006). Many sufferers do not respond to depression medications and may be able to benefit from psychotherapy.

The most effective medications to treat the most fundamental symptoms of ADHD seem to boost and balance levels of specific brain chemicals called neurotransmitters. Commonly prescribed stimulants include amphetamine, methylphenidate and similar medications.

Medications

Many of the medications used to treat ADHD in children can also be used on adults. The dosages and effects differ. The doctor will examine the medical history, the family health history, and other health conditions of the patient to determine which drug is the best for them.

The most well-known ADHD medication is a stimulant. It works by altering 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 decrease aggression. These stimulants are available in different forms, such as skin patches, liquids, and chewable tablets. Long-acting versions of these stimulants are preferred as they result in greater patient compliance and a longer lasting, smoother improvement of symptoms.

It is important to keep in mind that comorbid conditions such as anxiety and depression may affect the response to ADHD medication. Therefore it is recommended that disorders be treated first, and then medication used as a secondary measure. The drugs that can be used for comorbid mood disorders are atomoxetine (Bupropion), tricyclic antidepressants, and bupropion (Wilens 2004).

Some patients might have a "rebound effect" where their ADHD symptoms get worse after stopping stimulant medications. In these instances it is possible to try a short-term trial of an atypical stimulant drug could be helpful.

Some people are unable to take stimulant medication or take it because of addiction to drugs or other health issues such as severe hypertension or heart problems. In these situations, non-stimulant medications like atomoxetine (Strattera) and viloxazine (Qelbree) can be effective. These medications don't cause the same amount of adverse effects as stimulants, and are lower risks of abuse and diversion.

Psychotherapy

People with ADHD are able to benefit from psychotherapy (talk therapy). It can help them learn strategies to improve their lives, deal with anxiety and stress, resolve conflicts, and manage issues in relationships or at work. It can also aid in the treatment of those suffering from mental illness that are co-existing, like depression and addiction disorders.

Talk therapies include cognitive-behavioral therapy (CBT), mindfulness-based cognitive therapy and schema therapy. These treatments are based on the notion that a person's beliefs and thoughts affect how they feel, think and act. CBT helps individuals identify negative patterns of behavior and thoughts and then formulate and implement positive strategies to alter these. Meditation techniques are used in mindfulness-based cognitive therapy to help someone concentrate on their thoughts and emotions to control their impulses and improve executive functioning. Schema therapy, and other forms of psychotherapy that focus on a person’s family history could be beneficial for those suffering from ADHD.

In addition to medicines psychotherapy can assist in addressing the specific problems caused by ADHD problems, like having trouble keeping up with schoolwork, resolving conflicts, getting together with others, losing important dates or obligations and making impulsive choices that can lead to legal or financial issues. It can also assist people to identify and overcome underlying issues that contribute to their ADHD symptoms, like depression or anxiety.

Psychotherapy can assist people in finding healthy ways to cope and reduce stress. For example 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. Family therapy and marriage counseling can help couples and families communicate better and understand how to manage untreated adhd life expectancy symptoms together.

Cognitive Behavioral Therapy (CBT)

CBT is a form of psychotherapy that is focused on changing the negative patterns of thinking that clients have. It uses skill-based dialogue with a trained mental health professional (a therapist) to address the root causes of their symptoms. This treatment is designed to help patients overcome limitations and develop coping strategies that are appropriate to their everyday lives.

Therapists who specialize in adult ADHD-CBT instruct clients to recognize harmful thoughts and help them build the skills to replace them with more productive thoughts. This process can be lengthy. It is an option for those who cannot receive enough relief from their medications.

In the course of a recent RCT, it was found that cognitive behavioral therapy combined with medication is superior over cognitive behavior therapy by itself in terms of improving core symptoms, emotional symptom, self-esteem, and social performance in adults with ADHD (Clarke, et al. 2017). The combination of CBT and methylphenidate is especially effective for those who have more severe underlying issues.

The therapists that provide this type of treatment typically collaborate with the client to create a detailed action plan for solving their issues. They will teach them a set of practical skills that are easy to learn and have a high probability of success. Often a chart system is used to track progress and reward positive behavior. This could include an everyday report for children that lists the tasks they are required to complete at school, or the positive behaviors that need to be exhibited, and a system of recording and earning rewards. The therapists could also consider creating negative consequences if a child does not complete their tasks. This can be done in a sensitive and supportive manner.

Metacognitive Therapy

Metacognitive therapy is a newer type of psychotherapy that assists people change their mindset. This kind of therapy can be effective for people suffering from a range of mental health issues such as depression. It is a form of cognitive behavioral therapy that assists people in recognizing negative thoughts and their impact on their moods. This type of therapy helps to develop psychological tools that are versatile and useful.

The purpose of this study was to explore the relationship between metacognitive skills and daily functioning among adults suffering from ADHD. To accomplish this we compared self and informant-rated impairments in daily functioning with the predictors of metacognition (comprehensive knowledge, regulation of Cognition, Debugging, Information Management and Evaluation). The results showed that complete knowledge was linked to daily functioning among adults suffering from ADHD, but not regulation processes. Metacognition predictors had moderate predictive power which indicates that they can explain a significant amount of variance in daily functioning of people with ADHD.

Metacognitive Therapy (MCT) is an treatment that focuses on changing metacognitive beliefs that cause dysfunction and perpetuate mental states such as worry, rumination and attention fixation. Adrian Wells developed MCT based on a model of information processing by Wells and Gerald Matthews. One case series has demonstrated the effectiveness of MCT in tackling anxiety disorder, however it's still a relatively new concept and more research is needed to determine its effectiveness for other disorders.

This study was designed to assess the effectiveness of MCT in decreasing symptoms of anxiety disorder, but it can be applied to a range of disorders, and may be more effective than other therapies. It's important to keep in mind that this is not an effective treatment for ADHD but it could be employed 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 to help their loved family members. It also assists them in dealing with their frustrations and build better communication skills. Additionally, this type of counseling is useful in dealing with comorbid disorders like depression or addiction to drugs, which are typically found in conjunction with ADHD.

The therapist will commence with an intake session in order to gain a clearer understanding of the family's perception of the problem and evaluate their suitability for family intervention. This can be done in person or via the internet. The counselor will explain to each participant the nature of treatment and the rules for family therapy.

A therapist who has experience treating Inattentive adhd adults with ADHD will ask a lot of questions to gain insight into their present symptoms as well as their history and the impact they have on their work, family and relationships. They will also inquire if there are any other mental health issues, such as anxiety or depression.

Cognitive behavioral therapy is a structured type of counseling that helps you learn how to manage your behavior and transform negative thinking patterns to positive ones. It focuses on improving self-esteem and self-control by teaching you how to manage stress and anger. This is a short-term solution that can be used alongside other types of psychotherapy.

Individual talk therapy helps people with ADHD to manage the emotional baggage that comes from underachievement and failure. It can also assist them in dealing with relationship conflicts or job changes as well as academic challenges. It can teach you strategies for coping with stress and stress reduction, and how to better manage your financial and time management. It can also help with problems that are comorbid, such as mood and anxiety disorders, which are often seen with ADHD.