Treatment of ADHD in Adults
Treatment for adults with adhd focuses on medication, therapy and family support. Patients can also take part in clinical trials to try new ways of treating ADHD.
Stimulant medications are the most effective treatment for adults suffering from ADHD. But they need to be constantly monitored. This includes regular appointments with a physician and frequent examinations of symptoms.
Medicines
There are many medications that can reduce the symptoms of ADHD in adults. These are referred to as psychostimulants. They work by altering the levels of certain neurotransmitters (chemicals) in your brain that transmit messages between nerve cells. Your doctor will select the right medication for you and will determine the most effective dosage and timetable. It could take a while to determine the proper dosage and medication that control your symptoms.
Stimulants are often the first prescription medication doctors recommend to adults suffering from ADHD. These medicines increase the amounts of norepinephrine and dopamine in your brain, which improve your ability to focus and manage impulses. These medications are available in short-, mediumand long-acting forms. Short-acting stimulants can last for 6 hours. Intermediate-acting medicines last for 8-10 hours. Long-acting drugs last up to 16 hours. Long-acting stimulants have fewer negative effects than shorter- and intermediate-acting medicines, but they can still cause sleepiness and changes in appetite.
Nonstimulant drugs like atomoxetine, (Strattera) are used to treat adults with ADHD when stimulants don't perform or cause undesirable adverse effects. These medicines don't affect your norepinephrine or dopamine levels, but they increase the amount of norepinephrine available to your brain and improve your ability to concentrate. The capsules are taken one or twice daily.
Some adults with ADHD suffer from co-occurring disorders such as anxiety or depression. These are referred to as comorbid conditions and they can impact how you respond to treatment for ADHD. It is essential to treat any comorbid conditions before starting treatment for ADHD. For instance, those who have an history of using substances disorder are more likely to use psychostimulants. This is why it's generally advised to wait until a person has removed themselves from using substances before evaluating treatment with stimulants for ADHD.
Psychotherapy
Psychotherapy involves discussing and talking about topics that are troubling or disturbing to a person. The therapist offers guidance in accordance with their education, experience, credentials and therapeutic philosophy. Psychotherapy can be short-term (a few weeks or even months) or addressing more immediate issues, or more long-term. The patient and therapist determine the duration and frequency of treatment.
The use of psychotherapy and drugs together is an extremely effective treatment for adults suffering from ADHD. Behavioral therapy can help people improve their time management, organizational skills and prioritizing. It can also teach methods to manage emotions such as anger and frustration. Medication can reduce symptoms, increase concentration and improve work and academic performance.
Adults with ADHD are more likely to have co-existing issues, especially mood disorders like depression and anxiety. It is essential that any co-existing condition be addressed prior to beginning treatment for ADHD. Treatment of co-existing disorders may require different forms and dosages of medication than that used to treat ADHD.
A person with ADHD can also have hypertension. Selecting a medication that addresses the ADHD symptoms, but does not affect the patient's hypertension that is controlled requires understanding how different medications affect individuals over time and an understanding of the interactions between various medications.
It's important that you find a therapist who has had experience working with adults suffering from ADHD and with whom you are at ease. It's also important to schedule your first few sessions when you aren't distracted by your family obligations or work obligations.
Counseling
Adults suffering from ADHD often face many life challenges, including relationships and work issues. They may also experience anger, blame and frustration that have accumulated in their lives due to their symptoms. Psychosocial treatments can help patients and their families to develop new attitudes, skills and ways of communicating.
Psychotherapy can also include cognitive behavioral therapy, a type of psychotherapy that helps individuals change their thinking and behavior. It involves setting goals, training and the practice of skills, as well as strategies for teaching that help improve self-esteem and organization. It may be done in group or individual sessions. Metacognitive therapy has been proven to significantly reduce symptoms in adults suffering from ADHD and improve their performance (Stevenson, et al. 2002).
In addition to psychotherapy, some individuals with ADHD require counseling to deal with specific life issues. These challenges may include family conflicts, aggressive or impulsive behavior, and difficulties in dealing with failures and disappointments. Counseling can teach the skills to manage these situations, improve communication and enhance problem-solving abilities. It can also enhance interpersonal relationships, especially in long-term marriages or other partnerships.
Family therapy and supportive group therapy are also types of psychotherapy that can be used to treat ADHD. These therapies can help families cope and develop skills to lessen conflict and improve communication when dealing with a child who has ADHD. It can aid parents understand the condition and develop parenting methods that promote positive outcomes for their children.
It is crucial for people with ADHD to discuss their medications with their health care professionals regularly, and to reveal all other medications they are taking, including any over-the-counter medications. Certain medications may interact with specific medications or cause adverse reactions that are made worse by other medications.
Medication Monitoring
After a thorough examination and diagnosis is made, it is important 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 patients be examined for initial clinical monitoring within 30 days of starting treatment, and every month following that. For psychostimulants (methylphenidate, amphetamines) this enables thorough titration to an effective and well-tolerated dose. This permits accurate recording of the patient's response. It also assists in avoiding the patient from being kept on insufficient doses (slow metabolizers) or forcing those who require higher doses on unnecessarily high levels (rapid metabolizers).
For adults who are unable to respond well to stimulant medication or suffer from uncontrollable side effects, the use of nonstimulant medications may be indicated. This typically involves the use of atomoxetine or other related methylphenidate alternatives.
Adults who suffer from ADHD are frequently affected by comorbid conditions, like depression or substance abuse. Moreover, they may have persistent sleep disturbances or medical issues like vision and hearing disorders. adult treatment for adhd is essential to identify and assess these conditions in the initial assessment for ADHD because they can have a significant impact on functional impairment in adults.
Marital therapy can be helpful in the management of ADHD. Couples often say that they feel overburdened by the responsibilities of caring for their spouses who have ADHD and may become resentful and angry as a result. Increasing the patient's awareness of the symptoms of his/her illness and helping them understand that these aren't impulsive acts or a lack of love can help reduce marital conflict and resentment. Couples who undergo this type of therapy are more likely to be more functional as a family.
Behavioral Therapy
Psychotherapy for adults suffering from ADHD is typically advised. It should include a cognitive and behavioral component. Behavioral therapy can help patients improve their organizational skills, focus, and control impulsive behaviors. It teaches patients to manage their work, home, and social situations more effectively. Psychotherapy also helps patients understand how their condition affects different areas of their lives and relationships. This can help reduce the feelings of shame and low self-esteem that are often experienced by adults with ADHD who are viewed as inept or unintelligent.
ADHD symptoms can be mimicked by various psychiatric disorders. For instance, anxiety disorders occur at a high rate in adult ADHD patients and depression is seen in greater numbers among adults with the disorder. The presence of other psychiatric problems should be assessed in order to determine whether or not the patient's ADHD symptoms are related to them.
Adults with ADHD are typically treated with the combination of pharmacotherapy and psychotherapy. It has been proven that a combination of psychotherapy and medication can produce superior results over either treatment by itself. Future controlled medication studies will attempt to track and evaluate the effects of functional improvement, like improvement in school performance, the workplace, and interpersonal relations.