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https://www.iampsychiatry.uk/adhd-treatment-for-adults/

Adult ADHD and Comorbid Disorders Many people with ADHD suffer from comorbid disorders like major depression Kessler et al 2006 Many patients are not responsive to depression medications and may benefit from psychotherapy Medications that most effectively improve the most fundamental symptoms of ADHD seem to boost and regulate levels of certain brain chemicals called neurotransmitters The stimulants methylphenidate and amphetamine are often prescribed Medications Adults can use many drugs that are prescribed for ADHD in children The dosages and effects are different The doctor will examine the medical history family health history and other factors of the individual to determine which drug is most appropriate for the patient The most common ADHD medication is a stimulant It works by adjusting the levels of norepinephrine and dopamine in the brain Stimulants such as methylphenidate also known as Adderall and dextroamphetamine increase the availability of neurotransmitters that aid in improving focus reduce impulsivity and reduce aggression They are available in a variety of forms including chewable tablets liquids and skin patches Longacting versions of these stimulants are preferable because they provide more patient compliance and lasting smoother improvement in symptoms It is important to keep in mind that comorbidities like depression and anxiety disorders can affect the response to ADHD medications It is therefore recommended that these psychiatric issues be treated first before medication used as secondary measure Some medications that can be used to treat comorbid psychiatric disorders include atomoxetine bupropion and tricyclic antidepressants Wilens 2004 Some patients may experience some patients may experience a rebound effect where their ADHD symptoms worsen after discontinuing stimulant medication In these cases a short trial of a low dose of stimulant medication could be helpful Some people are unable take stimulant medications or take it due to the misuse of drugs or other health conditions such as severe hypertension or heart issues In these cases nonstimulant drugs like atomoxetine or viloxazine are effective These medications do not cause the same high rates of adverse effects as stimulants and carry a less risk of misuse and diversion Psychotherapy Psychotherapy talk therapy can be helpful for those with ADHD It can help them learn skills to improve their life manage anxiety and stress work out conflicts and deal with problems in relationships or at work It can also aid with cooccurring mental illnesses like depression and substance abuse disorders Talk therapies include cognitive behavior therapy CBT mindbody cognitive therapy as well as schema therapy These therapies are based on the idea that thoughts and beliefs can influence how someone is feeling thinks and behaves CBT helps individuals identify negative thoughts and behaviors and then formulate and implement strategies to alter these Mindfulnessbased cognitive therapy employs techniques for meditation to help a person learn to focus on their thoughts and emotions manage their impulses and improve their executive functioning Schema therapy and other forms of psychotherapy focusing on a persons history with their family can be beneficial for those suffering from ADHD who suffer from significant secondary issues In addition to medication psychotherapy can assist in addressing the specific issues that arise from ADHD problems like having trouble getting through schoolwork resolving conflicts being able to get along with others forgetting important dates or responsibilities and impulsive decisions that can lead to financial or legal troubles Psychotherapy can help someone overcome underlying issues such as anxiety and depression that could be contributing to their ADHD symptoms Psychotherapy can help people find healthy strategies for coping and decrease stress For example exercise sleep improvement and healthy eating habits It can also provide 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 families and couples learn to communicate better and manage ADHD symptoms together Cognitive Behavioral Therapy CBT CBT is a kind of psychotherapy that is focused on helping clients change their negative thinking patterns It utilizes skillbased dialogue with a trained mental health professional a therapist to address the root causes of their symptoms The goal of this treatment is to correct impairments and implement coping strategies that align with the clients daily life Therapists who specialize in adult ADHDCBT teach clients to recognize harmful thoughts and help them develop skills to replace them with more productive thoughts This process can take a while But it is an effective alternative for adults who are not getting adequate relief from medications A recent RCT study concluded that when paired with medication CBT is superior to cognitive behavioral therapy on its own in reducing the severity of core symptoms emotional symptoms selfesteem and social functioning of adults with ADHD Clarke et al 2017 The combination of CBT and methylphenidate is particularly effective for those who have more severe underlying problems Therapists who offer this kind of treatment work with clients to create an action plan to address the specific issues they face They typically teach them a set of practical skills that are simple to implement and have a good chance of success Charts are often used to monitor progress and reward positive behaviors For a child this might include a daily report that outlines all of the schoolrelated activities or positive behaviors they need to accomplish and an approach to monitoring and gaining rewards The therapists may also discuss the possibility of creating negative consequences if a child does not complete their work This can be done with sensitivity and encouragement Metacognitive Therapy Metacognitive therapy is a newer kind of psychotherapy that helps people to change their thinking This type of therapy can be beneficial for people who suffer from various mental health problems like depression Its a kind of cognitive behavioral therapy that assists people recognize their negative thought patterns and how they affect their moods This kind of therapy can help individuals develop psychological tools that can be flexible and useful The goal of this study was to examine the relationship between metacognitive capabilities and daily functioning in adults with ADHD To do this we compared self and informantrated impairments in daily functioning with predictors of Metacognition comprehensive knowledge regulation of Cognition Debugging Information Management and Evaluation Iam Psychiatry was found that the comprehensive knowledge of people was linked to daily functioning in adults with ADHD but that the processes of regulation were not Metacognition predictors had moderate predictive power which suggests that they could explain an important amount of variance in daily functioning of adults with ADHD Metacognitive Therapy MCT is an treatment which focuses on reversing metacognitive beliefs that cause dysfunction and perpetuate states such as worry rumination and attention fixation MCT was developed by Adrian Wells based on an information processing model created by Wells and Gerald Matthews MCT has been shown to be effective in treating anxiety disorder However it is still an indevelopment treatment and further research is needed to determine whether it can aid in other disorders This study was designed for evaluating the effectiveness of MCT to reduce symptoms of anxiety disorder However it can be used to treat a variety of disorders and is more effective than other treatment This isnt an effective treatment but it can be used to treat ADHD Family Therapy In family therapy the Therapist works with the entire family This allows all members to learn about the clients issues and to understand how to help their loved ones better It also helps them deal with their frustrations and develop more effective communication skills This kind of counseling can also be used to address comorbid conditions such as addiction and depression that are commonly associated as part of ADHD The therapist will commence with an intake session to gain a clearer understanding of the familys view of the issue and determine their potential for intervention by the family It can be done either in person or online The Therapist will discuss the nature of treatment with each person and spell out the rules and guidelines of family therapy A therapist who has worked with adults suffering from ADHD asks lots of questions to gain insight into their current symptoms as well as their past and the impact they have on their work family and relationships They will also inquire whether there are any other mental health issues such as anxiety or depression Cognitive behavioral therapy CBT is an organized form of counseling which teaches you to change your negative patterns of thinking and to manage your behavior It is focused on improving selfesteem and selfcontrol by teaching strategies to manage anxiety and stress This is a shortterm option that can be utilized in conjunction with other types psychotherapy Individual talk therapy can help those with ADHD deal with emotional baggage from longstanding patterns of failure underachievement academic difficulties as well as frequent job changes and conflict in relationships It can help you learn strategies for coping with stress and stress reduction as well as how to better manage your finances and time It can also address the comorbidity of disorders like anxiety and mood disorders that are commonly associated with ADHD