The Treatment Adult ADHD Case Study You'll Never Forget
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Adult ADHD and Comorbid Disorders
Many adults with ADHD also suffer from comorbid conditions like major depressive disorder (Kessler and colleagues, 2006). Many sufferers do not respond to medications for depression and may be able to benefit from psychotherapy.
Treatments that are most effective in reducing the symptoms of ADHD are those that boost and balance levels of specific neurotransmitters in the brain. The stimulants methylphenidate and amphetamine are often prescribed.
Medicines
Adults can take a variety of drugs that are prescribed for ADHD in children. However the dosages differ and the drugs can cause side effects that are not present in children. The doctor will examine the medical history, family health history, and other medical health conditions of the patient to determine which medication is most appropriate for the patient.
The most common 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 reduce aggression. These stimulants are available in a variety of forms, such as skin patches, liquids, and chewable tablets. Long-acting versions of these stimulants are preferred because they provide more patient compliance and lasting, smoother improvement of symptoms.
It is crucial to be aware that co-occurring disorders like anxiety or depression may influence the response to ADHD medication. Therefore it is recommended that psychiatric issues be treated first before medication is utilized as a secondary measure. The medications that can be used to treat comorbid mood disorders include bupropion, atomoxetine and tricyclic antidepressants (Wilens 2004).
Some patients may experience an "rebound" effect in which they experience a worsening of ADHD symptoms after discontinuing stimulant medication. In these instances, a short trial of a low dosage of stimulant medication could be beneficial.
Certain people are not able to take stimulant medications or are in a position to not take them due to abuse of drugs or other health issues, such as severe heart problems or hypertension. In these situations, nonstimulant medications such as atomoxetine and viloxazine are effective. These medications don't cause the same high rates of side effects as stimulants and carry a lower risks of misuse and diversion.
Psychotherapy
People suffering from ADHD can benefit from psychotherapy (talk therapy). It can help them develop skills to improve their life manage stress and anxiety, resolve conflicts, and manage issues in relationships or at work. It can also aid those suffering from mental illness that are co-existing like depression and substance abuse disorders.
Talk therapies include cognitive behavior therapy (CBT), mind-body cognitive therapy and schema therapy. These therapies are based upon the idea that thoughts and beliefs can influence how a person behaves, thinks and feels. CBT assists individuals in identifying negative thoughts and behaviors and then develop and implement strategies to change these. Mindfulness-based cognitive therapy utilizes techniques of meditation to help a person learn to concentrate on their emotions and thoughts, manage their impulses, and improve their executive functioning. Schema therapy and other forms of psychotherapy focused on a person's family history can be beneficial for those suffering from ADHD with significant secondary issues.
Psychotherapy, in addition to medication, can aid with specific ADHD issues, like difficulty keeping up with schoolwork or interacting with other people. It can also help in avoiding important dates and obligations and making decisions that are impulsive and result in legal and financial issues. It can help a person overcome issues of the underlying nature, such as anxiety and depression that could be contributing to their ADHD symptoms.
Psychotherapy can help a person find healthy coping skills and reduce stress through exercising, improving sleep and healthy eating habits. It can also provide assistance to the family member or spouse who is struggling with the negative effects ADHD affects their relationship. Therapy for families and marriage helps families and couples learn to communicate better and manage ADHD symptoms together.
Cognitive Behavioral Therapy
CBT is a form of psychotherapy which focuses on changing the patterns of negative thinking of the client. It involves a dialog based on skill with a mental health professional to address the root causes of the symptoms. The aim of this treatment is to overcome limitations and implement strategies for coping that fit with the daily routine of the client.
In addition to teaching clients to recognize harmful thoughts, those who specialize in adult ADHD CBT aid them in developing skills that allow them to replace unhelpful thinking with more productive ones. This process can take some time. It is an option for adults who do not receive enough relief from their medication.
A recent RCT study found that when combined with medication, CBT is superior to CBT on its own in reducing the severity of the core symptoms, emotional symptoms as well as self-esteem and social functioning of adults suffering from ADHD (Clarke et al., 2017). The combination of CBT and methylphenidate is especially effective for those with more severe underlying issues.
The therapists who provide this kind of treatment usually collaborate with the client to devise a detailed action plan for solving their issues. They train them in a series of practical skills that are simple to master and have a high chance of success. Charts are typically used to track progress and to reward positive behavior. In the case of children, this could be a daily journal that lists all the school-related activities or positive behaviors they have to perform, as well as a system for monitoring and gaining rewards. Therapists can also discuss the possibility of introducing negative consequences when children fail to complete their tasks. This can be done in a sensitive and supportive manner.
Metacognitive Therapy
Metacognitive therapy is a newer kind of psychotherapy that helps people change their thinking. This type of treatment is effective for those suffering from a range of mental health problems which include depression. It is a form of cognitive behavioral therapy which helps people recognize negative thinking patterns and their impact on their moods. This kind of therapy helps individuals develop mental tools that are flexible and useful.
The purpose of this study was to investigate the relationship between metacognitive capabilities and daily functioning in adults with ADHD. To accomplish this we compared self and informant-rated daily functioning impairments 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 with ADHD however, it was not associated with the processes that regulate. The predictors of metacognition had moderate predictive power, which indicates that they can explain a significant amount of variations in the daily functioning of adults suffering from ADHD.
Metacognitive therapy (MCT) is a type of psychotherapy that focuses on changing dysfunctional metacognitive beliefs that perpetuate states of worry and rumination, as well as attention fixation. MCT was developed by Adrian Wells based on an information processing model created by Wells and Gerald Matthews. MCT has been proven to be effective in treating illness anxiety disorder. However, it's still a relatively new treatment and more research is required to determine if it can help with other disorders.
This study was conceived for evaluating the effectiveness of MCT to treat symptoms of anxiety disorder. However it is also able to treat various disorders and is more effective than other treatment. It is not a cure, but can be used to treat ADHD.
Family Therapy
In family therapy the Therapist works with the entire family. This allows everyone to understand the client's problems and learn how to support their loved one more effectively. It also adhd impulsivity treatment assists them in dealing with their anger and develop more effective communication skills. This kind of counseling can be used to tackle the underlying conditions, like substance abuse and depression, which are often seen with ADHD.
The therapist will commence with an intake session to gain a clearer understanding of the family's perspective of the problem and evaluate their potential for intervention by the family. This can be done in person or online. The therapist will discuss the nature of the therapy with each individual and set out the guidelines and rules of family therapy.
A therapist who has experience in treating adults suffering from ADHD will ask a variety of questions to gain understanding of the client's current symptoms, their history and their impact on their work as well as their family and social life. They will also ask if any other mental issues are present, such anxiety or depression.
Cognitive behavioral therapy (CBT) is an organized form of counseling that helps you change your negative thinking patterns and manage your behavior. It focuses on boosting self-esteem and self-control by teaching you how to handle anger and stress. This is a short-term solution that can be utilized in conjunction with other types psychotherapy.
Individual talk therapy helps people with ADHD to overcome the emotional baggage that comes from failure and underachievement. It can also help them deal with conflicts in relationships as well as job changes and academic challenges. It can help you learn strategies for managing stress and coping and help you manage your time and finances more efficiently. It can also address problems that are comorbid, such as depression and anxiety which are frequently associated with ADHD.