Evidence Based Treatment For ADHD in Adults
ADHD affects people in ways that affect their work, home and relationships. Standard treatments involve medication, skills training and psychological counseling.
Atomoxetine (Strattera) is the only FDA-approved non-stimulant medication for adults with ADHD. Research has proven that it is effective and has low abuse potential. Psychosocial interventions to improve issues with organizational skills and comorbid disorders have a strong evidence base and are particularly effective in training parents to be behavioral (BPT). However, precision in psychosocial guidelines is difficult to attain.
Medication
Many people suffering from ADHD are able to determine that a mix of psychosocial therapy and medication is the best to treat their symptoms. It can take a while before someone can see any improvement in their ADHD symptoms. Talk to your doctor if you're considering using medication to treat your ADHD symptoms. Be sure that the medication is safe for you, and that it doesn't interact with other medications you take.
People suffering from ADHD struggle with staying focused and concentrating, regulating impulses, making plans and completing tasks in a timely manner. These issues can impact the school, work and social interactions. They can make it difficult to take time out and unwind.
Medicines are the most effective evidence-based treatment for ADHD. The use of medications can decrease or eliminate the need for psychosocial interventions, and can significantly enhance a person's quality of life. Fortunately, untreated adhd in adults are not addictive and they have the lowest risk of misuse. Several studies have shown that those with ADHD benefit from using stimulants. If you are not able to handle the adverse effects of stimulant medications can choose non-stimulants, such as atomoxetine (Strattera).
Treatment isn't the only answer. A thorough assessment will include a detailed description of ADHD symptoms and the effects they have on daily functioning. It is important to determine if the individual is suffering from any co-morbid conditions such as depression or anxiety that could affect the response to medication or therapy.
A medical examination will generally not reveal any symptoms of the disorder. Instead, a diagnosis is based upon clinical judgment, and an history of symptoms that started in childhood. A thorough interview can be helpful when combined with collateral information, such as school records or child health assessments.
Many psychosocial treatments for ADHD are available that include cognitive remediation, metacognition and working memory training. However, these do not seem to be more effective than the pharmacotherapy method, and are not likely to be as effective of effectiveness as a dosed medication. The more complex regimens are usually not adhered to and patients are advised to start with a low dosage of medication that can be easily coupled with therapy for behavioral issues.
Psychotherapy
Many people with ADHD discover that psychotherapy, or talk therapy, helps them improve their lives. Certain studies suggest that talk therapy such as cognitive behavior therapy (CBT) or relapse prevention treatment (RPT) can help reduce ADHD symptoms. Talk therapy is psychosocial treatment that involves sessions with a trained therapist or counselor. There are various types of talk therapy and the therapist you choose should be based on your goals and requirements.
Combining psychotherapy and medication is a common way to treat adult ADHD. Studies have proven that combining medication and psychotherapy is more effective than one alone. The National Institute of Mental Health also recommends this approach.
Talk therapy, or psychotherapy can aid you in managing your ADHD symptoms and learn coping skills. It can teach you strategies for dealing with problems in your work, relationships and school. Your therapist might suggest that you attend group, individual, or family therapy depending on your needs and goals.
Cognitive behavior therapy (CBT) is a type of psychotherapy that can help adults with ADHD improve their functioning and self-esteem. CBT teaches you how to identify negative thoughts and change them, which can impact your emotions and behavior. For example, CBT can teach you to change "all or nothing" thinking, which can cause people with ADHD to believe that they must do everything flawlessly or not at all.
During the course of a session your therapist will listen to you and ask questions to help you understand your thoughts and emotions. The therapist will then offer you advice based upon their knowledge and experience. You might also be assigned assignments, such as journaling or trying a new activity. It's crucial to complete homework because it will allow you to apply what you've learned.
It's important to keep in mind that seeking treatment isn't a sign of weakness. It's a brave move to live the life you've always wanted. You can accomplish your goals and dreams by utilizing psychotherapy.
Education
Education can be a beneficial tool for adults with ADHD. It can be used to teach organizational skills, methods to prepare for tasks, and methods to improve the way someone speaks and listens to other people. It is beneficial to concentrate on teaching patients to recognize signs and how these affect their behavior. This can be accomplished through individual sessions or through group therapy.
Research has shown that many psychosocial interventions can significantly reduce problematic symptoms and improve the functioning of people with ADHD. These include educational programs, which can boost academic performance and self-reporting of ADHD symptoms. Various cognitive and behavior treatments have been proven to be effective, such as hypnotherapy, neurofeedback, metacognitive learning, and cognitive remediation. Nevertheless they are not all have been proven to be superior over the controls. Further studies are needed to verify the results.
In an investigation it was found that a school program that taught students to recognize their own impulsive or inattentive behavior was more effective than waiting for a list to improve self-reported ADHD symptoms. A daily report card for behavior was discovered to improve academic performance for children with ADHD in a separate study. Training for parents to be more observant has been proven effective in decreasing negative parenting behaviors and enhancing positive family functioning, but the impact of self-directed parenting versus therapist-led parental training needs further investigation.
Adolescents suffering from ADHD are at high risk of impaired driving, such as crashes that result in injury or death. Intense summer "bridge" programs have been shown to improve driving skills among adolescents with ADHD. Other psychosocial interventions have been proven to be beneficial, including central executive training and training for working memory.
Adults suffering from ADHD have difficulty maintaining stable relationships or jobs. Inability to manage their time as well as inability to complete or follow through on tasks, and impulsive and inattentive behavior can leave coworkers and family members frustrated. Psychotherapy that helps patients improve communication skills can help them overcome these issues. This is also true for couples counseling which helps couples learn how to deal with each other's issues when they arise.
Counseling
Although medications are beneficial for a significant number of people suffering from ADHD, it is not always enough to eliminate all symptoms. Medicines can be unpredictably effective and cause negative side effects that affect certain individuals in a variety of ways. Counseling is therefore an important element of the overall treatment. Counseling can help patients discover better ways to manage their emotions, improve relationships and self-esteem, as well as learn strategies to deal with the unique challenges associated with living with ADHD.
The effectiveness of psychosocial treatments for ADHD has been demonstrated in several controlled studies that are randomized. Some studies found that when the combination of medication and behavioral therapy is used, both parents and students' ratings of academic performance improves. Studies have also demonstrated that a low dose stimulant medication combined with a behavioral therapy program improved the behavior of students in class as well as the performance on homework when compared to a control group.
In a recent research, high school counselors received training on how to implement two brief homework and organization programs for ADHD students. These interventions were compared to an initial course of low dose medication. The results suggest that a sequential multiple assignment randomized trial may be a viable method to bridge the gap between research and practice in school-based interventions for ADHD.
It is recommended that schools implement ADHD interventions, which include behavior training and parental education, before taking medication. For adults and adolescents the first course of treatment should consist of pharmacotherapy with psychosocial interventions. For More and adults the first drug to be considered should be stimulants (methylphenidate, dexamphetamine or lisdexamfetamine), unless they cannot use these medications due to other health issues. In these instances the use of atomoxetine or guanfacine could be considered.
A thorough medical exam should be conducted to determine the presence of any other disorder that could affect learning and functioning, including neurological disorders (such Tourette's Syndrome, epilepsy, or cerebral palsy) or nutritional issues as well as substance abuse disorder (SUD) chronic diseases like asthma, and other comorbid mental disorders. If the exam and history are not significant, a diagnosis of ADHD can be made by a qualified psychiatrist or psychologist using an established diagnostic criteria.