Evidence Based Treatment For ADHD in Adults
ADHD affects people in ways that affect their work, home and relationships. The most common treatments include medication, training in skills and psychological counseling.
Atomoxetine (Strattera) is the only FDA-approved non-stimulant medication for adults with ADHD. It is safe and effective, based on research. Psychosocial interventions to improve issues with organizational skills and comorbid disorders have a solid evidence base and are particularly effective in training parents to be behavioral (BPT). However, the precision of psychosocial guidelines is not easy to attain.
Medication
Many people suffering from ADHD discover that a combination of psychosocial therapy and medication is best to treat their symptoms. Medical treatment has been proven to be very effective in improving symptoms of ADHD however, it may take some time for a person to see results. Talk to your doctor if you're considering taking medication to help improve your ADHD symptoms. Make sure it's safe for you, and that it won't interact with other medications that you take.
People with ADHD might have difficulty focus and concentration, regulating impulses and planning tasks in time. These difficulties can impact on school, work, and social relationships. These problems can also make it hard to relax and take advantage of leisure activities.
Medications are the most effective evidence-based treatment for ADHD. They can reduce or eliminate the need for psychosocial interventions, and improve a person’s quality of living. The good news is that medications aren't addictive and have a very low risks of misuse. People with ADHD can benefit from stimulants, as per several studies. Those who cannot tolerate the side effects of stimulant medication can choose non-stimulants such as atomoxetine (Strattera).
Treatment isn't the only answer. A thorough assessment should include a detailed description of ADHD symptoms and the effects they have on daily functioning. It is essential to determine if the individual is suffering from any co-morbid conditions such as depression or anxiety which could impact the response to medication or therapy.
Medical examinations usually do not reveal any signs of the disorder and a diagnosis is based upon clinical judgment, with a clear history of symptoms that began in childhood onwards. In addition to a detailed interview, collateral information like school records and health assessments can aid in making a diagnosis.
There are a myriad of psychosocial therapies available for ADHD that include metacognition and cognitive rehabilitation. These psychosocial treatments don't appear to be as effective as pharmacotherapy and are not likely to have the same effectiveness. The more complex regimens are usually not followed and patients are advised to begin with a small dose of medication that can be easily combined with therapy for behavioral issues.
Psychotherapy
Many people suffering from ADHD discover that talk therapy or psychotherapy can help them improve their life. Certain studies suggest that certain forms of therapy, like cognitive behavioral therapy (CBT) and relapse prevention therapy (RPT) can help to reduce symptoms of ADHD. Talk therapy is a form of psychosocial treatment which involves individual sessions with a professional counselor or therapist. There are various types of therapy that can be used, and the therapist you choose should be based upon your goals and preferences.
A common method of treating adult ADHD is using a combination of medication and psychotherapy. Studies have demonstrated that combining medication and psychotherapy is more effective than either one on its own. The National Institute of Mental Health also recommends this approach.
Psychotherapy, also known as psychotherapy can aid you in managing your ADHD symptoms and learn coping skills. It can teach you how to handle problems at work, school and in your relationship. Depending on your goals and needs your therapist might suggest that you take part in individual or group therapy.
Cognitive behavior therapy is a kind of psychotherapy that helps people with ADHD to improve their self-esteem and functioning. CBT teaches you how to identify negative thoughts and change them, which can affect your mood and behavior. CBT, for example can help you to change "all-or-nothing" thinking that can cause people with ADHD to believe that they must do everything perfect or else not do anything at all.
In a therapy session your counselor listens to your story and asks questions to gain a better understanding of your thoughts and emotions. The therapist will then offer you suggestions based on their experience and research. They might also provide you with assignments, like journaling or trying something new. It is important to complete the homework as 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. In fact, it's an empowering step towards living the life you deserve. You can reach your goals and ambitions with the help of psychotherapy.
Education
Education can be an effective method for adults suffering from ADHD. Classes can be taught to improve communication skills, to learn to manage tasks and to learn how to talk and listen to other people. Therapy that focuses on teaching the patient to identify their symptoms and how they affect behavior could also be beneficial. This can be accomplished in a private session or group therapy.
Research has proven that a variety of psychosocial interventions can help to reduce symptoms that are problematic for ADHD individuals and improve their performance. These include educational interventions that can improve academic achievement and self-report of ADHD symptoms. A variety of behavioral and cognitive therapies have been shown to be efficient, including hypnotherapy neurofeedback, metacognitive learning, and cognitive remediation. However, not all of them have been proven to be superior to controls and the results need further testing.
In one study, a program that taught students to recognize their own inattention and impulsive behaviors was found to be more effective than waitlist control in improving self-report ADHD symptoms. Another study revealed that a daily report card enhanced academic performance for children with ADHD. Behavioral parent training has been proven to be effective in reducing negative parenting behaviors and enhancing positive family functioning, however the impact of self-directed parenting training for parents versus therapist-led parenting needs further investigation.
Adolescents suffering from ADHD are at a high risk of having impaired driving outcomes, including crashes that cause injuries or even death. Intensive summer "bridge" programs have been proven to enhance driving abilities in adolescents suffering from ADHD. Other psychosocial interventions have been proven to be beneficial such as central executive training and training for working memory.
Adults suffering from ADHD frequently have difficulty maintaining stability in their jobs or relationships. Inability to organize their lives as well as inability to complete or finish tasks, and impulsive and inattentive behavior can make co-workers and family members angry. Psychotherapy that assists patients in improving their communication skills can help manage these issues. Couples counseling teaches partners to resolve issues that arise.
Counseling
Although medications are beneficial for a significant number of people suffering from ADHD however, it isn't always sufficient to reduce all symptoms. The side effects of medications can be unpredictable and they may affect some individuals in a different way. For this reason, counseling is an essential part of the overall treatment plan. Counseling can help patients discover better ways to manage their emotions, improve their relationships build self-esteem and develop strategies to cope with the unique challenges that come with living with ADHD.
Multiple randomized controlled studies have demonstrated the effectiveness of psychosocial therapy for ADHD. Certain studies have shown that when the combination of medication and behavioral therapy is employed, both the parents and students' perceptions of academic functioning improves. Additionally, studies have demonstrated that using an extremely low dose of stimulant medication in combination with behavioral therapy improves both academic performance and classroom behavior compared to a control group.
In adhd treatment in adults , high school counselors were trained to implement two brief homework and organization interventions for students with ADHD. The two interventions were then compared with an initial course of low dose medication. The results indicate that a sequential multiple assignment randomized trial could be an effective method to bridge the gap between research and practice in school-based intervention for ADHD.
Before attempting medication, it is recommended that schools implement ADHD intervention which includes behavior education and parent education. For adolescents and adults the initial treatment should consist of psychosocial interventions and pharmacotherapy. For adults and adolescents, the first medication should be stimulants (methylphenidate dexamphetamine, dexamphetamine or lisdexam) as long as they are able to take these medications due to any other health conditions. In such cases the use of atomoxetine or guanfacine could be considered.
A thorough medical examination should be performed to determine if there are any other conditions that might affect learning and functioning, such as neurological disorders (such epilepsy, Tourette's Syndrome, or cerebral palsy) as well as nutritional issues, substance abuse disorder (SUD) chronic diseases like asthma, and comorbid mental disorders. If the history and exam are unremarkable the diagnosis of ADHD can be made by a qualified psychologist or psychiatrist using established diagnostic criteria.