Evidence Based Treatment For ADHD in Adults
ADHD affects people in ways that impact their work, home life and relationships. Treatments typically include medications, training for 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 that focus on organizational skills and comorbid conditions have a solid evidence base particularly behavioral parent training (BPT). However, precision in psychosocial guidelines is difficult to achieve.
Medication
Many people suffering from ADHD find that a combination of psychosocial therapy and medication is the best for managing their symptoms. The use of medication has been proven to be very efficient in reducing symptoms of ADHD however, it may take a few months for people to see results. If you're considering taking medication to improve your ADHD symptoms, speak to your doctor to ensure that it is suitable for you and does not interfere with other medications you are taking.
People suffering from ADHD have trouble focusing and concentrating, controlling their impulses, making plans and accomplishing tasks in a timely manner. These issues can have a negative impact on work, school, and social relationships. They can make it difficult for people to enjoy leisure activities and unwind.
The most effective treatment for ADHD is medication. Medications can reduce or eliminate the need for psychosocial interventions, and can significantly improve a person's quality of life. Fortunately, medication does not create addiction and carry the lowest chance of being misused. Several studies have shown that those with ADHD benefit from the use of stimulants. If you are not able to handle the adverse effects of stimulant medication can choose non-stimulants, such as atomoxetine (Strattera).
Treatment isn't the only option. A thorough evaluation should include a history of symptoms and a description of the effects of ADHD symptoms on the person's daily life. It should also be able to identify if the person suffers from any other comorbidities like depression or anxiety, which may impact the effectiveness of therapy and medication.
Medical examinations usually do not show signs of the disorder and a diagnosis is based on clinical judgement, with a clear history of symptoms from childhood onwards. In addition to a detailed interview, other information such as school records and health assessments can be useful in establishing a diagnosis.
There are many psychosocial treatments available for ADHD such as metacognition and cognitive rehabilitation. However, they do not appear to be more effective than psychotherapy, and aren't likely to achieve the same level of efficacy as a properly dosed medication. Complex regimens are often not adhered to, and patients are advised to start with a lower dose of medication that is easily mixed with behavioral therapy.
Psychotherapy
Many people with ADHD find that talking therapy or psychotherapy helps them improve their life. Some studies suggest that certain types of therapy, like cognitive behavioral therapy (CBT) and Relapse prevention therapy (RPT) can help reduce symptoms of ADHD. Talk therapy is a type of psychosocial treatment that consists of one-on-one sessions with a trained counselor or therapist. There are many kinds of talk therapy, and the therapist you choose should be based on your goals and requirements.
A common approach to treating adult ADHD is using the combination of medication and psychotherapy. Studies have shown that combining medication and psychotherapy is more effective than one alone. adhd treatment for adults without medication is also recommended by the National Institute of Mental Health (NIMH).
Talk therapy or psychotherapy can help you to manage ADHD symptoms and manage these symptoms. It can teach you how to deal with problems in your work, school and in your relationship. Your therapist may suggest you attend individual, group or family therapy based on your goals and needs.
Cognitive behavior therapy is a type of psychotherapy which can help adults with ADHD to improve their self-esteem as well as functioning. CBT will help you recognize negative thoughts and alter them, which can impact your mood and behavior. CBT, for example can help you learn to change "all-or-nothing" thinking that can cause people with ADHD believe they must do everything perfect or else not do anything at all.
During a therapy session, your counselor listens to your story and asks questions to help you understand your thoughts and feelings. The therapist will then give advice based on their research and experience. They may also assign you homework, such as journaling or trying something new. It's crucial to complete the homework as it will allow you to practice what you've learned.
It's important to keep in mind that seeking treatment does not mean you are weak. It's a courageous choice 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. Education can include classes to teach organizational skills, how to prepare for work, and ways to improve the way one speaks and listens to others. It can be beneficial to teach patients to recognize signs and how these affect their behavior. This can be done in private sessions or through group therapy.
Research has demonstrated that many psychosocial interventions can dramatically reduce problematic symptoms and improve the functioning of people with ADHD. These include educational interventions that can boost academic performance and self-report of ADHD symptoms. A variety of behavioral and cognitive therapies have been proven to be efficient. These include hypnotherapy and neurofeedback. However none of them have been proved to be superior to the controls and the results need further replication.
In the course of a study 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 on behavior was found to improve academic performance in children with ADHD in another study. It has been established that training for parents to be a behavioral one is effective in reducing negative parental behavior and enhancing positive family function. However, the effects of self-directed versus therapist-led training need further exploration.
Adolescents suffering from ADHD are at risk of impaired driving outcomes, such as crashes that cause injuries or even death. Intensive summer "bridge" programs have been proven to improve driving skills in adolescents with ADHD. Other psychosocial interventions have also been found to be helpful such as central executive training and training for working memory.
Adults with ADHD struggle to maintain stable jobs or relationships. Poor organizational skills and inability to finish or follow through on tasks as well as impulsive and indifferent behavior can leave coworkers and family members unhappy. Psychotherapy that helps patients improve communication skills can help them overcome these issues. This is also true for couples counseling that assists partners in dealing with each other's problems as they occur.
Counseling
While medications can be effective for many people with ADHD however, it is not always able to eliminate the symptoms in all cases. The adverse effects of medications can be unpredictable, and they may affect some people in different ways. For this reason, counseling is an essential part of the overall treatment plan. Counseling can assist people in learning to better manage their emotions, establish relationships, and improve self-esteem.
Multiple randomized controlled studies have proven the effectiveness of psychosocial therapy for ADHD. In certain studies, academic functioning of both parents and students improved when a combination of medication and behavioral therapy was used. Additionally, studies have shown that the use of a low dose of stimulant medications in conjunction with behavioral therapy improves classroom behavior and homework performance compared to a control group.
In a recent study high school counselors were trained on how to implement two brief homework and organizational interventions for ADHD students. The interventions were compared with an initial course of low dose medication. The results suggest that a continuous, multiple-assignment randomized trial could be a successful method to bridge the gap between research findings and practices in school-based programs for ADHD.
It is recommended that schools implement ADHD interventions that include behavior management and education for parents, prior to trying medication. A combination of pharmacotherapy and psychosocial interventions should be the first option for treatment for adults and adolescents. The first medication for adults and adolescents should be stimulants such as dexamphetamine or methylphenidate, except that other health conditions prevent them from taking these medications. In these instances either atomoxetine, or guanfacine may be considered.
A thorough medical exam must 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 as well as substance abuse disorder (SUD), chronic diseases like asthma, and comorbid mental disorders. If the history and exam are not revealing, a diagnosis of ADHD can be determined by a licensed psychologist or psychiatrist using established diagnostic criteria.