Evidence Based Treatment For ADHD in Adults
ADHD affects people in ways that impact their work, home and relationships. Standard treatments include medications, skill training and psychological counseling.
Atomoxetine (Strattera) is the only FDA-approved non-stimulant drug for adult 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 solid evidence base including behavioral parent training (BPT). However, precision in psychosocial guidelines is difficult to attain.
Medication
For many people suffering from ADHD the combination of psychosocial treatment and medication is the best approach to manage their symptoms. It can take a while for a person to notice any improvement in their ADHD symptoms. Consult your physician when you're thinking of using medication to treat your ADHD symptoms. Make sure that it's safe for you, and doesn't interfere with other medications you are taking.
People suffering from ADHD have difficulty with focusing and concentrating, controlling impulses planning and completing tasks in a timely manner. These issues can impact the school, work and social interactions. These difficulties can also make it difficult to relax and take pleasure in leisure activities.
Medicines are the most effective evidence-based treatment for ADHD. The use of medications can reduce or eliminate the requirement for psychosocial interventions and can enhance the quality of living. Fortunately, medication does not cause addiction and carry an extremely low chance of being misused. Numerous studies have proven that people with ADHD benefit from the use of stimulants. Those who cannot tolerate the side effects of stimulant medications may choose non-stimulants such as atomoxetine (Strattera).
Medication is not the answer. A thorough evaluation should include a history of symptoms and a discussion of the impact of ADHD symptoms on the person's daily life. It should also address whether the person suffers from any comorbid conditions such as depression and anxiety, which could affect the response to treatment and medications.
A medical examination will not usually reveal any signs of the disorder. However, a diagnosis is based on clinical judgment, and a history of symptoms that began in the early years of childhood. In addition to a thorough interview, collateral information such as school records and child health assessments can be helpful in diagnosing the condition.
Many psychosocial treatments for ADHD are available that include cognitive remediation, metacognition and working memory training. These treatments do not seem to be as effective as pharmacotherapy, and are unlikely have the same level effectiveness. Patients are advised to start with a low dose medication that can be paired with behavioral therapy.
Psychotherapy
Many people suffering from ADHD find that talking therapy or psychotherapy can help them improve their lives. Certain studies suggest that talk therapy, like cognitive behavior therapy (CBT) or Relapse prevention treatment (RPT) can help reduce ADHD symptoms. Talk adhd treatment for adults without medication is a type of psychosocial treatment that consists of one-on-one sessions with a trained counselor or therapist. Different modalities of talk therapy are available and your choice of the therapist you choose should be based on your needs and goals.
A common approach to treating adult ADHD is using a combination of medications and psychotherapy. Studies have demonstrated that combining medication and psychotherapy is more effective than any approach alone. The National Institute of Mental Health also recommends this method.
Talk therapy, or psychotherapy, can aid you in managing your ADHD symptoms and help you develop how to cope. It can also provide strategies to deal with difficulties in your work, relationships, and school life. Your therapist might suggest that you attend individual, group or family therapy based on your goals and requirements.
Cognitive behavior therapy (CBT) is a form of psychotherapy that can assist people with ADHD improve their functioning and self-esteem. CBT will help you recognize negative thoughts and modify them, which may affect your behavior and emotions. CBT for instance, can teach you how to overcome "all-or-nothing" thinking which can make people with ADHD believe they must do everything perfectly or not at all.
During a therapy session, your therapy therapist listens to you and asks questions to better understand your thoughts and emotions. They will then offer suggestions based on their experience and research. You may also be given homework, such as journaling or trying a different activity. You should do your homework because it will assist you in putting what have learned into practice.
It is important to keep in mind that seeking treatment doesn't mean that you're weak. In fact, it's an empowering step toward living the life you've always wanted. With the structure and support, as well as the skills that you build through psychotherapy, you will be able to achieve your biggest goals and dreams.
Education
Education can be a potent tool to help adults with ADHD. Classes can be taught to improve communication skills, to learn how to organize tasks, and also to learn to talk and listen to others. It is beneficial to concentrate on teaching patients to recognize signs and how these affect their behavior. This can be done in private 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 enhance academic performance 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 none of them have been proven to be superior to control methods and the results require further replication.
In the course of a study, a program that taught students to identify their own inattention and impulsive behavior was found to be more effective than a waitlist control in improving self-report ADHD symptoms. A daily behavior report card was found to boost academic performance in children with ADHD in a separate study. Training for parents to be more observant has been shown to be effective in decreasing negative parenting behaviors and increasing positive family functioning, however the effects of self-directed as opposed to therapist-led training for parents requires further exploration.
Adolescents with ADHD are at high risk for impaired driving outcomes, including crashes that cause injury or death. Intense summer "bridge" programs have been proven to improve driving skills among adolescents with ADHD. Other psychosocial interventions that have been found to be useful include central executive training and working memory training.
Adults suffering from ADHD struggle to maintain stable relationships or jobs. Inability to complete tasks or keep on track poor organizational skills, impulsive or inattentive behaviors can strain the patience of co-workers, colleagues and family members. Psychotherapy that helps patients improve their communication skills can help manage these difficulties. Couples counseling helps partners resolve issues that arise.
Counseling
While medications can be beneficial for a lot of people with ADHD it does not always eliminate the symptoms in all cases. The effects of medication can be unpredictable, and they can affect some people in different ways. This is why counseling is a crucial element of the overall treatment plan. Counseling can be used to assist people in learning to better manage their emotions, build relationships, and improve self-esteem.
The effectiveness of psychosocial treatments for ADHD has been proven in multiple randomized controlled trials. In certain studies, the academic functioning of both parents and students improved when a combination of medication and behavioral therapy was used. Studies have also shown that the use of a low dose stimulant combined with a behavioral therapy program improved both classroom behavior as well as homework performance when compared with a comparably group.
In a recent research, high school counselors received training on how to implement two short homework and organization programs for ADHD students. These interventions were compared with an initial course low dose medication. The results suggest that a continuous, multi-assignment, randomized trial may be a viable method of bridging the gap between research findings and actual practice in school-based interventions for ADHD.
Before attempting to take medication, it is recommended that schools implement ADHD intervention, which includes behavior training and parent education. For adolescents and adults the initial treatment should consist of psychosocial interventions and pharmacotherapy. The first treatment for adults and adolescents should be stimulants, such dexamphetamine or methylphenidate, except that other health conditions prevent them from taking these drugs. In these instances, atomoxetine and guanfacine are options.
A thorough medical examination should be conducted to rule out any other conditions that could affect functioning and learning, including neurological disorders (such as epilepsy, Tourette's Syndrome, or cerebral palsy) as well as nutrition issues, substance use disorder (SUD), chronic illnesses such as asthma and comorbid psychological disorders. If the exam and history are not significant and the diagnosis is not clear, ADHD is made by a qualified psychologist or psychiatrist based on established diagnostic criteria.