When adults are diagnosed with attention deficit and hyperactivity disorder (ADHD), they often respond with a feeling of relief rather than dismay. Many have struggled with symptoms since childhood, and receiving a diagnosis tends to place their life experiences in perspective: So thats why I had such a hard time concentrating in school. And, even better, now they can get treatment.
Luckily for these adults, recognizing ADHD and getting an official diagnosis may be the hardest part. Unlike treatments for some other neurobehavioral disorders, such as autism, the treatments for ADHD are usually manageable and effective, and they may begin to work right away.
"Adult ADHD is one of the most responsive disorders to treatment, and patients are generally very receptive to the program," says David W. Goodman, MD, director of the Adult Attention Deficit Disorder Center of Maryland and assistant professor of psychiatry and behavioral sciences at Johns Hopkins University School of Medicine.
"ADHD sufferers may have very low self-esteem because the environment has always been critical of their unsatisfactory performance," he adds. "In only six to nine months of treatment, many notice that their self-image has improved tremendously."
Prescription medication is typically the cornerstone of ADHD treatment, especially for adults. The most commonly prescribed drugs for adult ADHD are stimulants, such as Adderall and Concerta. (The best known ADHD stimulant, Ritalin, is not officially approved for use in adults but is often prescribed to them off-label.) Side effects are generally slight and temporary, although there is some concern that the risk of cardiovascular problems associated with stimulant use may be greater in adults than in children.
Because of the psychoactive effect of stimulants, which can include feelings of euphoria, there is always the possibility of dependence and even abuse. In 2002, the FDA approved the first nonstimulant drug for ADHD, atomoxetine (known by its brand name, Strattera). Though some experts claim it is less effective than stimulants at managing the symptoms of ADHD, Strattera appears to be resistant to abuse and safe and effective for long-term use.
Medication is invaluable for controlling the most pressing symptoms of ADHD, but the emerging consensus is that successfully managing the disorder over the long termbecause there is no “cure” for ADHDalso requires learning a set of behaviors and techniques to minimize its secondary effects: low self-esteem, troubled relationships, poor organization, and so on.
Experts say that therapy for people with ADHD should be focused and highly structured. The most widely used form of therapy for ADHD is cognitive-behavioral therapy (CBT), a type of short-term therapy that is geared toward teaching everyday coping strategies rather than analyzing a persons psyche. Though the research on the subject is somewhat thin, CBT has been shown to produce results in adults with ADHD. In a 2002 study, a group of adults with ADHD who received eight weeks of cognitive therapy (some were also on medication) was matched with a comparable group who received no therapy. The therapy group reported a greater improvement in ADHD symptoms than the control group did, and, after a year, the symptoms of those who received therapy had decreased by 50%.
Opinions vary on whether talk therapy is better suited to adults or children with ADHD. Some experts maintain that talk therapy is more effective in children, but the little research that exists on the subject suggests that cognitive-behavioral approaches may be especially effective in adults, who are likely to be more aware of their thinking patterns (and how to change them).
Alternative and high-tech treatments
An Internet search for ADHD treatments will turn up plenty of home remedies, special diets, and alternative medicine options, many that promise results that sound too good to be trueand that's because they are. Adults often shy away from the idea of taking medication on a daily basis, or worse, giving it to their children who have been diagnosed with ADHD. But unfortunately, most alternative medicine treatments have not been shown to be effective for this disorder.
An innovative treatment known as neurofeedback has become more prominent in recent years.
So-called brain games, video games that respond to a players brain waves, have been designed as a way to condition behavior in people with ADHD. Players wear a special helmet that gauges electrical activity in the brain and sends the information to a computer and game controller. In order to play the game successfully, the player must force himself to relax and stay focused, a state which corresponds to a type of brain wave that is underactive in people with ADHD. (While playing a racing game, for instance, becoming too excited or distracted will cause the on-screen car to slow down or crash.) Learning to control this brain activity, the thinking goes, will allow the player to apply the same technique away from the game machine.
Little research into the effectiveness of neurofeedback for ADHD has been conducted. While some studies have shown that it can help improve behavioral symptoms, most experts do not recommend it as a stand-alone treatment.