“I can’t believe it! I snapped-off on my wife again. That’s the third time this week. I don’t understand, it just seems to come out of nowhere. This has gotta’ stop!”
Yesterday we began chatting about Adult ADHD (Attention Deficit/Hyperactivity Disorder). We learned what it looks like and how to determine if you may have it. Click here to read Part 1.
Today we’re going to review treatment options. Ready, set? Let’s go…
If you’re a chipur follower, you know I’m not a meds-first kind of guy. However, ADHD is a different matter. And it all depends upon the degree of life-interruption one is experiencing, as well as one’s ability to implement effective self-management techniques.
Actually, those enduring Adult ADHD often don’t need to be medicated because they’ve learned to manage their disorder for years without meds.
“So why would a stimulant, of all things, work for ADHD?” First and foremost, it isn’t about some sort of mysterious opposite-effect. Very simply, here’s the deal…
The neurotransmitters dopamine and norepinephrine play a key role in the areas of the brain in charge of regulating attention and executive functioning (planning, organizing, paying attention to and remembering details, managing time and space).
The central nervous system stimulants prescribed for ADHD ramp-up the availability of dopamine and norepinephrine. And that improves activity and communication in key brain areas. Their impact can be immediate.
Here are the FDA approved stimulant medications for the treatment of Adult ADHD…
- amphetamine-dextroamphetamine extended release (Adderall XR)
- methylphenidate extended release (Concerta)
- lisdexamfetamine dimesylate (Vyvanse)
- dexmethylphenidate extended release (Focalin XR)
- atomoxetine (Strattera): The only non-stimulant FDA approved drug for the treatment of Adult ADHD. Strattera impacts norepinephrine only.
- guanfacine ER (Intuniv): Influences norepinephrine
- clonidine (Catapres): An anti-hypertensive
- antidepressants: Certainly not the top choice, but they’re prescribed in some cases. Often used are the older tricyclics (TCAs) because they impact dopamine and norepinephrine. Also commonly used are duloxetine (Cymbalta), venlafaxine (Effexor), and desvenlafaxine (Pristiq). Bupropion (Wellbutrin/Zyban) is showing promise in clinical trials.
A big heads-up! Existing medical conditions, drug interaction, and side effects are major areas of concern when taking any medication. As it applies to stimulants, don’t take them if you suffer from hyperthyroidism, glaucoma, moderate to severe high blood pressure, other heart-related situations (including heart disease and congestive heart failure), or have a history of substance abuse.
Always chat things over with your physician. And make sure he/she knows all of your medical and psychiatric history.
The following suggestions and tips are relevant and helpful even if one is taking meds. I might add, it’s important that spouses, partners, significant others, family members, friends – even supervisors and teachers – understand the dynamics of Adult ADHD.
Okay, here we go…
- Learn all you can about your disorder.
- Use noise-canceling headphones if you live, work, or school in a noisy environment.
- Leave the TV and cellphone off when you’re working on tasks.
- Write daily reminders for tasks, appointments, etc.
- Jot down specific instructions regarding where you leave things you typically misplace.
- Learn to stop and take a deep breath before acting and talking inappropriately – and before overreacting emotionally.
- Write down what you were going to do or say – or how you may have emotionally overreacted.
- Plan ahead/Have a plan: If you know a situation is coming-up that’s traditionally made you uncomfortable; come up with coping strategies and techniques ahead of time. Examples: Fidgeting is an issue during meetings. Take notes or spin a pen under the table. You’re uncomfortable with what others may think of you during that meeting. Tell them you tend to get antsy and may have to move around a bit.
- Physical Exercise – especially doing things that involve the brain. Examples: dance, yoga, karate, tai chi
- Mind Exercise – do crossword puzzles or Sudoku-type games. Click here to check-out Cogmed’s Working Memory Training.
- Consider lowering your sugar and caffeine intake.
- Is an intolerance to wheat or dairy products making things worse?
- Participate in counseling (or professional coaching) to assist you with issues of focus, organization, fidgeting, impulsivity, time management, unstable emotions, etc.
Conclusion & Resources
The many and varied presentations of Adult ADHD hold the potential to severely disrupt your relationships, social routines, work, and schooling – your entire life.
But as with any emotional/mental health disorder, the situation is never hopeless. If you suspect, or know, you’re enduring Adult ADHD, learn about it and get help!
Here are two sites that provide a lot of helpful information. Just click on the links…
image credit healthjockey.com