Adult Attention Deficit Disorder: Talking it Out Will Help
Although attention deficit and hyperactivity disorder (ADHD) is more frequently talked about in children, about 9 million American adults also suffer from the condition. There are many therapies that can help ease the cycle of procrastination and disorganization, including cognitive behavioral therapy – sessions of therapy that identify and set strategies to change behaviors related to ADHD.
Adults with Attention Deficit/Hyperactivity Disorder Need Active Support
The 4th Edition of the Diagnostic and Statistical Manual of Mental Disorders divides Attention Deficit Disorders and Attention Deficit/Hyperactivity disorders into two groups: symptoms of inattention and symptoms of hyperactivity/impulsivity.
Those with inactivity symptoms often fails to give close attention to details or makes careless mistakes, has difficulty sustaining attention during tasks, does not appear to listen when being spoken to, and often fails to complete tasks. Hyperactive/Impulsive symptoms include fidgeting, restlessness, excessive talking, interrupting, and difficulty waiting their turn.
Dr. Steven A Safren PhD, of Massachusetts General Hospital, and colleagues studied cognitive behavioral therapy (CBT) on 86 adults with ADHD who were being treated with medication, but still showed symptoms. Patients were randomly assigned to either twelve 50-minute individual sessions of CBT or the same number of sessions in a relaxation therapy program.
CBT sessions taught the patients organizations skills and planning, skills to reduce distractibility, steps to take to think more adaptively in stressful situations, and how to prevent a relapse. Those in the relaxation therapy group received training in relaxation techniques and education about ADHD.
Compared with the relaxation group, the CBT group showed more improvement in ADHD symptoms (using the Clinical Global Impression Scale) and many maintained the improvement over the course of the next year.
Dr. Safren does not suspect that CBT will replace medications such as Ritalin as first-line treatments for ADHD. "ADHD is a neurobiological disorder, but this might help in addition to medication and we may be able to do this in people who can't tolerate drugs," he said.
There are many avenues of support for adults with ADD/ADHD. Professionals trained in the disorder can help patients control impulsive behaviors, get and stay organized, manage time and money, and communicate more clearly. Support groups, behavioral coaches, and professional organizers can also help support therapy sessions by giving encouragement and practical solutions.
For self-help strategies to manage ADD/ADHD symptoms, Helpguide.org offers the following tips:
• Take care of yourself – exercise, eat right and get plenty of sleep. Exercising can help work off extra energy and aggression in a positive way and limiting junk food can help with mood swings and feelings of fatigue. Try to get 7-8 hours of sleep each night because being tired makes it more difficult to focus.
• Practice better time management – use a calendar and to-do list to set deadlines and priorities for everything you do, even small tasks. Use timers or alarms to stay on track, and take regular breaks. Break down large and overwhelming projects into smaller chunks. Avoid procrastination by handling items as they come in – either deal with it, file it, or toss it.
• Create a supportive environment – relationships can become strained when one partner has ADD/ADHD. Cultivate positive relationships with those close to you and help them understand the struggles you are facing. At home and work, organize your space so you can find things when you need them, reducing frustration and the tendency to procrastinate. Learn to recognize stressful situations and have a plan to respond to those more effectively.
"Cognitive Behavioral Therapy vs Relaxation With Educational Support for Medication-Treated Adults With ADHD and Persistent Symptoms"
Steven A. Safren, PhD, ABPP; Susan Sprich, PhD; Matthew J. Mimiaga, ScD, MPH; Craig Surman, MD; Laura Knouse, PhD; Meghan Groves; Michael W. Otto, PhD; JAMA. 2010;304(8):875-880. doi:10.1001/jama.2010.1192