Treating ADHD

Medication can help our brains react differently, but therapy can help us feel differently about ourselves and therefore allow us to work towards more ambitious goals and improve our self-esteem.

Treating ADHD

Most clinicians would agree that the most effective solution to treat the core symptoms of ADHD and ADD is to use a combination of different approaches.

1. Medication is recognised as the ‘first-line’ treatment for ADHD / ADD – it is recommended by NICE (the UK’s body who determine the best treatments for health conditions¹).
2. Talking therapies, such as CBT, can also be very helpful and effective for those adults diagnosed as having ADHD. CBT can teach valuable coping strategies that can help the individual overcome some of the challenges associated with ADHD, like difficulties focusing and being disorganised.

¹ NICE Guidance

Therapy for ADHD

For adults who have spent years not knowing they have ADHD, it is common to develop low self esteem and a negative set of beliefs about yourself. You may have always felt that you were somehow in the wrong, badly behaved or useless at doing things. These negative beliefs can become firmly set in our minds and can be hard to change – which is where therapy can be highly effective.

Behavioural therapies, like CBT, challenge the truth behind our negative thought distortions and can help us develop new and healthier internal dialogs with ourselves.

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CBT for treating ADHD

The basis of CBT is to look at the thoughts that dictate our behaviours and challenge the thoughts that aren’t helpful or simply aren’t true. People with ADHD / ADD may have suffered with more setbacks in life than the general population; these setbacks may have resulted in developing a very negative or pessimistic set of beliefs.

If you have the following thought characteristics, it might be that CBT can be useful for you.

1. Overgeneralising things – “I’m always late, you can’t trust me to get there on time”
2. Fortune telling – “I know things will go badly at the meeting, they always do”
3. Should statements – “I should have achieved more by now”
4. Comparisons – “Other people could easily do that, I’m just useless”

CBT can therefore help those Adults with ADHD to:

• Improve necessary executive functions such as time management, organisation and planning skills
• Coping mechanisms for dealing with problems areas are taught, for instance breaking large, unpleasant tasks down into smaller, manageable components
• Improve emotional regulation, impulse control and stress management
• Help deal with the common comorbidities that accompany ADHD, such as anxiety and depression
• Limit behavioural symptoms
• Help deal with frustration caused by family members and others
• Teach the individual about their symptoms and how their medication works, which can help medication compliance

We are not only physical beings but more important – psychological ones. An holistic approach needs to bear this in mind if we truly want to achieve a comprehensive recovery. Therefore, counselling – whether CBT or more focused on emotions – alongside the medication ensures that we are addressing the problem in a comprehensive manner and making the best out of the treatment for ADHD / ADD.

Dr Pablo Jeczmien

MD MRCPsych

Consultant Psychiatrist

Brighton

Dr Pablo Jeczmien is a Consultant Psychiatrist in General Adult Psychiatry for the Sussex Partnership NHS Foundation Trust. Dr Jeczmien has a medical degree and is a Member of the Royal College of Psychiatrists.