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  • Q&A with Australian Health Practitioners

    What is the best treatment for Adult ADD?

    Related Topics
    Anxiety Attention Deficit/Hyperactivity Disorder Mental Health
    Adult ADD is often accompanied by depression / anxiety, PTSD, ODD etc. Is there a treatment for ADHD that would also effect these other (comorbid or secondary disorders)?
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    Dr Tim Edwards-Hart

    Clinical Psychologist, Psychologist

    Dr Tim Edwards-Hart is a clinical psychologist working with adults, young adults and adolescents (age 15+). He has expertise assessing and managing ADHD, anxiety, and … View Profile

    You are certainly right in identifying the range of other conditions that are associated with adult ADHD. Whether or not they will respond to treatment of ADHD depends on the individual and what else is impacting their mental health. Effective treatment of ADHD will usually help address the symptoms of other conditions. Even if it doesn't directly affect their symptoms, by reducing the impact of ADHD then the person involved is better able to address those other conditions.

    In terms of what treatment is best for ADHD, there is no single answer that will apply to everybody. For example stimulant medication works very well for about 80% of people, but that means there are 20% for whom it doesn't work. As a general rule though, the recommended first line treatment for ADHD is twofold: medication to address the biological aspects of ADHD along with psychological therapy such as Cognitive Behaviour Therapy to address the behavioural aspects and the long-term psychological impact of ADHD (especially if it wasn't diagnosed until adulthood).

    The best way of addressing ADHD and any accompanying conditions is to arrange for a thorough assessment by a Psychiatrist or a Clinical Psychologist with specialist expertise in ADHD. They can work with you to identify the most pressing areas to address and the types of therapy that will be most likely to benefit you.

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    Dr Peter Heffernan

    Psychiatrist

    I am a Consultant Psychiatrist and Psychoanalytic Psychotherapist who specialises in Adult ADHD, Jungian Psychotherapy, and the Psychological Medicine aspects of Chronic Pain conditions. View Profile

    The most important treatment of conditions associated with ADHD is actually the optimal treatment of the ADHD itself, usually with optimal doses of either dexamphetamine or methylphenidate (misleadingly referred to as 'stimulants' by some, in spite of the fact that ADHD sufferers find these medications calming, not stimulating). The Current Symptom Barkley Scale is the recommended screen for treatment monitoring, and is readily available online. If symptoms are evident on the Barkley Scale, then treatment is not optimal. Atomoxetine, from a different medication class, is potentially a very helpful additional treatment, we await sustained release guanfacine here in Australia, clonidine is on the list, but often disappointing in my clinical experience. 

    Depression often fades once optimal ADHD treatment is in place, so-called 'anxiety' is often actually the agitation symptom of undertreated ADHD, and resolves when the ADHD medication is optimised. 

    Should the conditions associated with ADHD still be evident with optimal ADHD medication treatment I recommend the conventional treatments for the associated condition. Substance use disorders require 'anti craving' medications, SSRI for true anxiety and depression, mood stabiliser medication for Bipolar Disorder, etc, etc

    Psychotherapy, of whatever 'school' appeals to patient and therapist is very valuable in assisting with the self esteem, confidence and relationship issues so very often blocking the ADHD person from connecting with their full creative potential. 

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