Managing ADHD: Medication, Psychotherapy, and the Potential of Music Therapy
The ABCs of ADHD
ADHD is a prevalent neurodevelopmental disorder that primarily manifests in childhood and often continues into adulthood and is characterized by difficulties in maintaining attention, controlling impulsive behaviors (acting without considering the consequences), and excessive levels of activity.[1] It impacts approximately 11 percent of children attending school; in over 75 percent of cases, symptoms persist into adulthood. Although individuals with ADHD have the potential for success, it is crucial to identify and treat the condition appropriately and in a timely manner. Without proper intervention, ADHD can lead to significant consequences, including academic difficulties, strained family relationships, emotional distress, challenges in forming and maintaining social connections, substance misuse, involvement in delinquent behaviors, accidental injuries and difficulties in employment. Early identification and timely treatment play a vital role in mitigating these potential effects.[2] There are a number of intervention methods for people who experience symptoms of ADHD.
Common Treatments
Two common treatments for ADHD include medication and psychotherapy.
Medication
ADHD medication is used to address the symptoms such as hyperactivity and impulsiveness.[3]
Types of ADHD Medication Include:[4]
Stimulants
Non-stimulants
Antidepressants
Stimulants, such as medications containing methylphenidate or amphetamine, are the usual primary prescriptions for ADHD. These stimulants seem to enhance and stabilize the levels of neurotransmitters, which are brain chemicals responsible for various functions.[5] However, stimulants are classified as controlled substances, implying that they possess the risk of being misused or leading to substance use disorders.
Additional medications utilized in ADHD treatment consist of non-stimulant options (e.g., atomoxetine) and certain antidepressants (e.g., bupropion).[6] While non-stimulants are prescription medications, unlike stimulants, they are not classified as controlled substances. As a result, the risk of improper use or dependency is lower with non-stimulant medications. These medications function by elevating the levels of norepinephrine in the brain. Healthcare providers may prescribe non-stimulant medications either on their own or in conjunction with a stimulant for managing ADHD.
Antidepressants are also used to treat symptoms of ADHD. The antidepressants commonly prescribed for ADHD primarily target the levels of dopamine and norepinephrine in the brain.[7] While atomoxetine and antidepressants have a slower onset of action compared to stimulants, they can still be viable choices when stimulants are not suitable due to health issues or when the side effects of stimulants are too severe for someone.[8]
Psychotherapy
Psychotherapy is frequently utilized alongside medication to address mental health conditions. Depending on the situation, medication might be the more appropriate choice in some cases, while psychotherapy may be the preferred option in others.[9]
Psychotherapy can assist people with ADHD in various ways:[10]
Enhancing time management and organizational abilities
Teaching techniques to minimize impulsive behavior
Fostering improved problem-solving skills
Dealing with past academic, work, or social challenges
Boosting self-esteem
Learning methods to strengthen relationships with family, co-workers, and friends
Developing strategies to manage anger effectively
The typical forms of psychotherapy for ADHD treatment include cognitive behavioral therapy (CBT), marital counseling and family therapy. CBT involves a structured approach to teach skills for behavior management and transforming negative thought patterns into positive ones. It aids in handling life challenges like school, work, or relationship issues and also addresses other mental health conditions such as depression or substance misuse.[11] Marital counseling and family therapy aim to assist family members in coping with the challenges of living with someone who has ADHD. They provide tools and techniques to improve communication and problem-solving skills within the family dynamic.[12]
Music Therapy
There is another form of psychotherapy that can be utilized for treatment of the symptoms of ADHD known as music therapy. Music therapy is a form of psychotherapy that follows a systematic process of intervention. The therapist employs musical experiences and the relationships that evolve from them as dynamic catalysts for promoting health in the client.[13]
During a music therapy session, a patient may:[14]
Create music
Sing music
Listen to music
Move to music
Discuss lyrics
Play an instrument
Music plays an inherent role in the human experience, eliciting responses related to pulse, rhythm, breathing, movement and a wide array of emotions. These deep connections with music can persist even in the face of disabilities and illnesses. As a result, music therapists and counselors can effectively use music to assist individuals, both children and adults, who have diverse needs arising from various causes such as learning disabilities, mental and physical illnesses, physical and sexual abuse, stress and terminal illnesses. Through interactive musical experiences, emotional, cognitive and developmental needs can be addressed.[15] The ADHD brain exhibits reduced levels of dopamine, a neurotransmitter that plays a crucial role in motivation, attention, working memory, and focus. Music has the unique ability to activate both hemispheres of the brain, facilitating comprehensive brain engagement, allowing the activated components to collaborate more effectively and potentially strengthen over time. Consequently, this process enhances motivation and improves the capacity to concentrate.[16]
A number of studies have highlighted the positive effects of music therapy on people with ADHD. One study conducted by Zhang et al. (2017) aimed to assess the effectiveness of music therapy in improving attention, behavior, and social skills in children and adolescents with ADHD. Music therapy was associated with a significant reduction in hyperactivity and impulsivity, and improvements in attention, social skills, and academic performance.[17] Another study by Park et al. (2023) investigated the effects of music therapy as an alternative treatment on depression in children and adolescents with ADHD by activating serotonin and improving stress coping ability. The results showed that both music therapy and pharmacotherapy were effective in reducing depression symptoms.[18]
If you are interested in finding out if Music Therapy can benefit you, you can access the American Music Therapy Association’s provider link here.
If you or someone you know has or suspects that they have ADHD, please reach out to a licensed mental health professional (e.g., a psychotherapist, psychologist or psychiatrist) for guidance and support.
Contributed by: Ananya Kumar
Editor: Jennifer (Ghahari) Smith, Ph.D.
References
1 Centers for Disease Control and Prevention. (2022). What is ADHD?. CDC.
2 Children and Adults with Attention-Deficit/Hyperactivity Disorder. (2023). About ADHD - Overview. CHADD. https://chadd.org/about-adhd/overview/
3 Mayo Clinic. (2023). Adult attention-deficit/hyperactivity disorder (ADHD). https://www.mayoclinic.org/diseases-conditions/adult-adhd/diagnosis-treatment/drc-20350883#:~:text=and%20certain%20medications-,Treatment,they%20don%27t%20cure%20it
4 Cleveland Clinic. (2022). ADHD Medication. https://my.clevelandclinic.org/health/treatments/11766-adhd-medication
5 Mayo Clinic
6 Ibid.
7 Cleveland Clinic
8 Mayo Clinic
9 Bhatia, Richa. (2023). What is Psychotherapy?. American Psychiatric Association. https://www.psychiatry.org/patients-families/psychotherapy
10 Mayo Clinic
11 Ibid.
12 Ibid.
13 Zhang F, Liu K, An P, You C, Teng L, Liu Q. Music therapy for attention deficit hyperactivity disorder (ADHD) in children and adolescents. Cochrane Database Syst Rev. 2017 May 2;2017(5):CD010032. doi: 10.1002/14651858.CD010032.pub2. PMCID: PMC6481398.
14 Music Therapy. (2020). Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/8817-music-therapy
15 Zhang (2017)
16 Attention Deficit Disorder Association. (2022). Can Music Therapy Help with ADHD?. ADDA. https://add.org/can-music-therapy-help-with-adhd/
17 Zhang (2017)
18 Park, J. I., Lee, I. H., Lee, S. J., Kwon, R. W., Choo, E. A., Nam, H. W., & Lee, J. B. (2023). Effects of music therapy as an alternative treatment on depression in children and adolescents with ADHD by activating serotonin and improving stress coping ability. BMC complementary medicine and therapies, 23(1), 73.