DBT for Attention Deficit Hyperactivity Disorder (ADHD)

Have you ever felt like your brain is going a million miles an hour, and it’s impossible to focus on anything? If this sounds familiar to you or is something you observed in others, then it might be Attention Deficit Hyperactivity Disorder (ADHD). Here, we’ll explore how dialectical behavior therapy (DBT) for ADHD can be a powerful tool for managing symptoms and improving overall well-being.

DBT for ADH

ADHD is a condition that is characterized by long-term and significant patterns of inattention and/or hyperactivity and impulsivity. Some common symptoms that both children and adults exhibit may include difficulty with attention, issues with attention to detail, difficulty waiting, excessive speaking, forgetfulness, fidgeting, and more.

To be diagnosed with ADHD, these symptoms must be present before the age of 12 and significantly affect several areas of life, such as school, work, or home. ADHD can range between mild and debilitating and can harm one’s quality of life.

DBT has received more attention in recent years for its benefits in treating ADHD. It shows great potential in treating the emotional dysregulation and impulse control issues that often present in people with ADHD. Since DBT focuses on skills such as emotion regulation and distress tolerance skills, it is fit to treat those with an ADHD diagnosis.

How DBT Works for ADHD

DBT was not specifically designed for ADHD; in fact, it was originally created for patients who had borderline personality disorder. However, many of its principles and strategies can be adjusted to address the unique challenges associated with ADHD and manage its symptoms.

DBT can target some of the common difficulties experienced by individuals with ADHD, including:

• Emotional dysregulation. Individuals with ADHD, including ADHD in children, struggle when it comes to managing their emotions. This results in mood swings, impulsivity, and interpersonal conflicts. DBT skills like emotion regulation, mindfulness, and distress tolerance can help individuals of all ages better understand and cope with their emotions.
• Impulsivity. Impulsive behavior is central to ADHD and can result in negative consequences in various aspects of life. DBT emphasizes mindfulness and distress tolerance, which can help people with ADHD pause before acting on impulses so they can make more well-thought-out decisions.
• Interpersonal difficulties. ADHD can also affect social functioning. This can lead to challenges in communicating effectively and maintaining relationships. DBT also focuses on interpersonal effectiveness as a skill, which can help individuals navigate social situations better.

DBT Skills for ADHD

What exactly are DBT skills? These are DBT modules for ADHD or tools that one can develop and use to better cope with different challenges.

Mindfulness

Mindfulness skills are about being grounded in the present moment while focusing on your current situation. Regularly practicing mindfulness can help you stay grounded and increase your focus. By doing this, you can recognize your impulsive behaviors and fluctuating emotions, allowing you to cope ahead for future stressors.

Related: 7 DBT Mindfulness Exercises to Help Control Your Emotions

Distress Tolerance

Many of our worst emotions can seem unbearable or intolerable, which can influence us to make hasty decisions. Distress tolerance gives you tangible skills like guided self-soothing and other easy-to-use methods that activate your parasympathetic nervous system to reduce distress. It gives you space from the emotion so that you can choose balanced behavior.

Emotion Regulation

Inconsistent self-care and dysregulated emotions can exacerbate ADHD symptoms. DBT emotion regulation skills, which can be found in DBT for adults or DBT for kids, help you stop unwanted emotions from appearing, help you regulate or change them when they start, and learn how to accept and be comfortable with them. Skills for emotion regulation also involve prioritizing balanced diets, sleep, exercise, and prescription medication age, all of which can reduce the symptoms of ADHD.

Interpersonal Effectiveness

Those with ADHD can sometimes struggle with ineffective social behaviors that can negatively affect relationships. DBT for teens and adults can help in learning how to be a good friend and keeping friends through this interpersonal skill. It provides clear instructions on maintaining relationships with others, asking for what you want, and preserving your self-respect. This skill also allows you to head off problems and resolve conflicts before they become overwhelming.

In several studies, DBT skills training has been found to improve many conditions.

Is DBT Effective for Managing ADHD Symptoms?

While research is still being done on the use of DBT for ADHD, there have been some studies that show its effectiveness.

For example, one study explored the treatment of ADHD in teens who participated in a DBT-based skills training group. Findings showed that participants with higher impulsivity, hyperactivity, conduct problems, and emotional dysregulation benefited from the DBT intervention [*].

Another study found that adults with ADHD who were recipients of a 14-week DBT-based group treatment significantly improved in different areas, such as ADHD symptoms, executive functioning, and overall quality of life [*]. This was compared to participants receiving treatment as usual. The observed improvements were maintained even after a six-month follow-up.

How Long Does it Take to See Results from DBT for ADHD?

The timeframe for seeing results from DBT for ADHD can vary depending on several factors, including the severity of ADHD, commitment to therapy, and individual differences.

Some general guidelines can help you set realistic expectations:

• Initial benefits. Some people report feeling a sense of validation and improved emotional regulation skills within the first few weeks.
• Skill development. Learning and mastering the core DBT skills (mindfulness, distress tolerance, emotional regulation, interpersonal effectiveness) can take several months of consistent practice.
• Symptom reduction. Significant reductions in ADHD symptoms like inattention, impulsivity, and hyperactivity might take three to six months or longer, depending on the factors mentioned above.

Remember, DBT is a long-term therapy approach. While initial changes can be encouraging, consistent practice is key to sustained improvements in managing ADHD and its impact on your life. Discussing your progress and expectations with your therapist throughout the process is important.

Are There Risks and Side Effects Associated with DBT for ADHD?

DBT is generally considered a safe and effective treatment for various mental health conditions, including some ADHD symptoms. However, it's important to understand that it's not without some potential challenges.

DBT can be intensive, requiring regular therapy sessions and consistent practice of the learned skills on your own. This commitment can be demanding for some individuals. It may also involve confronting difficult emotions and past experiences. While this ultimately leads to growth, it can be uncomfortable in the short term.

DBT also emphasizes changing unhelpful behaviors and thought patterns. This can be challenging, especially when dealing with ingrained habits or long-standing emotional responses.

The success of DBT heavily relies on a strong therapeutic relationship. Finding a therapist you feel comfortable with and who specializes in DBT for ADHD is crucial.

It's important to note that these are not necessarily side effects but rather potential challenges that can arise during DBT therapy.

The Bottom Line

So, is DBT good for ADHD? Of the various ways that ADHD is treated, DBT stands out for its ability to treat the emotional, behavioral, and interpersonal difficulties that come with the condition. DBT and ADHD go hand in hand and can help individuals by better managing their symptoms and enhancing their general functioning by teaching them skills like mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.

Although further research is required to determine DBT's full efficacy in treating ADHD, the data we have suggests that it can serve as a beneficial supplement to a comprehensive therapy strategy.

For more tools on DBT, feel free to check out our printable DBT worksheets, which are visually engaging and relevant for kids, teens, and adults. We also offer ADHD resources that target the primary executive function deficits found in ADHD, but are not related to DBT treatment.

References:

1. Meyer J, Zetterqvist V, Hallerbäck M, et al. Moderators of long-term treatment outcome when comparing two group interventions for adolescents with ADHD: who benefits more from DBT-based skills training? 6 December 2022.
2. Halmøy A, Ring A, Gjestad R, et al. Dialectical behavioral therapy-based group treatment versus treatment as usual for adults with attention-deficit hyperactivity disorder: a multicenter randomized controlled trial. 28 November 2022.