ADHD and Depression

[diamondgirl19]

I have never posted on this board. I found this website because I was addicted to pain killers. It was a life saver for me. I have been clean since March 1st. I have also been seeing a psychiatrist since March. I didn't know it but I was very depressed. I thought the way I was feeling was normal. I am now taking my 3rd different antidepressant because the first 2 didn't work for me. Here's my question. My psychiatrist and I recently discovered that I have ADHD. It's not severe and I don't work so it's not affecting job performance or anything like that. My doctor would like to put me on a stimulant but he is afraid because I have a history of abusing medication. Pain killers aren't the only drug I abused. When I quit opiates I was put on Suboxone and I also took too much of that. I actually felt nothing from it but I think I was craving something to just make me feel better (depression). I read in someone's post that they took Adderall for depression. Now I am wondering if it would work for my depression since I also have ADHD. I wonder if I am depressed because I have ADHD. I really don't think it's why I'm depressed but I am wondering if ADHD and depression go hand in hand. I have all my medication under control at this time. I started taking a new antidepressant a week ago so I don't know if it will work for me yet. But I would like to be prepared if it doesn't. Do ADHD meds make you feel good? Do they make you want to take more? Do they help with depression? Do you think it would be a serious mistake for me to try these meds given my addictive nature?

Thanks for reading and for any and all information you can provide to me.

[Thunor]

Diamondgirl,

Unfortunately yes, there is potential for abuse and addiction with most ADHD meds, including Adderall. Most ADHD meds are stimulants in the amphetamine family, and will give you a "high" if you take too much. If you have a history of addiction, be very careful about ADHD medications, especially Adderall. You may have some success with Strattera which is a non stimulant medication which has recently been introduced for treatment with ADHD, but I know little about this medication, so I can't give you a lot of details about efficacy and such.

All that said, you should discuss with your psych the fact that people with ADHD are prone to addiction because a large part of ADHD is sloppy impulse control. The part of your brain that controls your impulses is hypoactive, leading you to make poor decisions, including the decisions to take too much medication. It's kind of ironic, the best way to treat a condition that makes you prone to addiction is with potentially addictive medication.

Do you live with someone you can trust? Parents, siblings, significant other? One way to avoid abusing meds, especially ones you need only once a day (such as the SR and XR variants of ADD meds) is to have someone keep them for you so you can't take more than one at a time. Another thing is to have your doctor prescribe carefully, ensuring that you're not back for more in half the expected time (though there are ways around both if you're desparate enough, I know).

To answer your original question, I was once told by a psychologist that stimulants were the way depression was treated prior to Prozac, and they're still used for depressions that don't respond to traditional antidepressants, so Adderall may work for your depression as well as your ADHD.

[janewhite1]

Whether stimulants would be safe for you, with your history of addiction, I can't say. However, as Thunor mention, there are ways to reduce the risk.

Another question is, are you having problems as a result of ADHD? What does a typical day for you involve? Do you struggle with losing things or forgetting tasks frequently? Do you have trouble doing whatever it is you do?

If the answer is yes, then you might benefit from ADHD medications, but if ADHD isn't causing you stress and chaos, then why medicate it?

[diamondgirl19]

ADHD causes me to forget a lot of things. I have a huge problem focusing. It's impossible for me to get through a book. Ever since I started wearing glasses a couple of years ago, they have distracted me and now I think also ADHD distracts me. I am extremely forgetful. People tell me things all the time and I have little or no recollection within minutes. I have piles of papers in my home office because I can't stay on task. I am very easily bored. I can't watch a movie with my husband because I can't focus that long and he gets frustrated with me when I start fidgeting. When cleaning the house I will walk into a room to get something and then see something else I need to do and then forget the reason why I was in that room in the first place.

Do these things affect my daily life? Absolutely. But I am a stay at home mom and I don't work. I will function without meds. But after reading the posts on this board, I wonder about the person I could become. But it's not worth an addiction to me. I spent 3 years caught in a spiral and I'm not willing to go back. My psychiatrist told me that in his over 20 years of experience, he only had 1 patient that abused the meds. But from what I have read, I would think the percentages are higher.

[janewhite1]

Ah, that is a different matter. It does sound as if you might benefit from medication. Strattera probably has the lowest risk of addiction, as in I've never heard of it happening ever. It does take a few weeks to a couple months to start working, though.

The risk of addiction from the stimulants really is small. Most people who get addicted to prescription drugs do so because they deliberately misuse them, taking in a prescribed manner and getting hooked by accident is pretty rare. What can get you in trouble with the stimulants is if you start taking them as a substitute for sleep.

So, if you go that route, use the lowest effective dose. It should not cause euphoria or anything, the perfect place to be with the stimulants is where you feel normal, like yourself, just yourself having a particularly productive day. My Adderall XR, 5 mg has about the same effect on me as one cup of coffee sipped throughout the workday. Most adults are on doses higher than that, I just happen to be particularly sensitive to stimulants.

I support Thunor's suggestion of letting someone else hold the medication, if you aren't sure you can trust yourself. Also, skipping at least one day per week helps prevent you from developing physical tolerance to the drug.

Now, whether you choose medication or not, you might benefit from ADHD coaching. This isn't counseling, it's coaching. Counseling is about your feelings (and it can be very helpful) but coaching is learning about how ADHD affects you and learning ways to work with it. Six months or so of ADHD coaching did more for me than years of tutors and therapists, because my coach understood why I was having the particular problems I was, and showed me better ways to manage.

Also, do you have kids with ADHD? It's possible that what you learn could give you better ways to parent them!