ADHD and Depression

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!

index.html

I agree with all the advice you've already been given.

Strattera would be the ADD medication with the lowest potential for abuse. It has - for my son anyway - a nice antidepressant effect. I think that effect is believable since Strattera is similiar to the antidepressant Wellbutrin (which also occasionally prescribed for ADD, by the way).

The other stimulants are not effective as antidepressants except for the relief of not dealing with so much distraction. The stimulants can, in fact, cause more moodiness.

There's one thing I'd want you to be aware of it you do start stimulants. Although at a low dose, you won't experience euphoria, there's a good chance that you'll have a nice feeling of well-being. That feeling won't last. You absolutely can not keep increasing your dose to get that feeling back. That's the path that leads to addiction.

Let us know what you decide!

addprogrammer

diamondgirl,

You just got the best education possible from Thunor, Jane and Index. There is no shrink, no book, no school, no amount of dough can buy you better.

I can't add a thing except validation. I went into rehab for meth addiction.

Some of us just plain suck at being our own doctors. We don't know what we are doing and get both the med and dose wrong. We don't even know when we're doing it that we are playing doctor. We are trying to fix a medical problem we do not know we have. We are miserable and think we are nothing more than underachieving losers. Then we find temporary relief in a high. Most of us quickly discover the price is more than we are willing to pay and get help and get over the addiction.

Now it is time for you to get help with the real problem. Even though it has been mentioned, it bears repeating, be careful and take precautions with stimulants. We think they work immediately because they immediately make us feel good. It took only a few days for the "feel good" to vanish in my case. "Oh, no, it's not working anymore" can lead to resuming our tried and proven buzzological methods.

Bob

diamondgirl19

I saw my psych again today and he thinks it's too risky to put me on any type of stimulants since I have a habit of self medicating and also because we haven't figured out the right antidepressant yet. I started Wellbutrin a week ago so we don't know if it's working yet. My doc did tell me that it does have some ADD med qualities so that is good. I really have to trust my doc. He has experience treating addiction, depression and ADD. I do think my daily life would improve with the medicine but it's too risky right now and that sucks. But I got myself into this mess.

Thank you all for your help. I will keep you updated if anything changes.

addprogrammer

Wellbutrin is a good choice. Good decision.

Sometimes we need a few years between stimulant meds and our last fling. Plus there is fairly good possibility Welbutrin will do the job for you. No need then to risk playing with fire.

Yes, keep us posted.

index.html

I agree. Wellbutrin is a good choice for you. Many docs are now prescribing it for ADD, even in the absence of depression. I wish you the best of luck.

Editing to add: I don't know if you smoke or not, but if so, now is a good time to try to quit. Welbrutrin is also sold under the name of Zyban - an aid to beating the smoking habit.

diamondgirl19

Here is my update. Any advice is greatly appreciated. I am at a loss at the moment. I have been taking Wellbutrin for almost 3 weeks and Psychiatrist is ready to increase dose to 450mg this week. I don't feel better or worse. I do have some side effects (dry mouth, anxiety, very forgetful and very emotional and weepy). This is 3rd antidepressant that seems to not be working but doc wants to keep plugging along. Every visit he looks at my chart and brings up the likelihood of ADD and how he would like to put me on ritalin but he can't because it's too risky. It's extremely frustrating listening to this because part of me wonders if it's the ADD that's making me depressed. Or is this not possible? I have been on 3 different antidepressants during the past 5 months and nothing has worked, not even slightly. I have always been a very impatient person wanting a quick fix. I have only been seeing this doc for 2 months and he wants me to slow down and try to be more patient. When I was abusing pain meds, i got a quick fix. But it's very difficult to take it slow when tv commercials make you cry on a daily basis. Any suggestions would be appreciated. Thanks.

Thunor

I'm afraid my only advice is take it slow. I don't have extensive experience with antidepressants, but the experience I do have is that they take time to work. Give the Wellbutrin at least four to five weeks before passing judgement.

You say this is the third antidepressant med you've been on that hasn't worked, which others have you taken? How long were you on them? I apologize if you mentioned this before, I did scan the rest of the thread to see if I could find out, but it's early; I'm only on my second cup of coffee and my Ritalin hasn't kicked in yet. Wellbutrin works on different neurotransmitters than some other antidepressants, and I would be interested to see what classes of meds you've tried.

As far as the stimulants, they may indeed help, but that has to be between yourself and your doctor. We've covered the potential benefits and risks previously.

In the meantime, take strength from anywhere you can find it, whether it be from here or elsewhere, and do your best to give it time. Think things through before you give up, going back to old habits won't help, give the new habits time to do their thing.

diamondgirl19

I was previously on Cymbalta. Started at 30 mg a day and went up to 120 with no positive results. Then tried Celexa. I think I started at 20 mg and went up to 40 mg before doc wanted me to stop and start taking Wellbutrin. Part of my frustration is how slowly I have to increase to get to the point to determine it's ineffectiveness for me and then how slowly I have to ween down to get off it. It's about a month and a half process which seems like forever when I'm not getting better. I'm not considering going back to pain medication. I spent too long caught in that nasty spriral. Like Suboxone was a magic pill to take away withdrawals, I wish there was a magic pill to make me feel better. Thanks for listening.

Thunor

Trust me, I think most of us understand the longing for a quick fix or a magic pill. Don't think you're weak or adnormal for wanting that. Alas, we're all in the same boat playing the waiting game, looking for support and small improvements where we can find them.

We're always here to listen.