25 ms·

Association between ADHD medication and depression: A 10-year follow-up

168 points by imperio59 4y ago

frigate 4y ago
This study focused specifically on methylphenidate, one of many medications prescribed for ADHD. The title should be adjusted accordingly, as the current title is ambiguous and potentially misleading.
- pflats 4y ago
  The study also does not claim to show a causal relationship.
  - citilife 4y ago
    I was actually going to point that out. IMO from what I've seen of parents are that people who bring their children at a young-ish age to a therapist have a different issue. Especially "being to hyper" or "being unable to focus" have a different issue. Children are supposed to be outside moving 8-12 hours a day, have you seen puppies? They need something similar. Instead many parents give their children tablets, plop them in front of the TV and do something else. Kick them into the back yard or go throw a ball with them. Every child I know diagnosed with ADHD had parents who didn't want to deal with them. Bringing them to the gym, to the park, playing in the backyard; it's a lot of work. Kids who have trouble focusing are likely tired and overstimulated. Reduce the number of toys, remove TV / tablets, and send them outside. It'll probably solve itself. As an experiment, look at the people you know on medication (or ask), look at the troubled children, etc. I guarantee you'll see the same trend: single parent home, started medication at an early age, regular therapist appointments, etc. They're unhappy and need depressants, ADHD medication, etc. It's not always the case, but it's a trend. People who are diagnosed with ADHD at a younger age likely have parents who just don't want / know how to deal with issues. Mental health "experts" treat the symptoms via medication, but the underlying issue(s) just continue to fester. What we really need is a strong emphasis on family development, courses built around it and support groups. Parents naturally do this, but I think it's been severely broken down the past 50-60 years and is getting exponentially worse. As such we see more: single parent homes, abundance of medication, reduction in religion and adult social clubs, etc.
    - zrail 4y ago
      So it feels to me that you're saying ADHD doesn't exist and it's a matter of parental failure or indifference. Do I have that right?
      - nominusllc 4y ago
        I have ADHD, and increasing eustress by working out or doing fun physical things like sports to the point of being tired is one thing that is better than anything I've been prescribed. It's not fall asleep tired, it's more akin to being physically spent. When there is no more need to fidget and do things, I focus like a laser and am less prone to impulse.
        adastra22 4y ago
        Great it works for you. You probably have the hyperactive type of ADHD. For me and my daughter with inattentive/non-hyperactive ADD, doing physical things, while fun, just make us tired and want to sleep. Not a good idea if you need to focus and get work done. I take daily medication and it has been literally life saving as I was able to turn things around and keep my marriage from falling apart, not to mention my happiness from being able to accomplish much, much more. I'm holding off medication for my daughter only because it lessens appetite and she is very skinny already. Once she's grown to her full height we'll get her meds she can use too.
        nominusllc 4y ago
        I feel for you, I hope you guys settle on something that works with as little sides as possible. It's a spectrum with a lot of means to address a moving target, so some trial and error unfortunately comes with it. Luckily I was able to work with my doc to find things that work for the things that eustress cannot solve. Just curious, what do you take?
      - davemp 4y ago
        I don’t see how you are getting that from OP’s comment. OP seems to be claiming that ADHD is often over diagnosed and/or treated improperly. A viewpoint shared by people I know in the field.
  - jobu 4y ago
    As the parent of a child with ADHD that is medicated, it seems completely plausible that it could cause depression. When my kid has had too high a dosage (or accidentally takes a double dose) she's like a zombie, completely flat affect, and very little motivation. It's like it drains her life away. Part of the problem is that it's very difficult to get the right dosage for any given day because diet, metabolism, and hormones seem to have a big impact on how effective it is. We've found it's better to go with a lower-dose extended release, and then let her self-medicate with 5mg regular tablets as needed. This works great now because she's a fairly responsible teenager (when medicated), but it was really hard when she was younger.
    - adastra22 4y ago
      What is she taking?
      - jobu 4y ago
        It's changed a few times over the years because of insurance, but right now it's Focalin XR and 5mg Ritalin as needed up to 2 times a day.
        adastra22 4y ago
        Thanks!
    - krono 4y ago
      I share this experience myself, in particular the dosage not providing a consistent effect day to day - every specialist I've spoken has told me this is weird and shouldn't be happening and yet it is so. Switching to staged release medication (Medikinet CR) has helped me too. Unfortunately extended release Methylphenidate of any kind/brand is only partially covered by Dutch health insurance[1], and I'm certain the cost is prohibitive for people who might be less well off. 1: In essence, the government has determined that all Methylphenidate variants are equal, and so you can just take the cheapest instant release variant or else pay the difference out of your own pocket.
    - 4y ago
- calvinmorrison 4y ago
  Common brands: Quillivant XR, Daytrana, QuilliChew ER
  - kayodelycaon 4y ago
    It's marketed as Ritalin and Concerta in the US. Wikipedia has quite a lot of information on it: https://en.wikipedia.org/wiki/Methylphenidate https://en.wikipedia.org/wiki/Methylphenidate
ALittleLight 4y ago
- echelon 4y ago
  Nor is the structure of life after school. (Offices? 9 AM start times?) Kids with ADHD can go on to find incredible success in breaking the rules.
  - Avamander 4y ago
    Sure they can, people endure and cope with a lot of things. That's a really low and unnecessarily painful approach though. They could do even better, do things they want to do, when they aren't hindered as much by the disorder. I really think the comparison with glasses is apt, sure someone can squint their eyes and sit a bit closer at times, but why should they? We'd call it neglect to force someone to cope with bad eyesight without correction. Now you're talking about some ADHD kids doing well breaking the rules, so it's fine not to help? Eugh. Do you know how many without help end up with incredible failure? Teen pregnancies, accidents, addiction, depression? It's more likely to be bad. I really wish this discussion would revolve around helping, not potentially forcing coping.
    - falcolas 4y ago
      Especially with the plethora of evidence about how much harm "masking" can cause for a neurodivergant individual. Because that mask can never really be taken off.
    - echelon 4y ago
      I don't know where you're going with your comment. I didn't say anything about whatever you're implying. You might be responding to a different person? ADHD kids can take medicine, but the rest of the world can also lighten up. That's my point. The rules and benchmarks are stupid and impose unnecessary stress on ADHD individuals. Over half of the time you can ignore it and be fine.
- giraffe_lady 4y ago
vorpalhex 4y ago
This was for ONE adhd medication and the risk was only increased for the initial 90 days... and then went back to baseline.
- jimmygrapes 4y ago
  Should also note that the return to baseline was only after discontinuation of the MPH. Can't really tell if it would return to baseline if the medication was continued without digging into the study more than I have so far. Also worth noting for those less familiar with medication names, methylphenidate is sold under the brand names Ritalin and Concerta.
  - deleted 4y ago
    [deleted]
- baskethead 4y ago
  You misread it. It went back to baseline after discontinuing the treatment which means that the increased depression was during the time while taking the medication.
- mmmrtl 4y ago
  The authors show increased depression risk in the 90 days PRE-exposure (before starting treatment). To me, the authors seems to have dangerously misinterpreted the data. It could easily be the case that a depression diagnosis leads to seeing a psychiatrist and deciding to treat their underlying ADHD with methylphenidate. How could being about to go on methylphenidate in the next 90 days possible be the cause of depression???
sascha_sl 4y ago
Considering stimulants (generally, but also specific ones) only work for a portion of people that try it, I find this very unsurprising. The increase isn't that big and probably down to a mixture of disappointment and side effects without the main effects. It's one of the main reasons doctors prescribe different stimulants. I've personally heard every mutation of "This one worked for me but the other one gave me bad side effects and little effect".
- kayodelycaon 4y ago
  The study is useful as something to watch for when using medication, not for avoiding medication. We already know starting antidepressants has an increased suicide risk.
  - sascha_sl 4y ago
    Do I really seem so defensive? I really didn't mean to... I of course know that this is how it's meant to be used. But having gone through ADHD and trans healthcare I know everything that looks like ammo will be used as ammo. Even the things that explicitly state they are not ammo. By healthcare professionals and those that want to enact change on a higher level.
    - kayodelycaon 4y ago
      I was attempting to add on what you were saying. :)
- jimmygrapes 4y ago
  You'd think by now we would have some way to test the concentration of various things (serotonin, norepinephrine, etc.) in the body BEFORE issuing medications that might modify them, and then measure such concentrations afterwards to get a better idea of what to use, rather than the current "try different things and rely solely on the subjective description provided by the (likely untrained and inarticulate) test subject." Or maybe we do and I've never been privy to this knowledge nor provided such a test.
westcort 4y ago
An approximately 30 percent increase in incidence rate ratio that reversed upon discontinuation of methylphenidate is was was reported here. I would be interested to see what the data would be with a nonstimulant like atomoxetine, which has a structure very similar to that of fluoxetine. Could use in combination cancel out this effect?
- 331c8c71 4y ago
  Atomoxetine also has side effects. Problems with erection for instance. Should one take viagra or likes on top to fix tgat?
fwip 4y ago
For what it's worth, as an undiagnosed (and unmedicated) ADHD kid, I was depressed from age 8 to $current_age. Doing much better now with therapy, Adderall, and an SSRI. Trying to conform to a neurotypical world is hard.
falcolas 4y ago
FWIW, ADHD increases the risk of depression too. Executive Function Disorder creates a lot of internal thoughts of "I'm a loser" "I'll never be able to succeed", and so forth. Though, being fair, those are thoughts other people will direct at those with ADHD as well.
- robonerd 4y ago
  > "I'll never be able to succeed" Is it the condition which causes this, or the diagnosis of the condition? I think diagnoses can easily inspire feelings of futility. It's no longer something you can change about yourself by wanting to change, it becomes a medical condition you've been stuck with.
  - dymk 4y ago
    It's the condition that causes it. One of the diagnostic criteria for ADHD is anxiety over not being able to get things done. Your comment sounds dismissive of the real adverse impact of ADHD on one's inherent executive function; rather it's just someone being too "in their head" after they're giving a diagnosis. > it becomes a medical condition you've been stuck with 90-ish% of people with ADHD respond well to stimulants, and have complete remission of symptoms. And for those who don't respond well to stimulants, we have bupropion, etc. It's the one class of mental disorders where medication is very effective. For almost all with ADHD, it's not something you're "stuck" with.
    - FollowingTheDao 4y ago
      "One of the diagnostic criteria for ADHD is anxiety over not being able to get things done." No, it is not. https://www.aafp.org/dam/AAFP/documents/patient_care/adhd_toolkit/adhd19-assessment-table1.pdf https://www.aafp.org/dam/AAFP/documents/patient_care/adhd_to... If you have to keep taking amphetamines you are stuck with it. It is clear that something dopamergenic is going on with these kids, but no one is trying to find out why they do not have enough dopamine. You know we have biological pathways that produce dopamine which are controlled by things in our environment. https://www.researchgate.net/figure/he-biosynthetic-pathway-of-dopamine-Tetrahydrobiopeterin-BH4-is-generated-from_fig1_243970581 https://www.researchgate.net/figure/he-biosynthetic-pathway-... Yeah, I said it, you can control ADHD by changing the environment. Zinc, B6, air pollution, protein intake, etc... Yet all we get is a pill? And you are all happy with that?
avgDev 4y ago
I hate sounding like an alarmist....but something is extremely wrong with how physicians handle adverse reactions. So, I took a flouroquinolone and had a text book reaction. 50+ physicians later at mayo and other top US hospitals and I was gaslighted more than helped in any way. I am now in a group for sufferers and meet new people daily, who took the drug and the doctor completely dismissed their neurological issues as anxiety. After sending documents to my primary he agreed that I suffered an ADR and stopped prescribing it completely unless no other options exist. "Health care providers/professionals (HCPs) play a critical role in ADR surveillance. Only 6% of all ADRs are reported and under-reporting acts as great impedance in exchange of drug information." https://www.ijbcp.com/index.php/ijbcp/article/view/1652 https://www.ijbcp.com/index.php/ijbcp/article/view/1652
- code_duck 4y ago
  Not a drug reaction, but I had a rather dreadful experience with Mayo, where I reported severe digestive problems which had led to me losing a great amount of weight over a few months while being constantly in pain (175 to 118, I’m 5’10”). They did some esophagus tests, they looked okay and Mayo wrote it off as “health anxiety”. It turns out I was actually developing a form of adult onset type 1 diabetes (LADA).
  - Group_B 4y ago
    Was your blood sugar extremely high during that time before being diagnosed?
    - code_duck 4y ago
      I have no idea what it was when I was at Mayo, but later on, yes. I went into diabetic ketoacidosis and had 650 glucose at the ER, with an HbA1c that indicated an average of 300 for the preceding 3 months.
- dan_quixote 4y ago
  Primary care in the US is heavily reliant on the most basic heuristics to meet patient throughput requirements. Many clinics are operating at 15 min/patient. And no one wants to spend their free time charting the visit and making necessary orders (pharmacy, radiology, other providers, etc) if it can be avoided - so they try to cram it into that 15 min if possible. So they simply don't have time to ask the necessary questions and perform research.
carlmcqueen 4y ago
I'm not a doctor, but as a family member and extended family member, I know that many bipolar children appear with ADHD in their early years and are treated with ADHD medication. They are treated with stimulants that have no effect on bipolar disorder.
- kayodelycaon 4y ago
  This happened to me. Symptoms were noticeable when I was 5. First major depressive episode when I was 9. Was on stimulants from age 6 to 19. Didn't get properly diagnosed until I was 35. Bipolar is often comorbid with ADHD. Stimulants can help, but can they also cause mania if used alone.
- falcolas 4y ago
  Back when I was diagnosed with Bi-Polar disorder (I actually had ADHD and a touch of autism, but whatever), they put me on Lithium. I'd rather be on a small methamphetamine dose than Lithium if I got to choose my misdiagnosis.
  - IntrepidWorm 4y ago
    Can you clarify the aversion to lithium? I was under the impression from multiple friends and family on it that out of many of the other drug cocktails prescribed to manage bipolar disorder, lithium was one of the tamer and more effective medications.
    - falcolas 4y ago
      It's an effective mood regulator, because it's a mood dampener. You lose the lows, but you also lose the highs. Evanescence has a song about its effects, and they're much more eloquent about it than I could ever be. Especially as someone who wasn't bi-polar - it was creepy af... kind of like disassociation. It wasn't me.
    - minsc_and_boo 4y ago
      I'm not them, but Lithium can have an acquired resistance develop over time, which is unfortunate given how stable it is. It will be used as a first step for determining bi-polarism, or when a stable med is immediately needed, from what I've seen.
greatpostman 4y ago
In case people don’t know yet, doctors in some sense have an imperative to prescribe medication, regardless of whether it will destroy someone’s life. It’s almost considered mal practice not to prescribe SSRIs to a depressed person. But that prescription may follow them for life, most never get off them. Or don’t even know who they are when they get older, was that drugged person them or someone else?
- liveoneggs 4y ago
  doctors practice "medicine" not "health" :)
  - thatguy0900 4y ago
    Not many people will accept a prescription of "stop eating shit all the time and exercise ", unfortunately.
- MaxDPS 4y ago
  > More than 60% of Americans taking antidepressant medication have taken it for 2 years or longer, with 14% having taken the medication for 10 years or more. https://www.cdc.gov/nchs/products/databriefs/db76.htm https://www.cdc.gov/nchs/products/databriefs/db76.htm It seems like most people do stop using them with time.
- prismatix 4y ago
  I used to think like this. I was very anti medication, pro meditation and mindfulness, and then it happened to me. After a significant life event, a lot of things bubbled to the surface. I wasn't as in touch with myself as I used to be but, again, I was anti medication and thought I could fix things myself. It took me a scary amount of time to ask my doctor for meds, and of course they were happy to prescribe but they never pushed them on me in any way. I was worried I'd feel different, not like myself. Now, 2+ years on SSRIs and I can honestly say I've never felt more like myself. With the meds, I feel like I've unlocked my full potential. Before, I had bouts of heightened success, but they were always weighed down by this underlying instability. I don't consider myself a "drugged" person, but rather the version of myself that I want to be.
user_7832 4y ago
On a related by side note, methylphenidate has been shown to have mild neuroprotective effects (unlike some amphetamine derivatives) [1]. Interestingly dopamine can cause/be neurotoxic (presumably at high levels for a long time). [2] (Both sources were quickly googled, I'm sure there are better papers. 1 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2701286/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2701286/ 2 - https://link.springer.com/chapter/10.1007/978-1-59259-006-3_9 https://link.springer.com/chapter/10.1007/978-1-59259-006-3_...
cronix 4y ago
And then we stick them on antidepressants. > Although only 8.6% of American males are on antidepressants at any given time, they seem much better represented as a percentage of mass shooters. Here are 39 mass shooters who were either on antidepressants at the time of their rampage, had abruptly quit taking their medication when they went on their spree, or had been prescribed antidepressants at some point in the past. https://thoughtcatalog.com/jeremy-london/2019/09/37-mass-shooters-who-were-on-antidepressants/ https://thoughtcatalog.com/jeremy-london/2019/09/37-mass-sho... Michael Moore came to the same conclusion when researching for his movie, Bowling for Columbine: https://www.youtube.com/watch?v=04UqzYOdGNs https://www.youtube.com/watch?v=04UqzYOdGNs These drugs can have serious side effects in x/1,000,000 people. What happens when you give them to tens of millions? You'll start to see those edge cases. Why didn't we have many of these mass shootings prior to 1990? When did we start mass dosing our kids? I think we have a lot more research to do, if anyone is actually willing, but you'd be going up against the big guys.
throwaway420691 4y ago
unless you require acute trauma care, look away from western medicine for solutions to your problems
- dymk 4y ago
  And what "non-western" medicine would you suggest for ADHD?
- swayvil 4y ago
  My friend, an ex head nurse, agrees. She puts it like this. Unless you are in great pain, or can't walk, stay completely away from doctors and hospitals.
  - galoisgirl 4y ago
    Yes, all people in hospitals are sick or injured. Don't go there.
TrevorJ 4y ago
This doesn't surprise me. I've been prescribed Ritalin at times both as a child and an adult in small doses. It is a remarkable strong medication, and operates much like I imagine recreational drugs operate - there's a definite strong high, and an equally brutal comedown afterword. I would be extremely cautious about prescribing this to anyone, especially children unless nearly every other kind of intervention has been explored. If you are a parent and considering Ritalin for your child, first ask yourself if you'd consider legal cocaine to be a reasonable solution for your child. If that sounds insane to you, then you should consider the fact that Ritalin is probably not so different.
- n8cpdx 4y ago
  If you’re getting a high from it, your dose is too high. If there is a “brutal” come down, your dose is too high. What do you consider a “small” dose?
  - TrevorJ 4y ago
    First off, do you are assuming that everyone reacts to drugs in the same way? I was taking 1/5th to 1/10th of a 'normal' dose. Secondly, if you do a few minutes of research online you will find that both issues (the high, and the comedown) is not at all an uncommon complaint. Ritalin is a CNS stimulant. With respect, you are being a bit too condescending relative to the amount of knowledge of the issue you posses.
    - Avamander 4y ago
      They aren't assuming it about you specifically. It's just a common part of the process, with a common solution. It's likely a very valid question. If you're one of the few for whom it didn't work out, cool. But with equal respect, your anecdotal experience is not sufficient to call it "legal cocaine". Neither is it sufficient to make generilizations about how medical care of ADHD should be approached.
      - TrevorJ 4y ago
eyelidlessness 4y ago
It’s worth mentioning that ADHD also increases the risk of depression. Along with anxiety, depression is one of the most common comorbidities particularly in people with undiagnosed ADHD. I didn’t take ADHD meds as a kid, so I can’t speak to their effect on me. But when diagnosed as an adult, I had suffered nearly my whole life with chronic depression and anxiety. Both reached a crisis level a few years back, which was a major factor in seeking diagnosis. This diagnosis, and treatment, saved my life. I won’t share my medical charts or anything, but I will say that since my meds and dosage have been consistent, depression is still there but barely noticeable. Anxiety much more manageable. These meds helped me put my life back together. I’m not dismissing the study, or that other people have different experiences. But I share my perspective when things like this come up, in case it benefits others who might have similar struggles and wonder if ADHD might be a factor.
- lettergram 4y ago
  > worth mentioning that ADHD also increases the risk of depression I don’t think that’s true, I thought it was a correlation, not causation.
  - Avamander 4y ago
    It doesn't matter what you think. It's fairly obvious even without any research that losing some amount of agency and struggling with things others don't can impact someone very negatively.
    - lghh 4y ago
      And the research backs that up so we don't have to rely on it being obvious!
  - WhompingWindows 4y ago
    Consider: ADHD reduces executive functions, which are like the "secretary" of the mind. This means they can not direct attention onto where they need to: work, school, onto family and friends, etc. Those with ADHD have less 3 friendships on average, due to less ability to hold their attention on others. As they age, they may find relief in drugs like cocaine, caffeine, nicotine, and THC, which may lead to more drug abuse than neurotypical people. They're more likely to commit suicide. These are evidence-backed conclusions from the literature, which I reviewed for my MS. All of these problems then feed into depression and anxiety. Is that so hard to believe? Less friends, less success, more abuse of substances, it's a potentially rough life. If so, look at these articles, which review the hard evidence and find there's very strong links between ADHD and depression, and anxiety: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2990565/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2990565/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6493806/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6493806/
kurupt213 4y ago
weird. amphetamine is one of the medications of last resort for debilitating depression
- sph 4y ago
  Last resort doesn't mean it's not effective. And depression is often a symptom, not an illness itself. In the case of ADHD, amphetamine helps the dopamine dysfunction which in turns alleviates the depressive symptoms.
  - kurupt213 4y ago
    Last resort normally means the cons are plentiful. With adderall and Dexedrine, there is high likelihood of habit forming psychological addiction if not physical addiction. There’s the ever increasing tolerance, etc. But sometimes dopamine and norepinephrine levels are so low you need a firehouse.
tjridesbikes 4y ago
Anecdata, but I've been on methylphenidate (Concerta) since age 7, and holy cow has it impacted my life in an insanely positive way. 21 years later, I'm still on Concerta, but excelling in my career, spending meaningful time with friends, family, and hobbies, and generally pretty happy with myself. When I tried dropping the meds in college, my life basically fell apart in a matter of months. My then-girlfriend now-wife almost broke up with me, I started failing classes, I lost contact with friends, and really struggled to feel alive. The Concerta doesn't fix my ADHD, but wow does it make it manageable. Thankfully, I had a supportive and invested family, understanding friends, and support structures all around me. I'm so glad my parents put me on meds instead of making me struggle throughout my childhood due to an outdated believe that "drugging kids bad". I owe my life and success to this drug, and while it doesn't work perfectly for everyone diagnosed with ADHD, it works so well for me that you'd have to pry my prescription from my cold, dead hands.
- sph 4y ago
  Same. I've had a low-grade depression for all my adult life, which has worsened in the past 5 years. I got diagnosed with ADHD 5 months ago, started medication 2 months ago, and last week I told my therapist I'm pretty sure my life-long depression is in remission. There's a definite feeling that my life is now in a slight upwards trajectory, even on the worst of days. Life tends to become pretty sad when you have no control over your executive function and action.
  - FollowingTheDao 4y ago
    Why is it so strange that an amphetamine would get rid of depression?
    - hombre_fatal 4y ago
      Well, a dose doesn’t last forever. It wouldn’t be surprising if it was a net negative. You tend to feel worse on the comedown for example.
      - 4y ago
FollowingTheDao 4y ago
As long as everyone else here is giving anecdotal data, here’s mine. My nephew was diagnosed with ADHD and was given Ritalin. He hung himself a week later.
- galoisgirl 4y ago
  I'm sorry for your loss.
kbd 4y ago
This was positive at least: > After MPH treatment discontinuation... returned to baseline levels by 31 to 60 days
screye 4y ago
Can someone comment on whether ADHD medication leads to 'loss' of the unfiltered imagination that I have come to associate with my perpetually distracted self ? A friend on ADHD meds told me that it feels like trading unbridled creativity for stability. He found it to be an essential drug for functioning, but I got a sense that it involved losing something really central to your sense of self. Almost like being made sedated/compliant by force. I have long dealt with the double edged sword of ADHD (diagnosed at 27, obvious symptoms since early age). I have had my best ideas / 1st author papers during moments of hyperfocus. At the same time, I struggle to do mundane busy-work with any level of reliability and have had bouts of depression tied to ADHD derived perfectionism/procrastination (if you know, you know). I have yet to make the leap to medication as I have managed to 'hang on' through the different things I have tried in life. I often joke that I will start medication if I get fired. I am grappling with the decision of making the leap over to medication, and if the cons are worth it in any situation that isn't incredibly desperate. Some perspective here would really help. edit: Thanks a lot for sharing your personal experiences. It really helps in at least convincing me to give meds a try. I'll set up an appointment .... tomorrow, soon, surely
- whiddershins 4y ago
  I used it for a while and it was life changing. I learned a number of lessons about how my mind makes things harder, and since, have been able to for example shop at the grocery store when before it was infeasible. However, I felt I lost a subtle intuition edge. When I stopped I was a mess, until I found Chen Style Tai Chi, which somehow mitigated my worst symptoms without any (negative) side effects. From there, I’ve been able through (simply aging) and deliberate practice of various techniques to make it so ADD is rarely an issue for me anymore.
- crucialfelix 4y ago
  That has always been my fear and objection. I worshipped my own crazy creative engine. But after decades of failing to complete those awesome ideas, failure to execute, follow through I would suggest that you experiment. It's not some permanent contract. Currently I take L Tyrosine, CDP Choline, coffee, lionsmane and kava. My focus and ease of attention are amazing, and I've been very productive. Even if I get diagnosed and get a prescription, I would still take these supplements as they support the core problem: low dopamine, low acetylcholine. Eat well, exercise too.
swayvil 4y ago
Warping ourselves to fit our society. Modern footbinding.
deleted 4y ago
[deleted]
am_lu 4y ago
A bit of perspective from speed user (amphetamine, not meth) who I know: Been into it for 10+ years. Usual weekend binge on 3.5 grams of good quality amphetamine. Can last from Friday evening till Tuesday, will little sleep between. Lots of things get done. Rest of the week head and brain is out service, depression you call it, nothing is been done, hard to go to work, any excuse willdo, sort out yourself some food or a takeaway, watch some youtube, sleep a lot till you get better. Current state, 5 weeks clean: go to work, no problem 8 hours shift, do your duty to pay the bills. After work - eat, relax for a bit, read a lot be it books or just daily news. Bed time. Personal projects be it coding or electronics just put on hold....
- adhdthrowaway89 4y ago
  As context for readers who might not know normal dosing, the maximum therapeutic Adderall dosage in the US is 60mg per day. So what this commenter is describing is between 15x and 20x the maximum therapeutic dosage based on whether you count this as 3 or 4 days.
  - nowahe 4y ago
    As a semi-regular user of speed, I can almost guarantee you that a gram of street amphetamine is nowhere near 100% concentrated. You would be lucky to find it at 20% (cut with half caffeine half random white powder). I've done acetone washes of amphetamine paste, and it's almost unbelievable how little amph there is in it. A few times I was able to get my hands on really pure dextroamphetamine (>90% validated by a lab test), and even with a tolerance, there is no way you're consuming more than 100mg over the course of a day. 10-15mg was my sweetspot to get enough focus without getting locked into tasks and feeling wired. Although speed like that is pretty hard to find and quite pricey (~60-70€/g). I've also realized that most of the unpleasant physical side effects of speed (palpitations, jittering, elevated cardiac rythm, anxiety, etc) are actually due to the massive amount of caffeine in it and not the amphetamine themselves (tho I'm sure there is a synergy between them). Even while feeling pretty high on pure amphetamine, my bpm only rose by about 4-5 bpms (compared to 15+ on street speed). For anyone in the same case, L-theanine works wonders to calm down the caffeine side effects, highly recommend you keep some around just in case.
dijit 4y ago
So, I had a psychologist tell me that I have many ADHD markers and referred me to the central mental health agency for an official diagnosis. Unfortunately, In Sweden, an official diagnosis means higher insurance (fine), higher mortgages (not fine) and the inability to hold certain licenses. Of course those markers of ADHD are pretty severely affecting my life, which is why I was seeing the Psychologist in the first place... Would anyone recommend seeking a diagnosis in those conditions? Has anyone done this in Sweden and then gotten a mortgage? Is there anything else I can do?
- kcolford 4y ago
  That is horrifying that your medical issues could be used against you in insurance, mortgages, and licensing... I'd suggest just leaving the country at this rate or getting the diagnosis in a sane country that won't share this information and getting the medication from over there (assuming you can move somewhere close to the border)
  - dijit 4y ago
    > I'd suggest just leaving the country at this rate or getting the diagnosis in a sane country that won't share this information and getting the medication from over there (assuming you can move somewhere close to the border) I live on the border with Denmark, I’m not sure if it’s ok for me to access healthcare in Denmark without a “CPR Number” https://international.kk.dk/cpr-number https://international.kk.dk/cpr-number
- unethical_ban 4y ago
  Wow. That sounds like a terrible abuse of government power, and a great way to keep people from getting the mental health assistance they need. The idea that ADHD affects mortgage rates! How terribly absurd. I'm sorry to hear that.
- KingMachiavelli 4y ago
  How does a medical diagnosis result in higher mortgage costs? Is health privacy data not protected in Sweden?
anon291 4y ago
ADHD is not a disease. Expecting children to pay attention to boring adults is. A good portion of teachers are incredibly unanimated and boring. They should not be teaching ADHD kids. Look, my mother has ADHD (or something like it), and she had no problem teaching the (mostly boys) in her class with ADHD. A few even went off their meds in her class. Unfortunately, the next year, they were put right back on with a new teacher.
- thescriptkiddie 4y ago
  ADHD (and associated things like autism) is not just a problem for children in school, but also for adults at work and in their personal lives. I would argue that society should be changed to better accommodate neurodivergent people, but until then medication is really helpful for most people.
- galoisgirl 4y ago
  ADHD is when you have trouble paying attention to most teachers, not just the boring ones. Happy for the kids, but when they're adults, they'll find out that they have many other executive functions impaired, not just attention management, and the cool teacher won't fix these.
  - anon291 4y ago
    My mother is not a cool teacher -- at all. We shouldn't conflate interesting and engaging with 'cool'.
throwaway892238 4y ago
When I was on ADHD medication and developed depression, they gave me ADHD meds + anti-depressants. When those didn't work they added anti-psychotics. I was 12 years old, getting my blood checked regularly to try to detect the liver or kidney failure (I don't remember which) they knew was a side-effect. Turned out I just didn't like living in Florida.
- dudus 4y ago
  Maybe you could have got worse without the meds.
  - throwaway892238 4y ago
    True. But there should have been some limits. They put over eight different drugs into me over 1-2 years. I flunked out of school because the drugs made me either fall asleep or manic or sick. I don't know if it's changed, but they seemed to be able to put me on nearly any drug, or any combination, without recovery in between, as long as the doctor signed a script. I had been on Ritalin since I was 8, too, I think.
  - tsol 4y ago
    But also, maybe he could have gotten better without the meds
- throwaway_1928 4y ago
  They have to make money somehow.
nickstinemates 4y ago
I just started on ADHD meds after knowing I've had it most of my life and not wanting to be reliant on drugs. I turn 37 in 8 weeks or so. I have had bouts of apathy, have had some really rough times, definitely anxiety and sadness. Still early days. I'm about 2 months in. I can feel the effects when I am on it. I can feel when it starts to wear off. No feeling of addiction at all. No dependence. No taking it every day like I've heard about for depression medication. Take breaks on weekends / on light work days without looming deadlines. I actually like a big part of my ADHD brain more than the drugged version. Probably because I am used to it. But also I kind of like being multi-threaded by nature. It feels great to be able to do a lot of things simultaneously. The downside to this is it's very hard to be "present" in anything. This is where the ADHD meds come in. I've been taking a lot of notes on feelings and side-effects since starting, and on the emotional side I feel a stronger sense of everything - from pleasure to joy to sorrow. Maybe it's the "present" part of it. I have always been very good at "listening," well, hearing what people are saying and internalizing it/remembering it. But I've never been good at listening - in terms of applying critical thought to what people are actually saying to me. More like a note+file vs. analysis. Some parts of me that have been dormant, especially the creative as in creating (not creative as in thinking) side of me has really sprung to life. And I'm enjoying that aspect the most. Anyway, depression seems to be very far away from the side effects for me. It would suck and I empathize with anyone who has complications/side effects like that.
instagraham 4y ago
Does this study really account for the fact that depression is a common co-morbidity for ADHD? And that ADHD leads itself to people getting depressed? Sounds like they just did a meta-analysis and saw a link between ADHD and depression and blamed the med.

168 points by imperio59 4y ago

This study focused specifically on methylphenidate, one of many medications prescribed for ADHD. The title should be adjusted accordingly, as the current title is ambiguous and potentially misleading.

pflats 4y ago
The study also does not claim to show a causal relationship.
- citilife 4y ago
  I was actually going to point that out. IMO from what I've seen of parents are that people who bring their children at a young-ish age to a therapist have a different issue. Especially "being to hyper" or "being unable to focus" have a different issue. Children are supposed to be outside moving 8-12 hours a day, have you seen puppies? They need something similar. Instead many parents give their children tablets, plop them in front of the TV and do something else. Kick them into the back yard or go throw a ball with them. Every child I know diagnosed with ADHD had parents who didn't want to deal with them. Bringing them to the gym, to the park, playing in the backyard; it's a lot of work. Kids who have trouble focusing are likely tired and overstimulated. Reduce the number of toys, remove TV / tablets, and send them outside. It'll probably solve itself. As an experiment, look at the people you know on medication (or ask), look at the troubled children, etc. I guarantee you'll see the same trend: single parent home, started medication at an early age, regular therapist appointments, etc. They're unhappy and need depressants, ADHD medication, etc. It's not always the case, but it's a trend. People who are diagnosed with ADHD at a younger age likely have parents who just don't want / know how to deal with issues. Mental health "experts" treat the symptoms via medication, but the underlying issue(s) just continue to fester. What we really need is a strong emphasis on family development, courses built around it and support groups. Parents naturally do this, but I think it's been severely broken down the past 50-60 years and is getting exponentially worse. As such we see more: single parent homes, abundance of medication, reduction in religion and adult social clubs, etc.
  - zrail 4y ago
    So it feels to me that you're saying ADHD doesn't exist and it's a matter of parental failure or indifference. Do I have that right?
    - nominusllc 4y ago
      I have ADHD, and increasing eustress by working out or doing fun physical things like sports to the point of being tired is one thing that is better than anything I've been prescribed. It's not fall asleep tired, it's more akin to being physically spent. When there is no more need to fidget and do things, I focus like a laser and am less prone to impulse.
      - adastra22 4y ago
        Great it works for you. You probably have the hyperactive type of ADHD. For me and my daughter with inattentive/non-hyperactive ADD, doing physical things, while fun, just make us tired and want to sleep. Not a good idea if you need to focus and get work done. I take daily medication and it has been literally life saving as I was able to turn things around and keep my marriage from falling apart, not to mention my happiness from being able to accomplish much, much more. I'm holding off medication for my daughter only because it lessens appetite and she is very skinny already. Once she's grown to her full height we'll get her meds she can use too.
        nominusllc 4y ago
        I feel for you, I hope you guys settle on something that works with as little sides as possible. It's a spectrum with a lot of means to address a moving target, so some trial and error unfortunately comes with it. Luckily I was able to work with my doc to find things that work for the things that eustress cannot solve. Just curious, what do you take?
    - davemp 4y ago
      I don’t see how you are getting that from OP’s comment. OP seems to be claiming that ADHD is often over diagnosed and/or treated improperly. A viewpoint shared by people I know in the field.
- jobu 4y ago
  As the parent of a child with ADHD that is medicated, it seems completely plausible that it could cause depression. When my kid has had too high a dosage (or accidentally takes a double dose) she's like a zombie, completely flat affect, and very little motivation. It's like it drains her life away. Part of the problem is that it's very difficult to get the right dosage for any given day because diet, metabolism, and hormones seem to have a big impact on how effective it is. We've found it's better to go with a lower-dose extended release, and then let her self-medicate with 5mg regular tablets as needed. This works great now because she's a fairly responsible teenager (when medicated), but it was really hard when she was younger.
  - adastra22 4y ago
    What is she taking?
    - jobu 4y ago
      It's changed a few times over the years because of insurance, but right now it's Focalin XR and 5mg Ritalin as needed up to 2 times a day.
      - adastra22 4y ago
        Thanks!
  - krono 4y ago
    I share this experience myself, in particular the dosage not providing a consistent effect day to day - every specialist I've spoken has told me this is weird and shouldn't be happening and yet it is so. Switching to staged release medication (Medikinet CR) has helped me too. Unfortunately extended release Methylphenidate of any kind/brand is only partially covered by Dutch health insurance[1], and I'm certain the cost is prohibitive for people who might be less well off. 1: In essence, the government has determined that all Methylphenidate variants are equal, and so you can just take the cheapest instant release variant or else pay the difference out of your own pocket.
  - 4y ago
calvinmorrison 4y ago
Common brands: Quillivant XR, Daytrana, QuilliChew ER
- kayodelycaon 4y ago
  It's marketed as Ritalin and Concerta in the US. Wikipedia has quite a lot of information on it: https://en.wikipedia.org/wiki/Methylphenidate https://en.wikipedia.org/wiki/Methylphenidate

ALittleLight 4y ago

echelon 4y ago
Nor is the structure of life after school. (Offices? 9 AM start times?) Kids with ADHD can go on to find incredible success in breaking the rules.
- Avamander 4y ago
  Sure they can, people endure and cope with a lot of things. That's a really low and unnecessarily painful approach though. They could do even better, do things they want to do, when they aren't hindered as much by the disorder. I really think the comparison with glasses is apt, sure someone can squint their eyes and sit a bit closer at times, but why should they? We'd call it neglect to force someone to cope with bad eyesight without correction. Now you're talking about some ADHD kids doing well breaking the rules, so it's fine not to help? Eugh. Do you know how many without help end up with incredible failure? Teen pregnancies, accidents, addiction, depression? It's more likely to be bad. I really wish this discussion would revolve around helping, not potentially forcing coping.
  - falcolas 4y ago
    Especially with the plethora of evidence about how much harm "masking" can cause for a neurodivergant individual. Because that mask can never really be taken off.
  - echelon 4y ago
    I don't know where you're going with your comment. I didn't say anything about whatever you're implying. You might be responding to a different person? ADHD kids can take medicine, but the rest of the world can also lighten up. That's my point. The rules and benchmarks are stupid and impose unnecessary stress on ADHD individuals. Over half of the time you can ignore it and be fine.
giraffe_lady 4y ago

vorpalhex 4y ago

This was for ONE adhd medication and the risk was only increased for the initial 90 days... and then went back to baseline.

jimmygrapes 4y ago
Should also note that the return to baseline was only after discontinuation of the MPH. Can't really tell if it would return to baseline if the medication was continued without digging into the study more than I have so far. Also worth noting for those less familiar with medication names, methylphenidate is sold under the brand names Ritalin and Concerta.
- deleted 4y ago
  [deleted]
baskethead 4y ago
You misread it. It went back to baseline after discontinuing the treatment which means that the increased depression was during the time while taking the medication.
mmmrtl 4y ago
The authors show increased depression risk in the 90 days PRE-exposure (before starting treatment). To me, the authors seems to have dangerously misinterpreted the data. It could easily be the case that a depression diagnosis leads to seeing a psychiatrist and deciding to treat their underlying ADHD with methylphenidate. How could being about to go on methylphenidate in the next 90 days possible be the cause of depression???

sascha_sl 4y ago

Considering stimulants (generally, but also specific ones) only work for a portion of people that try it, I find this very unsurprising. The increase isn't that big and probably down to a mixture of disappointment and side effects without the main effects. It's one of the main reasons doctors prescribe different stimulants. I've personally heard every mutation of "This one worked for me but the other one gave me bad side effects and little effect".

kayodelycaon 4y ago
The study is useful as something to watch for when using medication, not for avoiding medication. We already know starting antidepressants has an increased suicide risk.
- sascha_sl 4y ago
  Do I really seem so defensive? I really didn't mean to... I of course know that this is how it's meant to be used. But having gone through ADHD and trans healthcare I know everything that looks like ammo will be used as ammo. Even the things that explicitly state they are not ammo. By healthcare professionals and those that want to enact change on a higher level.
  - kayodelycaon 4y ago
    I was attempting to add on what you were saying. :)
jimmygrapes 4y ago
You'd think by now we would have some way to test the concentration of various things (serotonin, norepinephrine, etc.) in the body BEFORE issuing medications that might modify them, and then measure such concentrations afterwards to get a better idea of what to use, rather than the current "try different things and rely solely on the subjective description provided by the (likely untrained and inarticulate) test subject." Or maybe we do and I've never been privy to this knowledge nor provided such a test.

westcort 4y ago

An approximately 30 percent increase in incidence rate ratio that reversed upon discontinuation of methylphenidate is was was reported here. I would be interested to see what the data would be with a nonstimulant like atomoxetine, which has a structure very similar to that of fluoxetine. Could use in combination cancel out this effect?

331c8c71 4y ago
Atomoxetine also has side effects. Problems with erection for instance. Should one take viagra or likes on top to fix tgat?

fwip 4y ago

For what it's worth, as an undiagnosed (and unmedicated) ADHD kid, I was depressed from age 8 to $current_age. Doing much better now with therapy, Adderall, and an SSRI. Trying to conform to a neurotypical world is hard.

falcolas 4y ago

FWIW, ADHD increases the risk of depression too. Executive Function Disorder creates a lot of internal thoughts of "I'm a loser" "I'll never be able to succeed", and so forth. Though, being fair, those are thoughts other people will direct at those with ADHD as well.

robonerd 4y ago
> "I'll never be able to succeed" Is it the condition which causes this, or the diagnosis of the condition? I think diagnoses can easily inspire feelings of futility. It's no longer something you can change about yourself by wanting to change, it becomes a medical condition you've been stuck with.
- dymk 4y ago
  It's the condition that causes it. One of the diagnostic criteria for ADHD is anxiety over not being able to get things done. Your comment sounds dismissive of the real adverse impact of ADHD on one's inherent executive function; rather it's just someone being too "in their head" after they're giving a diagnosis. > it becomes a medical condition you've been stuck with 90-ish% of people with ADHD respond well to stimulants, and have complete remission of symptoms. And for those who don't respond well to stimulants, we have bupropion, etc. It's the one class of mental disorders where medication is very effective. For almost all with ADHD, it's not something you're "stuck" with.
  - FollowingTheDao 4y ago
    "One of the diagnostic criteria for ADHD is anxiety over not being able to get things done." No, it is not. https://www.aafp.org/dam/AAFP/documents/patient_care/adhd_toolkit/adhd19-assessment-table1.pdf https://www.aafp.org/dam/AAFP/documents/patient_care/adhd_to... If you have to keep taking amphetamines you are stuck with it. It is clear that something dopamergenic is going on with these kids, but no one is trying to find out why they do not have enough dopamine. You know we have biological pathways that produce dopamine which are controlled by things in our environment. https://www.researchgate.net/figure/he-biosynthetic-pathway-of-dopamine-Tetrahydrobiopeterin-BH4-is-generated-from_fig1_243970581 https://www.researchgate.net/figure/he-biosynthetic-pathway-... Yeah, I said it, you can control ADHD by changing the environment. Zinc, B6, air pollution, protein intake, etc... Yet all we get is a pill? And you are all happy with that?

avgDev 4y ago

I hate sounding like an alarmist....but something is extremely wrong with how physicians handle adverse reactions. So, I took a flouroquinolone and had a text book reaction. 50+ physicians later at mayo and other top US hospitals and I was gaslighted more than helped in any way. I am now in a group for sufferers and meet new people daily, who took the drug and the doctor completely dismissed their neurological issues as anxiety. After sending documents to my primary he agreed that I suffered an ADR and stopped prescribing it completely unless no other options exist. "Health care providers/professionals (HCPs) play a critical role in ADR surveillance. Only 6% of all ADRs are reported and under-reporting acts as great impedance in exchange of drug information." https://www.ijbcp.com/index.php/ijbcp/article/view/1652 https://www.ijbcp.com/index.php/ijbcp/article/view/1652

code_duck 4y ago
Not a drug reaction, but I had a rather dreadful experience with Mayo, where I reported severe digestive problems which had led to me losing a great amount of weight over a few months while being constantly in pain (175 to 118, I’m 5’10”). They did some esophagus tests, they looked okay and Mayo wrote it off as “health anxiety”. It turns out I was actually developing a form of adult onset type 1 diabetes (LADA).
- Group_B 4y ago
  Was your blood sugar extremely high during that time before being diagnosed?
  - code_duck 4y ago
    I have no idea what it was when I was at Mayo, but later on, yes. I went into diabetic ketoacidosis and had 650 glucose at the ER, with an HbA1c that indicated an average of 300 for the preceding 3 months.
dan_quixote 4y ago
Primary care in the US is heavily reliant on the most basic heuristics to meet patient throughput requirements. Many clinics are operating at 15 min/patient. And no one wants to spend their free time charting the visit and making necessary orders (pharmacy, radiology, other providers, etc) if it can be avoided - so they try to cram it into that 15 min if possible. So they simply don't have time to ask the necessary questions and perform research.

carlmcqueen 4y ago

I'm not a doctor, but as a family member and extended family member, I know that many bipolar children appear with ADHD in their early years and are treated with ADHD medication. They are treated with stimulants that have no effect on bipolar disorder.

kayodelycaon 4y ago
This happened to me. Symptoms were noticeable when I was 5. First major depressive episode when I was 9. Was on stimulants from age 6 to 19. Didn't get properly diagnosed until I was 35. Bipolar is often comorbid with ADHD. Stimulants can help, but can they also cause mania if used alone.
falcolas 4y ago
Back when I was diagnosed with Bi-Polar disorder (I actually had ADHD and a touch of autism, but whatever), they put me on Lithium. I'd rather be on a small methamphetamine dose than Lithium if I got to choose my misdiagnosis.
- IntrepidWorm 4y ago
  Can you clarify the aversion to lithium? I was under the impression from multiple friends and family on it that out of many of the other drug cocktails prescribed to manage bipolar disorder, lithium was one of the tamer and more effective medications.
  - falcolas 4y ago
    It's an effective mood regulator, because it's a mood dampener. You lose the lows, but you also lose the highs. Evanescence has a song about its effects, and they're much more eloquent about it than I could ever be. Especially as someone who wasn't bi-polar - it was creepy af... kind of like disassociation. It wasn't me.
  - minsc_and_boo 4y ago
    I'm not them, but Lithium can have an acquired resistance develop over time, which is unfortunate given how stable it is. It will be used as a first step for determining bi-polarism, or when a stable med is immediately needed, from what I've seen.

greatpostman 4y ago

In case people don’t know yet, doctors in some sense have an imperative to prescribe medication, regardless of whether it will destroy someone’s life. It’s almost considered mal practice not to prescribe SSRIs to a depressed person. But that prescription may follow them for life, most never get off them. Or don’t even know who they are when they get older, was that drugged person them or someone else?

liveoneggs 4y ago
doctors practice "medicine" not "health" :)
- thatguy0900 4y ago
  Not many people will accept a prescription of "stop eating shit all the time and exercise ", unfortunately.
MaxDPS 4y ago
> More than 60% of Americans taking antidepressant medication have taken it for 2 years or longer, with 14% having taken the medication for 10 years or more. https://www.cdc.gov/nchs/products/databriefs/db76.htm https://www.cdc.gov/nchs/products/databriefs/db76.htm It seems like most people do stop using them with time.
prismatix 4y ago
I used to think like this. I was very anti medication, pro meditation and mindfulness, and then it happened to me. After a significant life event, a lot of things bubbled to the surface. I wasn't as in touch with myself as I used to be but, again, I was anti medication and thought I could fix things myself. It took me a scary amount of time to ask my doctor for meds, and of course they were happy to prescribe but they never pushed them on me in any way. I was worried I'd feel different, not like myself. Now, 2+ years on SSRIs and I can honestly say I've never felt more like myself. With the meds, I feel like I've unlocked my full potential. Before, I had bouts of heightened success, but they were always weighed down by this underlying instability. I don't consider myself a "drugged" person, but rather the version of myself that I want to be.

user_7832 4y ago

On a related by side note, methylphenidate has been shown to have mild neuroprotective effects (unlike some amphetamine derivatives) [1]. Interestingly dopamine can cause/be neurotoxic (presumably at high levels for a long time). [2] (Both sources were quickly googled, I'm sure there are better papers. 1 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2701286/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2701286/ 2 - https://link.springer.com/chapter/10.1007/978-1-59259-006-3_9 https://link.springer.com/chapter/10.1007/978-1-59259-006-3_...

cronix 4y ago

And then we stick them on antidepressants. > Although only 8.6% of American males are on antidepressants at any given time, they seem much better represented as a percentage of mass shooters. Here are 39 mass shooters who were either on antidepressants at the time of their rampage, had abruptly quit taking their medication when they went on their spree, or had been prescribed antidepressants at some point in the past. https://thoughtcatalog.com/jeremy-london/2019/09/37-mass-shooters-who-were-on-antidepressants/ https://thoughtcatalog.com/jeremy-london/2019/09/37-mass-sho... Michael Moore came to the same conclusion when researching for his movie, Bowling for Columbine: https://www.youtube.com/watch?v=04UqzYOdGNs https://www.youtube.com/watch?v=04UqzYOdGNs These drugs can have serious side effects in x/1,000,000 people. What happens when you give them to tens of millions? You'll start to see those edge cases. Why didn't we have many of these mass shootings prior to 1990? When did we start mass dosing our kids? I think we have a lot more research to do, if anyone is actually willing, but you'd be going up against the big guys.

throwaway420691 4y ago

unless you require acute trauma care, look away from western medicine for solutions to your problems

dymk 4y ago
And what "non-western" medicine would you suggest for ADHD?
swayvil 4y ago
My friend, an ex head nurse, agrees. She puts it like this. Unless you are in great pain, or can't walk, stay completely away from doctors and hospitals.
- galoisgirl 4y ago
  Yes, all people in hospitals are sick or injured. Don't go there.

TrevorJ 4y ago

This doesn't surprise me. I've been prescribed Ritalin at times both as a child and an adult in small doses. It is a remarkable strong medication, and operates much like I imagine recreational drugs operate - there's a definite strong high, and an equally brutal comedown afterword. I would be extremely cautious about prescribing this to anyone, especially children unless nearly every other kind of intervention has been explored. If you are a parent and considering Ritalin for your child, first ask yourself if you'd consider legal cocaine to be a reasonable solution for your child. If that sounds insane to you, then you should consider the fact that Ritalin is probably not so different.

n8cpdx 4y ago
If you’re getting a high from it, your dose is too high. If there is a “brutal” come down, your dose is too high. What do you consider a “small” dose?
- TrevorJ 4y ago
  First off, do you are assuming that everyone reacts to drugs in the same way? I was taking 1/5th to 1/10th of a 'normal' dose. Secondly, if you do a few minutes of research online you will find that both issues (the high, and the comedown) is not at all an uncommon complaint. Ritalin is a CNS stimulant. With respect, you are being a bit too condescending relative to the amount of knowledge of the issue you posses.
  - Avamander 4y ago
    They aren't assuming it about you specifically. It's just a common part of the process, with a common solution. It's likely a very valid question. If you're one of the few for whom it didn't work out, cool. But with equal respect, your anecdotal experience is not sufficient to call it "legal cocaine". Neither is it sufficient to make generilizations about how medical care of ADHD should be approached.
    - TrevorJ 4y ago

eyelidlessness 4y ago

It’s worth mentioning that ADHD also increases the risk of depression. Along with anxiety, depression is one of the most common comorbidities particularly in people with undiagnosed ADHD. I didn’t take ADHD meds as a kid, so I can’t speak to their effect on me. But when diagnosed as an adult, I had suffered nearly my whole life with chronic depression and anxiety. Both reached a crisis level a few years back, which was a major factor in seeking diagnosis. This diagnosis, and treatment, saved my life. I won’t share my medical charts or anything, but I will say that since my meds and dosage have been consistent, depression is still there but barely noticeable. Anxiety much more manageable. These meds helped me put my life back together. I’m not dismissing the study, or that other people have different experiences. But I share my perspective when things like this come up, in case it benefits others who might have similar struggles and wonder if ADHD might be a factor.

lettergram 4y ago
> worth mentioning that ADHD also increases the risk of depression I don’t think that’s true, I thought it was a correlation, not causation.
- Avamander 4y ago
  It doesn't matter what you think. It's fairly obvious even without any research that losing some amount of agency and struggling with things others don't can impact someone very negatively.
  - lghh 4y ago
    And the research backs that up so we don't have to rely on it being obvious!
- WhompingWindows 4y ago
  Consider: ADHD reduces executive functions, which are like the "secretary" of the mind. This means they can not direct attention onto where they need to: work, school, onto family and friends, etc. Those with ADHD have less 3 friendships on average, due to less ability to hold their attention on others. As they age, they may find relief in drugs like cocaine, caffeine, nicotine, and THC, which may lead to more drug abuse than neurotypical people. They're more likely to commit suicide. These are evidence-backed conclusions from the literature, which I reviewed for my MS. All of these problems then feed into depression and anxiety. Is that so hard to believe? Less friends, less success, more abuse of substances, it's a potentially rough life. If so, look at these articles, which review the hard evidence and find there's very strong links between ADHD and depression, and anxiety: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2990565/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2990565/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6493806/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6493806/

kurupt213 4y ago

weird. amphetamine is one of the medications of last resort for debilitating depression

sph 4y ago
Last resort doesn't mean it's not effective. And depression is often a symptom, not an illness itself. In the case of ADHD, amphetamine helps the dopamine dysfunction which in turns alleviates the depressive symptoms.
- kurupt213 4y ago
  Last resort normally means the cons are plentiful. With adderall and Dexedrine, there is high likelihood of habit forming psychological addiction if not physical addiction. There’s the ever increasing tolerance, etc. But sometimes dopamine and norepinephrine levels are so low you need a firehouse.

tjridesbikes 4y ago

Anecdata, but I've been on methylphenidate (Concerta) since age 7, and holy cow has it impacted my life in an insanely positive way. 21 years later, I'm still on Concerta, but excelling in my career, spending meaningful time with friends, family, and hobbies, and generally pretty happy with myself. When I tried dropping the meds in college, my life basically fell apart in a matter of months. My then-girlfriend now-wife almost broke up with me, I started failing classes, I lost contact with friends, and really struggled to feel alive. The Concerta doesn't fix my ADHD, but wow does it make it manageable. Thankfully, I had a supportive and invested family, understanding friends, and support structures all around me. I'm so glad my parents put me on meds instead of making me struggle throughout my childhood due to an outdated believe that "drugging kids bad". I owe my life and success to this drug, and while it doesn't work perfectly for everyone diagnosed with ADHD, it works so well for me that you'd have to pry my prescription from my cold, dead hands.

sph 4y ago
Same. I've had a low-grade depression for all my adult life, which has worsened in the past 5 years. I got diagnosed with ADHD 5 months ago, started medication 2 months ago, and last week I told my therapist I'm pretty sure my life-long depression is in remission. There's a definite feeling that my life is now in a slight upwards trajectory, even on the worst of days. Life tends to become pretty sad when you have no control over your executive function and action.
- FollowingTheDao 4y ago
  Why is it so strange that an amphetamine would get rid of depression?
  - hombre_fatal 4y ago
    Well, a dose doesn’t last forever. It wouldn’t be surprising if it was a net negative. You tend to feel worse on the comedown for example.
    - 4y ago

FollowingTheDao 4y ago

As long as everyone else here is giving anecdotal data, here’s mine. My nephew was diagnosed with ADHD and was given Ritalin. He hung himself a week later.

galoisgirl 4y ago
I'm sorry for your loss.

kbd 4y ago

This was positive at least: > After MPH treatment discontinuation... returned to baseline levels by 31 to 60 days

screye 4y ago

Can someone comment on whether ADHD medication leads to 'loss' of the unfiltered imagination that I have come to associate with my perpetually distracted self ? A friend on ADHD meds told me that it feels like trading unbridled creativity for stability. He found it to be an essential drug for functioning, but I got a sense that it involved losing something really central to your sense of self. Almost like being made sedated/compliant by force. I have long dealt with the double edged sword of ADHD (diagnosed at 27, obvious symptoms since early age). I have had my best ideas / 1st author papers during moments of hyperfocus. At the same time, I struggle to do mundane busy-work with any level of reliability and have had bouts of depression tied to ADHD derived perfectionism/procrastination (if you know, you know). I have yet to make the leap to medication as I have managed to 'hang on' through the different things I have tried in life. I often joke that I will start medication if I get fired. I am grappling with the decision of making the leap over to medication, and if the cons are worth it in any situation that isn't incredibly desperate. Some perspective here would really help. edit: Thanks a lot for sharing your personal experiences. It really helps in at least convincing me to give meds a try. I'll set up an appointment .... tomorrow, soon, surely

whiddershins 4y ago
I used it for a while and it was life changing. I learned a number of lessons about how my mind makes things harder, and since, have been able to for example shop at the grocery store when before it was infeasible. However, I felt I lost a subtle intuition edge. When I stopped I was a mess, until I found Chen Style Tai Chi, which somehow mitigated my worst symptoms without any (negative) side effects. From there, I’ve been able through (simply aging) and deliberate practice of various techniques to make it so ADD is rarely an issue for me anymore.
crucialfelix 4y ago
That has always been my fear and objection. I worshipped my own crazy creative engine. But after decades of failing to complete those awesome ideas, failure to execute, follow through I would suggest that you experiment. It's not some permanent contract. Currently I take L Tyrosine, CDP Choline, coffee, lionsmane and kava. My focus and ease of attention are amazing, and I've been very productive. Even if I get diagnosed and get a prescription, I would still take these supplements as they support the core problem: low dopamine, low acetylcholine. Eat well, exercise too.

swayvil 4y ago

Warping ourselves to fit our society. Modern footbinding.

deleted 4y ago

[deleted]

am_lu 4y ago

A bit of perspective from speed user (amphetamine, not meth) who I know: Been into it for 10+ years. Usual weekend binge on 3.5 grams of good quality amphetamine. Can last from Friday evening till Tuesday, will little sleep between. Lots of things get done. Rest of the week head and brain is out service, depression you call it, nothing is been done, hard to go to work, any excuse willdo, sort out yourself some food or a takeaway, watch some youtube, sleep a lot till you get better. Current state, 5 weeks clean: go to work, no problem 8 hours shift, do your duty to pay the bills. After work - eat, relax for a bit, read a lot be it books or just daily news. Bed time. Personal projects be it coding or electronics just put on hold....

adhdthrowaway89 4y ago
As context for readers who might not know normal dosing, the maximum therapeutic Adderall dosage in the US is 60mg per day. So what this commenter is describing is between 15x and 20x the maximum therapeutic dosage based on whether you count this as 3 or 4 days.
- nowahe 4y ago
  As a semi-regular user of speed, I can almost guarantee you that a gram of street amphetamine is nowhere near 100% concentrated. You would be lucky to find it at 20% (cut with half caffeine half random white powder). I've done acetone washes of amphetamine paste, and it's almost unbelievable how little amph there is in it. A few times I was able to get my hands on really pure dextroamphetamine (>90% validated by a lab test), and even with a tolerance, there is no way you're consuming more than 100mg over the course of a day. 10-15mg was my sweetspot to get enough focus without getting locked into tasks and feeling wired. Although speed like that is pretty hard to find and quite pricey (~60-70€/g). I've also realized that most of the unpleasant physical side effects of speed (palpitations, jittering, elevated cardiac rythm, anxiety, etc) are actually due to the massive amount of caffeine in it and not the amphetamine themselves (tho I'm sure there is a synergy between them). Even while feeling pretty high on pure amphetamine, my bpm only rose by about 4-5 bpms (compared to 15+ on street speed). For anyone in the same case, L-theanine works wonders to calm down the caffeine side effects, highly recommend you keep some around just in case.

dijit 4y ago

So, I had a psychologist tell me that I have many ADHD markers and referred me to the central mental health agency for an official diagnosis. Unfortunately, In Sweden, an official diagnosis means higher insurance (fine), higher mortgages (not fine) and the inability to hold certain licenses. Of course those markers of ADHD are pretty severely affecting my life, which is why I was seeing the Psychologist in the first place... Would anyone recommend seeking a diagnosis in those conditions? Has anyone done this in Sweden and then gotten a mortgage? Is there anything else I can do?

kcolford 4y ago
That is horrifying that your medical issues could be used against you in insurance, mortgages, and licensing... I'd suggest just leaving the country at this rate or getting the diagnosis in a sane country that won't share this information and getting the medication from over there (assuming you can move somewhere close to the border)
- dijit 4y ago
  > I'd suggest just leaving the country at this rate or getting the diagnosis in a sane country that won't share this information and getting the medication from over there (assuming you can move somewhere close to the border) I live on the border with Denmark, I’m not sure if it’s ok for me to access healthcare in Denmark without a “CPR Number” https://international.kk.dk/cpr-number https://international.kk.dk/cpr-number
unethical_ban 4y ago
Wow. That sounds like a terrible abuse of government power, and a great way to keep people from getting the mental health assistance they need. The idea that ADHD affects mortgage rates! How terribly absurd. I'm sorry to hear that.
KingMachiavelli 4y ago
How does a medical diagnosis result in higher mortgage costs? Is health privacy data not protected in Sweden?

anon291 4y ago

ADHD is not a disease. Expecting children to pay attention to boring adults is. A good portion of teachers are incredibly unanimated and boring. They should not be teaching ADHD kids. Look, my mother has ADHD (or something like it), and she had no problem teaching the (mostly boys) in her class with ADHD. A few even went off their meds in her class. Unfortunately, the next year, they were put right back on with a new teacher.

thescriptkiddie 4y ago
ADHD (and associated things like autism) is not just a problem for children in school, but also for adults at work and in their personal lives. I would argue that society should be changed to better accommodate neurodivergent people, but until then medication is really helpful for most people.
galoisgirl 4y ago
ADHD is when you have trouble paying attention to most teachers, not just the boring ones. Happy for the kids, but when they're adults, they'll find out that they have many other executive functions impaired, not just attention management, and the cool teacher won't fix these.
- anon291 4y ago
  My mother is not a cool teacher -- at all. We shouldn't conflate interesting and engaging with 'cool'.

throwaway892238 4y ago

When I was on ADHD medication and developed depression, they gave me ADHD meds + anti-depressants. When those didn't work they added anti-psychotics. I was 12 years old, getting my blood checked regularly to try to detect the liver or kidney failure (I don't remember which) they knew was a side-effect. Turned out I just didn't like living in Florida.

dudus 4y ago
Maybe you could have got worse without the meds.
- throwaway892238 4y ago
  True. But there should have been some limits. They put over eight different drugs into me over 1-2 years. I flunked out of school because the drugs made me either fall asleep or manic or sick. I don't know if it's changed, but they seemed to be able to put me on nearly any drug, or any combination, without recovery in between, as long as the doctor signed a script. I had been on Ritalin since I was 8, too, I think.
- tsol 4y ago
  But also, maybe he could have gotten better without the meds
throwaway_1928 4y ago
They have to make money somehow.

nickstinemates 4y ago

I just started on ADHD meds after knowing I've had it most of my life and not wanting to be reliant on drugs. I turn 37 in 8 weeks or so. I have had bouts of apathy, have had some really rough times, definitely anxiety and sadness. Still early days. I'm about 2 months in. I can feel the effects when I am on it. I can feel when it starts to wear off. No feeling of addiction at all. No dependence. No taking it every day like I've heard about for depression medication. Take breaks on weekends / on light work days without looming deadlines. I actually like a big part of my ADHD brain more than the drugged version. Probably because I am used to it. But also I kind of like being multi-threaded by nature. It feels great to be able to do a lot of things simultaneously. The downside to this is it's very hard to be "present" in anything. This is where the ADHD meds come in. I've been taking a lot of notes on feelings and side-effects since starting, and on the emotional side I feel a stronger sense of everything - from pleasure to joy to sorrow. Maybe it's the "present" part of it. I have always been very good at "listening," well, hearing what people are saying and internalizing it/remembering it. But I've never been good at listening - in terms of applying critical thought to what people are actually saying to me. More like a note+file vs. analysis. Some parts of me that have been dormant, especially the creative as in creating (not creative as in thinking) side of me has really sprung to life. And I'm enjoying that aspect the most. Anyway, depression seems to be very far away from the side effects for me. It would suck and I empathize with anyone who has complications/side effects like that.

instagraham 4y ago

Does this study really account for the fact that depression is a common co-morbidity for ADHD? And that ADHD leads itself to people getting depressed? Sounds like they just did a meta-analysis and saw a link between ADHD and depression and blamed the med.