Association between ADHD medication and depression: A 10-year follow-up • Hacker News Board

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

#191

Post by andybak » Tue, Jun 14, 2022, 6:27 PM UTC

nobodyandproud wrote: post #112

jobu wrote: post #43

Earlier quoted context omitted.

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…

I take phentermine (another legal amphetamine; partial doses), and this doesn’t surprise me at all. The bipolar-level manic highs and depression/lows are very real. The feelings of suicide and hopelessness creep up; I have enough personal awareness and grit to ignore it but it feels awful. To avoid that creep-up, the best thing I found is to have “break” days at least once or twice a week. That is, no pills. I doubt…

There's big differences between drugs in the same family. Personally speaking Methylphenidate is much less intense and easier to fit into my normal life than the Lisdexamfetamine (which are probably closer to phentermine)

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

#192

Post by andybak » Tue, Jun 14, 2022, 6:31 PM UTC

citilife wrote: post #154

Djvacto wrote: post #52

Earlier quoted context omitted.

I started medication as an adult, lived in a home with two involved & present parents, never saw any doctor about ADHD until I was an adult, and was never an unhappy child. Looking back, I clearly had ADHD, but since it's a condition that's unique and specific symptoms vary per person, I just happened to have mechanisms that worked and got lucky with how my brain patterns fit into school from Elementary - High School…

One way I try to explain it to people: "We give people insulin because they have diabetes. Diabetes is the disease, but you can cure it through diet and exercise for Type 2 (it's environmental), Type 1 you cannot (it's genetic). Insulin treats the disease, but doesn't cure it" Why is it not the same for ADHD or depression? Type 1 is genetic and Type 2 is environmental. The argument I was attempting to make is differe…

Let me put it another way then - ADHD meds increase the range of tasks I'm able to do succesfully. They add to my life rather than take something away.

I'm talking about tasks I want to do but would struggle with without medication (mainly coding for pleasure).

Yeah - I could find different things to do with my life, but I love coding and I am delighted to find there's a simple pill I can take that helps me do more of it.

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

#193

Post by citilife » Tue, Jun 14, 2022, 6:33 PM UTC

adastra22 wrote: post #177

Taywee wrote: post #156

Earlier quoted context omitted.

Not them, and I don't have ADHD, but I am the parent of a child with ADHD and I know plenty of people with ADHD, and it's not just "having trouble focusing". For a lot of people, it's a complete inability to focus on any one thing for any real amount of time. They can try as hard as they can to force themselves, but become disfocused and distracted despite any effort. It also often involves impulsiveness that is incr…

Thank you for you sympathy and empathetic response. Your son's in good hands. As an ADHDer, I never understood what it was like for others until I got treatment with stimulants. It's like I can just take this magic pill and for 8 hours I'm "normal." I wish there was an opposite pill, one which made people inattentive and impulsive. Then everyone else could try it for a day or two and see how debilitating it is. Regul…

> I wish there was an opposite pill, one which made people inattentive and impulsive.

I suggest you have someone sleep 4 hours a night for a week. You'll often see the same symptoms as someone with ADHD.

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

#194

Post by andybak » Tue, Jun 14, 2022, 6:34 PM UTC

robonerd wrote: post #45

falcolas wrote: post #19

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.

> "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.

A diagnosis had completely the opposite effect for me. I stopped blaming my own failings and could compartmentalize those aspects of my life that were holding me back as something external that wasn't my "fault". The result was a big reduction in guilt and a big increase in happiness and productivity.

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

#195

Post by screye » Tue, Jun 14, 2022, 6:37 PM UTC

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

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

#196

Post by Taywee » Tue, Jun 14, 2022, 6:40 PM UTC

adastra22 wrote: post #187

Taywee wrote: post #182

Earlier quoted context omitted.

My son is 9 now. We only started him on medication this year (we were trying so hard to get it under control without medication, and his doctor was worried about his weight if we put him on the stimulants). Getting him to eat is a challenge, but it always was anyway and he's always been pretty skinny. Fortunately, he loves milk, so we can always get some calories and protein in him that way. We get a low-carb full-fa…

Thanks for replying. Which meds? Do you have off days?

Dextroamphetamine. Worked great for a few months, but have lessened in effectiveness. Now it still works for focus, but the impulsiveness came back (he was actually able to explain to me that he was having trouble controlling his actions), so he's now on guanfacine too, for impulse control.

We do a couple off days now and then, but not a lot because he feels like it's a wasted day because he can't focus on anything he really wants to. I suggested that he could take weekends off the stimulant, but he says he'd rather be able to operate mostly every day than to have a more focused week and completely wasted weekend, and I feel like he's capable of making that decision for himself.

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

#197

Post by citilife » Tue, Jun 14, 2022, 6:44 PM UTC

andybak wrote: post #192

citilife wrote: post #154

Earlier quoted context omitted.

One way I try to explain it to people: "We give people insulin because they have diabetes. Diabetes is the disease, but you can cure it through diet and exercise for Type 2 (it's environmental), Type 1 you cannot (it's genetic). Insulin treats the disease, but doesn't cure it" Why is it not the same for ADHD or depression? Type 1 is genetic and Type 2 is environmental. The argument I was attempting to make is differe…

Let me put it another way then - ADHD meds increase the range of tasks I'm able to do succesfully. They add to my life rather than take something away. I'm talking about tasks I want to do but would struggle with without medication (mainly coding for pleasure). Yeah - I could find different things to do with my life, but I love coding and I am delighted to find there's a simple pill I can take that helps me do more o…

I understand what you're saying, but reread what you said and replace "medication" and "pill" with "cocaine". Amphetamine can be used in the same manner and for the same perceived reasons.

Granted, I am happy for you and I think drug laws are ridiculous.

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

#198

Post by whiddershins » Tue, Jun 14, 2022, 6:45 PM UTC

screye wrote: post #195

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…

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.

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

#199

Post by jobu » Tue, Jun 14, 2022, 6:45 PM UTC

nobodyandproud wrote: post #112

jobu wrote: post #43

Earlier quoted context omitted.

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…

I take phentermine (another legal amphetamine; partial doses), and this doesn’t surprise me at all. The bipolar-level manic highs and depression/lows are very real. The feelings of suicide and hopelessness creep up; I have enough personal awareness and grit to ignore it but it feels awful. To avoid that creep-up, the best thing I found is to have “break” days at least once or twice a week. That is, no pills. I doubt…

> The bipolar-level manic highs and depression/lows are very real.

I've had to be very careful about NOT using those terms when talking to doctors and psychiatrists. As a layperson that description seems to fit, but it causes huge red flags for medical professionals and they freak out, resulting unnecessary tests and evaluations for my kid.

The key term for the "manic" phase after the meds wear off is "Rebound Effect". Also when the dose is too high the generally accepted term is "zombie mode" or "zombie-like". Calling it an "overdose" will really cause people to freak the fuck out.

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

#200

Post by ALittleLight » Tue, Jun 14, 2022, 6:45 PM UTC

CodeMage wrote: post #186

ALittleLight wrote: post #149

Earlier quoted context omitted.

I wrote that it is horrifying so many children are drugged to be more complacent in school. I saw you objecting to that and assumed I'd need to come back and support the idea that ADHD is over diagnosed and over medicated (e.g. the diagnoses have about doubled in the past couple decades in the US and are substantially higher than in European countries and US pharmaceuticals have a history of being over prescribed). Y…

I've already expressed what I object to: that it's a pithy, kneejerk, judgmental trope-parroting that does more to stigmatize the majority who want to help their kids, than to help combat the abuse perpetrated by the minority of bad parents. It is remarkably difficult to find any figures even estimating the overdiagnosis and overmedication rates for ADHD. Most of the talk around this issue tends to make a big deal ou…

To me you're coming across as defensive when you make these insults and assert that I'm ignorant and don't know what I'm talking about (when, ironically, you have no way of knowing and are therefore ignorant to my level of exposure to the topic). I understand being defensive - you've made a significant decision about your child's health and I hope for your, and his, sake that it's the correct one.

Your defensiveness aside - it's actually not a "trope" or a kneejerk reaction to notice that the rates of ADHD and ADHD medication have doubled in the past couple decades in the US and are significantly higher in the US than in Western Europe. The US has a pattern of over prescribing medications - the current opiod epidemic is an example. My understanding of this is that it's most likely there is over-diagnosing, and therefore overmedicating, of ADHD, and that's bad.

"Are there bad parents who don't want to deal with their kids' behavior" - there are, sure, but that's not what I think is most common. My intuition is that bad parents would just not care what their kids are doing and leave it to the school to handle. If I had to guess, I would guess that the modal problem parent is one who, understandably, wants what is best for their kids and is concerned about what the schools are telling them. The schools, for their part, want kids who don't overly disturb the system. The doctors hear about a problem that they have the pharmaceuticals to treat.

I don't think the people involved are evil and acting out of malice or laziness but I do think that this group works together to create a system where a fundamentally boring place (school) has a problem managing people who are fundamentally bad at being bored (boys) and they, in part, solve that problem by giving them drugs (ADHD medication). I've been thinking about my choice of the word "complacent" from earlier, and maybe it's not quite right - I originally meant it in the sense that the natural state of the boys is to think of school as a problem and rebel against it and their medicated state is to not rebel against school as much or to the same extent.