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

#271

Post by aidenn0 » Tue, Jun 14, 2022, 9:30 PM UTC

mrtranscendence wrote: post #222

nobodyandproud wrote: post #112

Earlier quoted context omitted.

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…

I’ll be honest, I’ve been on adderall (with occasional periods off the drug) for almost 20 years now, and I’ve never experienced anything remotely approaching mania or severe depression (as distinguished from rare bouts of sadness). And I’ve not always been the most careful taker of the medication, frequently alternating between taking too much or lowering my dose. I’m not saying it’s not possible to have those side…

Everyone is certainly different; I know people on Adderall (or Vyvanse, which is similar) that have great outcomes, but Adderall gives me manic episodes, raises my resting heart rate by 20bpm, prevents me from sleeping, and causes mild hallucinations. I took it exactly once. Vyvanse had the same side-effects, but much milder and it lasted longer. I ended up on Focalin, which works and the only side effect is mild interference with my sleep.

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

#272

Post by dijit » Tue, Jun 14, 2022, 9:33 PM UTC

KingMachiavelli wrote: post #240

dijit wrote: post #234

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…

How does a medical diagnosis result in higher mortgage costs? Is health privacy data not protected in Sweden?

In general Sweden treats as much data as possible as being open. As such you can find my home address, who I live with and my phone number (and what car I drive) with a simple google search of my name.

Salary data is also publicly available, but as a nominal fee and you buy a “book” which is an area of the country.

When it comes to mortgages, banks ask for extended rights to look into your data on your behalf, you have to sign this with your digital ID (BankID).

This information is centralised and you give permission because they are ostensibly looking for outstanding debts and bankruptcies.

Unfortunately I only learned about the health discrimination when I was applying for an official diagnosis, I received a letter from a company “Modigo” warning me against getting a diagnosis because it can negatively impact my life in this way.

I heeded the warning of course.

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

#273

Post by prismatix » Tue, Jun 14, 2022, 9:38 PM UTC

greatpostman wrote: post #33

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?

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.

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

#274

Post by LocalPCGuy » Tue, Jun 14, 2022, 9:40 PM UTC

doliveira wrote: post #244

falcolas wrote: post #103

Earlier quoted context omitted.

Well, 5% of the population in general is the expected ratio of people with ADHD, but only 2% of the adult population is diagnosed with it, and it doesn't magically go away when you become an adult. So, there's definitely a chance. Two thoughts: - Everyone will occasionally exhibit some ADHD symptoms, the question is how often. Monthly? Probably not a problem. Hourly, or every few minutes? Probably is a problem. - See…

Yeah, mine have persisted all day along for as long as I can remember... I guess I'm not the stereotypical hyperactive, but when it comes to the attention span it does fit me a glove. I should probably get it checked. Thing is I'm afraid of "faking it", if it makes any sense?

I'd personally recommend to go get checked. The evaluation I went through was like 6 hours long (I know, getting checked for ADHD and they want 6 hours of testing?! Seriously.) But it is to rule out other issues, other conditions and to ensure that the results are correct. In fact, they even adjust for "faking it" in the tests (not that someone couldn't do it, but they are looking for common patterns that would indicate someone try to sway the tests).

I'm definitely not, as you put it, the stereotypical "hyperactive", but on learning more, I realized how many little tics I have that I do but in very masked ways so as to not draw attention. But that aside, there is 3 different diagnosis for ADHD - primary hyperactive, primary-inattentive or combination (both to some level). Despite what I said about tics, my diagnosis was for the inattentive side of things. "Head in the clouds", "daydreamer", etc.

It's all relatively new for me, it wasn't something I really seriously considered until a year or two ago (and I'm in my 40s now), despite having a brother who was medicated fairly young and a father who displays many of the same traits (never diagnosed though). It's definitely helped me to know this, puts some puzzle pieces in place, so to speak, and gives me a path forward toward managing something I didn't really realize I needed to manage, but was having a significant impact on my life regardless.

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

#275

Post by nickstinemates » Tue, Jun 14, 2022, 9:44 PM UTC

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.

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

#276

Post by danShumway » Tue, Jun 14, 2022, 9:47 PM UTC

slingnow wrote: post #255

tjridesbikes wrote: post #135

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-wi…

Have you considered that you're an outlier and that policy and approaches shouldn't be based on your outcome? It's clear you're an evangelist for this approach, but your complete dismissal of people who have issues with drugging children doesn't add anything to the discussion.

> Have you considered that you're an outlier and that policy and approaches shouldn't be based on your outcome?

I don't think it's reasonable for OP to advocate for policy that would materially make their life worse. I'm not sure what you expect their response to be, but it's not going to be, "medication doesn't work for everyone? Great, I'll just go back to being miserable then so no one accidentally takes it unnecessarily."

Prescription medication is something you should work out with a doctor/psychiatrist who monitors your behavior and figures out whether the approach is right for you. But even if methylphenidate only worked for even just 10% of the people who have ADHD -- those people should have access to it. And the rest of the people don't need to take it, that's something their psychiatrist/doctor can work out with them.

> complete dismissal of people who have issues with drugging children

It bothers me that people read "hey, medication worked for me and didn't give me depression" as "literally everybody and their dog should be on this." I don't think that OP is the person here who's dismissing or generalizing.

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

#277

Post by FollowingTheDao » Tue, Jun 14, 2022, 9:49 PM UTC

dymk wrote: post #61

robonerd wrote: post #45

Earlier quoted context omitted.

> "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.

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 stimu…

"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_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-...

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?

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

#278

Post by FollowingTheDao » Tue, Jun 14, 2022, 9:55 PM UTC

Deritio wrote: post #259

stainablesteel wrote: post #249

Earlier quoted context omitted.

What worries me more for lifetime-use like this are epigenetic effects (generational-level adaptations to DNA via methylation) that will be felt by anyone inheriting the outcome of their parents behavior. Epigenetic mechanisms are what turn pigs into boars when released into the wild. In humans, if someone undergoes drastic starvation in their childhood, their children will often be fat. Their bodies hold onto fat mo…

Good for you not needing meds...

Hey, this is really bad. I am disabled for Bipolar Schizoaffective disorder, living with it for 30 years, hospitalized quite a few times. I was on countless meds. They told me I needed them or I would get worse. But I kept getting worse.

Now, for the last 8 years I am med free and showing signs of recovery.

You do not need meds. You need to find out why you need them biologically. We know that ADHD is primarily caused by low dopamine. So why are you not making enough dopamine?

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

#279

Post by throwaway_1928 » Tue, Jun 14, 2022, 9:55 PM UTC

throwaway892238 wrote: post #267

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.

They have to make money somehow.

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

#280

Post by CodeMage » Tue, Jun 14, 2022, 9:55 PM UTC

luckydata wrote: post #162

CodeMage wrote: post #130

Earlier quoted context omitted.

That's true. And it's also true that ADHD is overdiagnosed and overtreated, and the rate is non-negligible. That is a problem that both the public and the medical community are aware of. I agree with maintaining awareness of that, but I strongly disagree with going to the extremes and stigmatizing ADHD medication and everyone involved. Look at the comment I objected to. Does it read like a rational, polite way to mai…

who told you it's over-diagnosed? Science generally agrees ADHD is under-diagnosed. Read the statement of consensus. There's some sort of moral panic cause the beautiful souls of a bunch of people can't fathom stimulants can be used for medical purposes cause "all drugs are bad and Concerta is essentially meth" which is absolute BS. There's no need to spew hearsay and lies when you know next to nothing about a medica…

I based what I said on the study by Kazda, Bell, Thomas, et al [1], although there's always a chance that I might have misunderstood it. From what I understood, it seems that there's a certain degree of overdiagnosis in milder cases of ADHD. Again, it's perfectly possible that I either misunderstood it or that they're wrong.

If you look at the rest of my comments in this discussion, you'll see that I'm not pushing the moral panic you mention -- on the contrary, I'm pushing against it strongly -- and that it's definitely not true that I "know next to nothing" about this condition.

It wouldn't surprise me to find that ADHD is being simultaneously over- and under-diagnosed, because it's new enough that we're still discovering more and more about it. That's why I don't dispute that there's probably some degree of overdiagnosis, but I strongly object to pushing the narrative that it's some kind of an overmedication epidemic or crisis.

[1]: https://jamanetwork.com/journals/jamanetworkopen/fullarticle...