Depression and ADHD

[NJC12]

New to the group. I am in my mid/late 30s now. I had ADHD since childhood and i always kinda knew and "felt different" but was never treated. In my teens, I self-medicated with pot and alcohol. I struggled with addiction for many years. I have been sober from alcohol for 3 years; i still use pot to help me sleep and with anxiety. I recently started strattera and that has helped a lot for concentration and at work. However, my depression is severe recently. My wife also says i am still very impulsive and have outbursts...though much improved from previous. I have been on lexapro for almost 4 years now. I never thought it helped that much. Anyone on strattera and an SSRI? Was wondering if wellbutrin is better. Also wondering if guanfacine helps with impulse and is well tolerated. Lastly, has anyone done ECT for depression? Sometimes I think that is a last resort.

[Gettingittogether]

Welcome and my heart goes out to you. Just a tip: you don't need to figure all this out. You just need to tell your provider LOUDLY and BLUNTLY where you are suffering. And your provider--if they have basic competence--will change the depression meds. And it's their job to know which meds interact with other meds.

I don't know if was me or ADHD but it seems I wasted a ton of time trying to figure these things out. That's the job of the professional. Now I do LOVE getting informed and reading. Doing so calms some of my anxiety, gives me a sense of power. But I realized at some point that I was not tapping the expertise of my providers because I was not telling them the blunt truth. Sometimes I was sugarcoating my pain to my providers! That's a bullet directly at my own knees.

Now back to you, you say your depression is "severe recently." OK, here's the deal. You need to get off this board. Call your provider and say those exact words. That's a multi-alarm fire. You do NOT wait passively til a next appointment when depression gets severe. You scream! Figuratively and literally to your provider. You describe the agony... and that gives them the information and cause to change your med routine.

Now I know this is hard. Especially when we're depressed. I'm asking you to be bossy and entitled and insist on being attended to while you are depressed. I get how hard that is. Do me a favor: make the call anyway!

Now, Yes, I'm on Wellbutrin and a stimulant and yes, I love Wellbutrin.

And if I were severely depressed and the depression resisted treatment over a prolonged period of time,, sure I would go for ECT, which is now considered a legitimate treatment for treatment resistant severe depression.

Ritalin (methylphenidate) has a record of working off label as a medication for treatment-resistant depression. Have you been on that?

[Old_Owl]

I totally agree with Gettingittogether. You need to be clear and blunt with your provider, or providers. It might also be that meds won't solve it all- it didn't for me.

I have a handle on my depression though therapy and meds. Therapy provides me the understanding and tools to keep it at bay; meds make it easier to keep it up. Both of these came through working with providers. And even then I didn't start seeing progress until I was open, honest and blunt. Like Gettingittogether, I didn't start off being honest. Being a people pleaser I'd often say what I thought he wanted to hear and avoided items I thought would unviel me as a horrible human being. Silly that I paid someone to help while actively hiding parts of the problem. Wasted time.

[Old_Owl]

I totally agree with Gettingittogether. You need to be clear and blunt with your provider, or providers. It might also be that meds won't solve it all- it didn't for me.

I have a handle on my depression though therapy and meds. Therapy provides me the understanding and tools to keep it at bay; meds make it easier to keep it up. Both of these came through working with providers. And even then I didn't start seeing progress until I was open, honest and blunt. Like Gettingittogether, I didn't start off being honest. Being a people pleaser I'd often say what I thought he wanted to hear and avoided items I thought would unviel me as a horrible human being. Silly that I paid someone to help while actively hiding parts of the problem. Wasted time.

[Boss_barbie]

honestly, I’ve been on anti depressants for 21 years. The thing I’ve found is that you need to find the combination that works for you. I’ve tried so many different medications and some worked for a period of time and others were terrible from the beginning. I also found that you need to be properly diagnosed as for instance I have manic depression and bipolar. Also cptsd and BPD. So I am on a combination of 2 medications for my depression and bipolar and a separate medication for my adhd.

It can be difficult but stick it out and once you find what works for you it gets so much better.

Hope this helps a little.

[Shelley11 in reply to Boss_barbie]

Hello, I just want to validate your reply in this post. You are exactly right that sometimes it’s a combination of medication that will give the patient relief. The problem for many is Doctors have limitations to the time they can spend with each patient. People go on suffering because these drugs are never a quick fix.

[Mamamichl]

Guanfacine is a blood pressure med. basically it allows people to stay calm and not have as much freak outs.

[JMPhD]

ECT is a last resort, so much to try before this. Wellbutrin is better for depression c ADD//ADHD benefits…definitely saw difference when I used it. Good luck!

[Lpnmba]

Have you ever checked if you’re a candidate for transcranial magnetic stimulation or tms?

[Shelley11]

Hello, My heart went out to you when I was prompted to read your post.

I suffered severe depression for many years and ect was my last resort. However I asked my Psychiatrist to trial me on Dexamphetamine first. After taking the first dose the depression lifted and I felt this huge weight lift for the first time in many years.

That was in May 2013 and I have not relapsed or experienced the severe depression ever since. I believe I had ADHD all along. Anti depressants help to keep serotonin active in the brain. But if it’s ADHD that is causing the depression the person needs help to increase dopamine in the brain which most anti depressants don’t help with that enough to make a difference.

It does my head in why did I have to suffer for so many years when the right treatment was right under the nose of the many medical professionals all a long? That is because dopamine is what drug addicts seek to give them the high their body craves.

I have been taking Dexamphetamine exactly how it’s prescribed and go to the same Doctor and pharmacist for my repeats and have no trouble. As long as people do the right thing with their medication and never need to request prescriptions early you’ll have very few problems. Occasionally I have come up against a pharmacist who new to the chemist I go to, who has questioned why a 62 year old needs an ADHD medication. One guy who was providing relief for the regular pharmacist, actually refused to give me my weekly supply of Dexamphetamine. He said he had worked in emergency at major hospitals and had seen too many overdose cases. Because I am so forgetful I choose to pick up a weeks supply at a time & he assumed I had a problem.

I still take Prestiq which is anti depressant as well as the dex. The combination literally saved my life. It’s not appropriate for me to tell what to do in this setting. But I do encourage you to think about what I have shared with you because getting your brain zapped is a scary thought.

The other thing that increases dopamine is exercise. Depression does make it hard to get up and do at least 20 minutes of exercise but if you have someone who could encourage you to get going that would make a huge difference as well.

Best wishes for your future and take one day at a time. Be kind to yourself and remember you have the right to quality health care.