View Full Version : depression & ADHD & suicidal ideation (Trigger warning)


icarusinflames
05-14-15, 08:05 PM
I was just reading a webpage about how to approach the diagnosis of ADHD, when the person also has a depression, and how to tell the depression that is simply from ADHD from a true comorbid condition of depression that exists among the ADHD issues.

THey were saying that if the person has suicidal ideation, to not treat the ADHD but to move straight to depression treatment first. I understand the point of this, but I am now worried that if I mention that i indulge in suicidal ideation (with no plans to do it), then they may insist that I can't get ADHD treatments but have to take some awful anti-depressant first. I once tried Paxil for like 8 months and it left me feeling about as vibrant as shoe leather.

So what do you think? Will a psychiatrist always refrain from starting ADHD treatment if you show up at evaluation talking about suicidal feelings and depression?

I literally hate my depression now because for years, they always just told me that I was depressed and the cognitive behavioral therapy was so horrible to me. And I disliked the med I tried for depression too.

I would rather deny my depression and focus on the neurological issues that I perceive even more clearly now!

rickymooston
05-14-15, 09:02 PM
If you step outside the box, assuming the depression is severe enough, the depression can be extremely dangerous and thus it's natural they might treat that first or take it into account

So the question really boils down to whether the depression is a more immediate threat to you or not.

If depression is a side effect of your medication, isn't there are risk it could kill you? Anyway, as a non-doctor who doesn't even take medication for my ADHD, I hope you will be extremely careful on this. There could exist a medication that doesn't cause you to be depressed ...? I have a craving for a red bull right now but don't feel like going outside. Trying coffee with honey.

PLease take care. You probably have to be honest with your doctor to get the best treatment.

Pilgrim
05-14-15, 09:25 PM
This is just my 10 cents worth from my experience.

When I first started ADD meds I felt great. Before this I was constantly foggy and not really in the human race. And although I was depressed, I was to apathetic more than anything else.

After being on Stims for a while I started to think a lot more of death. It gave me a chance to look at my life closely. To the point where I dreaded coming down off Dex. I gradually got through this process. It did make me change certain parts of my thinking.

Tried heaps of SSRIs before Dex and although they took away the idea of suicide the made me feel very emotionally blunted and confused.

When I started to go through this period of thinking bad things, which I thought was largely anxiety, I spoke to my Psyciatrist and he put me on Citalopram.
This was not a bad combination with Dex. He should know right.

Pilgrim
05-14-15, 09:30 PM
I guess a good Psyciatrist will deal with the depression if it is a major problem for you.
The only reason I rejected SSRIs is that although they helped they always felt like extra baggage.
With Dex it doesn't feel like that at all.

TheChemicals
05-14-15, 09:40 PM
I'm in the personal belief that if you have adhd and get adhd treatment that works....you don't have depression anymore or in the least...minimized enough to where it's not a problem. so as a non-doctor....I'd say you don't have ADHD. You're just depressed. My very simple personal opinion that needs no grounds for debate. Maybe some self discovery.

I still get the blues on vyvanse...noone in the world is free from getting depression. suicide is pretty rock bottom depression, in whatever terminology you want to label it as.

icarusinflames
05-14-15, 11:34 PM
Thanks everyone. I'll have to ask at my evaluation for some recommendations of psychotherapist. It just dawned on me, while reading all your kind and excellent replies, that I could perhaps raise these concerns when I go see whoever is going to become my prescribing doctor. I find it hard to believe the person who gives you the evaluation is the same person who you will become dependent on for medication. Your expert evaluation will just make it easier to get someone more local to you, to consider taking you upon their care, as in writing scripts that you will become dependent on. I would prefer a very stable and reasonable person who understands that if I can just pick up a prescription every few times, and then come in for appointments to discuss the m eds like every 4 to 6 months... that would be amazing. I hold out hope for this, as I kind of resent the idea of even having to take meds and then become dependent upon people who like to charge hundreds for a session. I just can't do that every week!

Unmanagable
05-15-15, 10:38 AM
I was told I had severe depression for years, and they never got past trying to treat that to determine any other diagnoses. They all totally ignored PTSD from various forms of abuse starting at the age of 13.

Later, I finally discovered a therapist who strongly suggested the adhd diagnosis, and once that was brought up, and I returned to another psychiatrist, and was once again prescribed a cocktail with an anti-depressant involved, on top of vyvanse, and xanax for anxiety, which was major f'n overload and had me dealing with severe side effects, did my doc finally decide to prescribe adderall IR, which helped tremendously, but took a whole lot of tweaking in dosage to get it right. I was even told during that stint by the psychiatrist that I have "some type of personality disorder, but he can't quite narrow it down to which one". Still waiting to have one named after me.

The relief from the adderall helped me for quite some time (a couple years), but again, the side effects discomfort won out, and I'm now off all prescriptions, trying to get through the days with other supports in place, such as neurofeedback, massage therapy, acupuncture, herbal tinctures, dancing, drumming, breathing, etc.

I'm now convinced that PTSD has played a much larger role in my struggles than adhd, but none of the "professionals" seem to want to acknowledge that, for whatever reason. I don't recall ever hearing any commercials on TV for PTSD related drugs, so I'm guessing that may have a little something to do with it, which infuriates me to no end.

InvitroCanibal
05-23-15, 04:40 PM
I was just reading a webpage about how to approach the diagnosis of ADHD, when the person also has a depression, and how to tell the depression that is simply from ADHD from a true comorbid condition of depression that exists among the ADHD issues.

THey were saying that if the person has suicidal ideation, to not treat the ADHD but to move straight to depression treatment first. I understand the point of this, but I am now worried that if I mention that i indulge in suicidal ideation (with no plans to do it), then they may insist that I can't get ADHD treatments but have to take some awful anti-depressant first. I once tried Paxil for like 8 months and it left me feeling about as vibrant as shoe leather.

So what do you think? Will a psychiatrist always refrain from starting ADHD treatment if you show up at evaluation talking about suicidal feelings and depression?

I literally hate my depression now because for years, they always just told me that I was depressed and the cognitive behavioral therapy was so horrible to me. And I disliked the med I tried for depression too.

I would rather deny my depression and focus on the neurological issues that I perceive even more clearly now!

I get suicidal ideation a lot, what keeps me going is that I know how to pull myself out of it. I can still be depressed and sometimrs I just introspect as well. I ask myself if it really mattered how I started life or how I finished life? In that I mean I just want to learn to be there for others in whatever ways,I can. I also wanted to figure some things out.

thomass
07-26-15, 08:59 PM
I'm in the personal belief that if you have adhd and get adhd treatment that works....you don't have depression anymore or in the least...minimized enough to where it's not a problem. so as a non-doctor....I'd say you don't have ADHD. You're just depressed. My very simple personal opinion that needs no grounds for debate. Maybe some self discovery.

I still get the blues on vyvanse...noone in the world is free from getting depression. suicide is pretty rock bottom depression, in whatever terminology you want to label it as.

I'm no doctor either, but I believe once the dopamine wears off (i.e. The crash) after taking a stimulant, a state of depression can sink in. Maybe this is why doctors are nervous to prescribe stimulants to people with depression.

qanda
07-26-15, 09:53 PM
Unmanageable: Have you heard of EMDR? There are some studies that this therapy helps with PTSD. My daughter has just started it. It was hard to find a therapist. If a therapists does it correctly, they teach you grounding techniques and ways to calm down before doing EMDR.

Powderbucket
07-28-15, 09:26 AM
I'm no doctor either, but I believe once the dopamine wears off (i.e. The crash) after taking a stimulant, a state of depression can sink in. Maybe this is why doctors are nervous to prescribe stimulants to people with depression.

This is interesting, because yesterday I had a bad experience related to this.

I was very tired, so I didn't take Concerta like I usually do. When I say tired, I mean that was DEAD, zombie tired... I didn't sleep at all the night before (I think I had too much coffee or something stupid). At around 6pm, something ticked me off and I went into major depressed / agro mode and shut myself in the shower crying and crying and crying and thinking of ways to hurt myself. Then my GF came in and helped me when she saw my state.

This hasn't happened to me in a VERY LONG time. It would happen every now and again before I got medicated. Like, I consider Concerta to be my LIFE-saver because it helped stop these "episodes".

It scares me how I can just "switch" like that when I'm off my medication and in a bad mood. Then I don't really know I'm depressed or what.

4rch0n4n6313
07-29-15, 12:40 AM
I have a aspergers, Chronic Depression, PTSD, ADD diagnosis...I take adderall.

That being said..the depression never goes away for me, because all the me I have to deal with, never fully goes away...and that is depressing. I have a reason to live, and that is my children. Regardless of how well I do or dont do that is a legacy they dont need in their life. So I have made a commitment to that. So while I am sometimes at a loss with what to do with myself, that is never an option.

I have been on every bi-polar and anti-depressant in the book, only to find that I either couldnt muster the motivation to do more than pee, or lost all behavioral inhibition...which lead to allot of problems with authority figures.

Adderall has been the only medication I have taken that has had a positive effect. I can stop myself from doing things that I know are inappropriate. For example, I moved and had not been on adderall for a while. When I decided to resettle, the doc I went to gave me Strattera and Welbutrin...I ended up doing cartwheels in an office during an internship..something I would blatantly refuse to do on adderall.

Everyones chemistry is different though, so it is hard to say what you should and shouldnt do.

What i did when I talked to my new dr, was tell him that I get depressed, I have thought that I would like to not deal with life because its so hurtful, but that I would never really try to kill myself because I have to much to live for. The truth is, dr deal with things not only by what you tell them, but how you describe it. So instead of telling him your obsessed with dying, find ways to emphasize why you want to live.

tazoz
07-29-15, 02:48 AM
Not telling your psychiatrist that you have depression can be irresponsible and dangerous. Stimulants can make your depression worse which both puts you in danger and often counters the positive effect of the stimulants as one of the symptoms of depression is attention problems...

Stimulants are the first line of treatment for adhd without commorbids and if you don't tell the psychiatrist he will undoubtedly prescribe some to you... the thing is, there are ADHD medications that treat ADHD and depression - Wellbutrin or Strattera and you can probably safely suggest to try them... if they don't successfully treat uour ADHD but fo treat your depression the doctor might add on later a stimulant. One thing to keep in mind is because depression causes ADHD like symptoms differential diagnosis can be important, if you remember clearly that you had ADHD before having depression then mentioning it might convince the psychiatrist to immediately start on the combination treatment...

it's important to be patient with treatment as there are multiple medications used to treat adhd and sometimes it can take time to find the right combination that works for you. I tried seven different types of medication before I found the right combination but after doing so my life drastically improved...

Yael

sarahsweets
07-29-15, 05:18 AM
I'm no doctor either, but I believe once the dopamine wears off (i.e. The crash) after taking a stimulant, a state of depression can sink in. Maybe this is why doctors are nervous to prescribe stimulants to people with depression.

are you saying that everytime someone takes a stimulant they experience a crash due to a dopamine thing?

4rch0n4n6313
07-29-15, 02:18 PM
Not telling your psychiatrist that you have depression can be irresponsible and dangerous. Stimulants can make your depression worse which both puts you in danger and often counters the positive effect of the stimulants as one of the symptoms of depression is attention problems...

Stimulants are the first line of treatment for adhd without commorbids and if you don't tell the psychiatrist he will undoubtedly prescribe some to you... the thing is, there are ADHD medications that treat ADHD and depression - Wellbutrin or Strattera and you can probably safely suggest to try them... if they don't successfully treat uour ADHD but fo treat your depression the doctor might add on later a stimulant. One thing to keep in mind is because depression causes ADHD like symptoms differential diagnosis can be important, if you remember clearly that you had ADHD before having depression then mentioning it might convince the psychiatrist to immediately start on the combination treatment...

it's important to be patient with treatment as there are multiple medications used to treat adhd and sometimes it can take time to find the right combination that works for you. I tried seven different types of medication before I found the right combination but after doing so my life drastically improved...

Yael

I started hallucinating when I was prescribed strattera and welbutrin together.

First I was perscribed strattera wich made me feel like I had drunk bad coffee and too much of it. I was sluggish and jittery at the same time. It was better than nothing however. I told my doc and he gave me Welbutrin. A couple days after he put me on Welbutrin I completely lost all impulse control. Reality wasnt real and I became really really emotionally unstable.

I dont crash from adderall, im not sure why, but its not horribly "stimulating" to me, other than having a clear enough thought process to follow through on ideas. If life is going on as normal, I have no problems sleeping. As a matter of fact I have fallen asleep trying to get my children to take a nap, after my noon dose. I take 30mg X 2 daily.

Im sure im the only one in the world with this experience...but, in case im not, Im sharing. So just make sure you have a Doctor who is willing to listen to you, and not bring preconceived notions to the table about what he/she thinks you need, cause he/she read some study in school on how 60% of people respond to cat pee. 40% is a big number....

tazoz
07-29-15, 03:33 PM
I'm sorry to hear of your experience, Wellbutrin and Straterra are on occasion prescribed together but straterra increases the potency of Wellbutrin making the combination fairly dangerous. Wellbutrin xr above 300 mg is supposed to be really dangerous, potentially causing seizures and other side effects so taking a medication that increases its potency is probably a bad idea.

By combination I meant Adderall or Ritalin with Wellbutrin as they compliment each other well.

Abi
07-29-15, 03:48 PM
Correction, Wellbutrin above 450mg /day is dangerous.

tazoz
07-29-15, 04:36 PM
Correction, Wellbutrin above 450mg /day is dangerous.

Thank you for the correction. :)

wrd9000
10-13-15, 09:18 AM
Psychostimulants like Dexedrine can help with depression symptoms. There is NO need to take SSRIs or SNRIs. Here's the point. Psychostimulants work immediately so you can bypass the weeks and months of trying SSRIs/SNRIs. And those drugs work if you have a serotonin deficiency. If you have a dopamine deficiency that is causing depression then it will be become readily apparent if a psychostimulant is working. In the past, I had tried SSRIs, TCAs, an SRNI, benzos, ketamin infusions and nothing worked. A recent pdoc diagnosed me with dysmythia and prescribed Adderall. That lifted my depression and made me jittery so we switched to Dexedrine with is much smoother. This is the FIRST time anything worked. I plan on trying to see if there is any other medication that is better. Focalin, Desoxyn, and Provigil is on the list. Remember that only 30% of patients are helped by SSRIs. In my opinion, drugs that increase dopamine should be first line instead, and for those who are leery of psychostimulant addiction can try Wellbutrin first. Obviously there will be people who vary in their levels of serotonin, dopamine, and NE so one drug may not cut it.

Fortune
10-13-15, 09:30 AM
I've found zoloft to work really well for me. The meds aren't useless for everyone.

I am not really convinced by any argument to not take SSRIs because I like not being suicidal all the time and I like not having crippling anxiety all the time.