View Full Version : Treating ADD or anxiety first?


mentalmama24
08-09-16, 08:41 PM
For those who have ADD/ADHD along with anxiety, which did you treat first? I've had depression and anxiety for as long as I can remember and was recently diagnosed with ADD. Because I am in college I want to focus on treating my ADD before I delve into the depression and anxiety. BUT, I've found that all of the stimulants I've tried so far (strattera, concerta, adderall, and currently vyvanse) exasperate my anxiety to the point where I (almost) don't even care about the ADD anymore and just want to get rid of the crippling anxiety I'm feeling. I've read that some feel a sense of calm with stimulants, while others do experience some anxiety, but the benefits of the medication outweigh the cons so they just try to cope with it. I've been having difficulties figuring out whether or not the medication is even working for me, so that plus the anxiety is just a big fat no for me. Sorry, i'm rambling. I guess I want to know whether others experienced a big increase in anxiety with stimulants, and if you did, did you just cope with it?

lisag519
08-09-16, 10:11 PM
I am the mother of an 18 year old young man with OCD, anxiety and ADHD. We were treating the ADHD so that he could do well in school, however the anxiety was so bad that it was taking over his life. We switched doctors and took him off the stimulant medication. Meds alone were not helping the anxiety so he began CBT. (cognitive behavioral therapy) That was a godsend! It lowered his anxiety and OCD to the point where it was almost non-existent. He tried going back on the stimulants for the ADHD but they still make him too anxious. Just wanted to share my experience.

Rockkso
08-18-16, 12:27 PM
I don't think there is a reason you can't treat both simultaneously, but this is something you need to talk about with your psychiatrist. Are you currently on any anxiety meds? Many people with ADD and anxiety disorders take both. It's very common.

I was diagnosed with panic disorder at age 23 and have been off and on (mostly on) low-to-moderate doses of sertraline for ten years to treat it along with therapy. About six months ago I was also diagnosed with ADHD and was then prescribed Adderrall XR. Like many people in this situation my immediate concern was that a stimulant medication would re-trigger my panic attacks, but it turned out not to be the case. In fact if anything my extra focus probably calmed me a little bit (many people with ADD and anxiety report that stimulant meds actually help their anxiety). An important thing is to start with a low dose of the stims and slowly ramp up until you find a dose that is effective and doesn't make you jittery (you don't want to just go from zero to 30mgs of adderall right away). My doc started me at 5mg of Adderall XR and we gradually added 5mg a week until I reached my current dose (20mg). Talk to your doctor about both conditions, your concerns, and come up with a treatment plan for both.

Cyllya
08-22-16, 11:40 PM
I'm not sure that treating your anxiety disorder will make the stimulants stop having bad side effects, but if you haven't been able to get adequate ADHD treatment, I guess trying anxiety treatment is the next best thing.

The only other thing I can think of is listing the doses/schedules/lengths of time you took the ADHD meds to see if anyone has suggestions to discuss with your doctor. (For example, the recommended starting dose of Adderall for adults is 20mg per day, but if I'd started at that dose, I probably would have dropped dead :eek: or at least have had horrible side effects. I started at 5mg and I'm still only taking 15mg after being on Adderall for a few years. So if you started those meds with anything other than the smallest possible dose, it might be worth your time to go back and try the smallest dose.)

mildadhd
08-23-16, 01:55 AM
I guess I want to know whether others experienced a big increase in anxiety with stimulants, and if you did, did you just cope with it?

I do not suffer from anxiety due to methylphenidate SR.

I would not take methylphenidate, if it made things worse.

G

extrabatteries
08-25-16, 04:02 AM
I'd definitely treat the ADHD first. I had anxiety and depression for as long as I can remember, and it got increasingly bad until earlier this year I decided to go for treatment. The doctor wanted to see if the anxiety and depression were being caused by stresses resultant from coping with issues related to ADHD behavior. Low and behold the anxiety started dropping after beginning Strattera. About two months later the depression dropped off too.

So for me, I went in thinking I needed anti-depressants or anti-anxiety medications. I thought I'd be given Wellbutrin or something, but the doctor wanted to start with ADHD in case it was amplifying the other two.

However, I'd also get the recommendation from your own doctor, who likely has a degree or two to say about it :)

FinallyDxed!
11-13-16, 09:21 PM
nurse let me try Ritalin and my limited experience is that anything over 5mg was too much and bc it was immediate release the ups and downs were stupid at higher doses. Irritable grrrrrr then sad boooo ;-)

Yeah so now on Zoloft (reluctantly) to treat GAD ans SAD and I think I'm mildly depressed. The new psychiatrist's plan was to put me on Adderall 2 months down the road but now that I'm like almost 3 weeks in I read online about MAJOR interactions between Zoloft and Adderrall so I am very anxious to hear what he says about his "plan" tomorrow when I see him and explain that I'd rather not .....die.

dvdnvwls
11-14-16, 02:53 AM
If I ruled the world, I would prohibit medical information websites from serving side-effect lists to people with anxiety disorders. :)

sara_janie33
11-15-16, 10:14 PM
Hi, I have inattentive ADD, depression, and anxiety. I see this thread started a while ago but wanted to add to it.

I would recommend researching/asking your doctor about guanfacine or clonidine. They are non-stimulant medications used to treat ADD, anxiety, depression, and high blood pressure. I just started guanfacine a week ago and already feel improvement. It has helped with the social anxiety/obsessive thoughts and feelings. And lowering blood pressure has helped shakiness, blushing, and just the head spinning physical part of anxiety.

I am about to start vyvanse - I tried a bunch of ritalin and adderall types a while back and they didn't work for me mainly due to the heart racing and increased anxiety. But they definitely helped with motivation and focus. So the guanfacine should mitigate the bad effects of stimulants.

I'm also on lamictal (mood stabilizer) for depression/anxiety.
I take hydroxyzine - definitely safer than benzos - non addictive anti anxiety medication similar to benadryl, but you can take very small up to larger doses. I take it as needed for general anxiety and insomnia.
Also take xanax as needed for panic attacks, but I haven't had to take that since starting guanfacine :)

If you're interested in an herbal anti-anxiety, valerian root is a good one to look in to. Its super safe, prescribed to pregnant women even. It'll knock you out if you take a normal dose, so start small. It tastes like rotting grass lol but worth trying for sure.

I found out about guanfacine through this article, this Doctor Dodson put a name to a set of symptoms/traits of ADD relating to anxiety, called rejection sensitive dysphoria. Really struck a chord with me and others with ADD I've shared with. And my psych has never heard of this term relating to ADD, but she said guanfacine is prescribed for rejection sensitive depression. She read the article and finds it interesting and helpful.

"How ADHD Ignites Rejection Sensitive Dysphoria" (http://www.printfriendly.com/print?source=homepage&url_s=uGGC%25dN%25cS%25cSJJJmnqqvGHqrzntmpBz%25cSn quq%25cSnEGvpyr%25cSbcbbemuGzy) by William Dodson, from ADDitude Magazine

I hope that helps! :)

sarahsweets
11-16-16, 07:04 AM
I read about the zoloft interaction but I wonder if thats because its an SSRI? I have been on cymbalta for 13 years and amphetamines for 15 years and never had an issue but cymbalta is an SNRI.

FinallyDxed!
11-16-16, 02:14 PM
I read about the zoloft interaction but I wonder if thats because its an SSRI? I have been on cymbalta for 13 years and amphetamines for 15 years and never had an issue but cymbalta is an SNRI.

SO...update. Psychiatrist said he uses stimulants and ssris all the time. The key is slow gradual increases and proper dosages. In his 20 something years only 3 people with serotonin syndrome. Made me feel a little better.

FinallyDxed!
11-16-16, 02:15 PM
If I ruled the world, I would prohibit medical information websites from serving side-effect lists to people with anxiety disorders. :)

AMEN. :giggle: talk about amplifying our obsessive anxiety!

Pilgrim
11-16-16, 05:58 PM
Workout the type of anxiety. If the Stimulints are making them immeasurably worse you can't keep taking them (and they work so well), or reduce the dose.

This has been an issue for me, part of the problem was that my Dex dose was to high and I titrate up to an effective dose very slowly. SSRI helped a bit, but the side effects suck.

I felt the anxiety was the priority but the ADD/anxiety was enmeshed together, this was a problem. Goodluck.

JennK258
11-26-16, 02:56 PM
For those who have ADD/ADHD along with anxiety, which did you treat first? I've had depression and anxiety for as long as I can remember and was recently diagnosed with ADD. Because I am in college I want to focus on treating my ADD before I delve into the depression and anxiety. BUT, I've found that all of the stimulants I've tried so far (strattera, concerta, adderall, and currently vyvanse) exasperate my anxiety to the point where I (almost) don't even care about the ADD anymore and just want to get rid of the crippling anxiety I'm feeling. I've read that some feel a sense of calm with stimulants, while others do experience some anxiety, but the benefits of the medication outweigh the cons so they just try to cope with it. I've been having difficulties figuring out whether or not the medication is even working for me, so that plus the anxiety is just a big fat no for me. Sorry, i'm rambling. I guess I want to know whether others experienced a big increase in anxiety with stimulants, and if you did, did you just cope with it?

I vote for both, and don't wait! My son began to experience worse anxiety on stimulants, the doc added a med for that, and he did fine. Maybe stimulants aren't for you, but then again maybe you can make them work with the right combination- it's worth a try for sure!

MommasLove
01-13-17, 12:27 PM
Interesting thread. We are just in the early stages of a diagnosis of ADD that was treated with Concerta but my sons anxiety got too bad. We are now off the Concerta and trying to deal with the anxiety. I'm hoping the doctor will prescribe Clonidine. Good luck to you.

oldtimer
01-26-17, 10:30 AM
You ought to treat them both ASAP. My youngest son has anxious ADD. He is treated for both. You want to make sure the different drugs do not conflict. Stimulants can affect anxiety and anti anxiety drugs can lessen the effect of stimulants. All too often the same Dr will prescribe conflicting drugs.

Good luck!