View Full Version : ADHD inattentive + anxiety + depression, meds advice


Glacier
09-22-08, 09:18 PM
Just got dx'd ADHD inattentive + anxiety + depression. My psych wants to put me on meds for the depression and anxiety first, then take care of the ADHD.

Want to know what any of you with the same dx think, cos to be honest, the ADHD is the main thing that's bothering me.

amu_d
09-23-08, 02:19 AM
The best route is to treat anxiety and depression first. I would stick with the doctor's advice.

If the comorbid conditions are out of the way, it is much easier to treat ADHD.

If anxiety and depression don't go into remission within a few months, ask your doc to start you up on ADHD treatment and continue with anxiety/depression treatment.

Glacier
09-24-08, 10:41 PM
Thanks for your advice. I just wanna get some kinda semblance of normal brain working order going here, so speed is my main concern, especially this deep into the school year.

gellamc
09-26-08, 10:17 AM
Hi Glacier,
I'm new to the group and just saw your posting. I have the EXACT same dx (I feel so happy to kind of "meet" someone!).
Anyway, I started out about 4-5 years ago for treatment of depression. I got dx with anxiety 2 years after that. It wasn't until about a month ago that we figured out the last part of the puzzle, ADHD inattentive. So, I was treated for the other conditions first. This was probably best in my case since those were the worse conditions (I mean, I didn't even know about the ADD until now). So I did prozac then lexapro for depression and klonazepam for anxiety. I'm now starting tx for ADHD.
That being said, I feel like if your biggest obstacle right now is ADD, then try treating that first. For me, i was the opposite so we went that way. But the thing about this particular dx is that my doctor has told me, and I have also read, that the dep/anxiety may stem from the ADHD, and when you begin to treat that, the symptoms for the other decrease. I feel like I have had some relief since starting tx for ADHD (though I continue tx for the other conditions).
So I would say try the ADD first...a lot of dep/anx meds have more side effects, I think, and take a long time to go into effect. You could take a fast acting ADHD drug and see if other symptoms decrease right away and then decide from there. Another thing to keep in mind is that the antidep/anx meds are hard for some people to withdraw from, so if you started treating those first and then started feeling even better after treating ADHD, then you could possibly have a long road to withdraw off the others (if you wanted).
Just some thoughts!
Have a good one

ikgbixcal
09-27-08, 02:03 PM
im dx'd with all three. first the doc just put me on prozac and that was it and i even told him about the anxiety. after switching through many ssri's i finally got wellbutrin and klonopin. but if you complain enough to the doc or whoever about or concentration and focus thats wat i did nd finally he gave me vyvanse for adhd. it took sumtime to get these going threw all the ssri's and stuff. and if ya got social anxiety's the adhd med an the anxiety should help with that. the wellbutrin helps me alot more than any ssri did but im am on an snri with this combo. wellbutrin300mg xl cymbalta 60mg vyvanse and klonopin. and ambien for sleep

~carol~
10-03-08, 03:01 AM
Just got dx'd ADHD inattentive + anxiety + depression. My psych wants to put me on meds for the depression and anxiety first, then take care of the ADHD.

Want to know what any of you with the same dx think, cos to be honest, the ADHD is the main thing that's bothering me.

I don't know the full situation; it's possible your Dr. has it backward. I had to get the ADHD treated before the anxiety and depression cleared. I had years of failures on antidepressants before it was found that the ADHD was causing the problem.

Good luck.

hollywood
10-06-08, 02:45 PM
your in a fragmented situation ...

The picture can be distorted anytime anxiety, depression and mood issues interplay with adhd. For example if you have untreated adhd and hit your teen years you are likely to start experiencing some social problems that can be misinterpreted as a broad spectrum of anxiety or social phobia related disorders ....This is a common misrepresentation when a lack of confidence , compounded with structural social deficits become present or have stemmed from the lack of being able to pay attention to these important aspects. For example, One would start out by socially being inappropriate, which could lead to low self esteem , which could lead to social isolation , which could lead to major depression. I would try and treat the adhd first and see what your results are like, what I'm saying is that if you can't be attentive then even if your are slightly depressed the results from an antidepressant will only be short lived. I would treat them in two step approach. Adhd first then the mood if still present. Adhd in many environments can be misrepresented as many shapes and forms... Hope that helps

Glacier
10-08-08, 04:06 AM
I'm on 300mg of Wellbutrin rite now. To be honest, I dunno if it's working... If anything, my focus is still shot.

g2uncompressed
10-21-08, 12:10 AM
My First post!!!!!!

My psych wants to put me on meds for the depression and anxiety first, then take care of the ADHD. Mark, I had all 3 symptoms about 8 months ago. Super depressed, but I thought ADD treatment should come first. I was put on Celexa (20mg then 40mg) and the depression began to subside! Then, a few months later, when the ADD symptoms were still present, we then knew depression wasn't the cause of my inattentiveness.

Now on Celexa and Vyvanse (30mg inattentive type) I feel more myself and happier as a result. Getting depression out of the way first was big for me and I recommend that course of action. All the problems aren't solved, but I'm much better off than 8 mo. ago!

Btw I'm 17, male, and still in High School unfortunately...

meriellyn
10-21-08, 12:32 AM
I take Lamictal for my depression. It also seems to help a bit with my anxiety.
Started the Lamictal first and got regulated on a therapeutic dose (you have to build up), then added stims (finally settled on Dexedrine after trying a couple others) for the ADHD.
I think this was the right order for me. The stims take care of the lingering situational depression caused in part by the ADHD but I needed to get my general depression under control before I was ready for that.
And as far as anxiety, as I mentioned the Lamictal helps some. Then then Dex seems to halp a lot too because a lot of my anxiety stems from dealing with my ADHD symptoms.

Before my ADHD diagnosis, I tried a number of SSRIs, an SSNRI, and Welbutrin. The only one of those I responded well to was Welbutrin. I personally loathe SSRIs. To each their own though.
Welbutrin did help me a good bit but Lamictal is the only thing that has really really handled my depression with absolutely no side effects. With that out of the way, I'm finally able to deal with my other problems (the ADHD and anxiety).

ADDMagnet
11-02-08, 06:25 PM
This is my first posting at this forum. I'm so glad to have found this place. I was active in another forum but there were too few posters. This has so much more information and activity.

I have anxiety and ADD, my sister has depression and ADD. Many adults with ADHD that was never diagnosed or treated in childhood go on to develop anxiety and/or depression. Usually the disorder that is causing the most problems or is more serious will be treated first. In many cases that would be the depression. But each situation can be different. Also if the ADHD is treated first, the medication may worsen the individual's anxiety (and therefore sometimes it is erroneously assumed that a particular ADHD medication can not be used), so it would be preferable to treat the anxiety first. But if the ADHD caused the anxiety then treating the ADHD first would make more sense. A skilled doctor can make a big difference as he or she would be able to determine the best treatment sequence for the individual situation.

timmtc
11-05-08, 05:40 AM
I started with treatment for my ADHD then went on anti-depressants and anxiety meds. I'm on Effexor right now (375mg) and it works incredibly well for anxiety and depression. I'm having a hard time understanding the side effects though. Since starting the Effexor I feel much more lethargic and fatigued throughout the day. It's difficult to determine if it's the Effexor or the Adderall/Dex, but I think in many ways the Effexor has made some of my ADHD symptoms worse - i'm not sure if that's even possible or if it makes sense. I had a similar experience with Celexa a few years back. It helped my anxiety and depression but I lost my motivation to do well in school.

pADDyjay
11-05-08, 11:17 AM
my md wanted to change my prozac to celexa/some of my coleagues told me great things about celexa over stimulants and after 15ys I would like to try...bad move I thought was in cardiac failure/ cp/tired lightheadedness/ so celexa not for me /Im going for med check end of month but for now no more celexa

ikgbixcal
11-05-08, 03:43 PM
My First post!!!!!!

Mark, I had all 3 symptoms about 8 months ago. Super depressed, but I thought ADD treatment should come first. I was put on Celexa (20mg then 40mg) and the depression began to subside! Then, a few months later, when the ADD symptoms were still present, we then knew depression wasn't the cause of my inattentiveness.

Now on Celexa and Vyvanse (30mg inattentive type) I feel more myself and happier as a result. Getting depression out of the way first was big for me and I recommend that course of action. All the problems aren't solved, but I'm much better off than 8 mo. ago!

Btw I'm 17, male, and still in High School unfortunately...

adderall and wellbutrin have both work wounders for my depression and adhd. its nice to see someone my age on here. lol

elegy
11-06-08, 06:49 PM
You have multiple diagnoses that need to be addressed. No medication, by itself or in a cocktail, will effectively treat you. Some form of therapy should ALWAYS be used in conjunction with medication, and may even eliminate the previously assumed need for meds.
The best way to attempt to determine which path to take, is to thoroughly assess the accuracy of your diagnoses. You need to find out whether the anxiety and depression stems from the ADD, or the ADD and depression from anxiety, or the ADD and anxiety from depression, etc, etc.
If you feel confident in your diagnoses and have a good relationship with your provider, then give their plan a try.

Psychiatry is more of an art than a science. Trial and error, having a good prescriber, and educating yourself about your meds are the things that will help you find the right treatment. This is what the past 5 years of my life have taught me, what with the numerous med combos, diagnoses, and providers of all sorts.

Tominal
11-07-08, 02:42 PM
I think most doctors begin by trying to treat with antidepressants, because they are not controlled substances and sometimes they work. Benzos are prescribed liberally by some, but very cautiously by others. (Having been addicted to benzos, I am in the "stay away from daily use of benzos" camp). If these don't work, The ADD meds are often tried last, beginning with the unscheduled Straterra.

In my case, I was treated for years for anxiety with benzos, and then spent almost 2 years tapering off of the nasty little buggers. Then I finally got diagnosed with ADD and my psych. doc tried Vyvanse on me, God bless him. My anxiety (and related lethargic depression) evaporated overnight. :)

In my opinion, I think it would make a lot more sense to try ADD meds on a patient who presents with ADD symptoms mixed with anxiety and/or depression. It's an easy test--take the meds and see what happens. You'll probably know within 2 weeks or less. On the other hand, if you go the SSRI/SNRI route and/or start covering things up with benzos, and accurate diagnosis and effective treatment could be delayed indefinitely.

But I'm not a doctor, and they don't call me for advice.

Living2bwell
11-14-08, 12:50 PM
Hi Glacier!

I have also similar diagnosis, Im being treated for anxiety, depression and add (inattentive) and OCD.

I started treatment for my anxiety and depression first, I take xoloft 150mg, and now take meds for my ADD (inattentive type) - vyanase 40mg and/or Concerta 54mg, still evaluting the add meds, need to pick one best for me...

Good luck, the only crappy thing is that the anxiety/depression meds take soooo long it seems, takes like 4 weeks to kick in, so you might want to also try add meds to help jump start you feeling better.

Cheers,
;O)

Tyboulder
12-03-08, 02:26 AM
I have the exact same dx. Inattentive ADD, depression, anxiety and some OCD. I think this combo is a hard one to treat. I've seen some expensive psychiatrists and one expensive therapist. I tried almost every stimulant in the book (except vyvanse) and dexadrine was clearly the best foe me. For depression not much has worked. I've tried 40mg of paxil, 400mg of lamictal, 450mg of wellbutrin (though only a month into it), trazadone, and serzone. I'm not saying these can't help you- they very well might. I'm also very sensitive to stimulant medications (the crash is bad), but they absolutely help with the ADD. Depression and anxiety can be widely affected by your situation and environment. I'm in an environment that triggers high anxiety and depression. I'm an accountant :) My current psych (M.D., Ph.D.) says that 80% of those with mood disorders have ADD. Very hard to believe but there must be a high correlation. My mood is very sensitive. At baseline I'm slightly depressed or okay, in a stressful environment anxiety, depression and ADD all manifest themselves thouroughly. I'm happy when I'm interacting with friends (very rare these days) or on alcohol/drugs. The drugs are minimal, but it's like I need something to stimulate and excite me. I'm also sensitive to music (couldn't live without it), light (might have SAD), other's moods, etc. Sleep is HUGE for me. I should be in bed right now, but I've fought off going to bed since my parents let me stay up as late as I wanted. Delayed sleep phase? I don't know. I'd nod off in class in H.S., totally lose attention, (didn't know I had ADD until I was 26, I'm 29 now), and under perform. Excercise is also really really helpful (especially aerobic) but I have a tough time getting that done. I work late and I lack motivation. The best advice I can give you is to find a path/career that you're either good at (stimulating / changing) or something that you like (preferably both, but it's hard). People always say "follow your dreams" and it's absolutely true, but it can be one of the hardest things to do- especially if making a competitive wage is part of your goal. I feel like I've wasted 7 years of my life in accounting. If I was the person I am now after or during college I'd pursue something I loved as long as I could feed myself and crash on someone's couch. Meds take time. Especially the mood varieties (anx. / dep.), so be patient. Wow, this is a long rambling post, but because I feel we all share some common characteristics (and our type of ADD is rare), so I wanted to share a little of what I've learned over the last 3 years. Thanks for reading this whole post fi you made it :)

coolhand129
01-12-09, 12:11 AM
I don't know the full situation; it's possible your Dr. has it backward. I had to get the ADHD treated before the anxiety and depression cleared. I had years of failures on antidepressants before it was found that the ADHD was causing the problem.

Good luck.
I had exactly the same situation. Anxiety, depression. Once diagnosed with ADHD combined, the stimulant meds helped all three the first week

yankees440
01-22-09, 01:15 AM
This is actually my first post on this site... I am going to make it short as it is getting late.
I have been diagnosed with ADHD (inattentive) and could just as well be called Sluggish Cognitive Tempo. I have anxiety, depression comorbid with the ADHD.
The medications i am taking now have improved my life for the better as i am less involved in my own world and more able to open up to the outside world.
I am taking 40mg of celexa for anxiety and depression and obsessive thoughts. Zyprexa 5mg to stabilize my mood and stop the racing thoughts. Strattera 60mg twice daily for the inattentive ADHD and to get me going in the morning and to help focus.
Before i was put on this combo of meds (months of changing doses and medications before getting to the point i'm at now), i was a mess. I had trouble getting out of bed in the morning, had absolutely no focus, obsession of what was wrong with me (I would look up diagnoses of what could be wrong with me on the internet), grouchy, social anxiety, and episodes of major depression.
Well, i hope this is a help to anyone that is finding the right meds to go on. I would love to hear more medication stories and about your struggle with ADHD in general.
-Jordan-

hollywood
01-22-09, 10:54 AM
wow ,

I'd say the stims would be the base line defense against adhd if your just now starting

anon9000
08-05-09, 02:36 PM
I did effexor for two or three months. I had a great response to it in reducing the depression and anxiety. After that, I added adderall xr 10 mg, and it has worked great. I am glad we did it this way because I really needed to get back to eating and sleeping properly.

But when I look at the situation over a longer time frame, I realize now that had I been treated for adhd in the beginning (2006) instead of anxiety, I never would have been depressed to begin with.

2Springers_Matt
08-05-09, 07:52 PM
I too have all three. I was put on anti depressants first, the add meds came shortly there after. We didn't real realize that the anxiety was such an issue at first, so that med came later.

I am now on aa very helpful combo of vyvanse + prozac in the am, and trazadone at night (because I can never sleep without the millions of thoughts, ideas and noise in my head.) I also have ativan for those specific times when I just start freaking out.....

110sad
05-24-10, 02:11 PM
I was diagnosed depression , then anxiety, finally ADHD inattentive. Up until 2 weeks ago 20mg lexapro & 100mg strattera. The Strattera seemed to have stoppped so I was weaned off that & put on 5mg Focalin & 10mg Focalin XR. The Focalin Doesnt seem to be cutting it, so starting tomm. I start to titirate on strattera back up to 100mg. So I'll be on that ,plus 20mg lexapro, & 10mg Focalin xr.. For me the Strattera really helps with the memory!!

BellaVita
08-05-11, 01:10 PM
My First post!!!!!!

Mark, I had all 3 symptoms about 8 months ago. Super depressed, but I thought ADD treatment should come first. I was put on Celexa (20mg then 40mg) and the depression began to subside! Then, a few months later, when the ADD symptoms were still present, we then knew depression wasn't the cause of my inattentiveness.

Now on Celexa and Vyvanse (30mg inattentive type) I feel more myself and happier as a result. Getting depression out of the way first was big for me and I recommend that course of action. All the problems aren't solved, but I'm much better off than 8 mo. ago!

Btw I'm 17, male, and still in High School unfortunately...

Glad to know that Vyvanse is working for someone else with the inattentive type...I've been put on 40 mg of Vyvanse with .5mg Clonazepam at night to help with sleep...I'm also weaning off of Trazadone which I've been on for about 5 years to help with sleeping issues..(always had constant "chit chat" going on in my head whenever I hit the pillow..it's like my brain turned on when it was supposed to be winding down.) I also have pretty bad anxiety which seems to subside when I take the Vyvanse...but always comes back at night.

Quick question, do you experience a "crash" towards the end of the day when your Vyvanse wears off? I alwaaays feel irritable, uncaring, unloving, and totally self-absorbed along with intense feelings of anxiety and hopelessness when it's worn off...(Normally at night I'm a happy-go-lucky and very caring person) I hate it cuz it seems the Vyvanse works so well during the day! (as long as I drink enough water, get enough sleep the previous night, and eat enough!) I am also weaning off of Trazadone which, although it was to help for sleep, it is also classified as an antidepressant. So, perhaps this is interfering with the whole thing..) Or perhaps I'm on too high of a dosage...It feels very similar to a caffeine crash for me...except about 5 x worse...

Drizzy
09-03-11, 02:14 AM
Just got dx'd ADHD inattentive + anxiety + depression. My psych wants to put me on meds for the depression and anxiety first, then take care of the ADHD.

Want to know what any of you with the same dx think, cos to be honest, the ADHD is the main thing that's bothering me.


I was dx w/ the same combo last summer and my pdoc wanted to put me on Wellbutrin XL. I wanted to tackle the ADD first bc thats what I felt was causing the depression so I started taking Adderall. 2 months later, the magic wore off and I was depressed again. I decided to give the Wellbutrin a try and it worked wonders. I have improved 20x more than what I was. I still take the Adderall every now and then for school, and Xanax or Klonpin for anxiety(be careful with benzos, addiction forms FAST)

hoolio
09-03-11, 03:15 AM
I was diagnosed about 8 months ago with severe depression and "high likelihood" of ADHD. I have had problems with depression most of my life (diagnosed with dysthymia as a teen and have had several bouts of "major depression" over the years - I am 32 now). As I was in the middle of a major bout of severe depression that was treated first (Wellbutrin and therapy). In the last few weeks we have started addressing the ADHD (started Vyvanse about a week or so ago).

Most dr.'s don't like to start multiple meds at the same time as it makes it difficult to gauge the effectiveness of each. Depression meds take time to work, and usually involve weaning you off if they are not working, whereas ADHD meds tend to work faster and can be stopped easier if they are not working so it can be preferable to sort out the depression meds first.

Also, I have heard it said that ADHD meds can increase anxiety for some and depression as well (from the "crash" as meds wear off and also because the increased ability to focus means you could potentially "focus more" on what is depressing you and/or making you anxious). And I know from my own experiences, that as long as I am depressed, it is hard (if not impossible) to be motivated and proactive in addressing anything else.

Also, in order to diagnose ADHD the symptoms have to NOT be caused by anything else. Since depression in particular can mimic ADHD symptoms, sometimes they will treat the depression first and see what ADHD symptoms remain (ie: determine that they are not caused by the depression itself). This is another reason (in my case) that they treated the depression first.

The above is either what happened in my case, or what I have learned through research, but I am new to a lot of this, and not a dr. so please take it with a grain of salt!

N.

kathrynsmathryn
10-27-11, 01:02 PM
I have the same dx, and we treated the depression with Citalopram first. But then the ADD kinda got in the way, not to mention the Citalopram just wasn't working for me. So I tried Methylin ER (methylphenidate) and I became suicidal. =/ So we recently switched me to Sertraline (Zoloft) and Clonazepam for the anxiety and i've never felt better. We'll get back to the Methylin in a month or so. :)

VelvetTiger
10-30-11, 02:28 AM
I've been on multiple types of SSRIs and SNRIs throughout my adult life, as well as mood stabilizers. I was Dx'ed with major depression, then, when the serotonin drugs caused my panic attacks and ADHD symptoms to worsen, they called my hyperactivity and inability to sleep "mania" and switched the Dx to bipolar II, drug-induced bipolar III (I doubt the validity of this), and/or cyclothymia. Enter the mood stabilizers. Very, very bad news for me. I was non-functional and potentially suicidal, hearing voices, etc. My fiancee went through essentially the same thing with Lamictal and lithium, so I think he's ADD too, though primarily inattentive type. He currently takes no treatment. This is why, JMHO, the ADD needs to be addressed first.

I was Dxed with panic disorder last year and ADHD on top of that this year. However, my p-doc is always monitoring my mood, because bipolar is a black mark on your record that never goes away. I feel I'm always in danger of being tried on the newer and/or more experimental drugs, which will mess my mind up for good, and which I can't afford. I simply cannot take any serotonin drugs, period.

I take Xanax and Ritalin 4-5 times a week (scared of getting hooked), and Topomax and Sinequan every day for migraine headache prophylactic and sleep. Aside from dry mouth, sensitivity to sun, and tingly hands if I miss a dose of Topomax, those drugs work well. The Xanax and the Ritalin are fine, but I refuse to increase my dose. I lack an enzyme in my liver that processes certain drugs, so a tiny dosage hike for someone else is a massive dose hike for me.

I'm having severe depression right now because I am about to lose my job. As in, on Monday. I called my p-doc last week and she started talking already about juggling and tweaking my med doses. This lady's great in terms of diagnosing me properly, but her solution to everything is meds. I mean, I could go in there with my whole family dying at once, and she wouldn't say, "It's totally reasonable and natural that you're depressed." She'd say "Let's adjust your meds again."

irishgirl49
12-16-11, 12:27 PM
This is interesting to me. I have ADHD (kinda not sure which type, docs all disagree)

I am in college and tried adderall, which made me think about the possibility of ADHD.
I saw a psychologist at my school who thought I might have ADHD and sent me to a psychiatrist.

Psychiatrist diagnosed me with anxiety with a tinge of depression (she did use the word tinge..) and told my psychologist he was probably wrong and that she saw no symptoms of ADHD. She gave me a script for celexa, told me to stop drinking alcohol and consuming caffeine, and sent me on my way.

I went back a month later, have not taken celexa but I did remove all alcohol and nearly all caffeine from my diet. I made a point to talk about my problems with attention and forgetfulness... and tried to leave out most of my social problems. She suddenly saw the ADHD and perscribed me dextroamphetamine, and wrote another script for the celexa.

Anyway... I personally decided to get the ADHD treated first, even though my psychiatrist disagreed.
I have felt much better because of the ADHD meds, and most anxiety (and my tinge of depression) has disappeared. I still bite my nails A LOT though. A little annoying, but whatever.
So... luckily I chose to get myself treated relatively young, before major anxiety or depression developed. But I just wanted to say that ADHD can be treated first, even if the doctors don't quite agree.

Ezraconway21
10-10-12, 07:01 AM
Hey y'all so I have all three as well and it seems like a cycle that won't end. I've tried different medicines for anxiety depression and ADD, but it feels like they still break through. I'm currently not taking any medication because I have no insurance or income due to the ineffectiveness of the medications I can't seem to hold a job. do you know if there are programs out there to assist a single white male? because it seems like they are geared toward everyone but me?