Comment by gremlinsinc | Hacker News Reader

Comment by gremlinsinc | Hacker News Reader

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you wouldn't know anything about adhd meds and depression/anxiety?

I've had panic attacks this year, I had depression years ago, went to therapy a lot better on that front. Enter: Xoloft followed by Trintellix (1 week in). I dealt w/ them pretty well, I'd go lay down, breathe and maybe take a cat nap, wake up in 30 minutes go back to work feeling like a million dollars. Now, not so much.

So, I started xoloft a month ago, it screwed up me libido and made me continually 'want it' but not able to 'deliver' (or it'd take way too long). Switched to Trintellix, still have panic attacks, sex is better, but anxiety doesn't seem affected. Now, I feel I'm actually more depressed though, and just not wanting to get out of bed. Motivation is rough.

I'm also taking Vyvanse for ADHD. It doesn't seem to be as effective as it was before adding anxiety meds.

Should I just scrap the anxiety meds altogether and just deal with adhd? Anyone else w/ similar experience want to chime in? It's really messing me up, and I've recently lost my main client so I really need to focus and get some income (web dev/laravel), or I'm gonna be homeless (40 w/ wife and 2 kids - so not an option).

This is absolutely something you should be working with a psychiatrist to regulate and find the dosage that works best for you. I don't take any medication for anxiety/depression but I regularly smoke pot and that does wonders for my anxiety. Of course, for some people pot can have the opposite effect which is why using it to self-medicate is a risky proposition.

Honestly my best advice is that, if you aren't having a good experience with your psychologist/psychiatrist you should find a better one. I've been lucky enough to be with a therapist who worked well for me as a teenager that I recently started seeing again for my anxiety. He recommends me to a local outpatient psychiatry department for my ADHD meds so I don't have to switch, but I don't know how much use the meds would be if I wasn't able to talk to him regularly.

How is your sleep? Exercising enough?

Biology is complex, the drugs mess with that system in direct and indirect ways. Coupled with lag and resistance, it makes accounting for outcomes hard.

ADHD is interesting in that to me, our interaction and methods of coping with it need to be participatory. The drugs don't work on their own, we need to still make lists, walk around, exercise, crack jokes. Just realizing you have it pushes it off the mainline to a branch.

I'd say slow down, do some science and take great notes.

Haven't taken any of the anxiety mediation, but do have some experience of anxiety + ADHD.

I was taking Dextroamphetamine for ~4 years, great for ADHD symptoms, focus and energy is amazing, but terrible for libido and really raised my anxiety. I tried switching from Dex to Methylphenidate, but after one day I quit because of how it made me feel (paranoia++).

Fluctuated on-and-off the Dex for a while (i.e. taking it a few days a week), but the whip-saws in dopamine levels really hit me hard, anxiety++.

Recently switched over to Atomoxetine (brand name Strattera) which has an off-script application to treating ADHD. It has a much more subtle effect than Dex, and has to be taken daily it to be effective. After about ~30 days of Atomoxetine I feel MUCH better, anxiety and stress is only at background levels.

Atomoxetine is nowhere near Dex in terms of focus and energy, but it does certainly address many ADHD symptoms + doesn't create the residual anxiety (at least for me). Libido isn't 100% of unmedicated, but nowhere near as bad as amphetamines.

Sorry to hear you’re going through such a tough time right now. Was there myself back a couple of years ago, down to the two kids. I have also played the merry go round of trying different medications and even different diagnoses. Took 3 years of trial and error to find the right meds and the right diagnosis.

First, I will echo what the other poster said - work with your doctor. Everyone is different and reacts differently to medication.

I can only speak from personal experience, but be very careful with Vyvanse. In the beginning, the effects were wonderful. Increased motivation, focus, etc. however, after about a year the effects began to wear off and my dosage was titrated really high (120 mg per day). Even at that dosage, I could barely get out of bed sometimes. I also began having panic attacks and severe paranoia. As another poster described, when it wore off, I had some of the most sad periods to where I’d sit there and cry for no reason. It was like staring up a deep dark well with little to no light.

I had life stuff going on, so reactions weren't completely unwarranted, but they were unnecessarily amplified. I’m not a doctor, but I felt like covers up depression and kicks the can down the road. Sometimes it gives people the motivation to change their circumstances, thus improving their depression. But, in many cases, it drives people to chase the high in order to keep staving off the lows. I don’t mean the euphoric high, I mean the motivation/focus high.

Listening to your post, and please don’t take this the wrong way, but it sounds like you are chasing the high without addressing the low. If you are taking a benzodiazepine for anxiety, it may be worth trying a different medication since those can make anyone groggy (with or without stimulants).

For me, it didn’t end well and I had to stop taking Vyvanse cold turkey (whew that sucked). It took a couple of years, but life turned out so much better for me once I addressed the anxiety and depression (or in my case, bipolar depression). I also take stimulants again, without any issues.

I do. I was having anxiety attacks on dextroamphetamine. 5 mg a day. I was resigned to dealing with them sometimes.

Then I by happenstance quit caffeine. And panic attacks went away. Sleep problems went away.

The meds were potentiating the caffeine!

Try quitting caffeine!

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