Chemical depression is widely diagnosed and poorly understood. So much so that many people who are diagnosed with it and medicated for it do not exactly understand what it is or how it works. Of course, remaining ignorant may be a choice rather than an inevitable situation. After all, understanding chemical depression isn’t the same as understanding particle physics, or string theory.
In other words, it isn’t rocket science, but it is science. It’s brain science.
Many pharmaceutical drugs have been prescribed over the years for depression, from the tricyclic antidepressants to the MAOI antidepressants and then, after the “antidepressant revolution,” the SSRI and SNRI antidepressants in all their myriad forms.
Recently, some doctors have begun treating depression with Adderall, a mixture of amphetamines that is generally thought of as being used solely for those suffering from ADHD, or Attention Deficit Hyperactivity Disorder. It may sound strange, but it is not unusual for new classes of drugs to be discovered to be effective for things they were not designed for.
If you’re interested in the use of Adderall as a treatment for depression, it’s probably a good idea to begin by learning more about chemical depression in general. An excellent introduction to depression can be had in an online course called “What is Depression.”
It’s Not About Being Sad
To start at the beginning, we ought to talk a bit about depression per se, and the treatment of it. in Freudian terms, the sort of “depression” that results from having experience unpleasant events in one’s life that lead to a prolonged state of unhappiness should be thought of as “melancholia” rather than “depression.” As such, to further borrow Freud’s terminology, melancholia is about an “objective loss” that becomes internalized and made into a “subjective loss.” This sort of “depression” is not what we’re talking about in this article, and is not generally treated with medication. To learn more about this type of depression, you ought to take a look at this blog post by Rajib Mukherjee, called “Situational Depression.”
Major Depressive Disorder
The type of “depression” that doctors prescribe medications for is something quite different from being consistently sad because your girlfriend or boyfriend dumped you. Depression in the modern medical sense is understood to be a state of consistent lowered mood and self-esteem and a lack of interest in and inability to enjoy activities that are normally pleasurable.
While more is understood about depression than ever before, there is not, surprisingly enough, a unanimous point of view on what, exactly, causes it. The various hypotheses tend to center around imbalances and irregularities connected to key neurotransmitters like serotonin, norepinephrine, and dopamine. Whether the causes of the imbalances or irregularities in transmission of these substances is to do with irregularity in brain structure, brain damage, or other genetically-determined factors, the results end up being largely the same: the various medicines prescribed are generally intended to regularize and potentiate the production and transmission of these neurotransmitters.
Non-Pharmaceutical Treatment Modalities
It behooves us also to discuss the nature of the non-pharmaceutical methods for dealing with Major Depressive Disorder. While most professionals recommend medication, many shy away, instead opting for strategies like meditation, self-hypnosis, and visualization, and many find these methods effective. You can learn more about that strategy in this online course, “Meditation for Depression and Anxiety.”
Another strategy is to use talk therapies such as CBT, or Cognitive Behavioral Therapy to treat depression, generally driven by the desire to avoid the use of pharmaceuticals for whatever reason. Therapies such as this are also effective for many depression sufferers.
For those unfamiliar with it, Adderall is a combination of amphetamine and dextroamphetamine, two variations of the amine B ring. Amphetamines in general are central nervous system stimulants, and for many years were prescribed for those with chronically low energy or who struggled to lose weight.
In the modern era, amphetamines are prescribed for very different purposes. Adderall, a formulation of amphetamine and dextroamphetamine copyrighted by Shire Pharmaceuticals, is generally prescribed for children and adults diagnosed with attention deficit hyperactivity disorder (ADHD) and narcolepsy. Ironically, the prescription of a stimulant seems counterintuitive to most people for disorders such as these, but without going into the process by which it works, this is, indeed, the case. There is an excellent online class, “Learn More About Attention Deficit Disorder” that can give you a greater understanding of attention deficit hyperactivity disorder and the reasons for and methods of the prescription of stimulants like Adderall to treat it.
Adderall is available in a short acting and time-release format, Adderall XL. The short acting version has effects lasting from four to six hours, while the time-release version has a twelve hour period of action. Generally, the XL version is prescribed for depression when appropriate.
Adderall for Depression
We ought to begin with the premise that in general, Adderall alone is general not regarded by most medical authorities as a “stand alone” treatment option for Major Depressive Disorder. Rather, Adderall is used, for the most part, as an adjunct to another treatment, generally a pharmaceutical one, such as an SSRI or SNRI antidepressant.
Adderall is not labeled for use as a primary treatment for depression, but it does produce effects that are beneficial to sufferers. Amphetamines like Adderall modify production, transmission, and reception of norepinephrine in certain parts of the brain, which helps to promote energy and alertness. Since some of the key symptoms of depression are a profound lack of energy, motivation, and torpid states that are the antithesis of “alertness,” this indication does make sense. Particularly when depression is characterized by profound despondency, the use of Adderall as an adjunct to an antidepressant can help to restore vigor and attentiveness.
Adderall for Anxiety
Anxiety, often thought of as the “flipside” of depression, is also now being treated with Adderall, often in combination with other treatments and therapies. Whereas most people are under the assumption that anxiety and other similar disorders are caused by overstimulation, thus making amphetamines like Adderall a counterintuitive choice, the fact is that Adderall can ease anxiety in several ways. Firstly, it has an effect on norepinephrine and serotonin. Secondly, Adderall makes those who take it feel good, focused, and productive. All of these qualities also make it a good candidate for those with depression.
In fact, the effects of Adderall tend to be seen as profoundly “pro social” by the mental health community. Those who take it tend to be more outgoing and willing to engage in interaction with others. Socializing is easier, and therefore more successful interactions take place. Again, an indication for depression is clearly suggested.
Adderall also boosts mood and energy levels, and contributes to a general sense of optimism. Very little need be said about why some doctors are prescribing it, then, for both anxiety and depression.
A Caveat or Two
Of course, it ought to obvious by now that using amphetamines such as Adderall to treat depression (and/or anxiety) is akin to treating the symptom, but not the cause. And yes, everyone can recognize that chemically stopping depression from happening in the first place is a better option than treating the symptom after the fact, but the sad fact is that none of the current crop of drugs indicated for depression is one hundred percent effective. There is no one SSRI or SNRI antidepressant that is a “magic bullet.” In other words, there is no panacea, no drug that works perfectly for all who take it. The use of adjuncts such as Adderall or other preparations of amphetamines is a simple and effective method to ease some of the most crippling symptoms of depression while other modalities are employed.
Additionally, it must be pointed out that Adderall has great potential for abuse. In fact, it is in the top two most commonly abused prescription drugs, second only to oxycodone preparations such as OxyContin. Oftentimes, those looking to abuse Adderall themselves or sell it to others will steal it if they cannot get it any other way. Those who are prescribed it must be careful in terms of where they store their pills.
And of course, there are those who feign symptoms in order to get Adderall prescriptions when in fact those individuals do not have any medical need for such medications. It is, unfortunately, not difficult in 2014 to convince a psychiatrist or other prescriber that you should try a given new medication or other. The reasons for this are many, and could take up an entire article on their own, but the fact remains that a good number of the prescriptions written are completely unnecessary.
Ultimately, if you suffer from Major Depressive Disorder, you must consult with your doctor, family members, and trusted friends to determine the correct course of treatment for you. No article on the Internet can tell you whether a given medication is “right” for you, or if any medication is “right.” There are a multitude of ways to combat the crippling effects of depression, and Adderall is, at least for the moment, in fashion as an adjunct, helping to ease some of the worst symptoms associated with the disorder. If you have been diagnosed with depression, and think it may be beneficial to you, talk to your doctor.