Can Adderall Cause Depression?

What Is Adderall & How Is It Used?

Adderall (amphetamine/dextroamphetamine) is a central nervous system stimulant that is approved to treat attention-deficit hyperactivity disorder (ADHD) in adults and children ages 3 to 17 years of age and a sleep disorder called narcolepsy in people 6 years and older.¹ Adderall works by increasing the amount of dopamine and norepinephrine in the brain, a natural chemical made in the body, which works to improve focus and attention while reducing hyperactivity and impulsive behavior in those with ADHD.

It’s important to note that the brand-name of Adderall has been discontinued but an extended release version known as Adderall XR is still available as is generic mixed amphetamine salts. Depending on the specific form of Adderall being used, its uses or the people who are approved to use it may vary.

Can Adderall Cause Depression?

Generally speaking, Adderall rarely causes depression, but it is possible. If a person experiences depression while on Adderall, it may be for a variety of reasons. It is possible for people to develop depression as a side effect of the medication, but it is rare and this may also occur from improperly taking or stopping Adderall.

Depression from taking Adderall may be due to several reasons:*¹

• Side effect: A possible side effect, although not common, for Adderall is depression.
• Withdrawal: When a person suddenly stops taking Adderall, they can experience withdrawal symptoms, especially if they’ve been on Adderall consistently and at higher doses. One of the many symptoms of Adderall withdrawal is depression.
• Misuse, abuse, and dependence: Using Adderall other than how it was prescribed can lead to abuse and dependence. The misuse, and potential dependence, of Adderall can cause many signs and symptoms, including depression.
• Dosage is too high: If Adderall dosage is too high, a patient may experience more side effects, such as depressive symptoms.

*All medications, including Adderall, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

How Commonly Does Adderall Cause Depression?

How often Adderall causes depression is not exactly known, but it is considered a rare reaction.¹ The rate of those who suffer from depressive symptoms are higher in those who abuse and are dependent on stimulants, such as Adderall. Notably, these symptoms are a major component in stimulant withdrawal, which can occur if a person suddenly stops taking Adderall.²

Can Adderall Worsen Existing Depression?

Adderall may potentially worsen depression and other mental health conditions. Adderall use may worsen depression if it is not used as prescribed or if it is stopped suddenly without medical supervision. It may also trigger pre-existing conditions, such as bipolar disorder, or cause new psychotic or manic symptoms.

On the other hand, Adderall may improve depression symptoms as an off-label treatment. An off-label treatment is one that is not FDA-approved but a prescriber may use because they believe it may benefit a patient. Adderall may be used when a person does not respond to usual treatments for depression.³ How Adderall affects one’s mood is not fully known, so individuals who take it should keep track of how it affects them personally and notify a doctor should they see any deviations from their normal attitudes.

How Can I Tell If Adderall May Be Causing My Depression?

If your depressive symptoms worsen after starting Adderall or getting an increase in dosage, they may be caused by your medication. If your depressive symptoms stem from Adderall use, contact your doctor as this is a side effect and likely will not go away unless Adderall is decreased in dosage or stopped completely. When you first start taking Adderall, note how it affects you and bring up any concerns with your healthcare provider should they continue.

What Are Other Emotional Side Effects of Adderall?

Other than depression, some side effects of Adderall may affect personality and mood. Anger and irritability are common side effects that can occur when an individual takes Adderall. Mood swings may also occur where an individual can have sudden and intense emotional shifts, ranging from feelings of euphoria to aggression and unhappiness. Adderall may also exacerbate certain mental conditions, such as Bipolar Disorder, where it can trigger psychosis or mania in some patients which can also present through changes in emotions.¹

Who Is More at Risk for Developing Depression From Adderall?

Those who are more at risk of developing depression from Adderall may also misuse the medication. Developing depression from this medication is not common, but the risk increases when a person takes more than is prescribed. People who struggle with mental illnesses may also be at a higher risk.

People more at risk for potentially developing depression from Adderall include:

• People who misuse or abuse Adderall: Those who misuse Adderall may become dependent on the substance, increasing the likelihood they experience depressive symptoms. This can also occur to those who experience Adderall withdrawal.¹
• People who have a history of mental health problems: Adderall may worsen mental health conditions, such as bipolar disorder, and cause psychosis or mania.¹ It is recommended that these individuals have a mental health screening before taking Adderall.

What’s the Link Between Adderall Misuse & Depression?

Mental health and substance abuse are closely related. Adderall has high abuse potential, meaning that misuse may lead to dependence and substance abuse issues. This improper use of Adderall can increase the risk of side effects, including emotional side effects such as depression. Substance abuse problems occur more frequently in those with mental health problems. Talk to your provider if you believe you may need help with substance abuse and your mental health.

What Else May Be Causing Depression Symptoms?

Adderall usage is just one of many reasons a person may develop depression symptoms, such as untreated physical and mental health conditions,low levels of vitamins, and hormonal changes may potentially contribute to symptoms of depression. These underlying causes must be addressed first before depression becomes the focus of treatment with Adderall.

Other possible causes of depression symptoms may include:

• Having ADHD diagnosis: People with ADHD often have other coexisting conditions, such as ADHD and depression. ADHD symptoms were associated with earlier age of depression starting, higher impairment from depression, a greater recurrence of depressive episodes.⁴
• Disrupted sleep: Stimulants, like Adderall, can interrupt and influence a person’s sleep cycle. A lack of quality sleep can impact mental health, potentially increasing the risk of depression.⁵
• Anemia: In a study that investigated the association between anemia (low number of red blood cells) and depression, people with untreated anemia had increased odds of depression compared to those with no anemia.⁶
• Chronic fatigue syndrome/chronic pain: Depressive symptoms are commonly associated with conditions that have physical or bodily presentations. The common factor is usually chronic pain or discomfort, and possibly an uncertainty of what caused these symptoms or syndrome.⁷
• Hypothyroidism: Studies have found that undiagnosed, untreated, and undertreated patients with hypothyroidism (underactive thyroid gland) are at increased risk of developing depression. Treating hypothyroidism can significantly improve mood disorders such as depression.⁸
• Premenstrual dysphoric disorder (PMDD): PMDD is a condition in which a person has severe depression symptoms before menstruation. The cause is not known, but it has been linked to depressive symptoms, like sadness, hopelessness, and even thoughts of suicide.⁹
• Vitamin D deficiency: Low levels of vitamin D are associated with an increase in symptoms of depression.¹⁰

Adderall Alternatives With Lower Risk of Causing Depression

Adderall alternatives include other stimulants, non-stimulant medications, and non-medication options like therapy. Other stimulants and non-stimulant medications that modify your mood, or use similar mechanisms to Adderall, may still possibly have depression as a side effect, although these are considered uncommon reactions. Your prescriber may have suggestions in regards to treating your condition, so discuss your concerns with them to see what options may be available to you.

Alternatives to Adderall include:

• Other stimulant medications: Stimulants with the active ingredient methylphenidate are alternatives to Adderall. This includes medications like Vyvanse, Concerta, and Ritalin which also carry the risk of depression, but they are not commonly occurring side effects.¹¹
• Non-stimulant medications: Non-stimulant ADHD medications approved to treat ADHD include Strattera, Intuniv, and Kapvay. Strattera may affect your mood, but Intuniv and Kapvay largely avoid this problem since they manage ADHD symptoms through different mechanisms and tend to have side effects related to blood pressure rather than mood.¹² These options are also helpful for those who may be concerned about abuse potential as they do not carry the same risk of being habit-forming like Adderall.
• Non-medication options: Therapy is helpful as an add-on to medications or as a standalone treatment. CBT for ADHD is a therapy that teaches a person useful tools to manage unhealthy habits and thought patterns, and promotes helpful behaviors.¹²

How to Avoid & Manage Depression While Taking Adderall

When you are managing depressive symptoms while on Adderall, there are methods you can take to try to prevent them. To avoid worsening depression, you must take care of your daily needs, manage your stress in a healthy manner, and talk with your prescriber if you feel that your medications are not managing your symptoms like they should. Never stop your medication abruptly and without guidance from your provider as this can cause Adderall withdrawal, which may require medical care.

Here are 6 ways to avoid and manage depression while taking Adderall:

1. Get better sleep: There is a link between depression and sleep, with low quality sleep which can emphasize depressive symptoms. Learning sleep hygiene skills can increase the quality of your sleep, preventing mood problems.
2. Address life factors affecting your mood: Life stressors can impact your mood, potentially worsening depressive symptoms. When you recognize and address the life factors affecting your mood, it can give you the tools you need to
3. Talk to your prescriber about your dosage: Dosages can be an important factor in controlling your depression. Too much Adderall could potentially cause mood changes while too low of a dose of your antidepressant could mean your depression symptoms are not being treated adequately. Only a doctor or other authorized prescriber can make the decision to change your dosage. Never attempt to do this on your own.
4. Avoid drugs, alcohol, and smoking: Substances can exacerbate mental health conditions, such as depression. Avoiding recreational drugs, alcohol, and smoking can help to keep depression symptoms from being masked or getting worse.
5. Find ways to cope with stress: Stress can worsen depression, especially when it is left unaddressed. Having healthy coping methods can help a person to reevaluate their problems and search for solutions that may make these problems easier to manage.
6. Have strong, healthy relationships: Having social support can provide a safety net to those who have depression and ADHD. Friends and family are capable of providing support as well as recognizing when you are in a crisis and need further help.

Seeking Professional Help for Depression Symptoms

If you experience depressive symptoms that persist for more than two weeks, seek medical care. This may be a sign that you may not have adequate treatment for your depression. If you have thoughts about hurting yourself or others, seek immediate help which you can do by contacting the National Suicide Prevention Lifeline, calling 911, heading to the nearest emergency department, or by contacting your doctor.

Finding a therapist can be beneficial since therapy can be used alone or in combination with medications. Finding a psychiatrist is also beneficial as they are specialized doctors who are focused on treating mental conditions.

If you struggle to attend physical appointments, online psychiatry service may be a helpful solution given their convenience.

Questions to Ask Your Healthcare Team About Adderall Causing Depression

When treating multiple conditions, you may have question. When meeting with your psychiatrist, ask what medications are available to you, what are the expectations of said medications, and, in their opinion, what would be the best treatment for you. You may also ask your therapist for therapy with focus on helping those with depression and ADHD.

Questions to ask your care team about Adderall causing depression include:

1. How can I tell it’s the medication causing my depression?
2. Am I at risk for increased depression if I am already taking other medications, such as antidepressants or anxiety medications?
3. Will a previous history of depression make me more susceptible?
4. What is the best dosage to reduce the risk of depression?
5. Are there drugs I am taking that could have increased effects on depression?
6. When should I reach out to you if I am experiencing depression symptoms?
7. Are there other medications that may have less impact on my mood?
8. Are there non-medication methods to help control my mood?
9. Are there any over-the-counter medications, vitamins, or herbals I should avoid combining with my medications?
10. How do I get switched to another medication if I think my Adderall/antidepressant is working as intended?