Trying to Understand if ADHD is High Functioning Anxiety – or Anxiety? And What About Adderall? Does it Fix Anything? And, What Drug Don’t Mix and Mingle with Adderall? What about Benadryl? That’s Not a Problem, Is it? IS IT?
We can only do this topic justice if we include some data. So, let’s start there, shall we?
According to the National Institute of Mental Health, there are more than 6 million children and 9 million adults in the US that have been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD).1 The vast majority of people diagnosed with this condition are receiving treatment through stimulant medications, like Adderall, Concerta, and Vyvanse. The purpose of medication is to try to control some of the symptoms of ADHD, like impulsiveness, poor planning, and frequent mood swings. A great bulk of those with ADHD are also diagnosed with at least one other (coinciding, or, a.k.a. ‘comorbid’) mental health condition, most commonly depression, anxiety, or bipolar disorder.2 Because of the overlap between some symptoms of these closely related disorders, it is sometimes difficult for patients or doctors to tell the difference between ADHD and ADHD comorbidities.
Currently, there is no way to differentiate between ADHD and common ADHD comorbidities. A doctor may simply go with the diagnosis that is the most familiar – or simply choose one based on what the patient does or does not want to be used.
It is possible to use drug trial-and-error to ascertain the most likely diagnosis. Is it ADHD or a closely related comorbidity? Hmmm. If, after the ADHD drug trial (and error), symptoms seem alleviated, maybe the ADHD diagnosis is adequate. Just use one drug.
If, however, certain symptoms continue to persist, the possibility of a comorbid condition is considered. Then it’s time for more trial-and-error with the drugs.
Next, if the next trial-and-error medication (directed to treat depression, anxiety, or bipolar disorder, for example) seems successful in relieving the unwanted symptoms, the doctor will likely assume that the patient also suffers from the comorbid condition, too.
Lots of trials, errors, testing, and assuming going on here, right? Right.
Maybe you can see how mixing drugs ends up happening.
Before we launch into finding out what happens when the two drugs in the mix are Adderall and Benadryl, let’s explore the overlap between ADHD and high-functioning anxiety, and how mixing medications could lead to yet another diagnosis (and much more trouble than was there in the first place).
We will also take a peek at the way Adderall interacts with the brain. Plus, we’ll take a peek at what interacts with Adderall, and why it is so important to know.
The Similarities Between ADHD and Anxiety Symptoms Make Them Seem One-and-the-same
The overlap between ADHD and anxiety is astounding. Though handled as two separate problems, they share a number of similarities which lead to a misdiagnosis – and much in the way of mistreatment.
ADHD and anxiety may sound very different in theory, but, in an actual human, telling the difference between the two conditions is difficult. Some of the most common shared symptoms of ADHD and an anxiety disorder include the most common symptoms of both:
- Difficulty with concentration and paying attention
- Feelings of restlessness
- Mood swings
- Inability to relax
It is no surprise, then, that it is difficult to distinguish whether someone is struggling with ADHD, anxiety, or both. And, because there is no real “test” for either disorder, it’s either a matter of opinion, or maybe treatment trial-and-error, that is the basis for the diagnosis.
Apparently, most practitioners choose to go with an ADHD diagnosis first, moving on to treat anxiety as a potential secondary condition.3 That said, no less than 9 common symptoms of anxiety accompany the average ADHD patient’s experience. Who knows? Does one cause the other? Or, do both share a common cause? It matters.
As I already mentioned above, medicine insists the two conditions are different, and, with regard to drugs, must not be treated in the same way.
Adderall is one of the most common medicines used to treat ADHD. It’s a stimulant. If you have ever suffered from anxiety, you probably cringe at the idea of taking a stimulant during an episode. Stimulating an existing panic and fear in anyone already struggling with an anxiety disorder sounds like a recipe for disaster. And, guess what? Adderall is known to cause anxiety in those who don’t have it.4
Adderall’s True Effects on the Brain
There are various stimulant medications available to treat ADHD, but the most common one is Adderall. “Adderall”, launched in 1996, is the brand-name for a combination of two stimulants: Amphetamine and Dextroamphetamine. The generic combination of the drugs has also been approved by the FDA that states that there is no real difference between the two, other than price. (Am I the only one who wonders what ‘no real difference’ really means?)
The way Adderall works in the brain is by increasing levels of dopamine (the ‘pleasure chemical’) and norepinephrine (a neurotransmitter related to focus) in the executive center of the brain, called the prefrontal cortex.5 (That’s the area right behind your forehead.) Doing so is supposed to result in lowered impulsivity and increased focus for the person suffering with ADHD. However, Adderall, like all central nervous stimulants has been associated with some pretty severe side effects, including mood disturbances, loss of appetite, insomnia, social withdrawal, and even heart problems.6
So, yes, Adderall does what drugs often do: It creates either more of the condition it is supposed to stop or a new condition. Adderall is not without its problems. That’s for sure.
When a drug creates more of t he condition it is supposed to stop, it is called a paradoxical effect. Unfortunately, it happens with every drug, not just Adderall. No one can predict when it will happen, or who it will happen to, or with which drug, but it’s considered a typical ‘complication’ of medicines, depending upon the type and class of drug.
Think: What about someone living in the fast lane, who does not have ADHD, but takes it off-label as a performance, or recreational agent (as in, illegally)? In these cases, Adderall is taken in higher doses, to enhance cognitive function, or to improve athletic performance, or to suppress the appetite, or as just little somethin’ – for a boost. Could the drug itself be a precursor to ADHD or high functioning anxiety? Does using the drug cause the disorder it’s meant to treat?
The Risk of Mixing Adderall with Other Drugs
Adderall directly influences the brain. That means the target of the drug’s chemistry is brain tissue. Adderall is formulated to be able to go directly to your brain. It does not have to get permission to pass GO. It’s allowed IN.
There are many other central nervous system drugs, not the least of which are two familiar substances people often forget about:
- Caffeine is a central nervous system stimulant.
- Alcohol is a central nervous system depressant.
In case you did not know what the term ‘central nervous system’ means: It is another way of saying BRAIN.
Just imagine what kind of dangerous chemical traffic jam happens in the brain when someone who takes Adderall also takes another prescription that impacts the brain, plus drinks coffee in the morning and a little dram of scotch or glass of wine in the evening. Talk about interactions and side effects?!!
Suffice it to say, if you take central nervous system drugs, it’s important to review your pharma meds, over-the-counter meds, and recreational drug habits with someone who understands brain chemistry before you mix them into your body. Otherwise, you might negatively alter your brain function. The fall out will not be fun.
For the record, some of the most common drugs to avoid when taking Adderall include:
- Antidepressants from the MAO Inhibitors class, like Zelepar, Marplan, and Eldepryl
- Other (mixed class) antidepressants, like Wellbutrin, Pristiq, Cymbalta, and Savella
- SSRIs, like Celexa, Lexapro and Prozac
- Seizure medications, like Fintepla
- Antibiotics, like Zyvox
What happens if someone does take these drugs with Adderall? Poison Control’s phone rings off the hook. 911 lights up. Emergency Room doctors miss their coffee breaks.
While some docs say mixing drugs is necessary, and that even some potentially dangerous cocktails are ‘reasonable’, it’s tough to find out the hard way. If they don’t mix well, anything can happen. “Combining the use of Adderall, Wellbutrin, and Prozac for someone who is suffering from symptoms of depression, as well as attentional difficulties, may be reasonable,” said Brigham and Women’s Hospital psychiatrist, Dr. Kelly J. Hoagland when she was asked to comment on the suicide of the young Harvard student who had been taking all three medications before he killed himself.10
About the same case, a thoughtful comment by the medical director of the children and law program at Massachusetts General Hospital was sobering, “Though this mix of drugs is commonly prescribed for patients who exhibit such symptoms of depression, the combination may increase the risk of suicide….There is no data to indicate that the effects are additive, but it stands to reason that if one contains a risk that the addition of another would raise risks,” psychiatrist Andrew B. Clark said.
ERM…Apparently, when talking about dangerous pharma cocktails that are ‘necessary’ to treat brain function, ‘reasonable’ is a term doctors like to use to describe their efforts to mix up a cocktail, but it sure did not benefit John B Edwards III, the Harvard student who is now dead.
What about Mixing Adderall and Benadryl?
Though Benadryl is a common over-the-counter drug, it shares similarities with prescription anti-depressant medications like Wellbutrin and Cymbalta, which interact negatively with Adderall. All of these drugs are known as CYP2D6 inhibitors, which, in science talk, means they greatly increase the level of Adderall found in the blood, enhancing the risk of “Serotonin Syndrome”.7
Serotonin Syndrome is not only nasty, it is potentially life-threatening. Signs and symptoms can range from shivering and diarrhea to severe muscle rigidity, fever, high blood pressure, shock and seizures. Don’t be fooled. If you look up the incidence of Serotonin Syndrome, you might see it is low. According to some researchers, it’s low because emergency room docs and hospitalists don’t know how to diagnose it. It is likely much more common than estimates indicate because it often goes undiagnosed, unrecognized and unreported. 9
Benadryl is a potentially harmful drug. The active ingredient Diphenhydramine has been documented as immediately affecting mood and mental functions after just one dose.8 It has a depressing effect on mental functions, so it’s not uncommon for it to be used for insomnia, or to aid in winding down after an intense day. (And, yes, some parents use it to put their kids to bed or to keep them asleep on a flight. It can be used like that…to knock someone out.) Yet, like all drugs, it causes paradoxical effects in some people. In fact, it can lead to hyperactivity in children (…surprising some parents on the long flight…), restless leg syndrome, nervousness, and, interestingly, euphoria (in some men). When combined with a drug that increases other neurotransmitters in the brain, there’s really no telling the interactions that can occur. So, yeah…NO: Benadryl+Adderall does not a cocktail make. Ever.
It’s Time to Rethink Adderall
With the unknown, yet already high, number of dangerous drug interactions, plus the potential for complicating existing mental health conditions (and adding others) the therapeutic use of Adderall must seriously be reconsidered.
There is no ‘test’ for ADHD. The diagnosis is made clinically. That means, a clinician takes your history and sums up the problem in a one word nutshell called a diagnosis. Some doctors will diagnose it after glancing at your paperwork and meeting with you for 15 minutes. Other doctors may choose the diagnosis because they just read an article about ADHD, and it’s top of mind. For other doctors, it might be a favorite diagnosis. A therapist may spend an hour session gathering intel on the last six months of your life before issuing the diagnosis. It doesn’t mean the doctor is right. And, it’s certain that there is no real way to check to see if he or she is.
Listen, if you are forgetful, or you don’t listen, or you have trouble concentrating…or if you are late or disorganized or you restlessly fidget…or if you are emotionally volatile or have impulses that are hard to control…it may be that your brain is giving you feedback that you are super stressed, or that the environment around you is not adequate for your style of living…or a million other possibilities. It doesn’t necessarily mean you have ADHD. Putting an adult on central nervous system drug is a big deal. And, it’s dangerous. Adderall changes your brain chemistry in a way that is still not well understood. Don’t go there if you can do something else.
Children?! Placing children, especially, on a potentially addictive drug for a disorder that could have been misdiagnosed is not only reckless, it’s mean. And, in this little article, we haven’t even covered the long term consequences of its use.
It’s time to explore new ways to overcome impulsivity, hyperactivity, and the many expressions of anxiety. There are other answers out there that don’t include risking your brain and your life.
Answers begin with knowing something about your own brain: What to expect. How to handle stress triggers and reactions. What soothes the reactions. I call it learning how to Tame the Beast Within. If you want to learn about your beast brain, you’ve come to the right place.
Click on the button below to take your quiz, and we’ll start there.
References
- Mental Health, N. I. o. (2017, November 1). Attention-Deficit/Hyperactivity Disorder (ADHD). Mental Health Information. https://www.nimh.nih.gov/health/statistics/attention-deficit-hyperactivity-disorder-adhd.shtml#part_154905
- Sherman, J. (2013, July 26). What are Common Comorbidities in ADHD? Psychiatry Times. https://www.psychiatrictimes.com/view/what-are-common-comorbidities-adhd
- Dodson, W. (2020, January 20). Why is Anxiety Disorder So Often Misdiagnosed? ADDitude. https://www.additudemag.com/anxiety-disorder-diagnosis/
- Bhandari, S. (2019, September 5). What’s the Link Between Anxiety and ADHD. WebMD. https://www.webmd.com/add-adhd/anxiety-adhd-link
- Madison, U. o. W. (2006, June 26). Study Reveals How ADHD Drugs Work in Brain. ScienceDaily. https://www.sciencedaily.com/releases/2006/06/060626091749.htm
- Psychiatry, M. (2019, February 14). Potential Adverse Effects of Amphetamine Treatment on Brain and Behavior: A Review. NCBI. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2670101/
- Llamas, M. (2020, July 21). Adderall. DrugWatch. https://www.drugwatch.com/adderall/
- 202, P. (September, 1971 1). The effects of diazepam or diphenhydramine on healthy human subjects. SpringerLink. https://link.springer.com/article/10.1007/BF00403859
- Lawrence, L (2013, April) Be prepared: The ins and outs of serotonin syndrome https://acphospitalist.org/archives/2013/04/serotonin.htm
- Groll, E and Kolin, D, Crimson Staff Writers (2009, December https://www.thecrimson.com/article/2009/12/9/drugs-edwards-suicidal/
