When I am working with a new patient in the El Paso or Albuquerque area to find the right treatment for their anxiety, depression, or ADHD, they sometimes have concerns. These new patients sometimes voice questions about whether or not the medication I prescribe for them can be addictive. Some might be concerned that they will become dependent on their anti-anxiety medication. Or, they might have heard that stimulants used to treat adult Attention Deficit Hyperactivity Disorder (ADHD) are likely to be misused.

Different classes of medications have differing levels of possibility for abuse and dependence. Some types of medication that treat anxiety are addictive, and others have not been shown to be. The same is true for ADHD medication.

Another consideration is that when patients have a behavioral health condition like anxiety or ADHD that isn't being treated, they might use marijuana or alcohol to self-medicate. Although people might be trying to relieve their symptoms, using alcohol or marijuana to treat your behavioral health symptoms can come with a whole host of other problems. 

Medications to Treat Depression and Anxiety

Patients who have an anxiety disorder are sometimes prescribed a benzodiazepine medication (benzos for short), like Xanax or klonopin, or an antidepressant such as Prozac or Zoloft.  A diagnosis of depression might also cause a provider to prescribe Prozac or Zoloft or another medication in that class.

The differences in how benzos and antidepressants work explains their different side effects and how potentially addictive they are. Benzos like klonopin and Xanax are central nervous system depressants. They relieve symptoms of anxiety by calming down the entire brain and nervous system. Benzos can cause people to feel sleepy or forgetful when using them. Over time, patients will need more medication to get the same symptom relief from Xanax or other benzos. For this reason, patients can become physically dependent on benzos. 

Antidepressants like Prozac and Zoloft are called selective serotonin reuptake inhibitors (SSRIs). They can treat both anxiety and depression by increasing the amount of neurotransmitter (brain chemical) serotonin available to your brain. When your brain has the right amount of serotonin available, it leads to feeling less nervous and happier. The side effects of SSRIs are generally not severe, and unlike benzos, they are not habit-forming. 

Stimulant Medication to Treat Adult ADHD

Adult ADHD is characterized by the symptoms such as inability to focus, talking excessively, and being unable to sit still. These symptoms are caused by an issue with the way the neurotransmitters dopamine and norepinephrine work in a patient’s brain. Stimulant medication such as Concerta, Vyvanse, and Adderall help the relevant brain chemicals communicate more effectively. When dopamine is more available in the brain, patients with ADHD can pay better attention and can feel less restless, among other effects.

For some people, stimulant medication can be habit forming. To combat this, some patients may choose to only take their ADHD medication when it’s most needed, such as on workdays. Your behavioral health provider will work with you to ensure that you are on the lowest dose of stimulant medication that controls your ADHD symptoms. Evidence reflects that long-acting ADHD medications such as Adderall, Concerta or Vyvanse are less likely to be misused than a short acting stimulant such as Ritalin, so long-acting stimulants may be considered for patients who are at risk for misusing their medication. When stimulants are taken correctly, patients are not as likely to develop substance dependence.

Using Alcohol and/or Illegal Substances to Self-Medicate For Depression, Anxiety, or ADHD

When people have a behavioral health disorder that is not under control, they will sometimes “self-medicate” themselves with drugs or alcohol. Although the effects of drugs or alcohol might reduce the feelings of a particular symptom for a time, the fallout from the use of the substances can sometimes make the situation worse.

Alcohol

Consuming alcohol to lessen anxiety in a social situation or to relax when overcome with irritability as a result of anxiety or ADHD may seem like a good option. Because alcohol is legal for those over age 21 and easily accessible, people might feel that drinking is a safe and easy way to manage anxiety or other mental health symptoms.

However, drinking excessively can lead to difficulties in your everyday life. Alcohol can have far reaching effects on your overall health, social interactions, and behavior. These effects can often be negative, and can worsen your symptoms of anxiety. For example, you might become drunk at a work party and behave in a way that embarrasses yourself or your partner. The impact from behavior that happens under the influence of alcohol can worsen your symptoms of anxiety or depression in the long run.

As with other central nervous system depressants, people find that they will need to drink more and more alcohol as time goes by to achieve the same buzzed or relaxed effect. If you become physically dependent on alcohol, quitting drinking can lead to alcohol withdrawal. Alcohol withdrawal can be very serious, sometimes leading to seizures, increased pain, and hallucinations, among other symptoms. 

Marijuana

Other anxiety or depression sufferers might consider marijuana to lessen the physical pain that can be associated with depression, or to ease anxiety. Marijuana is not considered to carry the same risks of physical dependence associated with alcohol or benzos; however, studies have shown the possibility of experiencing physical and psychological withdrawal symptoms when trying to stop using marijuana. This is especially true for people who use marijuana heavily.

There can be other drawbacks to marijuana use to manage behavioral health symptoms as well. For young adults, there can be concerns about how marijuana impacts the developing brain. Although marijuana is legal in some states, it remains illegal in other states, and it is illegal at the federal level in the United States. Therefore, using marijuana can have legal ramifications if used unlawfully. It may also influence whether you can obtain employment at certain jobs, or whether you might lose your job if you test positive for marijuana use.

What Is My Risk for Substance Dependence When Being Treated For My Anxiety, Depression, or ADHD? 

We know that when patients are treated appropriately with stimulants for their ADHD, they are less likely to develop an addiction to drugs or alcohol. For people with anxiety disorders who also misuse alcohol, the evidence is mixed as to whether treating anxiety appropriately can decrease alcohol use. Physical dependence on alcohol can be dangerous and can lead to issues with employment and relationships. 

As noted above, some medications used to treat anxiety, depression, or ADHD have a higher risk for dependence than others. Patients run the risk of becoming physically addicted to benzos like Xanax or klonopin, while SSRIs like Zoloft or Prozac are not addictive. It’s possible for patients to become addicted to stimulants used to treat ADHD, although the risk is lower when long-acting stimulants like Vyvanse, Concerta, or Adderall are prescribed. Careful monitoring by a behavioral-health expert is indicated when you are being prescribed medication for any of these conditions. If you are in recovery from substance abuse, it’s important to let your provider know, so that they can consider what medication will be the safest choice to treat your disorder. 

I have seen many patients with anxiety, depression, and ADHD find relief from their symptoms when they find the right medication treatment. At Upper Valley Behavioral Health, we treat patients in El Paso, TX, and the entire State of New Mexico. Fill out our short application today to get the ball rolling on treatment for your ADHD, depression, or anxiety. We will work with you to determine the safest and best course of treatment for your lifestyle.

Disclaimer: This post is for informational purposes only. It does not replace instructions from your licensed prescriber. Please consult your healthcare provider for guidance on your specific medication regimen.

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