How do antidepressants compare to stimulants for treating ADHD. Which antidepressants are most effective for ADHD symptoms. What are the potential benefits and risks of using antidepressants for ADHD.

The Role of Antidepressants in ADHD Treatment

Attention-deficit/hyperactivity disorder (ADHD) is a complex neurodevelopmental condition that affects both children and adults. While stimulant medications are considered the first-line treatment for ADHD, antidepressants have emerged as an alternative or adjunctive therapy option. But how effective are antidepressants in managing ADHD symptoms?

Antidepressants differ in their efficacy for treating ADHD, with some showing more promise than others. Generally, they are not as effective as psychostimulants in addressing attentional and cognitive symptoms. However, certain antidepressants can help reduce impulsive and hyperactive behaviors associated with ADHD.

Comparing Antidepressants to Stimulants

Do antidepressants match the efficacy of stimulants for ADHD? The short answer is no. Psychostimulants remain the treatment of choice due to their unique effect on attention. They are more effective in managing the core symptoms of ADHD, particularly inattention and cognitive deficits.

However, antidepressants can play a valuable role in ADHD treatment, especially for patients who:

• Do not respond well to stimulants
• Experience significant side effects from stimulants
• Have comorbid conditions like depression or anxiety
• Are at risk for substance abuse

Types of Antidepressants Used for ADHD

Several classes of antidepressants have been studied for their potential in treating ADHD. Each type has its own profile of benefits and limitations.

Tricyclic Antidepressants (TCAs)

Tricyclic antidepressants have demonstrated efficacy in treating behavioral symptoms of ADHD. They work by increasing the levels of norepinephrine and serotonin in the brain. Which TCAs are commonly used for ADHD?

• Imipramine
• Nortriptyline
• Desipramine (though it should be avoided, especially in youth and adolescents, due to safety concerns)

While TCAs can be effective, they require careful monitoring due to potential side effects and the risk of toxicity in overdose.

Bupropion (Wellbutrin)

Bupropion, an atypical antidepressant, has shown promise in treating ADHD symptoms. It acts on both dopamine and norepinephrine systems, which are implicated in ADHD. How effective is bupropion for ADHD?

Studies have demonstrated efficacy in controlled trials, but its use may be limited by certain side effects:

• Increased risk of seizures at higher doses
• Potential to exacerbate tics
• Risk of skin rash, especially in younger patients

Venlafaxine (Effexor)

Venlafaxine, a serotonin-norepinephrine reuptake inhibitor (SNRI), appears to be effective in managing ADHD symptoms. However, more controlled studies are needed to establish its efficacy conclusively. Its dual action on serotonin and norepinephrine systems may contribute to its potential benefits in ADHD treatment.

Selective Serotonin Reuptake Inhibitors (SSRIs) and ADHD

SSRIs are commonly prescribed antidepressants, but their role in ADHD treatment is less clear. Have SSRIs shown efficacy in treating ADHD? The evidence is mixed and somewhat disappointing.

Key points about SSRIs in ADHD treatment:

• Lack of controlled trials specifically for ADHD
• Inconsistent effects on ADHD symptoms
• May sometimes aggravate ADHD symptoms
• Potential to cause frontal apathy and disinhibition

While SSRIs may be beneficial for comorbid conditions like depression or anxiety in ADHD patients, they are generally not considered a primary treatment for ADHD symptoms alone.

Other Medications: Clonidine in ADHD Management

Clonidine, an alpha-2 adrenergic agonist, is sometimes used in ADHD treatment, particularly for managing hyperactivity and impulsivity. However, its efficacy for core ADHD symptoms remains uncertain.

What do we know about clonidine’s effects on ADHD?

• Not adequately examined in large-scale controlled studies
• Seems to have small or uncertain effects on core ADHD symptoms
• May be more helpful for specific symptoms like sleep disturbances or aggression

Potential Benefits of Antidepressants in ADHD Treatment

While not as effective as stimulants for core ADHD symptoms, antidepressants can offer several potential benefits in ADHD management:

1. Reduced risk of substance abuse compared to stimulants
2. Management of comorbid conditions like depression or anxiety
3. Alternative for patients who don’t respond to or tolerate stimulants
4. Longer-acting formulations, potentially improving adherence
5. Less potential for abuse or diversion

Risks and Side Effects of Antidepressants in ADHD

As with any medication, the use of antidepressants for ADHD comes with potential risks and side effects. These can vary depending on the specific antidepressant used.

Common Side Effects

• Nausea and gastrointestinal disturbances
• Headaches
• Sleep disturbances
• Sexual dysfunction
• Weight changes

Serious Risks

Some antidepressants, particularly TCAs, carry more significant risks:

• Cardiac side effects (especially with TCAs)
• Increased suicidal thoughts in young people (black box warning for all antidepressants)
• Potential for serotonin syndrome when combined with other serotonergic medications
• Risk of manic episodes in patients with bipolar disorder

Individualizing Treatment: Choosing the Right Medication

The choice of medication for ADHD, whether stimulant or antidepressant, should be individualized based on various factors. What should be considered when selecting a treatment approach?

• Severity and specific presentation of ADHD symptoms
• Presence of comorbid conditions
• Patient’s age and medical history
• Potential side effects and risks
• Patient and family preferences
• History of response to previous treatments

A comprehensive evaluation by a qualified healthcare provider is essential to determine the most appropriate treatment strategy for each individual with ADHD.

The Role of Multimodal Treatment in ADHD

While medication plays a crucial role in ADHD management, it’s important to consider the potential benefits of a multimodal approach. Does combining medications with psychosocial interventions improve outcomes?

The research suggests that multimodal treatments (medications plus psychosocial interventions) might not be significantly more effective than medications alone for core ADHD symptoms. However, a comprehensive treatment plan can address various aspects of an individual’s functioning and quality of life.

Components of a multimodal ADHD treatment plan may include:

• Medication management
• Behavioral therapy
• Cognitive-behavioral therapy (CBT)
• Educational interventions and accommodations
• Family therapy or parent training
• Lifestyle modifications (e.g., sleep hygiene, diet, exercise)

The combination of these approaches can help individuals with ADHD develop coping strategies, improve organizational skills, and address any coexisting emotional or behavioral issues.

Future Directions in ADHD Treatment

As our understanding of ADHD continues to evolve, so does the landscape of potential treatments. What are some promising areas of research in ADHD pharmacotherapy?

• Novel drug targets based on advances in neuroscience
• Personalized medicine approaches using genetic and neuroimaging biomarkers
• Development of medications with fewer side effects and abuse potential
• Exploration of non-stimulant alternatives with improved efficacy
• Investigation of combination therapies targeting multiple neurotransmitter systems

These ongoing research efforts aim to expand the treatment options available for individuals with ADHD, potentially leading to more effective and tailored interventions in the future.

Monitoring and Adjusting ADHD Treatment

Regardless of the chosen medication approach, ongoing monitoring and adjustment are crucial for optimal ADHD management. How should treatment progress be evaluated?

Key aspects of treatment monitoring include:

• Regular assessment of symptom improvement
• Evaluation of functional outcomes (e.g., academic performance, social relationships)
• Monitoring for side effects and adverse reactions
• Adjusting medication dosages as needed
• Considering changes in treatment approach if response is inadequate
• Addressing any emerging comorbid conditions

Healthcare providers should work closely with patients and their families to ensure that the chosen treatment plan remains effective and well-tolerated over time. This collaborative approach allows for timely adjustments and optimizes the chances of long-term success in managing ADHD symptoms.

In conclusion, while antidepressants may not be as effective as stimulants for core ADHD symptoms, they can play a valuable role in the treatment of this complex disorder. The choice of medication should be individualized, considering the unique needs and characteristics of each patient. As research continues to advance our understanding of ADHD and its treatment, we can look forward to more targeted and effective interventions in the future.

Antidepressants in the treatment of attention-deficit/hyperactivity disorder

Review

. 1997;58 Suppl 14:14-29; discussion 30-1.

C W Popper 
¹

Affiliations

Affiliation

• ¹ Department of Child and Adolescent Psychiatry, McLean Hospital, Belmont, MA 02178, USA.

• PMID:

  9418743

Review

C W Popper.

J Clin Psychiatry.

1997.

. 1997;58 Suppl 14:14-29; discussion 30-1.

Author

C W Popper 
¹

Affiliation

• ¹ Department of Child and Adolescent Psychiatry, McLean Hospital, Belmont, MA 02178, USA.

• PMID:

  9418743

Abstract

Antidepressants differ in their effectiveness for treating attention-deficit/hyperactivity disorder (ADHD) in adults and children. None are as effective as psychostimulants for treating the attentional and cognitive symptoms, but they can help reduce impulsive and hyperactive behavior. Tricyclic antidepressants have well-demonstrated efficacy in treating behavioral symptoms, but desipramine should be avoided, at least in youths and adolescents (and perhaps adults), because safer tricyclics are available. Bupropion was effective in its few controlled trials, but tics and (especially in youth) skin rash limit its value. Venlafaxine appears effective, but controlled studies are needed. Serotonin selective reuptake inhibitors have not been tested in controlled trials, but they cause inconsistent changes, often aggravate ADHD symptoms, and can cause frontal apathy and disinhibition. Clonidine has not been adequately examined but seems to have small or uncertain effects. Psychostimulants remain the treatment of choice because of their unique effect on attention. Multimodal treatments (medications plus psychosocial) might not be more effective than medications alone.

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Medicine, Therapy, Counseling, and More

Written by William Moore

• Which Meds Work?
• Can Talk Therapy Help?
• What About an ADHD Coach?
• What About an ADHD Online Community?
• What if I Have Other Conditions, Too?

Many people with attention deficit hyperactivity disorder (ADHD) don’t know they have it until they’re adults. It was there all along, but they never got tested for it. Others have known they had it since childhood. But the symptoms — and the stress it adds to life — can change with age.

For example, you might be less hyperactive as an adult. But there’s a good chance you still have symptoms that affect your quality of life. Adults can have problems with paying attention, controlling impulses, and staying organized. These issues can affect your work, relationships, and self-esteem.

The same treatments used for kids with ADHD also treat adults. For most people, it’s a combination of medicine, behavior strategies, life skills training, and therapy. This is called multimodal treatment.

Sometimes, the meds you took as a child may work differently because your brain, body, and symptoms may have changed. As an adult, you also might need different skills to stay organized and manage your time. And you may need treatment for other issues like depression or anxiety.

To get the most from any treatment, it’s good to know specifically how ADHD affects you. Does it make it hard to meet deadlines at work? Are you struggling in relationships with your spouse or child? If you know, you can better seek care that’s tailored for you. And you’ll be better able to tell if it’s working.

Drugs are the main treatment for ADHD. But finding the one that works best for you may take some trial and error, and what works at first may not do so well over time. Also, while many drugs work for both children and adults with ADHD, clonidine (Catapres, Jenloga, Kapvay), guanfacine (Intuniv, Tenex), and modafinil (Provigil) haven’t been well-researched for adults and aren’t prescribed much.

Stimulants. These are often the first choice for ADHD, and they tend to work the best. Usually, you start at a low dose. You then increase it every 7 days until you get to where the medication controls your symptoms without too many side effects.

Stimulants commonly prescribed for ADHD include these drugs, sometimes in combination:

• Amphetamine (Adzenys, Dyvanel)
• Dextroamphetamine (Dexadrine, ProCentra, Zenzedi)
• Dexmethylphenidate (Focalin)
• Lisdexamfetamine (Vyvanse)
• Methylphenidate 

For most adults, long-acting stimulants work best. They last 10-14 hours, so you don’t have to remember to take as many pills. Once you get the dosage right, you’ll have regular follow-ups to make sure the drug keeps working and any side effects are minor. Most adults with ADHD will need to keep taking medications, but some will be able to stop. Your doctor may suggest:

• Going off the meds once a year to see if you still need them.
• Taking a drug holiday so your body doesn’t get too used to it. Otherwise, you might need a higher dose.

You may be able to manage your side effects by changing the dose or time of day you take it. Common side effects include:

• Anorexia or loss of appetite
• Anxiety or panic
• Dry mouth
• Headache
• Jitteriness
• Moodiness
• Slight increase in blood pressure and pulse
• Trouble sleeping

Stimulants are effective, but they’re not for everyone. For some, the side effects are too much. And you want to avoid stimulants if you have certain conditions, such as:

• Bipolar disorder
• Anxiety
• Heartbeat that’s faster than normal or whose rhythm is off
• High blood pressure
• Psychosis
• Severe anorexia
• Substance use disorder
• Tourette’s syndrome 

Nonstimulants.  When stimulants aren’t an option, other choices are atomoxetine (Strattera) and viloxazine (Qelbree). The full effects of these drugs don’t kick in quite as fast as with stimulants, but some people find they work well for them.

You start with a low dose and typically raise it every 5-14 days until you find the right balance. The side effects are similar to stimulants and may also include constipation, lower sex drive, and an upset stomach.

Antidepressants. Antidepressant drugs raise your brain’s levels of chemicals such as dopamine and norepinephrine. They aren’t usually the first choice for treating ADHD, but doctors have found they can improve attention span in some people with the condition. They also help keep a lid on behavior like being impulsive, hyperactive, or aggressive.

Although doctors prescribe antidepressants to treat ADHD, the FDA hasn’t specifically approved them for that purpose. Your doctor may suggest one of four types:

• Bupropion (Wellbutrin)
• Monoamine oxidase inhibitors (MAOIs)
• Tricyclic antidepressants like desipramine (Norpramin) and imipramine (Tofranil)
• Venlafaxine (Effexor)

The right antidepressant for you depends on your symptoms and other health problems. Some adults with ADHD also have depression and anxiety. Antidepressants might be an option if that’s your situation, since they can treat these conditions as well as ADHD.

Yes. The right medicine, along with a good therapist, is a powerful combo. Talk therapy can help you and your family members learn more about how ADHD works and how to better deal with the problems it can create.

There are many types of talk therapy. Two common ones for ADHD are:

Cognitive behavioral therapy. You learn to change your thoughts and actions in a way that gives you more control over your life. It can help with challenges in school, work, and relationships. And it’s used to address issues like substance abuse and depression.

Marriage counseling and family therapy. You and your family members learn how to communicate better and spot patterns that may cause issues. The counseling can help loved ones understand that the problems aren’t simply about your being messy or forgetful.

E-therapy

E-therapy may be a solution if you can’t afford a traditional therapist, you feel uncomfortable visiting a doctor in person, or you can’t find qualified help in your area. Counselors can reach people in different ways:

Phone calls. Counseling over the phone is hardly a new idea. Many therapists have reported positive results for their clients using this growing option.

Some of the pluses include:

• Lower costs
• More convenience
• Anonymity
• A better sense of control for the person seeking help.

Video conferencing. This may be especially valuable for people who live in rural areas, where travel is difficult, or where there may not be many counselors with the needed skills. Usually people using this method have more sessions than they would in person.

Text-based communication. Whether it’s email, chat rooms, or direct messages, text communication makes it easy for people to reach out to a therapist. It can also support more direct counseling. Research on this newer trend is ongoing. Generally, it’s found to be effective and helpful. Still, there’s some evidence that a chat feature is more effective than email alone.

You can learn practical skills, including how to make plans, set goals, manage time, and stay organized. A coach can share suggestions and tips and keep you focused and motivated to make the changes you want. Studies show that coaching can help you reach goals, manage stress, and achieve more in your life.

It can help to connect with other people who have ADHD or know someone with it. A support group is one way to do this. To find an ADHD support group, check the website of CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder). This nonprofit organization has chapters throughout the U.S. At CHADD’s web site, use the “Get Support” tab to find support and local chapters.

People with ADHD are more likely to have mental health issues like anxiety, depression, and drug use disorder. These types of conditions, and their treatments, can affect ADHD and vice versa.

For example, some stimulant medications for ADHD can make anxiety symptoms worse. So if you have both conditions, your doctor will look at which one is causing the most problems when deciding on your treatment plan.

On the flip side, research has found that treating ADHD with stimulants can help people who also have a substance use disorder stay in addiction treatment programs.

Other times, your doctor can safely combine treatments for more than one condition. A mix of antidepressants and stimulants may help if you have depression along with ADHD.

Some ADHD symptoms can also be signs of other conditions, such as behavior disorders or depression. Or ADHD medications might have side effects that look like different mental health problems. That’s why it’s important to talk with your doctor when you notice changes in yourself or a loved one. If you’re in treatment, keep them updated on any new concerns.

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What is it: ADHD, depression or both: signs, similarities and differences

Depression affects a person’s thinking and actions and causes feelings of sadness, loneliness, lack of interest in life. People with Attention Deficit Hyperactivity Disorder have a high risk of developing depression due to stress, although it manifests itself in a different way.

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What do these symptoms mean?

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Experts estimate that depression is almost three times more common in adults with attention deficit hyperactivity disorder (ADHD) than in the general population. Research also shows that about 30% of people with ADHD experience a depressive episode or mood disorder during their lifetime.

Contents of the article

Do not self-medicate! In our articles, we collect the latest scientific data and the opinions of authoritative health experts. But remember: only a doctor can diagnose and prescribe treatment. 9What is depression?

The person feels uncharacteristically sad, anxious, and wracked with guilt. Low energy leads to excessive bedtime and increased sleep duration. People have little or no interest in friends or daily activities, they have no hobbies.

The disease affects the feelings, thinking and actions of a person and causes feelings of sadness, loneliness, lack of interest in life.

Women are more likely to suffer from depression and make up 70% of the total number of patients with this disorder. Young people between the ages of 18 and 25 have a 60% greater risk of depression than people over 50.

Can ADHD and depression coexist

Attention deficit hyperactivity disorder (ADHD) and depression are conditions that can and often occur at the same time. Moreover, people with ADHD and depression experience the symptoms of each condition more acutely than if they had only one psychiatric disorder. As a result, depression in these people is sometimes misdiagnosed and treated, which has a significant impact on the condition of patients.

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ADHD and depression symptoms

Depression and ADHD share some common symptoms. Both of these conditions include difficulty concentrating and loss of motivation. A person with ADHD may lose motivation because they believe that their efforts will not be noticed. A depressed person cannot complete his work because he does not have a goal.

Signs of depression in adults with ADHD

• Problems with concentration;
• Excessive attention to one activity;
• Disorganization and forgetfulness;
• Impulsivity;
• Emotional difficulties, including inability to manage emotions such as anger or frustration;
• Hyperactivity or restlessness;
• About 50% of adults with ADHD have an anxiety disorder.

Symptoms of depression in adults with ADHD

• Marked change in appetite, sleep and wakefulness;
• Loss of interest in activities;
• Feelings of worthlessness, hopelessness and guilt;
• Recurrent thoughts of death or suicide;
• Physical symptoms such as headaches or abdominal pain.

Can untreated ADHD cause depression?

The presence of attention deficit hyperactivity disorder increases the risk of depression by four times. The risk is even higher for people with the hyperactive/impulsive type of ADHD, who are also at higher risk of suicide.

The very nature of ADHD, especially if left untreated, can sometimes cause depression. This type of “secondary depression” occurs as a direct consequence of the chronic dissatisfaction and frustration that many people with ADHD experience.

All the difficulties that can be caused by the symptoms of ADHD, such as problems with school, relationships, work, daily activities, lead to the fact that people with this condition often feel bad about themselves.

If ADHD is properly controlled and treated, depression can be avoided. But by some estimates, 25% of adults with this disorder did not receive proper treatment. After suffering so many blows to their self-esteem, they are resigned to the idea that they are lazy and stupid or not good enough to succeed in society or at work.

What else can cause depression in ADHD

Dopamine

The brains of people with ADHD are dysregulated, the hormone dopamine, the neurochemical responsible for motivation and mood. This makes them feel oppressed.

Emotional dysregulation

People with ADHD are more prone to emotional dysregulation—they can and often experience emotions more intensely than people without ADHD. People with ADHD may take longer to calm down from difficult emotions and find it harder to withdraw from and distract from them, which can contribute to depression.

Comorbidities

ADHD rarely occurs alone. A significant number of people with ADHD have a comorbid or associated disorder, whether it be depression, bipolar disorder, obsessive-compulsive disorder (OCD), binge eating disorder, substance abuse, or learning disability.

Of course, ADHD in combination with something else can increase the risk of depression. For example, a person with ADHD and OCD has to contend with a difficult combination of conditions—they may be constantly tormented and ruminated about all sorts of things, which can lead them to withdraw and feel helpless.

How ADHD and depression are treated

ADHD and depression are usually treated with psychotherapy, medication, or a combination of both. Cognitive behavioral therapy (CBT), for example, has proven to be highly effective against depression. The first goal of CBT is to enable the patient to identify and reduce frequent, intense negative thoughts such as “this is too hard to do”, “I’m not worthy of this”.

Whether or not depression is the result of ADHD does not change the fact that the person experiences guilt and emotional pain. Although there are some factors that doctors take into account when treating both conditions. For example, how ADHD medications and antidepressants can interact with each other. However, depression is often treated as a separate disease. Because the problems caused by ADHD are real, and depression can be life-threatening.

Antidepressants are the main treatment for severe depression. Most antidepressants work well with ADHD stimulants. In most cases, symptoms improve significantly after the first dose of the antidepressant. About half of those who take antidepressants achieve complete relief from their depression.

Lifestyle adjustments can also make a huge difference. Aerobic activity greatly affects the mood level of people with ADHD, improving it.

Many people with ADHD find that their mood deteriorates when they have nothing to do, and emotional stress can lead to increased anxiety and depression. It is important to fill these voids in life with reading, swimming, walking, hobbies.

Healthy food, adequate sleep, and regular exercise can reduce symptoms.

Meditation also plays an important role in the treatment of depression. You need to sit down, close your eyes and focus on your breathing. With each exhalation, repeat a one-syllable word – “world”, “com”, “house”. This should be done for a minute or 10 to 20 seconds whenever it is difficult to switch from one activity to another.

The goal of treatment is to reduce the frequency and intensity of depressive symptoms that interfere with a happy life.

Attention Deficit Hyperactivity Disorder (ADHD)

What if some mental disorders are not disorders at all?

What if mental disorders such as anxiety, depression or post-traumatic stress disorder are not mental disorders at all? In a new paper, biological anthropologists are calling on the scientific community to rethink mental illness. After careful study, they provide information that allows you to think of depression or post-traumatic stress as a reaction to adversity, rather than a chemical imbalance. And ADHD may be a way of functioning that has evolved in a hereditary environment that doesn’t fit the way we live today.

Adaptive response to adversity.

Mental disorders are usually treated with drugs within the medical model. So why do the anthropologists who wrote this study argue that these disorders may not be medical at all? They point to several key points. First, medicine has never been able to prove that anxiety, depression, or post-traumatic stress disorder (PTSD) are inherited conditions. Second, the authors of the study note that despite the widespread and growing use of antidepressants, levels of anxiety and depression are not improving. From 1990 to 2010 the global prevalence of depressive disorder and anxiety disorders was 4.4% and 4%. At the same time, data continues to show that antidepressants work no better than placebo. Thirdly, worldwide, the incidence of these disorders remains stable at 1 in 14 people. However, in conflict-affected countries, approximately one in five people suffer from depression, post-traumatic stress disorder, anxiety and other disorders.

Together, the authors suggest that anxiety, depression, and post-traumatic stress disorder may be adaptive responses to adversity. Defense systems are devices that are reliably activated in threatening situations to minimize losses. It’s not hard to see how this relates to anxiety – it helps us avoid danger. But how does this relate to depression? Scientists claim that the mental pain of depression helps us focus on adverse events in order to mitigate current adversity and avoid similar adversity in the future. If this does not inspire confidence in you, then consider that neuroscientists are increasingly relegating these three disorders to branches of the threat detection system. Anxiety can be caused by chronic activation of the fight or flight system. Post-traumatic stress disorder can occur when an injury triggers a freeze response that helps animals switch off from pain before death, and depression can be a chronic activation of the same freeze response.

Labels matter.

Labels are what help define who we are and what we are capable of. Too often labels limit us. That’s why it’s important to rethink how we treat anxiety, depression, or ADHD. Does anyone have depression, a brain disease, or a suppressed adaptive response to adversity? Adversity is something we can overcome, while mental illness must be fought. Labels offer a variety of possibilities.

Let’s talk a little about ADHD. A generation ago, boys with ADHD were called bad boys and punished or detained. We are now helping children with ADHD understand that they have learning differences. Instead of detention, we try to provide support in a variety of ways. When we do this, behavior problems often disappear. This re-labeling of learning difference is vital because it gives children with ADHD the opportunity to be good and succeed. However, ADHD is still an Attention Deficit Hyperactivity Disorder. In Finland, where a lot of physical activity is part of the school day, rates of ADHD are very low. Meanwhile, in Russia, children are asked to sit quietly for most of the day. Primary school students often only get 15-20 minutes of break per day. And as a result, ADHD rates have risen over the past 15 years.

The authors of the study state that ADHD is not a disorder. Rather, it is an evolutionary mismatch with the modern educational environment that we have created. If ADHD is not a disorder, but a mismatch with the person’s environment, then it is not a medical problem. This is a question of education reform. And that’s a compelling thought, given the evidence that physical activity improves children’s concentration and cognition. However, we must take this study with a grain of salt. There is a large body of research showing other biological factors associated with ADHD. For example, there is evidence that preterm birth further increases levels of ADHD.

Social reform or treatment?

The authors of the study compared the treatment of anxiety, depression or post-traumatic stress disorder with antidepressants with the treatment of a broken bone without fixing the bone itself. They believe that these problems are more like socio-cultural phenomena, so the solution is not necessarily to correct dysfunction in the human brain, but to correct dysfunction in the social world. This is a fair criticism of how we treat mental illness. But the stated goal of the article is not to change treatment, but to explore new ways to get rid of these problems. Research on depression, anxiety, and post-traumatic stress should focus more on mitigating conflict and adversity and less on manipulating brain chemistry.

Based on this, do we need to change the way we view mental health? Yes and no. When it comes to what labels we use, the change is welcome. Mental health recovery depends in part on whether patients believe they will get better. Telling patients that their symptoms may be related to a healthy response to adversity can be very reassuring. It’s not news to doctors that adversity affects mental health. But until reform removes the social causes of suffering, physicians should continue to provide patients with standard care.