Comorbid Depression and ADHD in Children and Adolescents4

Hoo boy. I read this some time ago, but I’ve never really felt like writing anything about it. I’m cleaning up my bookmarks today, though, so I’m getting this out of there and throwing out another, slightly related, link I’ve had kicking around. I’ll start with that one because it’s a lot shorter, then we’ll move onto the main event. As a cautionary measure, if my life bores you, you have my permission to skip this post and buy Recettear instead. It’s on Steam, and available completely DRM-free (if I remember right) through Impulse and GamersGate.

        If you’re still here, the first link is something vael tossed out once upon a time, so it may seem familiar to you. It’s simply the wikipedia article for anhedonia, which is a possibly theoretical? thing suggesting a chicken/egg relationship between depression and not feeling happiness. Does not feeling any pleasure come from the depression, or do you get depressed because you don’t feel any pleasure? There’s not enough info on it to really say for sure, but at any rate it’s something that feels extremely familiar to me. Regardless of which came first, not feeling the kind of pure joy a lot of people get from, well, everything has had a huge effect on my hobbies and my personality. The games I play, books I read, why I do it at all - it kinda comes back to what I get out of it and how I can get motivated to play or read them in the first place. It sounds very depressing, but that depends on how much I’m enjoying my current project. At the moment, I don’t have one, because I’ve been working on homework and will be for some time. Ah well.

        But back to the main link, which as I’m looking at it again… I think I might have mentioned it somewhere because I remember half of it making no sense. At any rate I will scroll through it and see what I have to say about it. I’ll let you know if it’s worth reading as well.

        We start with some numbers, for the sake of referring to research, and it basically says “no one knows the truth about this, oh well!” That seems to be the purpose of all the numbers in here, so keep on truckin’ even if you have no idea what exactly you’re reading at the moment.

        Anyway, the fact that depression in children leads to a lot of the symptoms of ADHD is interesting to note. Also the question of whether ADHD is even a valid thing or just a label we slap on kids when we don’t know what to do with ‘em. For the record, I’m no longer identifying myself as having had a learning disorder for official university purposes, despite the general idea that I was mega-ADHD as a kid. I’d have to get tested and have them tell me “no you are fine” and that would just be a waste of time. So, did I even have ADHD, or do I just have things that are associated with ADHD? Good question.

        They mention externalizing (taking things out on other people) and internalizing (taking things out on yourself) disorders, and then make slight mention of the fact that, actually, people who are depressed and have other internalizing disorders might still externalize things. I can guarantee that’s true and I wonder if it’s possible to even classify things that way except for the most absolutely simple diseases. Well, by that I mean, anxiety is internalizing there’s no way you could bring that onto other people. Because you are anxious and likely having trouble interacting with them. Generally it isn’t that clear-cut.

        Actually that’s the only thing I’ve found of note until the treatment issues part. Yeah, I knew there was a reason I hadn’t written anything about this article. What’s interesting about that is that they refer only treatment via medication - this being the Psychiatric Times, and not the Psychological Times. So their question is, when we’re sending them on their way with a bottle of drugs, how do we guarantee the maximum effectiveness before they come back in four weeks? No thought is even given to other forms of treatment. Which pill should we use… Hmm… Well this one is good for one thing, and that one is good for another… Maybe if we give them both…

Comorbid depression in patients with ADHD suffers from an “attention deficit” by both researchers and clinicians, compared with other comorbidities (eg, ODD, anxiety).

Yeah they said that.

        On further review I’ve decided this article is kinda shitty. There isn’t much redeeming value in it aside from the idea that ADHD and depression could affect/cause eachother and really it’ll have to all come down to what I have to say about myself and the concept. What do I have to say about it? I’m not really sure, mainly stemming from a lack of motivation to say anything at all. I mean, ADHD and depression are two things I dealt with at a very young age. The depression is something that, clearly, I haven’t conquered permanently, but I hope I have a better handle on it now. Same with the ADHD.

        I was diagnosed with ADHD, hmm, as early as 7 or 8. I couldn’t swallow the pills, or chose not to, or whatever, and likely that alone has strengthened my physical inhibition against it - I have to choose my medication (vitamins, or when I was getting my wisdom teeth out, antibiotics and whatnot) around the fact that swallowed pills aren’t an option for me. Actually, that’s probably why I never take ibuprofen or anything like that. They don’t tend to be available otherwise.

        At any rate, I took my ritalin by sticking it inside an Oreo cookie and chewing that, which was still disgusting, but it worked. I took it for three or four years before I decided I didn’t want to depend on it anymore, and out of stubborn rebellion avoided taking it and learned how to control myself. This places us around fifth grade, meaning it coincides with my decision to be mature and quiet and generally get rid of all the things I hated about myself - most of which were things I was taking the ritalin for. I felt that I spoke too much (not really my imagination, people complained), that I was too excited all the time, too childish, stuff like that. I didn’t want to depend on the ritalin anymore, and I hated the side effects as much as I could bring myself to care while it was in my system. So over time I got rid of all of that, maybe even went too far in the other direction, but I didn’t need the ritalin anymore and for all intents and purposes my ADHD was miraculously cured in a very short period of time. It was amazing, the medication was so fucking effective that rather than controlling the symptoms it made them go away! Wow!

        So the part where this article becomes interesting to me is the side effects of the ritalin. I felt nothing. No joy, no real sadness either, but then that’s just plain sad. It was emptiness, which was worse in a whole lot of ways than being a pain in everyone else’s ass. I didn’t start getting depressed until after I started taking the ritalin. After I stopped having fun playing video games, after I stopped laughing and smiling except in the best of circumstances. Maybe it was just a matter of time anyway, like I would be depressed now regardless of what happened then. But that’s some damn good timing.

        It’s interesting, as well, that the games I fell in love with are all games I played not long after getting off of the ritalin and not being as deeply depressed yet. Final Fantasy IX, the Ratchet & Clank series (which I still think of as extremely fun, despite not enjoying them much anymore), even Final Fantasy X-2, and of course a number of browser based games. Heh, I used to spend hours, every single day, playing daily browser based games. Before you could pay for more play time, I’d just find more games. My current set of webcomics (18 of them) is about what I would have had for browser based games at the very peak. There were plenty of flash games as well, a lot of stuff that’s probably terrible by today’s standards but entertained me a fair bit at the ages of 10-12.

        I think about that age range in years, 2002-2004, and think “where would I have found flash games that far back?” but of course Newgrounds was there, sites like AddictingGames were around, Armor Games might even still have been Games of Gandor (fact check: Games of Gandor existed from 2004-2005). Kids these days wouldn’t even know that all their bases are belong to us…

        /nostalgia

        Even though I own a physical copy of Final Fantasy IX, rented and played for 50 hours when it was initially released, then rescued from an EBGames bargain bin some years later (and finished with that same save file, thanks to the glory of memory cards), I bought it for $10 from the PlayStation Network so I could replay it eventually. No disc switching, no wonkiness, just ten bucks straight to Square Enix and (hopefully) a bundle of nostalgic joy for me. Will I get the same feeling for the game now that I’m more or less in the same joyless state as I was while taking ritalin? Good question. Will I still like the game without the pure joy of VIDEO GAMES flowing through my veins? Also a good question. I’ll let you know if and when I get back to playing it.