Adderall and Anxiety: Can ADHD drugs make anxiety worse? Can they help?

It may shock some of you, but Adderall is currently one of the most commonly abused drugs in North America. Although it is a pharmaceutical drug designed for the treatment of ADHD (under medical supervision), Adderall is widely used by diverse groups, from students and researchers to traders and programmers. Basically, if a job requires you to concentrate for hours on end and to regularly do all-nighters, then the people that do that job are no strangers to stimulants like Adderall.

This is a serious problem. Adderall is not a drug that you can abuse without consequences. What some people don’t realize about Adderall is that it is a collection of amphetamine salts – in other words, it is just amphetamine under a brand name, in a particular form. This is precisely why so many people have turned to natural Adderall alternatives, as these offer most of the benefits of the study drug with none of the risks.

One of the main concerns about Adderall abuse is that it may cause acute anxiety while users are under the influence, as well as generalized anxiety in long-term, frequent users.

Does Adderall cause anxiety?

If so, how exactly does Adderall cause anxiety?

Is there a way for you to combat the anxiety-inducing effects of Adderall?

In this article we’ll try to answer these three questions in as much detail as possible. Let’s kick things off with a look at what Adderall does to the brain.

How does Adderall work?

Adderall is a central nervous system stimulant. It has a very simple but extremely powerful effect on the brain which rapidly reduces fatigue, heightens focus, promotes alertness, and drastically increases information processing speed.

Adderall works primarily by stimulating the production of norepinephrine in the brain. This is your body’s “fight or flight” neurotransmitter – it is released when you need to deal with intense situations.

Norepinephrine sharpens focus and speeds up information processing, allowing you to concentrate on the most important aspects of a situation and rapidly come to the right decision about how to act (the body’s “figure this out fast” response to danger). Norepinephrine also produces feelings of excitability and confidence; the “adrenaline rush” you’ve no doubt experienced at some point.

At the same time, Adderall also triggers the release of large amounts of dopamine in the brain. Dopamine can be thought of as your reward for completing tasks. Dopamine is released when you reach a goal or when you satisfy a need; think winning a bet or scratching an itch. Interestingly, dopamine is also released in anticipation of achieving a goal, which is the basis for your motivation to keep going.

By stimulating the release of these two neurotransmitters, Adderall can dramatically boost motivation, focus, confidence, determination, information processing, and mental energy.

But it has its downsides.

BIG downsides!

Dangers of Adderall use

Adderall is not a drug that people should be using without medical supervision. While it may seem like something that “everybody is doing”, the prevalence of use does not indicate safety.

Adderall is not safe – far from it!

As a collection of amphetamine salts designed to prolong and hasten the drugs effects, Adderall produces a wide variety of side effects which range from the uncomfortable to life threatening. Adderall also interacts with a broad range of other substances; in particular, you should avoid mixing Adderall with caffeine and other potent stimulants as this will make the side effects much worse.

Common side effects of Adderall use include:

• Headaches
• Jitters
• Dizziness
• Confusion
• Hypertension
• Elevated heart rate
• Hyperventilation
• Sweating
• Distorted time perception
• Irritability
• Anxiety

The long-term consequences of Adderall use include higher risks of:

• Heart disease
• Stroke
• Addiction
• Dependency
• Insomnia
• Anxiety

As you might have noticed, anxiety came up twice on our list of Adderall’s side effects. That’s because Adderall can cause both acute and long-term, generalized anxiety depending on user susceptibility to anxiety, length of use, doses used, and other factors.

Can Adderall Cause Anxiety?

Can Adderall cause anxiety?

Yes! Of course it can!

As an extremely powerful CNS stimulant, Adderall raises your norepinephrine levels to way beyond normal bounds. Norepinephrine release to this degree is necessary when faced with an extremely dangerous situation, like a mountain lion or a car crash. But when you’re just trying to get a project done by deadline or to pay attention in class, having this kind of norepinephrine release is extremely damaging to your mental and physical health, not least because of the acute anxiety spike it causes.

Adderall use causes acute anxiety. While users are under the influence of Adderall, their anxiety levels go through the roof. Generally speaking, they will find themselves to be highly irritable, on edge, and jittery. This is just what norepinephrine does; it makes you anxious because anxiety is a correct response to threats (but not to a lecture or board meeting).

Even those people who do not become temporarily more anxious while using Adderall will usually find that the crash of norepinephrine, dopamine and serotonin that follows Adderall use -the Adderall ‘comedown’ – almost always induces anxiety.

More worryingly than this though are the long-term effects that Adderall can have on your mental health, not least of which is its tendency to cause generalized anxiety.

Adderall makes anxiety worse long-term

Repeated Adderall use places great stress on your brain’s ability to produce and respond to both norepinephrine and dopamine. These two neurotransmitters are intimately involved in your ability to cope with stress.

In cases of prolonged Adderall use (or any amphetamine use), receptors for dopamine can become severely depleted. This is because the brain needs to compensate for perpetually elevated dopamine levels, and because of damage to receptors from over-stimulation. This means that your brain will register lower dopamine levels at all times, which leads to chronic anxiety. The same goes for norepinephrine, and to some degree serotonin too.

This is the mechanism by which Adderall use can cause chronic, lasting anxiety issues in adults.

It is for this reason that we strongly advise against the use of Adderall for the purposes of merely enhancing cognitive function. There are plenty of effective, natural nootropics out there capable of improve focus, memory, mental energy, and motivation without causing acute or chronic anxiety.

Can Adderall Help Anxiety & Depression?

Can Adderall actually help anxiety?

It may seem counter-intuitive, but in some contexts Adderall can be an effective treatment for anxiety and depression. Some doctors even recommend prescribing Adderall for certain cases of acute anxiety, nervousness and depression.

However, cases in which Adderall is an appropriate treatment for anxiety or depression are rare and must be decided on by a medical professional. If you use Adderall while struggling with anxiety then it is highly likely the stimulant will make your anxiety much worse.

So how does Adderall help anxiety?

How Adderall helps anxiety symptoms

Adderall primarily helps anxiety by increasing dopamine levels in the brain. Dopamine is one of the primary “feel good” neurotransmitters of the human brain. More specifically it creates a rewarding feeling in response to goal seeking behavior.

A lot of cases of acute anxiety, panic attacks and even chronic stress can be attributed to low dopamine, downregulated dopamine receptors or neurotransmitter imbalances across the board. We know that low dopamine or dopamine crashes can cause panic attacks and feelings of acute anxiety. So by spiking dopamine release in the brain, Adderall can help eradicate severe anxiety and prevent panic attacks.

Adderall is an uncommon treatment for anxiety and can actually make anxiety symptoms worse. If you think Adderall can help your anxiety, talk to your doctor.

Adderall & Anxiety Medication: Are they safe to mix?

Addressing ADHD symptoms can often help reduce symptoms of anxiety as well. It is therefore possible to manage anxiety by treating ADHD symptoms in cases where ADHD or ADD is causing or exacerbating the anxiety.

Furthermore, it’s common for people who abuse Adderall to be suffering from anxiety. This is why people so frequently mix Adderall and anti-anxiety medications.

However, mixing Adderall with anti-anxiety medications is extremely dangerous. You should not mix Adderall with other common treatment for depression and anxiety.

While your doctor will provide a detailed list, you should avoid mixing Adderall with the following:

• Monoamine oxidase inhibitor (MAOI)
• Selective serotonin reuptake inhibitors (SSRI)
• Serotonin-norepinephrine reuptake inhibitors (SNRI)
• Tricyclic antidepressants
• St. John’s Wort, Rhodiola rosea and Ashwagadha

Illicit Adderall use can pose a particular danger. It is not surprising that people with substance abuse disorders may also seek treatment for anxiety and depression. This could lead to a potentially dangerous interaction.

Can you take Adderall and anti-anxiety meds at the same time?

Although there are risks, it is possible. It’s best to consult a doctor before you do. Sometimes, doctors will prescribe Adderall along with an anti-anxiety medication. If the side effects are not severe it may be safe for you to combine these two medication types, but you should only do so if advised to by your doctor.

Some prescription medications for anxiety may have less side effects than others. There may be some good reasons to consider other treatment options for ADHD. Adderall is typically less effective if someone has anxiety. There may be an alternative.

Second, treating other mental health problems may help with attention problems. As we’ve seen, treating ADHD can reduce anxiety. It is possible that anti-anxiety medications can also help with focus by reducing stress levels, suppressing anxiety and clearing brain fog.

Should you take Adderall if you have anxiety?

Should you be taking Adderall if you have anxiety?

The short answer to this question is “no”. More often than not Adderall makes anxiety significantly worse. If you have severe anxiety, suffer from panic attacks, or are dealing with anxiety as a symptom of depression, it is advisable to avoid any kind of stimulant drugs – including Adderall and other stimulatn ADHD medications – until you have spoken to a qualified medical professional.

Because of the powerful release of norepinephrine that Adderall induces, the drug can make anxiety much better in the very short-term. But once the drug wears off, it is highly likely that your anxiety will come back much worse than it was before you took the Adderall. This is what we expect from what we know of the pharmacodynamics of the drug and it is certainly what we hear from anecdotal reports from users of Adderall with anxiety.

That said, there are instances where Adderall can help with anxiety; some doctors have found that patients with severe anxiety who are resistant to other therapies sometimes repsond well to Adderall. But please remember that these are rare cases and they must be decided upon by a doctor.

Learn more:

• Why do stimulants make me sleepy?
• L-Tyrosine and Adderall
• Caffeine pills or Energy Drinks
• Coffee vs caffeine pills
• Adderall vs Alpha Brain

Brian Johnson, PhD

Brian Johnson is current Editor of Vagarights.com and a long-time writer for VAGA. A former psychologist, Brian is passionate about improving mental health and finding ways to stave off cognitive decline. He is an expert on nootropics, cognitive enhancement and biohacking more broadly. You can see his work on Google scholar.