Adderall Abuse, Dependence, and Mental Health Risks

What Is Adderall?

Adderall is a prescription stimulant made from a combination of mixed amphetamine salts, primarily amphetamine and dextroamphetamine, that works by acting on the central nervous system to increase the availability of dopamine and norepinephrine in the brain.[1] The Drug Enforcement Administration (DEA) classifies Adderall as a Class II controlled substance because of its potential for abuse and dependence.[2]

Adderall is primarily used to treat ADHD and narcolepsy. Used as prescribed and under the supervision of a physician, it can improve focus, impulsiveness, and executive functioning for people with ADHD. However, when misused by taking without a prescription, or more frequently or at higher than prescribed, Adderall produces increased alertness, energy, and concentration, along with an increased likelihood of developing serious health issues.

What Is Adderall Dependence?

Adderall dependence develops when the brain adapts to the increased levels of dopamine and norepinephrine that Adderall provides by down-regulating its own production.[3] Over time, this causes someone to need higher or more frequent doses of the drug to get the same effects as before. If this continues, eventually they will not be able to function without Adderall and will experience withdrawal symptoms if they stop.

Keep in mind that Adderall dependence is not the same as addiction. While both terms are often confused, dependence means a physical adaptation (your body needs it to function), while addiction involves compulsive use despite negative consequences.[4] These two conditions often overlap.

Adderall withdrawal symptoms include fatigue, depression, cognitive slowing, irritability, and cravings, causing an Adderall crash that makes it difficult to stop using without appropriate medical intervention.[5]

Signs of Adderall Addiction

The first step to getting help for Adderall addiction for you or a loved one is to recognize the signs:

• Taking a higher dosage or more frequently than prescribed 
• Using Adderall without a prescription
• Continuing to use Adderall even when there are negative consequences from its use
• Feeling unable to work, study, or function without Adderall
• Heavy withdrawal symptoms when attempting to discontinue use
• Hiding use from family, friends, or healthcare providers
• Escalating use over time due to tolerance
• Mood dysregulation, anxiety, or psychosis while using Adderall or attempting to discontinue use
• Neglecting responsibilities such as work, family, or social obligations in favor of getting and using the drug

Adderall addiction can develop slowly over time, especially in high-performing people with ADHD, who have learned how to mask their symptoms. Some may not even realize they have a problem until they try to stop and find they can’t.

Adderall and Mental Health

The relationship between Adderall use and mental health is complicated, with each affecting the other. Misuse or overuse of Adderall may exacerbate or contribute to many mental health disorders, including:

• Anxiety — Stimulants increase heart rate and activate the body’s stress response system, so prolonged misuse can contribute to anxiety symptoms.[6]
• Depression — Withdrawal and chronic misuse of stimulants can lead to depressive symptoms.[7]
• Psychosis — High doses of Adderall can trigger psychotic symptoms like disordered thinking, hallucinations, and paranoia, particularly in people with a predisposition to these disorders.[8]
• Sleep — Chronic use of Adderall can disrupt normal sleep cycles and lead to sleep disturbances.[9]
• Mood instability — The cycle of abuse and withdrawal experienced by many who misuse stimulants can lead to irritability and shifts in mood.[10]

Equally important is the reverse relationship: those who misuse Adderall frequently may do so to cope with undiagnosed or undertreated mental health disorders, including depression, anxiety, or a personality disorder.[11] 

Addressing Adderall Dependence

If a person with problematic Adderall use is simply treated for substance use without treatment for the underlying cause, it isn’t likely to result in long-term change. This is why Helios West Palm offers what it does. 

For many, the drug has become a method of coping with or compensating for previously unidentified mental health disorders. Undiagnosed ADHD leaves many people who struggle with it feeling as if they can’t perform “normally” without stimulants. Those with depression may seek out stimulants for relief. People with anxiety may find that Adderall offers a sense of productivity and focus.

Since many people who misuse Adderall do so primarily as a result of a mental health condition, addressing Adderall addiction in isolation is sort of like playing whack-a-mole: you can hit the substance abuse time and time again, hit it as hard as you can, but it’s never going to stop resurfacing. True success can only come from identifying and treating the mental health conditions that drove the Adderall abuse in the first place.

That’s what Helios West Palm does. We are not primarily an addiction treatment or detox facility. We are a mental health treatment center that treats substance abuse within a psychiatric treatment philosophy. For patients whose Adderall dependence is due to unaddressed mental health conditions, we offer coordinated psychiatric care that addresses both conditions. Every patient with a history of Adderall misuse undergoes a thorough initial psychiatric evaluation that incorporates far more than just a history of substance use. We take into consideration what is beneath the surface — the mental health conditions, neurodevelopmental differences, mood disorders, and personality characteristics that might explain why a person misused Adderall. Afterward, a comprehensive individualized treatment plan will be prepared.