People with attention-deficit hyperactivity disorder (ADHD) may be at higher risk for developing Parkinson’s disease and Parkinson’s-like syndromes, according to researchers at the University of Utah Health in Salt Lake City. Their study results were published in Neuropsychopharmacology.

The researchers analyzed 20 years of data from the Utah Population Database, which contains medical information for more than 11 million people. The study involved 31,769 people with ADHD — 4,960 of whom were prescribed medications, stimulants like Ritalin, Concerta, Daytrana, Metadate, Methylin (methylphenidate), Adderall (amphetamine salts), or Focalin (dexmethylphenidate) — and 158,790 controls without ADHD.

According to the researchers, people diagnosed with ADHD are more than twice as likely as those without the neurobehavioral disorder to develop early-onset Parkinson’s (between ages 21 and 66) and Parkinson-like conditions. For this group, Parkinson’s risk is six to eight times higher in people prescribed ADHD medications.

Strattera for ADHD: Pros and Cons

If you take medication for attention deficit hyperactivity disorder (ADHD), chances are you use a stimulant medication such as Adderall, Ritalin, or Concerta. These types of medication are effective in reducing impulsivity and inattention. However, for many people, they are not an option. Side effects, such as insomnia, loss of appetite, and irritability stop them from using stimulants. Other problems are the increased risk of cardiovascular problems or interference with other medical conditions or medication.

Strattera (atomoxetine) is a non-stimulant medication approved by the FDA to treat ADHD symptoms in children, adolescents, and adults. For some, this medication has proven to be effective. Others find it is not effective at all. Just as with stimulants, Strattera also has side effects that prevent some from taking it. As with all medications, you will need to weigh the pros and cons of the medication and discuss all your treatment options with your doctor.

The Benefits of Strattera

Stimulant medications are Schedule II medications, or controlled substances, meaning that the federal government regulates how the drug is made, prescribed, and dispensed. Your doctor must write a prescription every month and you must present the written prescription to the pharmacy. Your doctor cannot call in the medication, making it inconvenient for many. Since Strattera is not a controlled sbustance, you can receive a prescription for longer than 30 days and your doctor is able to call the pharmacy to fill or refill your prescription, saving you a trip to your doctor’s office each month.

Strattera is not considered to be addictive and does not have “abuse potential.” Because the full effect of Strattera can take up to three to four weeks (which is later listed as a disadvantage) and it does not give a euphoric feeling, it is not used to get high. For adolescents and adults who are prone to substance abuse or addiction, this medication might be a better alternative than stimulant medications.

The medication, when taken as directed, provides 24-hour relief from symptoms of ADHD. That means, as a parent, your child will be able to complete homework in the evening and mornings might not turn into a daily power struggle because the medication is still working.

Strattera appears to have some antidepressant properties and can help those who have symptoms of depression as well as symptoms of ADHD. When taking stimulant medications, those with depressive symptoms may need to add a second medication. With Strattera that may not be needed.

This medication is often a better choice for those with Tourette’s syndrome and ADHD because Strattera does not increase or aggravate tics. It also causes some urinary retention, which in some people may cause a problem but for those children with nocturnal enuresis (bed wetting), Strattera can help. Although you shouldn’t use Strattera specifically for this reason, it may be an added benefit for children struggling with bed wetting.

Disadvantages

As with all medications, Strattera does have side effects. Your prescription comes with a warning about a potential for suicide when on this medication. The warning indicates that children and teens may have suicidal thoughts while taking this medication. Other side effects for children and teens include:

• Stomach upset, nausea, vomiting
• Loss of appetite
• Dizziness
• Daytime sleepiness
• Mood swings
• Increased heart rate and blood pressure

For adults, the most common side effects are:

• Constipation
• Dry mouth
• Insomnia
• Dizziness
• Increased menstrual flow and cramps
• Problems urinating or pain when urinating

Another disadvantage is that it takes three to four weeks of sustained used to reach full effectiveness. There may be a number of people that start this medication and give up before waiting a month to decide if it works. Some individuals with ADHD choose to take medication only as needed, when focus and attention are required for a period of time, and to not take it on days when concentration isn’t required. If this is best for you, Strattera isn’t an option. Stimulant medications would be best.

Some men have complained of sexual side effects from Strattera, including a decreased sex drive, impotence, decreased ejaculation amount, or the inability to ejaculate and painful erections.

If you are having any side effects, including sexual side effects, from Strattera, talk with your doctor. Sometimes adjusting the dosage can help alleviate the side effects. In some cases, your doctor might suggest lowering your dosage or trying a different medication.

Seasonal affective disorder (SAD) impacts millions of people each winter. The farther someone lives from the equator, the greater the risk. Scientists are still learning about the causes behind SAD, and its connection to other conditions, in hopes of finding better treatments. For example, people with attention deficit hyperactivity disorder (ADHD)) are three times more likely to have symptoms of SAD than people without ADHD, according to a 2016 study published in the Journal of Psychiatric Research.

What is seasonal affective disorder (SAD)?

SAD is a type of depression that cycles with the seasons, according to the National Institutes of Health (NIH). People with SAD have symptoms that may include:

• Feeling lethargic or having low energy
• Sleeping more than normal
• Overeating, especially carbohydrates
• Weight gain
• Withdrawing from social activities

These symptoms usually occur during the winter months, but some people do experience SAD during the summer months. The exact causes of SAD are not known, however some proposed causes include serotonin dysregulation in the brain, overproduction of melatonin, and low vitamin D levels. It is the serotonin dysregulation that might explain the association between ADHD and SAD, according to a 2006 paper published in the American Family Physician, because both disorders are characterized by an under arousal of certain brain regions and a heightened sensitivity to the physical environment.

What you can do

There are currently a few different treatments available for SAD. Light therapy, cognitive behavioral therapy, and medication all reduce symptoms. But, there haven’t been any large-scale studies to show which of these treatments is best, according to the 2006 paper published in the American Family Physician. If you experience symptoms of SAD, it is important to talk with your doctor about the different treatments to determine which one is right for you.

Light therapy — Light therapy, the most common treatment for SAD, is found to work best when it is administered in the morning, according to the 2006 paper published in the American Family Physician. Light therapy involves sitting under a bright light for 20-60 minutes per day to help make up for lost sunlight, according to the NIH. Lightboxes for SAD therapy use 10,000 lux of cool, white fluorescent light and filter out the UV rays.

Cognitive behavioral therapy (CBT) — CBT is a type of psychotherapy based on the idea that how we think (cognition), how we feel (emotion) and how we act (behavior) all interlink. To this end it works to change negative thought patterns into realistic and helpful thought patterns and behaviors. For example, CBT would coach someone to change unhelpful thoughts about staying indoors extensively into thoughts about ways to find pleasurable activities to do outdoors. According to the American Family Physician 2006 paper, a small study of 26 participants found CBT to be equally as effective as light therapy in treating SAD. There have not yet been large or long-term studies to determine the effectiveness of this treatment.

Medication — Some medications that are used to treat depression can also be used to treat SAD, according to the American Family Physician 2006 paper. For example, some studies have found that sertraline (Zoloft) and fluoxetine (Prozac) are helpful in treating people with SAD.

ADD and ADHD are distinct conditions, though they share many of the same symptoms. Their differences do not make one better or worse than the other, but gaining a proper understanding of each condition will arm you with the information you need to create the best treatment regimen possible.

You have ADD: You have trouble at company meetings, you find yourself constantly daydreaming and being snapped back to paying attention when someone says your name. You consistently lose your keys, forget appointments, and are one of the most disorganized people in the office.

Your co-worker, on the other hand, has ADHD. He is constantly moving, constantly talking, and never seems to complete anything, moving from one project to the next. He always looks busy, but he says he never feels like he has accomplished anything. Even though you are so different, you both have the same disorder. It is baffling to think that you both take the same medication and it helps decrease his symptoms of hyperactivity while providing you with more motivation.

ADD is commonly used to refer to Attention Deficit Disorder without hyperactivity and ADHD is often used to describe Attention Deficit Disorder with hyperactivity. Both are considered to be a type of the same condition. There are some major differences between ADD and ADHD:

ADD without hyperactivity (ADHD, Predominantly Inattentive Type), includes symptoms such as inability to sustain attention, making careless mistakes, avoiding tasks that require sustained mental effort, and becoming easily distracted.

ADHD (ADHD, Predominantly Hyperactive-Impulsive Type), has symptoms such as fidgeting, being constantly in motion, restlessness, talking excessively, blurting out answers, and interrupting others.

In addition to the above symptoms, there are a number of characteristics that are often shared by both ADD and ADHD:

• Forgetfulness
• Difficulty in school
• Lack of organizational skills
• Regularly losing items
• Poor social skills
• Low self-esteem
• Relationship problems

Behavioral problems are more often associated with ADHD, while ADD has a high incidence of co-existing emotional conditions such as depression and anxiety. ADHD is normally diagnosed at an earlier age, as hyperactivity is much more recognizable. Problems associated with ADD may be misunderstood and mislabeled as extreme shyness and therefore not diagnosed until later, sometimes in middle school or high school or not until adulthood.

Relationship issues also seem to occur in both ADHD and ADD. The high energy level of ADHD can allow an individual to attract many people, although they may have more of a problem developing a close emotional bond. People with ADD, on the other hand, have a harder time making friends with others because of their quiet manner, but once they do, they are more easily able to create deep friendships.

At one time, it was thought that ADHD was a boy’s disorder and ADD was the girl’s disorder. This is now known not to be true. There are boys suffering from symptoms of ADD and girls that are hyperactive.

Overall, there are distinctive characteristics and symptoms for ADHD and ADD. There are also similarities. One is not worse or better than the other. There is simply a difference in behavior patterns. Treatment, when properly done, will not differentiate between ADD and ADHD, but will target the specific areas of difficulty in a person’s life and work to improve their lives.

Every day is filled with decisions. What to have for breakfast? What to wear today? Should I do my math homework first, or should I read first? Then there are the big decisions. Should I take this new job? Should I buy a house or rent one? Which college should I attend? For those with ADHD, indecisiveness is often a real problem. The inability to make a decision can leave them paralyzed. They might do nothing because they don’t have a clear idea of which path to follow.

The inability to make a decision might stem from executive functioning impairments. In an article on CHADD.org, Russell Barkley and Tom Brown, who have both done extensive research on ADHD, explain executive functioning differently, but both agree that it includes prioritizing, planning, organization, and self-regulation skills. The article also notes that deficits in executive functions and ADHD symptoms are commonly considered to be interrelated. Decision-making requires the ability to prioritize, plan, and self-monitor yourself to determine whether the process is working or should be revised.

Other symptoms of ADHD can also contribute to indecisiveness:

• People with ADHD often have a problem starting tasks.
• Some people with ADHD avoid complex problems or tasks that are unpleasant or uninteresting because of attentional difficulties.

There might also be the fear of making a wrong decision. Past failures might hold you back from moving forward. You might be afraid of making the wrong choice or worry that you will be judged. Sometimes, however, not making a choice means you give up your power. It allows someone else to make the decision for you.

The following are tips to help you become more decisive:

Categorize your decisions. When faced with a decision, decide if it is a small, medium, or large decision. Small decisions usually don’t have large consequences, and these are ones you should be able to make quickly, without too much analysis. Deciding what type of decision it is gives you an idea of how much thought and worry you should put into making it. You can ask yourself, “Will this matter in five minutes, five days, five months, or five years from now?” The answer might help you decide the category in which to put your decision.

Give yourself a time limit for making decisions. This becomes easier if you categorize them as in the previous tip. For small decisions, limit yourself to a few minutes and add to the time for larger decisions. Set a timer or put the deadline on your calendar. If you haven’t made a decision in that time, it might be helpful to talk it over with someone.

Think about what scares you about making decisions. Is it concern that you will make the wrong decision? If so, consider what will happen. Will it be consequential or a small inconvenience? Use this information to help you decide if a decision can be made quickly. Are you concerned about whether others will judge you? Consider whether their opinion is important in your life; if so, talk to them about the decision. If not, go ahead and make it. If you overcome your fear, your decision will be easier.

Give yourself credit for the decisions you do make. If you are always telling yourself, “I am not a good decision-maker,” think about the hundreds of decisions you successfully make each week: What should I wear? What route should I take to work? What movie should I see? Where should I go for lunch? Pat yourself on the back for making decisions every day and rephrase your thought to: “I make decisions all the time. I can make decisions.”

Get treated for ADHD. For some people with ADHD, treatment, including medication, helps ease the decision-making process. When ADHD symptoms are better managed and you aren’t quite so distracted or overwhelmed, decisions are easier.

Gather information. Before assessing your options, gather all pertinent information. Keep in mind that you can’t make a decision until you have all the information.

Make a pro-and-con chart. Look at what the potential benefits and costs of each decision are. Not every decision is going to offer the perfect choice, but you can look at which option has the best outcome.

Trust your instinct. If you keep coming back to one answer, or if one choice jumps out at you as the best choice, trust that it is the right choice to make, at least for now.

Remember that most choices are reversible. If you decide to take a job and it turns out not to be a good fit, you can look for another one. If you choose to move to an apartment and don’t like the noise from outside, you can find another one and not renew the lease. Most decisions can be adjusted, modified, or reversed.