Almost sounds like ADHD, which can be misdiagnosed as depression/anxiety OR can lead to those two things due to such cognitive dysfunctions and emotional dysregulation. It's interesting they mention guanfacine too, as I've heard that can be used to help with ADHD.
this post was submitted on 24 Jun 2023
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I think it's the other way around, I think "mood" disorders with cognitive deficits tend to get misdiagnosed as ADHD. It always seems weird to me when people with bipolar get diagnosed with ADHD given cognitive deficits, particularly in memory and executive dysfunction, are very common in the disease process.
Totally anecdotal, but I took escitalopram (the first depression medication mentioned in the study) for years. It worked all right for a while but I was always very low on energy, and after a while it stopped working for me. After some trial and error my doctor and I landed on bupropion (which is also used for ADHD treatment) and it made an enormous difference. I would absolutely believe there is a lot of overlap in treating the two conditions, especially for helping with the the willpower/doing things side of the symptoms (e.g. having energy to do anything in the first place, completing tasks that need to get done, overcoming executive dysfunction, and not getting "stuck" in negative thought spirals).
But of course, it depends on each person and their kind of depression. My doctor warned me that it could make anxiety worse, for example, because the added focus and energy could feed right into someone's anxiety and make them feel mildly panicked all the time. It's highly individual.
I was thinking literally the same thing. I wonder how these patients would respond to stimulant medication?
Or even non-stimulants like Atomoxetine (Strattera) that are known to be effective for ADHD. Could even try more experimental ones if you have money and a license to do whatever you want medically.
I just got put on Strattera (bipolar 2 and adhd) and i gotta say it's been working pretty good for me
When I get my diagnosis it's the first meds I'm trying, so hopefully it works out for me too.
I would be curious to know more about the age of the participants in the sample and if they cross assessed for other cognitive issues before this study began. 1000 people is statistically pretty small, and there can be many other factors contributing to depressive presentation, particularly if there is cognitive decline already occurring due to issues such as MCI or an (as yet) non-diagnosed dementia of some type. Major depression is commonly present in patients with brain illness, which can further complicate and delay correct treatment and diagnosis for both conditions.
1000 is not small at all and with a properly designed study it's more than enough for statistical significance
I was thinking of the sample in relation to the population being studied. There are reportedly over 21 million people in the US diagnosed with depression. 1000 people is representative of less than 0.005% of that group.
Yes, I'm aware. Sample sizes to get a 95% confidence interval are significantly smaller in most cases than the average person thinks. See https://en.wikipedia.org/wiki/Sample_size_determination and the section on required sample size for hypotheses tests. There's even sample size calculators online you can find that'll spit this number for a 95% CI out for you. Personally I think given that information, it's pretty unlikely the author made that error in a peer reviewed paper where reviewers are certainly aware as well
Just wait until people hear about all the medical studies with sample size goals of twelve, considered an adequate sample size for medical procedure studies and medical device studies.
Thanks. :) My curiosity about the other factors remains. Perhaps they will add more information about this next time.
Yeah, that's totally fair to question. I mentioned above, but it depends on sample selection and study design moreso than the actual number 👍