ADHD and depression co-occur for various reasons, and research shows those with ADHD often receive a depression diagnosis at some point in their lives.1 Specific factors associated with ADHD increase the likelihood of comorbid depression, including low dopamine levels, brain differences, and emotional dysregulation.
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What Is ADHD?
Attention-deficit/hyperactivity disorder (ADHD) features patterns of inattention, hyperactivity, or impulsivity that interfere with functioning or development. Symptoms of ADHD typically emerge in childhood as difficulties focusing (inattention), excessive motor activity (hyperactivity), and poor decision-making skills (impulsivity). Despite these challenges, neurodivergent individuals are frequently highly creative, intuitive, and intelligent.
Signs of inattentive ADHD may include:2
- Difficulty getting organized
- Chronic procrastination
- Trouble with follow-through on tasks
- High distractibility
- Difficulty following “proper” procedure
- Forgetfulness
Signs of hyperactive-impulsive ADHD may include:
- Tendency to speak with little insight into timing or appropriateness
- Frequent search for high stimulation
- Intolerance for boredom
- Low tolerance for frustration
- Impulsivity
- Restlessness
What Is Depression?
Depression involves depressed mood, loss of interest or pleasure in activities, or both for at least two weeks.3 Individuals with depression commonly experience insomnia or fatigue, and many children may exhibit more irritability than sadness.
Depressive episodes cause severe distress or impairment in social, occupational, or adaptive functioning. Depression can occur at any age, but the likelihood of being diagnosed with the disorder increases with entry to puberty.
Symptoms of depression may include:
- Changes in appetite
- Sleep disturbances
- Feelings of worthlessness or guilt
- Difficulty thinking/concentrating
- Trouble making decisions
- Lack of interest in activities
- Social withdrawal
ADHD & Depression: What Is the Connection?
ADHD and depression occur together frequently, possibly due to a combination of problematic early learning environments, biological factors, and genetics.4 Not everyone who experiences ADHD is at risk of depression, but these factors increase the risk significantly.
Below are nine connections between ADHD and depression:
1. Parenting Techniques
Researchers suggest early environmental factors, such as family interactions and parenting practices, may serve as a link between ADHD and depression.1 Due to the behavioral challenges common to children with ADHD, adults and caregivers may respond to behavior with negative, inconsistent, and coercive strategies.
Unfortunately, these unpredictable and unhealthy methods can leave many children with ADHD feeling unloved or neglected by their parents. Over time, they may develop low self-esteem and blame themselves for their symptoms, possibly leading to a later diagnosis of depression.
2. Genetics
Studies reviewing the association between ADHD and depression found familial factors appear to influence the co-occurrence. Twin studies in this area have also suggested that shared genetic factors might explain the overlap of ADHD, depression, and other internalizing disorders.5
3. Biological Disposition
Researchers have found evidence of a possible association between brain structure and function in people with ADHD and/or depression, particularly the stress-sensitive hippocampus. Some evidence suggests individuals with these conditions exhibit a smaller hippocampus, possibly explaining why these conditions commonly co-occur.6, 7, 8
4. Type of ADHD
The subtype of ADHD a person presents might position them at higher risk for developing depression. Research shows those with predominantly inattentive type ADHD are more likely to have depression than those with the hyperactive-impulsive type.9
5. Maternal Mental Health History
Maternal mental health history can be a valuable clue to the connection between ADHD and depression. Some research shows struggling with depression during pregnancy may increase the likelihood of a later ADHD or depressive diagnosis in the child.10
6. Sex at Birth
Though ADHD alone is more common in males, females are more likely to experience comorbid ADHD and depression.16 However, professionals commonly misdiagnose or overlook ADHD in girls, often because they exhibit less externalized, hyperactive behaviors than their male peers.
7. Low Dopamine Levels
Dopamine dysregulation may be at play when ADHD and depression co-occur. Neurotransmitters typically work together to support well-being.11 However, research suggests ADHD may be associated with diminished effects of dopamine, possibly leading to symptoms of depression, like lack of motivation, sleep disturbances, and difficulty concentrating.12
8. Emotional Dysregulation
Emotional dysregulation frequently accompanies ADHD, often resulting in Irritability, low frustration tolerance, and outbursts. Some researchers have suggested this low frustration tolerance may be a key mechanism underlying the connection between ADHD and depression.13
9. Other Co-Occurring Conditions
People with ADHD often have other co-occurring conditions. For adults, mood and anxiety disorders, substance use disorders, and personality disorders are most common.14 Research shows living with ADHD and comorbidities can negatively impact well-being, thus feeding into a cycle of depression.15
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Does ADHD Cause Depression?
Many may wonder, “Can ADHD cause depression?” Left untreated, ADHD can lead to feelings of depression, anxiety, and even self-harm behaviors. Given the symptoms of ADHD, like inattention and impulsivity, functioning in a neurotypical-oriented world can seem impossible.
For instance, individuals with ADHD often set unrealistic expectations for themselves as they attempt to follow societal norms. Unfortunately, failing to accomplish goals, whether because of ADHD or other factors, can trigger the anxiety and low self-esteem that drives depression.
On top of that, many feel burnt out from constant ADHD masking because they are ashamed of their symptoms. Over time, these patterns become overwhelming and disempowering, furthering the cycle of depressive episodes.
Can ADHD Medication Cause depression?
Some evidence suggests ADHD medication can influence symptoms of depression. For example, Adderall is a common medication for adult ADHD. However, this medication and other stimulants may cause sleep issues, constant fatigue, and self-harm thoughts, depending on the dosage.16 While these medications do not cause depression, their side effects can exacerbate or mimic symptoms of the disorder.
What Is the Risk of Suicidal Thoughts?
Sadly, individuals with ADHD are six times more likely to have thoughts of suicide than those without ADHD, and that number increases with a co-occurring depressive disorder.17 Depression alone can increase the risk of suicidal thoughts and attempts. When coupled with ADHD, individuals face additional challenges that further feed the low self-esteem, feelings of helplessness, and sadness that precede suicidal ideation.
Can You Have Both ADHD & Depression?
ADHD and depression are distinct conditions but can occur together. For example, the feelings of frustration and low self-esteem that result from living with ADHD can lead to depression. Differentiating between these conditions can be challenging due to overlapping symptoms. However, a licensed therapist or physician can help provide an accurate evaluation.
ADHD VS. Depression
ADHD and depression share some overlapping symptoms but manifest very differently. Everyone has a unique experience with mental health, but these disorders carry specific characteristics that differentiate symptom presentation, effects, and functionality.
Here are a few differences between ADHD and depression:
- Mood: Individuals with depression have chronic low moods that typically outweigh other emotions. Those with ADHD often have fleeting emotions triggered by their environment.
- Motivation: Many people with depression lack motivation and drive because their symptoms impact their ability to experience pleasure. On the other hand, those with ADHD usually struggle with and feel overwhelmed by decision-making, which may appear as poor motivation or laziness.
- Sleep issues: Hyperactivity and ADHD racing thoughts can make falling asleep difficult, and constant energy can lead to insomnia. While people with depression also experience insomnia, their sleep issues often stem from negative thoughts and low mood.
- Duration of diagnosis: ADHD is a lifelong condition that does not go away. Some people may experience depression for most or all of their lives, but treatment can help them experience symptom remission.
Treatment of ADHD & Depression
Combating ADHD and depression in adults generally includes therapy, medication, and positive lifestyle changes. Because of the high rate of ADHD and depression comorbidity, finding a therapist specializing in both conditions may be easier than you expect.
You can never seek professional help too early. Untreated ADHD and depression can wreak havoc on your emotional, mental, and physical well-being. Support is not exclusive to specific populations, diagonses, or symptoms, so consider finding a neurodiversity-affirming therapist to start your journey.
Therapy
Therapy can help individuals address depression and ADHD symptoms in many ways. Many therapies for depression and ADHD work to improve negative thoughts, self-beliefs, and self-talk that exacerbate symptoms of both conditions. Finding a qualified professional with experience in these approaches can go a long way in developing healthy coping skills and symptom management.
Therapy for comorbid ADHD and depression may include:
- Behavioral parent training (BPT): BPT for children helps parents create consistent structure, supervision, and rewards for appropriate behavior. These interventions work best when combined with cognitive therapies that address negative thoughts associated with ADHD and depression.
- Cognitive behavioral therapy (CBT): CBT for ADHD can benefit adults with both depression and ADHD. These techniques coach adaptive thinking, cognitive restructuring, and behavioral activation.18
- Family therapy: Family therapy can help families of children with comorbid ADHD and depression learn ways to provide support and improve functioning at home, school, and in the community.
- Acceptance and commitment therapy (ACT): ACT helps clients accept uncomfortable thoughts and feelings and identify their values.19, 20
- Interpersonal therapy (IPT): IPT aims to improve relationships and overall social functioning rather than focusing on their symptoms.21
- Dialectical behavior therapy (DBT): DBT helps individuals manage thoughts, feelings, and behaviors through mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness.
Medication for ADHD & Depression
Several medications can help treat ADHD and depression. A prescribing physician can help you determine which prescription best suits your needs and goals for symptom management. They will review the possible adverse effects, interactions, and risks of treatment with you to ensure safety. Everyone responds to medication differently, so finding the right fit may take trial and error.
Below are medications for ADHD and depression:
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Living With ADHD & Depression
Experiencing ADHD depressive episodes can be distressing, but making positive lifestyle changes can help you cope. Be mindful of your triggers and look after your emotional well-being to promote success. Most importantly, treat yourself with compassion as you navigate a dual diagnosis.
Below are ways to cope with co-occurring ADHD and depression:
- Stick to a routine: Grounding yourself with a familiar routine can eliminate decision fatigue and simplify your daily life.
- Reach out to loved ones for support: Stay connected to people who love you and care about your well-being. Having this support can provide motivation when experiencing the challenges of navigating depression and ADHD.
- Avoid or limit mood-altering substances: Nicotine, caffeine, and alcohol may provide temporary relief but result in long-term complications. Develop healthier coping skills rather than relying on substances to feel better.
- Practice mindfulness: Staying in the present moment can help you feel calm and grounded. Mindfulness means accepting your emotions without judgment, allowing you to recognize that sadness and overwhelm are temporary.
- Take care of your physical health: Aim to get enough sleep, eat regularly, and exercise. Your mind and body are connected, so prioritize your physical health to boost overall wellness.
- Get immediate crisis support: Reach out for support if you struggle with suicidal ideation. Crisis lines are available 24/7.
In My Experience
ADHD and depression are chronic conditions that require substantial support. Small, productive steps are essential to ensure your struggles do not become overwhelming. Short-term goal setting and finding opportunities to laugh or interact with others can be helpful during periods of high stress. Additionally, consider seeking professional support if symptoms affect your daily life.
ADHD & Depression Infographics
Additional Resources
To help our readers take the next step in their mental health journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy is compensated for marketing by the companies included below.
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Best Online ADHD Treatments
There are many considerations when looking for the best online ADHD treatments. It is important to know which online platforms can provide a diagnosis, which offers therapy only, which offers medication management only, and which offers a combination of treatments.
