ADHD and Depression

Estimated reading time: 24 minute(s)

Attention deficit hyperactivity disorder (ADHD) is a type of neurodevelopmental disorder that continues to affect millions of people across the world. The disorder can severely impact behaviors, emotions, and ways of learning. Often diagnosed in childhood, the disorder continues in adulthood, often leading to several associated complications. As a part of these complications, many children and adults acquire depression.

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With the risk of depression being times higher in people with ADHD, [1] it is imperative to learn more about both issues, the relationship they share, and how to manage them.

The Symptoms of ADHD and Depression

ADHD is an umbrella term used to describe a broad range of symptoms. The condition can be divided into three different types, each with a different set of symptoms. These include the following:

• Predominantly inattentive type: This type of ADHD leads to symptoms such as problems with attention, a tendency to get easily distracted, and poor organization of thoughts.
• Predominantly hyperactive-impulsive type: People with this type of ADHD feel restless and may blurt out information or interrupt conversations.
• Combination type: This type combines the symptoms of the two types mentioned above.

Depression can also lead to various symptoms, such as the following:

• Persistent feelings of hopelessness, sadness, and emptiness
• Loss of interest in things you previously used to enjoy
• Frequent feelings of frustration, irritability, anxiety, or restlessness
• Trouble paying attention
• Trouble sleeping
• Changes in appetite
• Fatigue

Some symptoms of depression may overlap with those of ADHD, making it difficult to tell them apart. For instance, boredom and restlessness may present as a symptom of both depression and ADHD. In some cases, medications used for managing ADHD can lead to side effects mimicking depression. For instance, some ADHD medicines may cause:

• Sleep difficulties
• Restlessness
• Mood swings
• Loss of appetite
• Fatigue

Can You Have ADHD and Depression? Exploring the Link

ADHD and depression can co-occur in some people without any particular risk factors. Experts have been investigating this co-occurrence to check if ADHD can be a causative factor behind depression. So far, the conclusions suggest that ADHD can contribute to the development of depression in some cases. Following are some proposed reasons why ADHD can make a person feel depression

• Negative self-image and poor self-esteem due to ADHD: People struggling with ADHD are more likely to have poor self-esteem. They often view themselves negatively, which contributes to low mood and feelings of depression.
• ADHD causing difficulties in relationships: People with ADHD often find it challenging to maintain relationships due to communication difficulties. They may also struggle to fit in or read body language, and due to these problems, they slowly isolate themselves from others. This social isolation also serves as a contributory factor to depression.
• ADHD affecting school and work: The symptoms of ADHD can cause a person to struggle at work or school. This may make them feel as if they are not meeting their goals and expectations of others. Some struggle to maintain good grades, while others keep losing their jobs. This not only makes them feel negative and low but also leads to financial restraints that act as another risk factor for depression.

The problems mentioned above collectively contribute to the development of depression. Research also suggests that the more severe the ADHD symptoms are, the more powerful the underlying depression becomes. This is usually because people with ADHD prefer avoidant coping to avoid stressful and challenging tasks instead of confronting and solving them. These coping mechanisms only cause these issues to worsen and eventually overlap with other areas of life, leading to depressive episodes.

Does ADHD Cause Depression? What are the Risk Factors?

People with ADHD are more vulnerable to developing depression if they have one or more of the following risk factors:

Sex

Males are more likely to acquire ADHD in their lives; however, research believes that females are more prone to developing ADHD and depression together. This is partially because the female gender is at a higher risk of developing low mood and depressive thoughts in general.

Type of ADHD

Researchers have found that people with combined or inattentive types of ADHD are more likely to acquire depression than people with hyperactive-impulsive ADHD.

Maternal Mental Health History

According to experts, the mental health status of a mother plays a vital role in determining the likelihood of depression in a person. Women who develop depression or serotonin impairment during pregnancy have been found to give birth to children who later get diagnosed with ADHD and depression. [2] While more research is needed to confirm this correlation, experts agree that low serotonin function can negatively affect the brain of a developing fetus, giving rise to ADHD-like symptoms.

Living with ADHD and Depression: What Treatments are Available?

The type of treatment offered to a person with ADHD and depression varies according to their particular situation. In general, the aim is to first work on the issue which is the most impairing. Therapy can address both problems at once; however, medications are prescribed in turn.

Medications

Following are some medications that may be prescribed for someone living with ADHD and depression.

• Stimulants: These medications, such as Adderall, can help alleviate the symptoms of ADHD by increasing brain chemicals that enhance focus. However, their use can sometimes lead to side effects, such as insomnia and loss of appetite.
• Non-stimulants: These medications, such as Strattera, can also help with ADHD symptom management.
• Antidepressants: These medications, such as Wellbutrin, can help relieve the symptoms of depression and ADHD together. However, it may take at least a few weeks for them to work.

Therapy

Psychotherapy is one of the best ways to manage co-existing ADHD and depression. Therapy for ADHD aims at improving focus while building self-esteem, whereas that for depression helps patients identify and replace negative behaviors and thoughts with positive ones. Both types of therapy complement each other and lead to better overall outcomes. Studies have found that adults with ADHD receiving extensive psychotherapy are less likely to develop ruminative thinking while showing more resilience to depressive episodes. [3]

Lifestyle Changes

Apart from professional treatment, there are different ways a person can do on their own to improve their depression and ADHD episodes. The essential tips include eating healthily, exercising regularly, and practicing good sleep hygiene. Keeping an interest closet at home is another tip to alleviate boredom and grab a healthy interest. Some activities to do in this interest closet may include arts and crafts, book reading, or listening to podcasts.

FAQs

What is the risk of suicidal thoughts in people with hyperactive depression?

People diagnosed with ADHD between 4 and 6 years are naturally at a higher risk of developing depression, which consequently makes them vulnerable to having suicidal thoughts in later stages. Studies have further confirmed that people with ADHD causing depression are more likely to have suicidal tendencies than those without ADHD. That said, the overall risk of suicide attempts remains relatively lower, with up to 80 percent of people not attempting it.

Can family therapy sessions make living with ADHD and depression easier?

Family therapy sessions are widely available at different rehabilitation centers to help people fighting ADHD and depression simultaneously. These sessions aim to help families gain a better understanding of both diseases that their loved ones have developed and learn how to manage the symptoms and communicate effectively with each other.

What is the best way to prevent suicide in a loved one with ADHD and depression?

If you suspect that a loved one is at immediate risk of self-harm or violence directed toward someone else, follow the tips mentioned below:

• Call the local emergency number.
• Get rid of any knives, medications, guns, or anything that can become a source of harm.
• Do not leave the person until help arrives.
• Listen to them, but avoid arguing, threatening, yelling, or judging.

References

1 Powell V, Riglin L, Hammerton G, Eyre O, Martin J, Anney R, Thapar A, Rice F. What explains the link between childhood ADHD and adolescent depression? Investigating the role of peer relationships and academic attainment. European child & adolescent psychiatry. 2020 Nov;29:1581-91.

2 Halmøy A, Johansson S, Winge I, McKinney JA, Knappskog PM, Haavik J. Attention-deficit/hyperactivity disorder symptoms in offspring of mothers with impaired serotonin production. Archives of general psychiatry. 2010 Oct 4;67(10):1033-43.

3 Oddo LE, Knouse LE, Surman CB, Safren SA. Investigating resilience to depression in adults with ADHD. Journal of Attention Disorders. 2018 Mar;22(5):497-505.