ADHD And Depression: Is There a Link?

Depression and ADHD are both very common conditions and diagnoses. Is there a link? Let’s discuss what we know about the connection between ADHD and depression, as well as the treatment options that can help. 

Can You Have ADHD and Depression?

You can have both ADHD and depression. Not only is it possible to live with both; it’s actually extremely common. General population statistics indicate that: 

• ADHD affects around 11% of children in the United States and about 8.1% of adults.
• 4.4% of children in the general population (not just those with ADHD) have received a depression diagnosis in the United States. 
• 8% of adults in the United States in the general population (not just those with ADHD) in the United States have depression.

Although depression is seen as one of the most prevalent mental health concerns, in those who have ADHD, depression rates are far more rampant. Up to 30% of children who live with ADHD may have a serious mood disorder such as depression, and it is said that depression is 2.7 times more likely in adults who live with ADHD. Some experts say that up to 70% of those who live with ADHD will also seek help for depression at some point in the course of their life. 

So, is there a link between ADHD and depression? Based on a large body of research and input from medical or mental health professionals across the globe, the answer appears to be a resounding “yes.” Statistically speaking, there’s a strong connection between depressive disorders and ADHD indeed. 

The question now is, how do you find out if depression is indeed what you or your child is experiencing?

Symptoms

Since symptoms of various conditions can overlap, understanding the specific symptoms and criteria for each disorder can be helpful in determining what the symptoms you notice are attributed to. 

ADHD

Symptoms of ADHD are divided into two categories: Symptoms of inattention and symptoms of hyperactivity or impulsivity. If someone is 17 or older at the age of their evaluation, they must only experience five or more symptoms in either one or both of these categories to receive an ADHD diagnosis. If someone is younger than 17, they must experience six or more symptoms in either one or both of these categories. 

Symptoms of inattention include: 

• Forgetfulness in daily activities
• Failure to give attention to detail, or making seemingly careless mistakes
• Seeming as though one is not listening when they are spoken to directly
• Difficulty remaining attentive during tasks or activities
• Trouble organizing tasks or activities
• Trouble following through with tasks or failure to finish tasks, such as chores and schoolwork (one may lose focus or become sidetracked)
• An avoidance of or dislike for tasks that require sustained mental effort, such as homework
• Losing items that are necessary for tasks or activities
• Getting distracted easily

Symptoms of hyperactivity/impulsivity include: 

• Excessive talking
• Fidgeting, tapping, or squirming
• Trouble remaining seated in situations where someone is expected to do so, such as at school
• Running or climbing in situations where it’s seen as inappropriate to do so, or in adolescents and adults, becoming restless
• Trouble taking part in quiet leisure activities
• Acting as though an individual is on the go or driven by a motor
• Blurting out answers to questions before the question has been completed
• Difficulty waiting for one’s turn 
• Interrupting other people, or intruding on other people's activities (games, conversations, etc)

Depression 

Depression is characterized by a loss of interest in activities one would typically enjoy, a down, depressed, or low mood, and a number of other potential symptoms, which include but aren’t limited to fatigue, irritability, changes in appetite, changes in sleep, isolation from others, feelings of guilt, hopelessness, or worthlessness, muscle tension or body aches, and trouble concentrating or focusing. 

There are different types of depression or depressive disorders that a person can be diagnosed with. Among some of the most commonly talked about types of depression are major depressive disorder (MDD), persistent depressive disorder (PDD), premenstrual dysphoric disorder (PMDD), and postpartum depression.

Situational depression, seasonal depression (seasonal affective disorder/major depressive disorder with a seasonal pattern), and bipolar disorder, which is not a depressive disorder but is a disorder that includes periods of depression, are also all common. Different depressive disorders will present differently, but for the most part, they share a high level of commonality and overlap. 

For individuals with ADHD, depressive symptoms may be hard to spot because of the overlap in symptoms. For example, ADHD may make it more difficult for someone to do their homework; however, it may also be difficult for someone with depression to do homework because of their fatigue, depressed mood, and lack of energy. 

If you believe that you may have a depressive disorder or have experienced the symptoms above, especially on an ongoing basis, it’s important to discuss it with a medical or mental health provider. Note that substance use disorders and anxiety disorders are common for individuals who live with ADHD. 

Also, read more about ADHD vs bipolar disorder.

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Risk Factors

Studies reveal a number of different risk factors that increase the likelihood that someone will develop depression, and some of these risk factors may reveal why people with ADHD are more likely to experience depression. Risk factors that may increase the likelihood of depression include but aren’t limited to:

• Bullying and other adverse experiences, such as the loss of a loved one, poverty, or abuse.
• The diagnosis or experience of another health condition (including physical conditions, like cancer or diabetes, as well as neurological, developmental, and mental health conditions). 
• Family history (genetics). 

ADHD symptoms can leave a person feeling misunderstood, and they can contribute to social issues or difficulties with self-esteem. This is not the fault of the person who lives with ADHD, and with the correct help or support, it is very possible for depression symptoms to improve. 

Diagnosis

While there are online depression screeners and articles that can inform you about depression symptoms, the only way to receive a formal diagnosis of depression is to see a professional who is qualified to diagnose mental disorders.

This could be your general doctor (or any primary care physician if you don’t have one that you see on a regular basis), a psychiatrist, or another medical or mental health professional. 

Diagnosing depression is generally a non-invasive and straightforward process. Your provider will ask you a series of questions, typically related to the symptoms you notice and how long you’ve been experiencing them for. The questions a provider will ask may sound something like, “In the past two weeks, how often have you experienced a down, low, or depressed mood?” 

They may have you fill out a depression screener, ask you questions verbally, or both. Every provider does this a little bit differently, and some things will be based on your age group and other factors, such as the need to rule out other potential causes of your symptoms. If you don’t agree with a diagnosis (or lack thereof) you receive from a provider, it is absolutely okay to see another provider for a second opinion.

Treating ADHD and Depression

Here are some treatment options that may be used for an individual who has both ADHD and depression: 

• Therapy. Various forms of cognitive behavioral therapy can be used for ADHD depression, as well as ADHD, and therapy is seen as the leading treatment for depression symptoms. Therapy is tailored to a person’s age and unique needs. It’s often helpful for individuals to seek therapists who specialize in the concerns they experience - in this case, you may look for a provider who has experience in working with ADHD and/or depression. 
• Medication. Prescription medication can be used to treat depression, and research shows that it is effective. There are a number of different medications on the market that can be used to treat depression. Most frequently, these will be SSRIs or SNRIs. Make sure to consult with your or your child’s doctor before changing your medication routine, and discuss all side effects or potential medication interactions if relevant. Some medications for ADHD like Adderall may cause depression.
• Lifestyle changes. Typically used in conjunction with professional support, some lifestyle changes may be helpful. These can relate to sleep, physical activity, the limiting or ceasing of alcohol consumption, stress management practices, working on positive self-talk, and so on. 

Other interventions and tools, such as support groups, can also be advantageous for those who live with ADHD and depression. The best treatment will vary from person to person, so it is crucial to work with your or your child’s care team to determine the most suitable options.