Is there a link between ADHD and depression?
People usually receive a diagnosis of ADHD in childhood, but sometimes a doctor does not diagnose it until adulthood.
ADHD affects a person's ability to pay attention and can result in hyperactivity and impulsive actions. It may be hard for the person to focus at work or in school. This can lead to additional complications, such as underachievement, relationship difficulties, and social ostracism.
Depression is a common yet serious mood disorder that affects a person's feeling, thinking, and actions. It can cause strong feelings of sadness, loneliness, and a lack of interest in life activities.
People with ADHD may be more likely than others to develop depression and anxiety. One reason why it is important to seek treatment for ADHD is that treatment may help to reduce the risk of complications, such as depression.
ADHD and depression links
Depression and anxiety may be more common among people with ADHD, possibly because of the challenges they face.
People with ADHD may be more likely than others to have another type of anxiety or mental health condition, such as depression.
People with ADHD have a higher risk of depression due to the stress it causes and the challenges they face.
The Centers for Disease Control and Prevention (CDC) cite figures suggesting that around 5 percent of children in the United States have ADHD, but they add that the number may be higher. Around 6.1 million children have had a diagnosis of ADHD at some time.
A study published in 2015 found that, among 135 children in Shanghai, China, with a diagnosis of ADHD, 42 percent also had an anxiety disorder, and 33 percent had a depressive disorder. The researchers note that other studies have put the figure between 12 and 50 percent for depression and 13–51 percent for anxiety.
According to the Anxiety and Depression Association of America, depression often affects adults with ADHD. The Association suggest that around half of all children with ADHD will continue to experience symptoms in adulthood, and half of all adults with ADHD also have an anxiety disorder.
Depression and ADHD can have some common symptoms but for different reasons. Both can involve difficulty concentrating or a loss of motivation.
A person with ADHD who has inattentive symptoms may seem to lack motivation, as they find it hard to focus and pay attention to details. A person with depression may not complete a task because they feel there is no purpose.
A person with ADHD may also have problems starting projects or keeping up with work or studies.
They may find it hard to get organized, so that they lose track of what they should be doing, or leave a project incomplete because they tune out, do not listen, or do not learn the material.
A person with depression may be unable to focus due to distraction or fatigue.
Sleeping difficulties, mood changes, and irritability are features of both ADHD and depression.
Self-harm, suicide ideation, and ADHD
A review of studies published in 2014 found that people with ADHD and depression may engage in self-harm or attempt or think about suicide.
The authors cite previous findings showing a link between ADHD and attempted and completed suicide in male teens and young adults and suicidal behaviour and suicide ideation in female adolescents.
One researcher had found that girls with both ADHD and major depression were more likely to think about suicide than girls with only major depression.
The review also noted that there might be a link between thinking of suicide and the use of some medications for ADHD. However, more research is needed to confirm this.
- If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Call 911 or the local emergency number.
- Stay with the person until professional help arrives.
- Remove any weapons, medications, or other potentially harmful objects.
- Listen to the person without judgment.
- If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours a day at 1-800-273-8255.
ADHD medication and depression
The medication that people use for ADHD can have side effects.
The drugs can worsen the symptoms of depression or they can cause symptoms that look like depression. This can also make a diagnosis of depression with ADHD more difficult.
This can make it difficult to identify the two conditions and to treat them properly. However, ADHD is normally a lifelong disorder, whereas depression can come and go.
Anyone who thinks that ADHD medication could be leading to symptoms of depression should seek medical advice.
ADHD and depression in children
ADHD can be challenging for children who are still developing emotionally, mentally, and physically, partly because they may not understand what is happening.
Issues with behavior and self-esteem can lead to depression. Unusual behaviors may lead to bullying and isolation.
Signs of depression in children with ADHD include:
- feeling very low
- losing interest in favorite activities or withdrawing from family and friends
- changes in sleep and eating patterns
- failing grades or not doing homework
- not attending school
- feeling hopeless, helpless or suicidal
Depression may cause an increase in ADHD-related behaviors.
A child may begin to:
- act out more
- be particularly inattentive
- become extremely overwhelmed and disorganized
Girls with ADHD often show different symptoms from boys. They are more likely to have difficulty focusing and less likely to show signs of hyperactivity.
A girl with ADHD and depression may become withdrawn rather than acting out.
Find out more about how ADHD affects girls in our dedicated article here.
The symptoms of ADHD and bipolar disorder can also overlap.
Although not very common, some children with a diagnosis of ADHD may actually have bipolar disorder. Depending on the type of bipolar disorder they have, mood shifts can lead to times of depression and times of euphoria and hyperactivity.
Older children may want to stop taking their medication, or they may begin to self-medicate with drugs or alcohol. These can lead to further complications.
ADHD and depression in adults
A change in sleeping patterns can be a sign of depression in adults.
Signs of depression in adults with ADHD include:
- trouble concentrating and staying focused
- excessive attention to one activity
- disorganization and forgetfulness
- emotional difficulties, including the inability to manage emotions such as anger or frustration
- hyperactivity or restlessness
These can also be signs of ADHD without depression, however, so it may be hard to know if a person with ADHD has depression.
According to one survey, major depressive disorder affects 18.6 percent of people with ADHD, compared with 7.8 percent of people without ADHD.
Signs of depression in adults include:
- a noticeable change in appetite or sleeping patterns
- a loss of interest and pleasure in activities that they used to enjoy
- feelings of worthlessness and hopelessness or guilt
- recurring thoughts of death or suicide
- physical symptoms such as headaches or stomachaches
Diagnosing ADHD can be difficult because no single medical, physical, or genetic test can detect it. Instead, doctors ask questions and collect information.
The Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM–5) offers guidelines for diagnosing ADHD.
These guidelines focus on patterns of inattention, hyperactivity, and impulsivity.
In childhood, diagnosis includes documenting the behavior of the child, with input from parents, teachers, other school officials, and mental health specialists.
For a diagnosis of ADHD, a child must show at least six specific behaviors by the age of 12 years, according to the DSM-5 criteria.
In adults, evaluation includes a detailed account of the person's medical and behavioral history. Adults should meet five or more of the DSM-5 criteria for a diagnosis of ADHD.
Treatment for ADHD and depression
A doctor may prescribe medication and counseling for ADHD and for ADHD with depression.
For children aged 6 years and over with ADHD, researchers recommend behavior therapy and medication. For those aged 5 years and under, behavior therapy should be the first line of treatment.
A doctor may prescribe:
- antidepressants to treat depression, if present
- stimulant drugs, such as Adderall and Ritalin, to help to curb hyperactivity and impulsivity and enable the person to focus better at school and at work
Individuals may react differently to the drugs, so they may need to try several combinations before finding the right one.
Supporting a child
Parents and caregivers of children with ADHD should monitor behavioral changes and look out for signs of depression or another behavioral or mood disorder.
Adults can help a child to make and follow plans.
There are a number of ways of offering support:
Communicating with the child's class teacher enables parents and caregivers to keep track of a child's progress and behavior in the classroom. The teacher and other educational support workers may also be able to offer suggestions about how parents can help the child in their studies.
Structure and routine can help a child develop organizational and time management skills. Caregivers, including teachers and parents, can work with the child to make and follow a schedule and to set goals.
Communicating with the child about how they feel and what is happening in their life will help them feel they are not alone. It can also help parents and caregivers to keep track of the child's concerns and to spot any early signs of depression.
Family or individual counseling can provide a space for children and their families to express feelings and find new solutions to challenges.
Cognitive behavioral therapy (CBT) can help the individual to learn how to manage their mood and stress levels. Emotional stress can lead to an increase in anxiety and depression.
Following a healthful lifestyle can help to reduce symptoms. This includes nutritious food, sufficient sleep, and exercise.
ADHD and depression can sometimes occur together.
However, appropriate diagnosis and treatment can help people with ADHD to manage their symptoms and reduce the risk of developing depression.