ADHD and Depression: Important Tips to Get Help If You Have Both ADHD and Depression

Introduction

Attention Deficit Hyperactivity Disorder (ADHD) and Depression are closely related. Depression is a common comorbidity in children with ADHD, with a rate as high as 12-50% [1]. The relationship between the two is complex and mediated by several social, psychological, and genetic reasons. This article explores the relationship between ADHD and depression.

What is the relation between ADHD and Depression?

There is a high prevalence of ADHD and Depression occurring together in individuals. While the exact prevalence is difficult to predict, some community samples have pointed out a 13-27% prevalence, while clinical models have expected as high as 60% prevalence [2]. These high rates have prompted psychologists and researchers to discover the relationship between the two disorders.

ADHD is a neurodevelopmental disorder that impacts a child’s executive functioning, which includes attention, planning, impulse control, emotional regulation, and working memory. This means that the disease begins in childhood and affects a range of behaviors that may cause difficulty in performing tasks like sitting still, paying attention, keeping track of things, controlling one’s behavior, etc. [3]. Depression, on the other hand, is a mood disorder that may cause intense sadness, hopelessness, irritability, and loss of interest in the person for an extended period [3]. Unlike ADHD, depression may or may not begin in childhood.

There are, however, significant overlaps in the symptoms of ADHD and depression. For instance, especially in children, both ADHD and depression can look like irritability and hyperactivity. Trouble focusing or keeping track of things is also a symptom that is common in both [3], along with the inability to regulate one’s emotions [4].

While exact relations are unknown, many researchers have found a strong genetic relation between ADHD and depression [5] [6]. Both disorders may be a function of specific genetic makeup, which may also explain why even with treatment of ADHD, the risk of depression remains high [6].

Apart from genetic makeup, researchers have also found that connectivity and thickness in some brain regions, such as the hippocampus, may also explain the relationship between ADHD and depression [7]. Thus, both disorders are significantly related at a biological level.

Our Wellness Programs

Symptoms of ADHD that may lead to Depression

It has also been speculated that the symptoms of ADHD may affect an individual in a way that they develop depression. In other words, ADHD may lead to depression as well. Several factors contribute to this speculation. One such factor is emotional dysregulation, an underlying feature of ADHD and depression [1]. Individuals with ADHD may feel emotions more intensely, cannot control them once they take over, and are often more explosive in their emotional reactions. This has been attributed to the differences in the brain networks of individuals with ADHD [8].

Researchers like Seymour and Miller suggest that individuals with ADHD may have poor tolerance of frustrating situations (a feature of emotional dysregulation). This may lead to giving up on tasks, feelings of inadequacy, and poor coping, which may lead to depression [1].

Researchers have also traced the relation between ADHD and depression to the outcomes of symptoms of ADHD. For instance, inattention, impulsivity, and hyperactivity that result from ADHD make it difficult for children to perform in traditional academic settings, cause conflicts in relationships – including primary relationships such as those with parents and may predispose them to become victims of bullying [6]. Taken together, these result in one or more environments that are stressful and inculcate feelings of shame, guilt, and inadequacy that may ultimately result in depression.

Depression in Adults with ADHD

There are many challenges when diagnosing ADHD in adults. Adults usually have poorer recall of their childhood days and how ADHD affected them at the time. They also have several coping strategies for the symptoms and may have chosen habits, addictions, or lifestyles in a manner that the effect of ADHD is not very apparent [9]. Since the person has lived with the condition for a long time, they may also under-report the symptoms as these symptoms, such as difficulty focusing or sitting in one place for a long time, have become a part of life. It is also for this reason that mood disorders like depression are often diagnosed, but ADHD is missed in the case of adults.

Further, when left untreated, the risk of depressive symptoms in adulthood increases. The prevalence of Major depressive disorder in adults with ADHD is as high as 18.6% compared to 7.6% in neurotypical adults. When these two disorders occur together, the chances of poorer long-term outcomes are much higher [9].

Read this article to get more information of ADHD.

How to Get Help If You Have Both ADHD and Depression

The consequences of concurrent ADHD and depression can be severe for an individual. These include poorer social relationships, poor academic and professional life, inability to settle into a job, and adjustment through substances.

The first step towards treatment is getting an adequate diagnosis. Especially in adulthood, ADHD and depression together can cause challenges during diagnosis. It is essential to consult an expert to differentiate between both conditions and identify whether one affects the individual.

The next step is to discover a treatment plan. Treatment for these conditions involves medication, psychotherapy, and lifestyle changes.

Medication as Treatment

Psychiatrists may provide medicines for ADHD and Depression, depending on the person’s need. Some medications that are commonly prescribed are:

• Stimulants for ADHD: these increase the presence of neurotransmitters in the brain, increasing attention or ability to focus. However, they may have some side effects, like changes in sleep and hunger. [3] [10]
• Non-stimulants for ADHD:  while slower to work, these have been identified as safer medications with lesser side effects and are usually prescribed when the stimulants do not work or are dangerous for the person [10].
• Antidepressants for depression and ADHD: when depression is co-occurring, the psychiatrist prescribes an antidepressant to help stabilize mood [3] [10].

Medication is essential but is less effective when taken alone. It is usually recommended to take some form of psychotherapy with these medications.

Psychotherapy as Treatment

ADHD affects almost all areas of a person’s life. This means that often, individuals with ADHD may have a negative view of self and the world, which may also be causing depression and demoralization. Psychotherapy can help in identifying these worldviews and substituting them.

Therapists may use modalities like Cognitive Behavioral Therapy and Dialectical Behavioral Therapy [11] to help clients identify their views, understand their effects, and develop healthy belief systems. The psychologist may also focus on discovering the relationships of the past which may be affecting the client and understanding ways to move past them. Discussions on functioning and performing daily life activities with ADHD may also occur. Thus, psychotherapy may help individuals manage their depression and ADHD and adjust to their life better.

A healthy lifestyle with regular meals, a good sleep cycle, and an exercise regimen is essential for overall mental health. However, this may become affected due to ADHD and depression. Psychologists often plan with clients a healthy lifestyle to combat depressive symptoms and keep ADHD symptoms in check.

One can make other changes in their lifestyle, such as identifying an “interest closet” with a list of things that interest a person when they feel at a loss [12]. This prevents boredom and reduces the challenges one may face in initiating tasks.

Read this article to get online service.

Conclusion

ADHD and depression are comorbid and strongly related. The prevalence of these two occurring together is very high, and the outcomes may be severe for the person. While the exact reasons are unknown, genetic factors and neural networks are suspected to be the underlying cause of this relation. At times depression can be an outcome of ADHD symptoms as well. It is, however, possible to get help for both via medication, psychotherapy, and lifestyle changes.

If you are currently experiencing Depression or are struggling with ADHD, contact the experts at United we Care. At United We Care, our team of wellness and mental health experts can guide you with the best methods for well-being.

References

1.  K. E. Seymour and L. Miller, “ADHD and depression: The role of poor frustration tolerance,” Current Developmental Disorders Reports, vol. 4, no. 1, pp. 14–18, 2017.
2. M. D. G. O. Gavin L. Brunsvold, “Comorbid depression and ADHD in children and adolescents,” Psychiatric Times. [Online]. Available here: . [Accessed: 12-Apr-2023].
3. “Depression and ADHD: How they’re linked,” WebMD. [Online]. Available here: . [Accessed: 12-Apr-2023].
4. P. D. Joel Nigg and A. D. D. Editors, “How ADHD amplifies emotions,” ADDitude, 22-Jan-2023. [Online]. Available here: .
5. T.-J. Chen, C.-Y. Ji, S.-S. Wang, P. Lichtenstein, H. Larsson, and Z. Chang, “Genetic and environmental influences on the relationship between ADHD symptoms and internalizing problems: A Chinese twin study,” American Journal of Medical Genetics Part B: Neuropsychiatric Genetics, vol. 171, no. 7, pp. 931–937, 2015.
6. L. Riglin, B. Leppert, C. Dardani, A. K. Thapar, F. Rice, M. C. O’Donovan, G. Davey Smith, E. Stergiakouli, K. Tilling, and A. Thapar, “ADHD and depression: Investigating a causal explanation,” Psychological Medicine, vol. 51, no. 11, pp. 1890–1897, 2020.
7. J. Posner, F. Siciliano, Z. Wang, J. Liu, E. Sonuga-Barke, and L. Greenhill, “A multimodal MRI study of the hippocampus in medication-naive children with ADHD: What connects ADHD and depression?” Psychiatry Research: Neuroimaging, vol. 224, no. 2, pp. 112–118, 2014.
8. L. A. Hulvershorn, M. Mennes, F. X. Castellanos, A. Di Martino, M. P. Milham, T. A. Hummer, and A. K. Roy, “Abnormal amygdala functional connectivity associated with emotional lability in children with attention-deficit/hyperactivity disorder,” Journal of the American Academy of Child & Adolescent Psychiatry, vol. 53, no. 3, 2014.
9. C. Binder, McIntosh, S. Kutcher, Levitt, Rosenbluth, and Fallu, “Adult ADHD and Comorbid Depression: A consensus-derived diagnostic algorithm for ADHD,” Neuropsychiatric Disease and Treatment, p. 137, 2009.
10. “ADHD medications: How they work & side effects,” Cleveland Clinic. [Online]. Available here:  [Accessed: 12-Apr-2023].
11. P. D. Roberto Olivardia, “Treatment for depression and ADHD: Treating comorbid mood disorders safely,” ADDitude, 07-Nov-2022. [Online]. Available here: . [Accessed: 12-Apr-2023].
12. A. Cuncic, “Do you have ADHD, depression, or both?” Verywell Mind, 22-Feb-2020. [Online]. Available here: . [Accessed: 12-Apr-2023].