ADHD and Depression: What's the Link?

While it’s mostly recognized as a disorder in children, many kids with Attention-Deficit/Hyperactivity Disorder, also known as ADHD, grow up to be adults with ADHD. And while adults with ADHD probably aren’t being sent to detention anymore, they’re still coping with a lot of difficulties — notably, ADHD and depression.

But how exactly does ADHD affect those adults living with it? Is depression related to ADHD? And if so, what’s the link? 

Let’s dig in.

ADHD is the initialized spelling of Attention-Deficit/Hyperactive Disorder, which is a mental disorder (possibly genetic) that’s usually first identified in school-aged children and is more commonly diagnosed in boys than girls. 

People with ADHD often have very limited attention spans. Some are also hyperactive and impulsive. Many kids with ADHD also have other concurrent conditions, including behavior/conduct problems, learning disorders, anxiety and depression.

Since there’s no lab test available to diagnose ADHD, it’s usually determined by a mental health professional who gathers information from teachers, parents and others, as well as through a medical evaluation to rule out other problems. 

While it’s often first identified in children, adults can also be diagnosed with ADHD. 

In fact, approximately 10 million adults live with ADHD, and the disorder can have a huge impact on adult life. 

As many as 80 percent of adults with ADHD have at least one comorbid psychiatric disorder, ranging from an anxiety disorder to a substance abuse disorder to a personality disorder, according to an article published in the journal, BMC Psychiatry. When two medical conditions exist simultaneously — and independently — they are referred to as comorbid disorders.

Unlike kids with ADHD, most adults are not hyperactive. 

However, other symptoms — like inattentiveness and impulsivity — still persist. Additionally, adults may also find that they have difficulty with executive function (which is a fancy way of saying the brain’s ability to prioritize and manage thoughts and actions). 

When executive function is compromised, individuals may forget important things and have trouble completing tasks. This can result in things like inconsistent performance at work or difficulties with family and friends, or it can affect other aspects of their lives, like finances and driving.

Grown-up responsibilities like having a career, being in a relationship and managing family issues can be difficult even without ADHD, but when you throw ADHD into the mix, everyday life can become even more complicated and, at times, overwhelming.

Sounds stressful, right? 

Then it probably isn’t so surprising to learn that The National Comorbidity Survey reported that adults with ADHD are three times more likely to develop major depressive disorder (MDD). 

MDD is defined as a mood disorder that causes persistent feelings of sadness and loss of interest. 

But what exactly is the reason adults with ADHD are at an increased risk of depression? 

Whether comorbid depression is because of the effects the symptoms of ADHD have on the lives of those living with the disorder (such as the daily difficulties described above), or whether there are genetic factors involved that put folks at a higher risk for depression or experiencing a depressive episode, is not entirely clear.

One study published in the journal, BMC Psychiatry, suggested that mood disorders and ADHD stem from similar neurobiology. In fact, some neuroimaging studies have demonstrated that similar regions of the brain are involved in ADHD and psychiatric disorders. 

However, another study, published in the Journal of Affective Disorders, concluded that the accumulation of adverse life events that happened because of ADHD — such as conflicts with others — partly explain the association between ADHD and depression. 

It’s also possible that the repeated pattern of failures and frustrations due to the disorder can worsen depression.

While we don’t know what exactly causes the relationship between ADHD and comorbid depression in adults, we do know that these symptoms of depression and of ADHD are treatable.

So, what’s the best treatment plan if you think you have both ADHD and depression? 

If a medical professional determines that you have ADHD and depression, treatment may include behavioral, psychological, educational and coaching interventions. 

The first step is to talk to your healthcare provider so you can receive a proper diagnosis. 

Sometimes, ADHD can be misdiagnosed as depression (for example, individuals with depression may have difficulty eating or sleeping, but these signs of depression are also symptoms of ADHD). 

However, sometimes, ADHD and depression actually do co-exist, and other times, depression is a direct result of the impact ADHD has had on the life of the individual. 

If you do have ADHD and depression, treatment can go hand in hand. In other words, you do not need to first treat one, and then the other. However, knowing the root of the depression can help determine the correct treatment plan. 

For example, if the depression is caused by problems occurring within a relationship or at work, managing the ADHD may end up alleviating the underlying issues, and the depression may dissipate on its own.

However, it’s possible that depression can make ADHD symptoms even worse. In that case, it may make sense to concentrate on managing the depression above all else.

ADHD and Depression Medication

When it comes to ADHD medications, psychostimulants are known to be effective, but it’s important to note that they do not “cure” the disorder. Instead, ADHD medications help ease the symptoms—and only while they are in your system.

Some commonly prescribed medications for ADHD include methylphenidate and amphetamines. However if an adult has a co-existing problem with substance abuse, psychostimulants are not recommended until the substance abuse is under control. 

It’s also possible that stimulants can agitate depressive symptoms. 

A non-stimulant medication like Strattera®, which is FDA-approved to treat ADHD, may be a good treatment option in either of these situations, as it’s also been shown to be effective in treatment-resistant depression, according to an article published in the book, StatPearls. Learn more about Strattera sexual side effects.

There are also medications such as bupropion as well as tricyclic antidepressants that are able to treat both depression and ADHD at the same time. However, they are not considered as safe as stimulants, and may also be less effective.

Therapy for Comorbid Depression and ADHD

Additionally, individuals suffering from comorbid depression and ADHD may also benefit from cognitive behavioral therapy (CBT), according to an article published in the journal, Cognitive Therapy and Research. 

One study showed that adults with ADHD and depression would benefit from modifying dysfunctional attitudes as well as establishing effective coping mechanisms and strategies.

The study also notes that this method of CBT to treat comorbid depression is very similar to methods used as a treatment of depression even when it does not co-exist with ADHD.

To better understand the relationship between ADHD and depression (and in turn, the treatment), more research is needed on the links between depression suicidality, and symptom dimensions of ADHD (such as impulsiveness vs inattentiveness).

ADHD is a very common disorder usually diagnosed in childhood. However it’s a lifelong disorder that many people struggle with into adulthood.

Studies show that there is definitely a link between ADHD and a diagnosis of depression. In fact, it’s estimated that 18.6 percent of adults are affected by both ADHD and depression. 

Whether depressive symptoms are brought on by the ADHD’s effect on an individual’s life, or whether there’s a genetic, neurological correlation is still being determined. (Maybe it’s both!) 

The good news is that there are many effective treatment options, including medication for ADHD, antidepressant medication and cognitive behavioral therapy. 

If you think you have ADHD and depression, reach out to a mental health professional who can help figure out the best treatment options for your needs. Consider scheduling a telepsychiatry evaluation today through our online offerings.