Attention Deficit Hyperactivity Disorder vs. Depression

Attention deficit hyperactivity disorder (ADHD) and major depression (MDD) are two common psychiatric disorders that can occur in children, adolescents and adults.

Although ADHD and depression are different conditions, there are several similarities between the two conditions. If you have ADHD, you may have a higher risk of developing depression at some point in your life.

Below, we’ve explained what ADHD and depression are, as well as how they differ in terms of symptoms, causes and their impact on your quality of life.

We’ve also shared what you should know about depression if you have ADHD, as well as the steps that you can take if you think you might be depressed.

Attention deficit hyperactivity disorder is a neurodevelopmental disorder. It’s usually diagnosed in childhood and can persist throughout a person’s life, causing symptoms that affect learning, attention and behavior even when a person is an adolescent or adult. 

Children and adolescents with ADHD may experience the following symptoms:

• Difficulty paying attention

• Excessive daydreaming

• Losing things and/or forgetting information easily

• Taking needless risks and/or making careless mistakes

• Finding it difficult to wait (for example, waiting in line or taking turns)

• Struggling to get along with other people

• Fidgeting, squirming and moving excessively

• Talking often and excessively

Some of these symptoms are common in children without ADHD. For example, it’s common and normal for kids and teenagers to occasionally daydream or have difficulty focusing on homework or other repetitive tasks.

In people with ADHD, these symptoms can be severe and persistent. Often, people with ADHD will continue to experience symptoms as they get older, long after most people would “grow out” of certain behaviors. 

To diagnose ADHD, mental health providers use a set of criteria. Children and adolescents are required to display a variety of symptoms, with settings present in multiple settings and from an early age, in order to be clinically diagnosed with ADHD.

Mental health professionals typically divide ADHD into three different types. A person’s type of ADHD depends on the specific symptoms they display.

Predominantly Inattentive ADHD

This type of ADHD is defined by inattention. People with a predominantly inattentive subtype of ADHD typically display six or more (or five, for people over 17) of the following symptoms: 

• Lack of attention to detail or careless mistakes in schoolwork or job tasks

• Difficulty staying focused on tasks or activities that require engagement

• Incomplete tasks and/or duties that are started but not always finished

• Avoidance or dislike of tasks that require sustained attention and effort

• Limited attention when spoken to (for example, doesn’t seem to “be there”)

• Difficulty organizing tasks, resulting in missed deadlines and messy work

• Loss of important everyday items, such as keys, wallet, books and glasses

• Forgetting everyday tasks, such as paying bills or keeping appointments

• Frequent distraction, such as during work, study or other important activities

Predominantly Hyperactive-Impulsive ADHD

This type of ADHD is defined by hyperactivity and impulsivity. People with this subtype of ADHD typically display six or more (or five, for people over 17) of the following symptoms:

• Unable to stay seated for long periods (for example, at work or in the classroom)

• Running and engaging in other physical activities at inappropriate times

• Squirming, fidgeting and tapping of the hands and/or feet

• Finishing people’s sentences (for example, answering a question before the person has finished asking it)

• Interrupting other people’s activities (for example, cutting into people’s conversations or taking over activities)

• Talking often, excessively or in inappropriate situations

• Difficulty waiting in line or in other settings that require patients

• An “on the go” attitude and constant sense of energy

• Excessive noisiness during activities

Combined Presentation ADHD

Some people display symptoms of both types of ADHD. When a person meets the diagnostic criteria for both inattentive and hyperactive-impulsive ADHD, they’re referred to as showing a “combined” presentation.

Major depressive disorder (MDD, or clinical depression) is a mood disorder that often appears during adulthood. It can cause severe, persistent symptoms that affect a person’s moods and quality of life. 

Common symptoms of depression include:

• Persistent, severe feelings of sadness, anxiety or emptiness

• Irritability and a “shorter fuse” when dealing with others

• Feelings of guilt, helplessness and worthlessness

• A pessimistic outlook on life and belief that things are hopeless

• Difficulty focusing on tasks and/or remembering information 

• Loss of interest in or pleasure from hobbies and activities

• Changes in eating habits, appetite and/or body weight

• Difficulty falling asleep, staying asleep or waking up

• Suicidal ideation and/or suicidal behavior

• Decreased energy levels and a general feeling of fatigue

• Aches, pains, cramps and other physical symptoms without an obvious cause

• Slowed speech and/or movements

It’s normal to experience some symptoms of depression from time to time, such as a low mood or negative outlook on life. 

To diagnose depression, healthcare providers typically look for a range of depressive symptoms in addition to a low mood. Most people who are diagnosed with depression have symptoms that occur on a daily or almost daily basis for a period of at least two weeks. 

Certain types of depression may involve unique or severe symptoms. These include persistent depressive disorder (dysthymia), seasonal affective disorder (SAD) and related conditions such as bipolar disorder. 

Like with many other mental disorders, experts haven’t yet been able to identify specific factors that may cause ADHD. 

Currently, research suggests that ADHD is at least partly genetic in origin. For example, studies have found that approximately 75 percent of people affected by ADHD have at least one relative that also has the disorder.

Other factors that may contribute to ADHD include:

• Injuries that affect the brain

• Exposure to lead or other environmental toxins prior to birth or at a young age

• Use of alcohol and/or tobacco during pregnancy

• Premature birth and/or low birth weight

Contrary to popular belief, there’s no evidence that ADHD is caused by excessive TV watching, eating too much sugary food or bad parenting. Research suggests that three to seven percent of school-aged children are affected by some form of ADHD.

Researchers have yet to pinpoint the specific causes of depression. However, current research suggests that a mix of genetic, environmental, psychological and biological factors may all play a role in a person’s risk of becoming depressed.

Like with ADHD, experts think that depression is partly caused by genetic factors. For example, when one identical twin has depression, the other twin has an approximately 70 percent chance of also experiencing depression symptoms at some point in life.

Other factors that may increase a person’s risk of depression include:

• Significant negative life changes, stress or trauma

• Physical illnesses, such as cancer, diabetes or heart disease

• Certain medications, including those for the conditions listed above

• High levels of anxiety during childhood and/or adolescence

• Long-term exposure to violence, abuse, poverty or neglect

• Personality factors, such as low self-esteem or a pessimistic attitude

• Low levels of certain brain chemicals, called neurotransmitters

Depression usually develops during adulthood, but it can also occur in children and teens. In young people, depression often involves irritability with fewer mood-related symptoms.

ADHD and depression have several things in common, including shared symptoms and a high level of comorbidity (meaning they often occur at the same time). 

Similarities between ADHD and depression include the following:

• ADHD and depression can both affect concentration. Inattentive ADHD and major depression share numerous common symptoms, one of which is difficulty focusing on tasks that require engagement and attention.

• Both disorders can cause a lack of interest in activities. ADHD and depression are both associated with a lack of interest in certain activities. In depression, this can occur as anhedonia — a loss of interest in or pleasure from activities and hobbies.

• ADHD and depression can both cause sleep issues. Sleep issues, such as difficulty falling asleep or nighttime awakenings, are common in people with depression. ADHD is also associated with sleep problems, including insomnia and difficulty waking up.

• People with ADHD are more likely to develop depression. Research shows a clear link between ADHD and depression. If you have ADHD as a child, you have a higher risk for depression as an adult.

• ADHD symptoms are common in depressed people. People with major depression, and particularly recurrent or chronic major depression, are much more likely than their peers to have symptoms of ADHD.

• Anxiety can also occur with ADHD and depression. In a study from China, a team of researchers found that 15 percent of children with ADHD also had comorbid depression and anxiety disorders.

Since ADHD and depression share several symptoms and are often comorbid disorders, it can be difficult to tell one issue from the other. 

Key differences between ADHD and depression include:

• ADHD is usually diagnosed in childhood. Most people with ADHD are diagnosed as children, with symptoms that may continue into adulthood (referred to as adult ADHD). Although depression may also develop during childhood, it’s more commonly first seen during adulthood.

• The symptoms of ADHD aren’t episodic. People with clinical depression go through depressive episodes — periods of two weeks or longer in which they develop the signs of depression. These episodes may come and go over time.In contrast, people with ADHD generally have long-lasting symptoms that occur on an ongoing basis.

• People with ADHD can experience motivation. People with ADHD can feel pleasure and motivation when they spend their time on something that interests them, such as a hobby or enjoyable activity. People with depression, on the other hand, often develop a complete lack of motivation, pleasure or interest in activities.

ADHD and depression are both treatable disorders. Treatment for ADHD typically involves the use of stimulant and non stimulant medications, usually with behavioral therapy.

Treatment for depression involves the use of prescription medications called antidepressants, either on their own or in combination with psychotherapy and lifestyle changes.

If you think you may have ADHD, depression or both disorders together, your first step should be to talk to a licensed mental health provider.

You can do this by asking your primary care provider for a mental health referral, scheduling an appointment with a psychiatrist in your area or from home with our online psychiatric evaluation service. 

Your mental health provider may ask you about your symptoms, mental health history and other health conditions you have that could contribute to ADHD and/or depression. Make sure to give your mental health provider all of the information they need for an accurate diagnosis. 

Medication

If you have ADHD and/or depression, your healthcare provider will likely prescribe medication to help you stay in control of your symptoms.

Commonly used medications for ADHD include methylphenidate (Ritalin®), dextroamphetamine (Dexedrine®) and atomoxetine (Strattera®). These medications may make it easier for you to focus, improve your thinking and reduce impulsive feelings and behaviors.

Common medications for depression include selective serotonin reuptake inhibitors (SSRIs) and other types of antidepressants. These medications work by increasing neurotransmitter levels in your brain to improve your moods and provide relief from other depression symptoms. 

If you’re prescribed medication for ADHD and/or depression, it might take several weeks before you feel any improvements. Make sure to keep using your medication, even if you don’t notice any immediate changes in your moods, feelings and other symptoms.

Psychotherapy and Behavioral Therapy

ADHD and depression both often improve with therapy, either on its own or in combination with medication. 

Several forms of therapy are used to treat ADHD, including cognitive behavioral therapy (CBT), family and marital therapy and parenting skills training (when ADHD occurs in children). 

Common forms of therapy for depression include cognitive behavioral therapy, problem-solving therapy and interpersonal therapy (IPT). 

Other Forms of Treatment

In some cases, your mental health provider may suggest making certain changes to your habits and lifestyle to reduce the severity of your ADHD and/or depression symptoms.

The symptoms of ADHD can often be managed by creating routines, lists and calendars to stop yourself from becoming disorganized. Simple steps, such as breaking down large, difficult tasks into smaller, more manageable steps may help to improve motivation and focus.

Many depression symptoms can improve with small changes to your habits, such as exercising regularly, setting realistic goals and spending more time with friends, family and people close to you who can provide emotional support. 

ADHD and depression are sometimes comorbid disorders, meaning they can occur in the same person, either concurrently or separately. They also have a few symptoms that can make it easy to mistake one mental health condition for the other. 

The good news is that both ADHD and clinical depression are treatable, generally with a mix of medication, therapy and lifestyle changes. 

If you think you might have ADHD or depression, it’s important to reach out for help. You can do this by talking to your primary care provider, meeting with a psychiatrist or from your home using our online mental health services. 

With effective treatment and care, many people with ADHD and/or depression are able to stay in control of their symptoms and enjoy a high quality of life. 

Interested in learning more about your mental health? Our guide to the signs of depression goes into detail about what you may feel if you’re depressed, while our mental health resources share free, proven strategies for dealing with issues such as depression, anxiety and more.