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ADHD and depression

By Peg Rosen

At a Glance

  • Kids with ADHD are more likely to have depression.

  • Signs of depression and ADHD can look similar.

  • Depression can be misdiagnosed as ADHD, and it’s possible to have both.

If you think your child with ADHD (also known as ADD) is depressed, you’re not alone. A lot of kids with ADHD — about 40 percent, according to one long-term study — struggle with depression at some point.

Here’s what you need to know about ADHD and depression — and how you can help your child.

The link between ADHD and depression

ADHD can create a lot of challenges for kids, and those challenges can lead to depression. School and behavior problems can wear down kids’ self-esteem . ADHD can affect kids socially, too. Classmates might tease or exclude them, which can make them feel isolated or even hopeless.

But some kids with ADHD may also be “pre-wired” for depression. Some differences in brain chemistry that can cause ADHD may make some kids more likely to feel depressed.

Researchers are looking into whether there’s a type of ADHD that occurs most often with depression. They’re also studying adults with depression who aren’t responding to antidepressants. Research suggests that in some cases, they may actually have ADHD.

Signs of depression in kids with ADHD

Depression in kids with ADHD can look the way depression looks in any young person. Depression symptoms include:

  • Feeling very “down” (or what doctors call a “low mood”)

  • Losing interest in favorite activities

  • Withdrawing from friends

  • Changes in sleep and eating patterns

  • Falling grades

  • Not doing homework or going to school

  • Talking about feeling hopeless, helpless, or suicidal

Depression can also amp up behaviors related to ADHD. For example, kids with ADHD who are depressed may start to:

  • Act out more. They may be unusually disruptive in class. They may break things or hit people. Irritability — snapping at people or blowing up over small issues — is also common.

  • Seem very inattentive or “spaced out.” They might be even more distracted by their low mood or by what’s going on in their head.

  • Get extremely overwhelmed and disorganized. ADHD already makes it hard to stay on track. When kids with ADHD are depressed, life can seem utterly unmanageable and hopeless.

  • Talk about wanting off their meds. Some kids mistakenly blame their low mood on their ADHD medication. They might even secretly stop taking it, thinking they’ll feel better.

  • Self-medicate. Tweens or teens with ADHD who are feeling depressed may try to improve their mood by using drugs or alcohol.

Why depression can be misdiagnosed as ADHD

There’s a lot of overlap between ADHD and depression, but not all kids have both. Sometimes depression can be misdiagnosed as ADHD, and vice versa. That’s because they can look similar on the surface. Here are some ways kids with either issue might act, but for different reasons:

  • Lose motivation. Kids with ADHD might think that working at something won’t make a difference. So they give up. Depressed kids who feel hopeless may not do their work because they don’t feel there’s any point.

  • Have trouble keeping up with schoolwork. Kids with ADHD may tune out in school and not learn the material. Depressed students may be distracted by negative feelings or lack of sleep and not be able to focus.

  • Have very negative self-esteem. Kids with ADHD may not feel good about themselves because they have trouble keeping up, no matter how hard they try. Depressed kids, on the other hand, may feel like they’re worthless for no apparent reason.

  • Resist going to school. Kids with ADHD might dread going to class because they know they’ll have to do things that are hard for them. Depressed kids may not have the emotional strength to get themselves through the day.

Kids who are depressed feel despair and hopelessness. They often have little energy and lose interest in socializing. A dark mood can last for weeks or even months.

Kids who have ADHD but aren’t depressed tend to be frustrated and even angry about the challenges they’re facing. They may struggle to get along with peers but still crave the chance to socialize.

If your child is depressed and you think the cause might be ADHD, there are steps you can take to find out .

ADHD and suicide

Many teens have suicidal thoughts. It’s rare for teens to act on these thoughts. But families of depressed kids with ADHD need to be especially vigilant.

That’s because kids with ADHD are more impulsive than kids who don’t have ADHD. They’re more likely to act “in the moment” when they’re feeling down or hopeless. They may not be able to step back and see the bigger picture.

A 2010 study found that teens who were diagnosed at a young age with ADHD were twice as likely to make a suicide attempt than peers who did not have ADHD. That’s why it’s important to take any talk of hopelessness, despair, or suicide very seriously and take immediate steps to find help.

If you’re worried your child may be thinking about suicide or other forms of self-injury, don’t leave your child alone. Call the National Suicide Prevention Lifeline at 800-273-8255, or call your child’s doctor or mental health professional.

Medication for ADHD and depression

If your child with ADHD is diagnosed with depression, antidepressant medication may help. Some primary care providers prescribe these drugs. But it’s wise to consult a specialist.

A psychiatrist or a psychopharmacologist will know which antidepressant medications are best suited for kids with ADHD. If your child is already taking ADHD medication , a specialist will be best equipped to coordinate and choose the right drugs.

Many people take ADHD medication and antidepressants. With the right approach, this can be done safely and effectively. Antidepressant medication is most effective when combined with talk therapy.

How you can help

If you suspect your child with ADHD has depression, there’s a lot you can do to help. Here’s how:

Pay attention to changes in your child’s mood and behavior. Look for changes in eating and sleeping patterns. Take notes on what you’re seeing. Your notes can help you and your child’s doctor figure out whether changes in appetite are due to ADHD medication or to depression.

Talk to your child’s teachers. Do they think your child has been:

  • Less attentive or acting out more than usual?

  • Sad or tired all the time?

  • Not interacting with others?

  • Underperforming on tests?

These kinds of comments are good reasons to request a meeting with your child’s resource teacher or the school psychologist.

Seek help. Your child’s pediatrician is a good first step. Or speak with the psychologist at school. Research shows that cognitive behavioral therapy  — a type of counseling that’s goal-oriented and focused on problem solving — can be very helpful for kids with ADHD.

Be on the lookout for anxiety. Depression often goes hand in hand with anxiety. So watch for signs of that, too. As with ADHD and depression, medication and talk therapy can help with anxiety.

Go outside together. When you’re feeling really down, it can be hard to get out of bed or off the couch. Try to carve out time for things that don’t involve chores or homework. Offer to go for a walk, grab lunch together, or head out to a movie.

With the right care and support, kids with ADHD and depression can manage these conditions and continue to thrive. Being the caregiver for a child with multiple issues can be stressful. So remember to take care of yourself, too. Finding an online community or joining a local support group can be a big help.

Key Takeaways

  • Experts think some kids with ADHD may be “pre-wired” for depression.

  • Kids with ADHD who are depressed may act out more or seem very “spaced out.”

  • There are many ways to help kids who have ADHD, depression, or both.

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  • Coming soonGoogle Classroom