When we hear about Attention Deficit Hyperactivity Disorder (ADHD), we often imagine a hyperactive kid recklessly running around and disturbing the peace or an adult who can’t concentrate on doing a specific task, daydreaming, or procrastinating instead.
Depression symptoms such as sadness or fatigue seem counterintuitive. However, research shows that major depressive disorder (MDD) is common among people with ADHD.
About 25% of healthy people are at risk of having at least one depressive episode before 30 years of age, while those with ADHD have a risk of 44%. The danger of ADHD is that it can contribute to clinical and situational depression. But how exactly is ADHD associated with these two types of depression?
Let's look at each depression type and its connection to ADHD.
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ADHD and Clinical Depression
Clinical depression, or major depressive disorder, is more severe compared to situational one. People with clinical depression may suffer from recurrent depressive episodes for years. But why exactly is ADHD associated with clinical depression? The answer is simple — genetics. The same genetic factors that contribute to the development of ADHD may also result in the development of depression.
Research indicates that several genetic factors are associated with ADHD and depression, particularly those pertaining to regulating neurotransmitters like dopamine and serotonin. These two chemicals are significant for controlling our moods as well as how attentive we can be — traits that are disrupted in individuals who suffer from either one of these conditions. A noteworthy example is the DAT1 gene: it codes a particular dopamine transporter with connections to ADHD and depression.
While genetic factors may increase the risk of developing ADHD and depression, it doesn't mean these disorders occur in all people with a genetic predisposition. For instance, environmental factors, especially those contributing to early childhood stress, play a critical role in developing clinical depression. So a complex interplay exists between environmental and biological factors that may contribute to ADHD and clinical depression.
ADHD and Situational Depression
Situational depression is different from clinical, and the difference is underlined by its name. Unlike major depressive disorder, which is often caused by genetic factors, situational depression is triggered by unpleasant experiences and situations. Considering that people with ADHD have high impulsiveness, and inattention, affecting various domains of their lives, they often have poor social adjustment and have problems at work or personal life.
Constant conflicts and misunderstandings, which may happen due to ADHD symptoms, significantly reduce the quality of social interactions with others, making it difficult for children and adults with ADHD to establish meaningful relationships. Scientific findings show that, in general, people with ADHD have poor satisfaction with familial relationships, have fewer friends, and have more conflicts with their spouses. As a result, it may lead to a constant feeling of rejection and isolation.
Moreover, those with ADHD can find it challenging to manage their emotions due to impairments in executive functioning effectively. This vulnerability may make them more prone to developing mood disorders, including depression and anxiety. The persistent struggle to concentrate, organize thoughts, and control behavior often leads to prolonged stress levels, which may deplete the individual’s resilience over time.
Eventually, people with ADD/ADHD lose their ability to resist stress effectively and have no internal resources to address stressful situations. This, consequently, leads to situational depression.
ADHD and Depression Overlapping Symptoms
While ADHD and depression are quite different from each other, they also have some overlapping symptoms. That is why it can sometimes be difficult to diagnose comorbid depression.
So, let’s have a look at the symptoms that both ADHD and depression can cause.
Difficulty Concentrating
Concentration issues can be a common symptom of both ADHD and depression. People with ADHD may have difficulty staying focused, whether it's due to their hyperactivity or simply not paying enough attention. Similarly, those
who suffer from depression might also struggle to concentrate. However, this is typically caused by low energy levels or preoccupation with negative emotions rather than restlessness.
Restlessness
ADHD in adults can often manifest as an edginess or a feeling of restlessness. On the other hand, restlessness and agitation indicate that someone may struggle with depression. However, it is not a very common symptom of depression.
Impulsivity
Attention Deficit Hyperactivity Disorder is characterized by impulsivity, or a tendency to act quickly without considering the potential consequences. While this symptom may be less frequent in cases of depression, severe episodes can cause individuals to take impulsive actions that could lead them toward self-harm and even suicide.
Sleep Problems
Almost every psychological disorder is associated with sleep problems, and depression and ADHD are no exception. Those with ADHD often find it difficult to fall asleep, as their thoughts are racing. People with depression may also have insomnia, or on the other hand, they may sleep more than needed. Depression makes people feel it is better to sleep than be awake and experience constant sadness and despair.
Fatigue
ADHD is commonly known for its association with hyperactivity, but it can also manifest itself in feelings of tiredness or fatigue after periods of intense activity. Similarly, depression often causes long-term exhaustion and an overall lack of energy.
Mood Swings
People with both ADHD and depression can experience fluctuations in their mood, even though mood swings are typically associated more closely with bipolar disorder and other disorders. Frustration stemming from the difficulties associated with having ADHD is one reason why this might occur. In depression, mood changes may occur when there are recurrent depressive episodes.
Low Self-esteem
People with ADHD and depression often face challenges that can impact their self-esteem. Struggles in academics or the workplace, as well as difficulty organizing tasks and managing time, may all lead to feelings of worthlessness for those living with these conditions.
How Does Depression Feel Like When You Have ADHD?
Feeling the effects of depression while living with ADHD can be overwhelming, like being in an epicenter of a whirlwind of emotions. The restlessness already present due to ADHD — never giving you respite and making it difficult to focus on even basic tasks — only intensifies when cloaked by the foggy cloud of despair associated with depression.
For adults with ADHD, the world can feel overwhelmingly bleak and cold. This is more than just a passing feeling of sadness. It's an intense emptiness that saturates every aspect of life. Those activities you once cherished have suddenly become dulled as if all their color has drained away. Your world may seem gray, uninspiring, and two-dimensional. Nothing brings you pleasure anymore, and you are not motivated to do anything.
The impulsivity linked to ADHD can become more intense if you have depression. You may end up making quick decisions that can be dangerous and risky. It's like being a passenger and having your impulsive side take control of the wheel with no chance for your more cautious self to pull it back on track. You may feel you are not controlling your life anymore.
Social interactions may seem more daunting than ever. ADHD might make focusing on conversations difficult, while depression whispers that no one wants to hear what you say anyway. This can lead to isolation, which only deepens the sense of loneliness and sadness.
You should be aware that you can’t self-diagnose depression and always ask for professional help, especially if you have ADHD. Only mental health professionals can tell for sure if you have depression. So don't be afraid to seek help if something feels wrong.
How to Prevent and Treat Depression if You Have ADD/ADHD
One of the most effective ways to prevent depression is to reduce sources of stress and learn effective stress management. Yoga, meditation, grounding techniques, deep breathing, and progressive muscle relaxation can be incredibly helpful in managing stress levels. These practices not only help improve focus and attention but also aid in elevating mood — which is beneficial for both ADHD and depression sufferers alike.
Plus, you can learn various time-management techniques such as Pomodoro or the flowtime technique.
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Engaging in physical activity has proven an effective remedy for ADHD, depression symptoms, and reducing stress. It can help trigger the release of endorphins, a feel-good chemical that will help to boost your mood. Moreover, being in reasonably good physical shape will improve your self-esteem and physical appearance, making finding friends and establishing a social support system easier.
Eating a balanced diet filled with nutrient-dense fruits, veggies, lean proteins, and whole grains can immensely benefit our moods and energy levels. Recent studies indicate that essential fatty acids like Omega-3 might even help to alleviate symptoms associated with Attention Deficit Hyperactivity Disorder and depression.
As for treatment, ADHD and depression are usually treated with complex therapy involving a combination of psychological interventions and medications. Cognitive-behavioral therapy (CBT) can be highly effective for ADHD and depression. Antidepressants can be used to treat depression, and stimulant or non-stimulant medications are often used to manage ADD/ADHD symptoms.
ADHD with comorbid depression can be difficult to treat, so you should always seek professional help.