Jul 11th 2023
Attention deficit/hyperactivity disorder (ADHD) and depression can affect people of any age and can cause significant impairments in functioning. It is common for people to experience both ADHD and depression, which can make symptoms feel more challenging. Treatment for combined ADHD and depression can include therapy and medication.
Attention deficit/hyperactivity disorder (ADHD) is a condition that affects behavior and concentration. Symptoms of ADHD can relate to inattention, hyperactivity, and impulsiveness.
ADHD often emerges in childhood and can cause issues with functioning at school, at home, and with social abilities. In many cases, it can continue into adulthood, although symptoms can improve with age for some people .
Depression is a mental health condition that impacts mood, thoughts, and behavior. Depression can cause physical and emotional symptoms that can severely impact functioning in various aspects of life.
Depression can emerge at any age, although it is often diagnosed in young adults. It can be a lifelong condition, although the severity of symptoms can fluctuate .
Symptoms of ADHD and depression can vary from person to person. Typically, symptoms of ADHD include :
Symptoms of depression typically include :
Various symptoms of ADHD and depression can appear similar. This can complicate diagnosis or cause one condition to go unnoticed in those with ADHD and depression .
Other causes or contributing risk factors of ADHD include :
Other causes or contributing risk factors of depression include :
Often, people with either ADHD or depression experience a comorbid condition. It is common for ADHD and depression to occur together. Research suggests that around 40% of children with ADHD also experience symptoms of depression . Furthermore, it is thought that approximately 70% of people with ADHD receive treatment for depression at some point during their lifetime .
Children with ADHD may develop symptoms of depression due to the consequences of ADHD symptoms. For example, it is common for children with ADHD to underperform academically, be told off by their parents or teachers for disruptive behavior, or experience difficulties with friendships. This could lead to feelings of guilt, shame, worthlessness, or unhappiness .
Similarly, if ADHD continues to impact functioning into adulthood, people may experience similar difficulties with relationships or work. This could further contribute to negative emotions and feeling hopeless and worthless. Experiencing these negative emotions and thoughts for a prolonged period can increase vulnerability to depression .
As such, it is likely that ADHD significantly contributes to or exacerbates symptoms of depression. This is demonstrated by a much higher prevalence of depression among people with ADHD than the general population. Research also indicates that ADHD is linked to an earlier age of depression onset, more severe symptoms, and increased suicidal ideation and attempts .
Similarly, it is believed that depression can also worsen symptoms of ADHD. Therefore, people who experience both ADHD and depression are likely to experience more severe symptoms than people with one of these conditions. This can worsen outcomes and make treatment more challenging .
Treatment for people with both ADHD and depression may be more challenging than for either condition alone. The symptoms of both can be more severe, and it may be likely for other conditions also to be present .
As both ADHD and depression can present differently from person to person, the best treatment will depend on the individual and their symptoms. In many cases, ADHD symptoms contribute to depression symptoms such as worsening mood and functioning. Therefore, treating symptoms of ADHD could also improve or prevent depression symptoms .
Commonly, ADHD is treated with stimulants, such as methylphenidate. These medications can be effective at managing symptoms of ADHD. However, for some people, they can cause a worsening in mood .
Commonly, depression is treated with antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs), including fluoxetine, sertraline, or citalopram. These medications can be very effective for some people with ADHD and depression, but for some, they can cause a significant worsening in suicidal ideation .
Treating combined ADHD and depression with medication must be considered with caution and on an individualized basis. Medication that may help one condition could worsen the other. As such, it is often best practice to utilize one type of medication and to wait before adding further medications to treatment, closely monitoring any changes in physical or mental well-being .
If medication is to be used, treating the more severe condition first is vital. For example, if someone is experiencing severe symptoms of depression, such as recurrent suicide attempts and self-harm, it is essential to treat these symptoms first. Likewise, if ADHD symptoms are the most prevalent and problematic, these must be managed before adding other treatments .
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