When Depression and ADHD Coexist: A Guide for Parents

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Living with attention deficit hyperactivity disorder is tough enough, but for some young people, it co-occurs with depression. If your child is experiencing ADHD and depression, they are not alone. One in three young people with ADHD also experiences depression or a depressive episode.

ADHD and depression are separate disorders, even though they often overlap. The good news is that your child can overcome the challenges they present with the proper treatment and support. Depressive symptoms can be particularly tough for teens with attention deficit hyperactivity disorder due to the added stress ADHD can cause.

Understanding Attention Deficit Hyperactivity Disorder

Attention deficit hyperactivity disorder (ADHD) is a widespread condition that can impact a young person’s ability to concentrate, organise, and complete tasks. Symptoms include restlessness, impulsiveness, and a need for constant stimulation. Understandably, this makes everyday life, school, and social situations more complicated.

ADHD is a neurodevelopmental disorder present from childhood. Teenagers with ADHD frequently struggle with executive functioning, which leads to difficulty completing tasks, disorganisation, and missing appointments. Diagnosis of ADHD typically happens in childhood, but sometimes it isn’t recognised and diagnosed until adulthood.

ADHD can make it challenging for a child to focus, resulting in hyperactivity and impulsivity. These symptoms often lead to complications like underachievement, low self-esteem, relationship difficulties, and social isolation. To combat this, a child must understand that having ADHD does not mean they are lazy, stupid, or lack willpower. It simply means that their brain works a little differently, and they may need support to navigate life in a way that works for them. ADHD is not a choice or a character flaw. It is a real and complex condition recognised in the Diagnostic and Statistical Manual of Mental Disorders (DSM5) that can make daily life more difficult; however, it’s not a barrier to success and happiness.

ADHD can be categorised into three different presentations:

  • inattentive
  • hyperactive-impulsive
  • a combination of the two

Young people diagnosed with inattentive ADHD may struggle to sustain attention for tasks they find boring, have trouble organising their thoughts, and become easily distracted. Those with the hyperactive-impulsive type may feel restless, say things without thinking, and find it hard to stay still. Teenagers with the combined presentation will experience both inattentive and hyperactive-impulsive symptoms.

Understanding Major Depressive Disorder

Major depression, or clinical depression, can profoundly impact a young person’s life. It causes persistent and intense sadness, hopelessness, and worthlessness that lasts for an extended period.

Symptoms of major depression include:

  • losing interest in activities previously enjoyed
  • sleeping difficulties
  • weight loss or gain
  • fatigue and feeling tired
  • trouble concentrating or making decisions

These symptoms can make even simple tasks feel overwhelming.

A child experiencing depression should understand that it isn’t a sign of weakness or something willpower alone can overcome. It’s a complex disorder caused by genetics, life events, and chemical imbalances in the brain.

There is hope for teens struggling with major depression. Many young people can manage their symptoms and regain control with the appropriate treatment, including therapy, medication, and lifestyle changes.

Depression can cause a teen to feel sad, empty, and disconnected from others, even when they are not alone. It differs from the “blues” or sadness that comes after a breakup, loss of a job, or grief after losing a loved one. While these situations can lead to depressive symptoms, they don’t necessarily mean someone has the condition.

As a common yet serious mood disorder affecting a young person’s feelings, thoughts, and actions, depression makes it hard to do everyday tasks. Taking care of personal hygiene and eating healthy meals becomes challenging, and in severe cases, it can lead to suicidal ideation. However, with the right support and treatment, young people can recover.

Does ADHD Cause Adolescent Depression?

For young people with ADHD, the risk of developing depression is significantly greater than for those without the condition. Teenagers with hyperactive/impulsive ADHD, compared to other types, are at a higher risk of suicide.

Children with an ADHD diagnosis may experience symptoms of “secondary depression”, which directly results from chronic frustration and disappointment stemming from the difficulties that come with ADHD. This dissatisfaction can lead to low self-esteem and a negative self-concept, making them more prone to depressive illnesses.

Managing and treating ADHD is vital to lifting depression. Unfortunately, some estimates suggest that by adulthood, 25% of people with adult ADHD have not received appropriate treatment.

ADHD is often associated with other disorders that can also increase the risk of depression. These conditions include dopamine dysregulation and emotional dysregulation. Mental health comorbidities like bipolar disorder, obsessive-compulsive disorder, and learning disabilities are other risk factors.

Young women with attention deficit disorder are at higher risk of depression than young men. Those with the predominantly inattentive or combined type are more susceptible to severe depression than those with the hyperactive-impulsive type. Also, maternal health history can impact a child’s risk of developing ADHD and depressive disorders.

It’s important to differentiate between ADHD and depression, as there are overlapping symptoms and key differences in mood, motivation, and sleep patterns. Identifying and managing ADHD can help prevent or alleviate depression symptoms.

Experiencing both ADHD and Depression

Being a teenager comes with challenges, and coping with ADHD and depressive disorders can make it even more difficult. It can feel like an internal battle, where the mind and emotions are constantly at odds. Tasks that should be simple can feel overwhelming, and it can be hard to find happiness in things that once brought pleasure.

The overlap of ADHD and depression is a common phenomenon, and peer-reviewed studies show a strong relationship between the two. Young people with ADHD are more at risk of developing depression, and those with depression are more likely to be diagnosed with ADHD. Both conditions share common symptoms like difficulty concentrating, lack of motivation, irritability, and changes in mood.

For young people with ADHD and depression, the symptoms of both conditions may be more pronounced than if they only had one. Managing the combined disorders is crucial. Identifying and treating ADHD is especially important, as it can significantly affect how depression presents itself.

If left untreated, ADHD can exacerbate symptoms of depressive illness, making it harder to manage. Working with a healthcare provider is essential to receive a treatment plan that addresses both conditions.

Teenagers with ADHD may struggle to stay organised and focused due to their inattentive symptoms. At the same time, those with depression may lack motivation due to a sense of purposelessness.

While living with ADHD and depression is challenging, parents can help teens suffering from these conditions to recognise that having ADHD and depression does not define them; they are capable of living a fulfilling life and achieving their goals.

Can ADHD and Depression Cause Suicidal Thoughts?

Young people with ADHD and depression may potentially engage in self-harm, suicide attempts, or think about suicide. Some studies have shown a link between ADHD and suicidal behaviour in teens and young adults. There may be a link between thinking of suicide and the use of certain medications for ADHD, but more research is needed to confirm this.

Girls between the ages of 6 and 18 with ADHD are more prone to suicidal ideation than their peers. Young people with hyperactive-impulsive type ADHD are at greater risk of becoming suicidal than those with other types of the condition.

However, parents will be relieved that the overall risk of suicidal thoughts is still relatively low. More than 80% of children with ADHD do not attempt suicide.

If you believe your child is at immediate risk of self-harm, calling 911 or your local emergency number to seek medical advice is crucial. Stay with your child until help arrives, and remove any harmful objects nearby.

Suicide prevention hotlines can provide help and support. In the USA, the 988 Suicide and Crisis Lifeline is available 24/7. Papyrus Prevention of Young Suicide operates Hope Line UK between 9 am and midnight on 0800 068 4141.

How Are Depression and ADHD Symptoms Treated?

If your child has a diagnosis of ADHD and depression,  you may be wondering about the best course of ADHD treatment to relieve symptoms. Fortunately, many options are available, including psychotherapy, ADHD medication, antidepressant medication, and lifestyle changes.

One effective form of talk therapy for depression is cognitive-behavioural therapy (CBT), which can help children identify and reduce negative thoughts contributing to their symptoms. Additionally, medication can be prescribed for depressive illnesses and to treat ADHD, including stimulant medications, non-stimulants, and antidepressants. Antidepressant and ADHD medications can have side effects, so working closely with your doctor to find the right treatment plan is essential.

In some cases, lifestyle changes can also make a big difference. For example, aerobic exercise impacts the mental health of people with ADHD positively. It can help guard against idleness and improve mood.

Early diagnosis and treatment are key to managing symptoms of both ADHD and depression. If you suspect your child has one or both conditions, make an appointment with your doctor and seek treatment. It’s important to remember that everyone’s experience is unique, and treatment plans will vary based on individual needs. However, with the proper support, your child can begin to manage their symptoms and live a happy, healthy life.

How Can Parents Help a Child with ADHD and Depressive Symptoms?

As a parent of a child with combined ADHD symptoms and depression, knowing how to support them can be confusing. Here are some strategies to help:

  • Monitor your child’s behaviour and mood changes, and look for signs of depression, comorbid anxiety, or other mood disorders.
  • Keep in communication with your child’s teacher to monitor progress and behaviour in the classroom. They may be able to offer suggestions on how you can help your child at home.
  • Create structure and routine to help your child develop organisational and time management skills. Work together to make a schedule and set goals.
  • Encourage open communication with your child about their feelings and what is happening at school. Knowing that you are there to listen will help them feel less alone and allow you to keep track of their concerns and spot any early depressive signs.
  • Consider family therapy or individual counselling to provide a safe space for your child and the family as a whole to express their feelings and find new solutions to challenges.
  • Cognitive behavioural therapy (CBT) can effectively teach your child how to manage their mood and stress levels.
  • Ensure your child follows a healthy lifestyle, including eating a balanced diet, getting enough sleep, and engaging in regular exercise. Aerobic exercise is especially valuable for those with attention deficit disorder.
  • To prevent boredom and worsened mood, create a space in your home where your child can go for stimulation when bored. Fill it with books, crafts, and other activities that your child finds enjoyable.

Treat Depression and Comorbid ADHD at The Wave

At The Wave, we understand how tough it can be for a teenager navigating life with both ADHD and depression. It can feel overwhelming; however, support is available. We offer tailored treatment options to help your child manage symptoms, and we support them on the path to recovery.

Further information on similar topics can be found via our blog What Is ADHD Inattentive Type?.

By working with our experienced team, they will learn about the connections between ADHD and depressive conditions and discover practical coping skills. We believe in empowering young people to make positive changes in their lives, and we’re here for them every step of the way. Don’t let ADHD and depression hold your child back. Contact us and take the first step towards a brighter future.

Further information on related topics can be found via our blog ADHD in Teenage Girls and Young Women.

Fiona - The Wave Clinic

Fiona Yassin is the founder and clinical director at The Wave Clinic. She is a U.K. and International registered Psychotherapist and Accredited Clinical Supervisor (U.K. and UNCG).

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