Every year, millions of people turn to psychiatric care for help with attention deficit hyperactivity disorder (ADHD) and major depressive disorder 10,7. An estimated 6% of U.S. adults have a current ADHD diagnosis 10, and 5% of U.S. adults have regular feelings of depression 7.
While both conditions can have a major impact on our mental and physical wellbeing, there are a few key differences to keep in mind.
ADHD is a neurodevelopmental disorder, which means that it starts during brain development, typically early childhood, but it can be diagnosed at any age 11. Depression, or major depressive disorder, is a mood disorder that can occur at any point in our lifetime. To complicate things even further, an estimated 47% of adults with ADHD also have depression 2.
Depression and ADHD symptoms can look a lot alike, so it can be difficult to accurately diagnose and treat these conditions. An experienced clinician can help you sort through your symptoms, figure out your diagnosis, and work with you to create a plan to get your life back on track.
Impact of ADHD and Depression
ADHD and depression both impact your productivity and overall success in life. Research shows that people with ADHD often face higher rates of unemployment, more workplace and legal problems, higher divorce rates and higher rates of substance abuse 11.
Depressive symptoms are also linked to higher rates of unemployment and substance abuse 12. Both conditions can seriously affect how you function at work and in your personal life, so it is important to get a thorough evaluation for an accurate diagnosis and the right treatment.
Common Misconceptions
“If you have ADHD, you can’t be depressed.”
If you feel like you are constantly failing to meet expectations or keep up, you can become overwhelmed and even depressed. With ADHD, you are actually more likely to suffer from depression at some point in your life 4.
“If you can’t focus or can’t concentrate, then you must have ADHD.”
Focus issues that develop only later in life can be linked to a variety of conditions, including depression, anxiety, trauma, insomnia, sleep apnea, vitamin deficiencies, brain injuries, hormone imbalances and more.
“ADHD is a childhood disorder; adults can’t have it.”
While ADHD is commonly diagnosed in childhood, it is a lifelong disorder. ADHD symptoms can and often do persist into adulthood, so some patients may be diagnosed for the first time as adults 10. Some patients are not diagnosed until their mental workload outpaces their focus ability.
Recognizing Symptoms
ADHD symptoms:
The main criteria for diagnosis of ADHD are the presence of inattention, hyperactivity and impulsivity 1.
- Hyperactivity can look different in an adult with ADHD. It can show up as being overly talkative, interrupting others, fidgeting or restlessness.
- Impulsivity can lead to losing or quitting jobs frequently, legal issues, substance abuse, motor vehicle accidents or driving violations.
- Inattention may look like forgetfulness, poor working memory, disorganization, and distractibility.
- Executive dysfunction can mean having trouble keeping track of tasks, not following through on tasks, difficulty staying on task, poor planning, trouble prioritizing tasks and difficulty multitasking.
Related: ADHD Symptoms and Management
Major depressive disorder symptoms 1:
- When you are depressed, you may experience persistent feelings of sadness, emptiness, worthlessness, or inappropriate guilt. You can also have a tough time feeling happy or joyful when doing something that you would typically enjoy.
- You may even withdraw from others socially, experience anxiety or feel tired even after getting a full night of sleep.
Related: Am I Depressed or Lazy?
Overlapping symptoms:
- Emotional lability: ADHD and depression can lead to low frustration tolerance, irritability, and even angry outbursts.
- Poor self-concept, low self-esteem: People with ADHD often develop low self-esteem due to their inability to meet demands. When you are not able to focus on tasks and maintain concentration, you can fall behind on work and this can affect your self-esteem. In depression, this can be related to intrusive or negative thoughts.
- Executive dysfunction: ADHD and depression can both affect how you organize your thoughts and manage your responses. You can have trouble starting tasks, you may even put off tasks that seem like they will be difficult or boring. You can also have trouble deciding which task is most important or pressing when you have many to do. It can also be difficult to make decisions and remember things.
- Sleep and appetite changes: Depression can make it difficult to fall asleep or make you want to sleep all day or affect your appetite. ADHD can make it difficult to wind down before bed, and some medications used to treat ADHD can affect sleep and appetite.
- Anxious or restless feeling: ADHD hyperactivity can appear as a general restlessness, while depression can also increase anxiety which can appear like restlessness.
Why They Often Co-Occur
Studies have shown that people with ADHD have a genetic vulnerability for depression 9. This connection is still being investigated, but it gives a lot of insight as to why so many people with ADHD experience depression at some point in their life. Studies have also shown that similar regions of the brain are involved in ADHD and psychiatric disorders like major depression, generalized anxiety disorder, and bipolar disorder 4.
There are also environmental influences that affect your risk for depression. For instance, living with ADHD can cause a lot of stress. Missing deadlines, falling behind at work, unemployment and tumultuous interpersonal relationships are stressful situations that can affect your mental health. This stress can lead to feelings of inadequacy and a sense of failure, increasing your risk for depression. Studies have shown that low self-esteem and poor self-concept can lead to depression 6.
Treatment Options
Treatment needs to be individualized and based on your diagnosis and symptoms. If you have ADHD alone, you will be treated differently than if you have depression. If you have both conditions, we do treat both but try to focus on the one that is most impairing first 4. Treatment options can include:
Psychiatric medication management
When it comes to treating depression and ADHD, psychiatric medication management can be a crucial aspect of a comprehensive treatment plan. While SSRIs are often the first-line treatment for depression, the specific medication choice ultimately depends on your unique situation and needs. Your psychiatrist will carefully consider your symptoms, medical history, and any potential risk factors to determine the most appropriate medication for you.
Similarly, ADHD treatment is tailored to your individual presentation. Stimulant medications are commonly prescribed, but non-stimulant options are also available. Your provider will work closely with you to find the medication that best manages your symptoms while minimizing side effects.
Talk therapy
While medication can help alleviate symptoms, talk therapy provides a space to explore the deeper emotional and psychological factors that contribute to our struggles. It’s a chance to gain insight, build resilience, and develop practical strategies for navigating life’s difficulties.
One of the most well-researched and effective forms of psychotherapy for both ADHD and depression is cognitive behavioral therapy (CBT). At its core, CBT is about understanding the interconnected nature of our thoughts, feelings, and behaviors. By learning to recognize and reframe unhelpful thought patterns during a depressive episode, we can begin to make meaningful changes in our lives.
CBT for ADHD
For individuals with ADHD, CBT can be particularly useful in addressing challenges with impulse control. Through therapy, you can learn to pause, reflect, and respond thoughtfully to situations rather than reacting on instinct. You might work with your therapist to develop practical strategies for managing distractions, breaking down overwhelming tasks, or communicating more effectively with others.
CBT for depression
In the context of depression, CBT often focuses on identifying and challenging negative, intrusive thoughts. Depression can make it feel like we’re trapped in a cycle of self-doubt, hopelessness, and despair. CBT helps us step back from these thoughts and question their validity. Through this process, we can begin to develop a more balanced, compassionate understanding of ourselves and our experiences.
Related: Depression Therapy: A Comprehensive Approach to Healing
Other types of therapy
Beyond CBT, there are many other therapeutic approaches that can be helpful for ADHD and depression. Dialectical Behavior Therapy (DBT), for example, emphasizes the development of mindfulness, distress tolerance, and emotional regulation skills. Interpersonal Therapy (IPT) focuses on improving communication and relationships, recognizing the profound impact our interpersonal lives can have on our mental health.
Ultimately, the most effective psychotherapy is one that is tailored to your unique needs and experiences. It’s a collaborative process, one in which you and your therapist work together to identify your goals, explore your challenges, and develop a plan for moving forward.
Related: Practical Benefits of Therapy: How Therapy Can Transform Your Life
TMS therapy
Transcranial magnetic stimulation (TMS therapy) has emerged as a promising alternative for individuals dealing with depression, particularly those who have not responded fully to medication or therapy alone. This non-invasive depression treatment uses magnetic pulses to stimulate specific areas of the brain associated with mood regulation, helping to alleviate depressive symptoms and improve overall quality of life.
For those also navigating ADHD, TMS can offer additional benefits. By targeting brain regions involved in attention, focus, and impulse control, TMS may help reduce ADHD symptoms and enhance overall functioning. This can be particularly valuable for individuals who have struggled with the side effects of ADHD medications or found behavioral interventions insufficient.
At its core, TMS represents a holistic approach to mental health treatment, one that recognizes the interconnected nature of the brain and the complex interplay of biology, environment, and personal experience in shaping our emotional well-being. By directly addressing the neurological underpinnings of depression and ADHD, TMS offers a path toward healing that honors the unique needs of each individual.
Non-medication approaches
Beyond medication, several key interventions can significantly improve functioning and quality of life for those navigating depression and ADHD.
Executive function coaching
This directly targets the planning, organization, and problem-solving challenges often associated with ADHD. By developing practical strategies and systems, you can build the skills needed to manage daily tasks more effectively 3.
Refining emotional regulation tools
Learning to identify, understand, and manage intense emotions can lead to improved relationships, better decision-making, and a greater sense of overall well-being. This often involves a combination of therapy, mindfulness practices, and targeted skill-building exercises.
Developing effective coping strategies
When faced with the challenges of depression or ADHD, having a toolkit of healthy coping mechanisms can make all the difference. This might include techniques for managing stress, navigating difficult situations, or finding healthy ways to express emotions.
Building a strong support system
Research consistently shows that social support plays a crucial role in recovery from depression and can significantly decrease functional impairment 8. Surrounding yourself with understanding, supportive people can provide a sense of connection and help you weather the more difficult moments.
Lifestyle factors
Establishing consistent routines, improving organizational systems, and prioritizing sleep hygiene, can have a profound impact on both ADHD and depression symptoms. Creating structure and predictability can help manage the chaos often associated with ADHD, while self-care practices like good sleep habits can improve mood and emotional regulation.
Exercise
Regular physical activity can improve focus, boost mood, and even alleviate behavioral symptoms. Whether it’s a daily walk, a yoga class, or a more intense workout, finding a form of movement you enjoy can be a powerful addition to your treatment plan.
Ultimately, the most effective approach to managing depression and ADHD often involves a combination of strategies tailored to your specific needs. By working closely with your healthcare providers and building a personalized toolkit of medications, therapeutic interventions, and lifestyle practices, you can create a path toward improved functioning and a greater sense of well-being.
Treatment Approaches at Neuro Wellness Spa
At Neuro Wellness Spa, we offer a comprehensive evaluation process which will take into account your genetic and family history, and past treatment in order to formulate a care plan that includes multiple treatment options for ADHD and depression, including in-person and online psychiatry, psychiatric medication management, TMS therapy, and talk therapy. We will work with you to find treatment options that are the best fit for situation, symptoms, and goals.
Our expert team of mental health professionals will curate combined treatment approaches for the best response and always emphasize the importance of regular monitoring and adjustments to help you take back control of your life.
References
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
- CHADD. (2015). ADHD and Coexisting Disorders. CHADD – The National Resource on ADHD. https://www.chadd.org/understanding-adhd/
- CHADD. (2015). ADHD Coaching for Adults. CHADD – The National Resource on ADHD. https://chadd.org/about-adhd/coaching/
- Katzman, M.A., Bilkey, T.S., Chokka, P.R. et al. Adult ADHD and comorbid disorders: clinical implications of a dimensional approach. BMC Psychiatry 17, 302 (2017). https://doi.org/10.1186/s12888-017-1463-3
- Knouse, L.E., Zvorsky, I. & Safren, S.A. Depression in Adults with Attention-Deficit/Hyperactivity Disorder (ADHD): The Mediating Role of Cognitive-Behavioral Factors. Cogn Ther Res 37, 1220–1232 (2013). https://doi.org/10.1007/s10608-013-9569-5
- Lerner, D., Adler, D. A., Chang, H., Lapitsky, L., Hood, M. Y., Perissinotto, C., … Rogers, W. H. (2004). Unemployment, Job Retention, and Productivity Loss Among Employees With Depression. Psychiatric Services, 55(12), 1371–1378. https://doi.org/10.1176/appi.ps.55.12.1371
- National Center for Health Statistics. Early Release of Selected Estimates Based on Data From the 2023 National Health Interview Survey. Public-use data file and documentation. https://www.cdc.gov/nchs/data/nhis/earlyrelease/earlyrelease202405.pdf
- Ozbay, F., Johnson, D. C., Dimoulas, E., Morgan, C. A., Charney, D., & Southwick, S. (2007). Social support and resilience to stress: from neurobiology to clinical practice. Psychiatry (Edgmont (Pa. : Township)), 4(5), 35–40.
- Riglin, L., Leppert, B., Dardani, C., Thapar, A. K., Rice, F., O’Donovan, M. C., … Thapar, A. (2021). ADHD and depression: investigating a causal explanation. Psychological Medicine, 51(11), 1890–1897. doi:10.1017/S0033291720000665
- Staley BS, Robinson LR, Claussen AH, et al. Attention-Deficit/Hyperactivity Disorder Diagnosis, Treatment, and Telehealth Use in Adults — National Center for Health Statistics Rapid Surveys System, United States, October–November 2023. MMWR Morb Mortal Wkly Rep 2024;73:890–895. DOI: http://dx.doi.org/10.15585/mmwr.mm7340a1
- U.S. Centers for Disease Control. Attention-Deficit/Hyperactivity Disorder (ADHD). Retrieved from https://www.cdc.gov/adhd/articles/adhd-across-the-lifetime.html
- Whooley MA, Kiefe CI, Chesney MA, Markovitz JH, Matthews K, Hulley SB. Depressive Symptoms, Unemployment, and Loss of Income: The CARDIA Study. Arch Intern Med. 2002;162(22):2614–2620. doi:10.1001/archinte.162.22.2614