ADHD and Depression

By Eileen Bailey

One out of every four adults with ADD/ADHD also suffers from symptoms of depression.  When there are co-existing conditions, it can be harder to diagnose and treat ADHD.  The symptoms may overlap and one of the conditions may not be accurately diagnosed.  Or medication may not be as effective. 

Previously, depression in patients with ADHD was thought to be situational and it was assumed that the depression was a result of constant failure or the inability to compensate for symptoms of ADHD in daily life.  Because of this, depression was often ignored and ADHD was treated, assuming that the depression would disappear when the ADHD was controlled and treated.  Research has now shown that ADHD and depression are separate diagnoses and both should be treated. 

Medication for ADHD can interfere with the diagnosis and treatment of depression.  Medications for ADHD sometimes mimic the symptoms of depression and sometimes exacerbate symptoms of depression (and bipolar disorder).  This can make it hard to distinguish which symptoms are caused by clinical depression and which symptoms are caused by the medication.  Often doctors will treat the depression first and once those symptoms are under control, they will treat the ADHD.  Depression, therefore, becomes the primary diagnosis and ADHD the secondary.  Some doctors, however, believe that in order for treatment to be effective, both conditions must be treated simultaneously.  Arguments for this method believe that in order for either condition to be under control, both must be under control.

Co-existing conditions increase the risk, especially when they are undiagnosed and/or untreated.  Some of these risks include:

  • Substance Abuse
  • Development of Conduct Disorders
  • Suicide
  • Aggressive or Anti-Social Behaviors

Some experts believe that the risk of undiagnosed co-existing conditions warrant a complete and thorough psychological evaluation for anyone with a diagnosis of ADHD, to determine if depression or any other related mental illness is present.  Once completed, a team of medical professionals, including your primary physician, psychologist, therapist and psychiatrist can work together to develop a treatment plan specific to the individual. 

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