For teens with ADHD, living with ADHD is a constant struggle. But for many, battling depression makes life even more difficult. In a previous post, Diagnosing ADHD and Cormorbid Conditions, we talked about how symptoms can overlap, causing depression to go undiagnosed. For example, teens with ADHD or depression can both have a hard time concentrating, have mood swings or can withdraw from activities.
The reasons for these symptoms, however, may be different. In ADHD, for example, a teen may withdraw from activities because he feels "different" or out of place. He may have low-self esteem or have a difficult time getting along with classmates. A teen with depression may withdraw because he lacks the motivation to go out with friends and has an overall feeling of sadness or despair. Parents may have a hard time understanding what is going on or may not recognize symptoms of depression.
Is It ADHD or Depression or Both?
We know that depression is more common in teens with ADHD than in teens without. But what isn't always so clear is what causes the depression. Living with chronic frustration, academic failures or problems with social interactions certainly can all lead to feelings of depression and may put someone at a higher risk of developing depression. But is this really depression or is it caused by symptoms of ADHD? If so, treating the ADHD should help to improve symptoms. If treatment for ADHD doesn't help, then it may be necessary to treat the depression as well.
There may also be a genetic link to developing depression as it tends to run in families and the risk factor may be higher for those with ADHD. It is quite possible for someone to have both ADHD and depression, where symptoms of both must be treated simultaneously.
Recognizing Depression Symptoms
Most descriptions of depression are written based on how symptoms appear in adults. And while generally, these symptoms are also present in teens, how they manifest is often different. Some of the signs of depression in teens include:
Physical - Teens with depression often complaint of not feeling well, having stomach aches or headaches. Discovering depression may begin with a visit to the doctor for these types of problems and when an examination and lab tests don't show any reason for the aches and pains, it may signal depression.
Irritability and anger - Depression usually includes feelings of sadness, hopelessness or despair. In adults this may appear as lethargy or lack of motivation, in teens it frequently appears as irritability and moodiness. They may get angry easily and often without provocation. They may spend much of their time grumpy and hostile to those around them.
Withdrawal from social activities - Adults with depression often isolate themselves, avoiding any social activities. Teens, however, may keep a few friends but avoid spending time with parents or other family members. They may find a new set of friends or spend less time participating in social activities.
Sensitivity - Just as adults with depression, teens feel hopeless and worthless. They may be overly sensitive to criticism or have a hard time dealing with failure or rejection.
Depression can cause low energy and feelings of sadness. It can take away motivation. But it can also cause "acting out" and, untreated, can lead to dangerous behaviors, such as:
- Running away
- Substance abuse and other addictions
- High-risk behaviors, such as driving fast or unprotected sex
- Suicidal ideations or attempts
Less dangerous, but also problematic can be failing grades at school, low self-esteem and feelings of shame or worthlessness.
If you suspect that your teen may be depressed it is important to seek professional help. Symptoms of depression don't go away on their own and can get worse or lead to more serious problems when not treated. If your child is seeing a mental health professional for ADHD, that would be a good place to start. If not, make an appointment with your family doctor. Be prepared to explain what symptoms you have seen and how these symptoms are interfering with daily life.
Antidepressants are often used for adults, however, they do carry risks for teens. If your doctor suggests medication, talk about the pros and cons of using medications. Ask for information on the risks to adolescents and what types of side effects you should be aware of. Antidepressants may increase the risk of suicidal thinking and behavior in teens.
It is important for you to let your teen know that you are there and unconditionally love them. Be willing to listen without judging and respect that the pain caused by depression is real. Don't minimize their feelings or try to talk them out of being depressed. Instead, let him or her know you are there to help and give support. Provide opportunities and support for social activities and try to get your teen to get some exercise as this has been shown to decrease symptoms of depression.
For more information on depression, visit Health Central's Depression Community. Some specific articles that may be helpful:
"ADHD and Coexisting Conditions: Depression," 2005, Staff Writer, Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD)
"Depression in Children and Adolescents (Fact Sheet)," Date Unknown, Staff Writer, National Institute of Mental Health
"Liking the Child You Love," 2011, April 9, Jeffrey Bernstein, Psychology Today