ADHD and Depression: What You Need to Know By Peg Rosen

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If you think your child with ADHD (also known as ADD) might be showing signs of depression, you’re not alone. A lot of kids with ADHD—about 40 percent, according to one long-term study—struggle with depression at some point.

Researchers know a lot about the overlap between ADHD and depression. Kids diagnosed with ADHD are at a higher risk for depression. And kids diagnosed with depression are at a higher risk for ADHD.

The two conditions can occur at the same time. They can be misdiagnosed for each other too. Here’s what you need to know about ADHD and depression—and how you can help your child.

The Link Between ADHD and Depression

ADHD can create a lot of challenges for kids, and those challenges can lead to depression. Issues with behavior and academics can wear down kids’ self-esteem. ADHD can affect kids socially too. Classmates might tease or exclude them, which can make kids feel isolated or even hopeless.

But some kids with ADHD may also be “pre-wired” for depression. Some of the differences in brain chemistry that can cause attention issues may make some kids more likely to feel helpless or worthless.

Researchers are looking into whether there may be a type of ADHD that is closely coupled with depression. Researchers are also studying adults with depression who aren’t responding to antidepressants. New research suggests that these adults may actually have undetected ADHD.

Signs of Depression in Kids With ADHD

Depression in kids with ADHD can look like depression in any young person. Symptoms might include:

  • Feeling very “down” (or what doctors call a “low mood”)
  • Losing interest in favorite activities
  • Withdrawing from friends
  • Changes in sleep and eating patterns
  • Falling grades
  • Not doing homework or attending school
  • Talking about feeling hopeless, helpless or suicidal

Depression can also amp up behaviors associated with ADHD. For example, kids with ADHD who are depressed may start to:

  • Act out more. They may be unusually disruptive in class. They may break things, hit people or vandalize property. Irritability—snapping at people or blowing up over small issues—is also common.
  • Seem particularly inattentive. They may be even more distracted by their low mood or by what’s going on in their head.
  • Become extremely overwhelmed and disorganized. ADHD already makes it hard to stay on track. When kids with ADHD are depressed, life can seem utterly unmanageable and hopeless.
  • Talk about wanting “off” of their meds. Some kids may mistakenly blame their low mood on their ADHD medication. They may even secretly stop taking it, thinking they will feel better.
  • Self-medicate. Tweens or teens with ADHD who are feeling depressed may try to improve their mood by using drugs or alcohol.

Why Depression Can Be Misdiagnosed as ADHD

There’s a lot of overlap between ADHD and depression, but not all kids have both. Sometimes depression can be misdiagnosed as ADHD, and vice versa. The two issues can look similar on the surface. Here are some ways a child with either issue might act, but for different reasons:

  • Has very negative self-esteem. A child with ADHD may not feel good about himself because he can’t keep up with other students, no matter how hard he tries. A depressed child may feel like he’s worthless for no apparent reason.
  • Loses motivation. A child with ADHD may lose motivation because he doesn’t think his efforts make any difference. A depressed child who feels hopeless about life may not do his work because he doesn’t feel there’s any point.
  • Has problems keeping up with school work. A child with ADHD may tune out in school and not learn the material. A depressed student may be distracted by negative feelings or lack of sleep and not be able to focus.
  • Is resistant to going to school. A child with ADHD may loathe the difficulties that await him every day in class. A depressed child may not have the emotional strength to get himself through the day.

Kids who are depressed feel despair and hopelessness. They often have little energy and lose interest in socializing. A dark mood may persist for weeks and even months. If your child is depressed and you think he might have ADHD, too, there are steps you can take to find out.

Kids who have ADHD but are not depressed tend to show signs of frustration and evenanger about the challenges they’re facing. They may struggle to get along with peers but still crave the chance to socialize.

ADHD and Suicide

Many teens have suicidal thoughts. It’s rare for teens to act on these thoughts. But parents of depressed kids with ADHD need to be especially vigilant.

That’s because kids with ADHD are more impulsive than kids who don’t have ADHD. Kids with ADHD may be more likely to act “in the moment” when they are feeling down or hopeless. They may not be able to step back and see the bigger picture.

A 2010 study found that teens who were diagnosed at a young age with ADHD were twice as likely to make a suicide attempt than peers who did not have ADHD. That’s why parents of kids with ADHD must take any talk of hopelessness, despair or suicide very seriously and take immediate steps to find help.

If you’re worried your child may be thinking about harming himself, don’t leave him alone. Call the National Suicide Prevention Lifeline at 800-273-8255 or call your child’s doctor or mental health professional.

Medication for ADHD and Depression

If your child with ADHD is diagnosed with depression, he may benefit from takingantidepressant medication. Some primary care providers prescribe these drugs. But it’s wise to consult a specialist.

A psychiatrist or a psychopharmacologist will know which antidepressant medications are best suited for a child with attention issues. If your child is already taking ADHD medication, a specialist will be best equipped to coordinate and choose his drugs.

Many people take ADHD medication as well as antidepressants. With the right approach, this can be done safely and effectively. Antidepressant medication is most effective when combined with talk therapy.

How You Can Help

Your role is key when it comes to recognizing depressed behavior. If you suspect your child with ADHD has depression, there’s a lot you can do to help. Here’s how:

Pay attention to changes in your child’s mood and behavior. Look for changes in eating and sleeping patterns. Take notes on what you’re seeing. Your notes can help you and your child’s doctor figure out whether changes in appetite are due to ADHD medication or to depression.

Talk to your child’s teachers. Do they think he’s been less attentive or acting out more than usual? Are they saying that he seems sad or tired all the time or is not interacting with others? Are his grades falling? These kinds of comments are good reasons to request a meeting with your child’s resource teacher or the school psychologist.

Seek medical help and counseling. Your child’s pediatrician is a good first step. Or speak with the psychologist at school. Research suggests that cognitive behavioral therapy—a type of counseling that is goal-oriented and focused on problem solving—is particularly effective for kids with ADHD.

Be on the lookout for anxiety. Depression often goes hand in hand with anxiety. Sowatch for signs of that, too. As with ADHD and depression, medication and talk therapy can help with anxiety.

Provide structure and support at home. Depressed kids with ADHD may have even more trouble getting started on tasks or finishing them. Acknowledge out loud that he seems to be struggling more than usual. Bring structure to his day and brainstorm ways you can help him with certain tasks.

Go outside together. When you’re feeling really down, it can be hard to get out of bed or off the couch. Try to carve out time for things that don’t involve chores or homework. Offer to go for a walk, grab lunch together, or head out to a movie.

With the right care and support, kids with ADHD and depression can manage these conditions and continue to thrive. Being the caregiver for a child with multiple issues can be stressful, so remember to take care of yourself too. Finding an online community or joining a local support group can be a big help.

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