• Kids with ADHD are at higher risk for depression.
• Depression can sometimes be misdiagnosed as ADHD.
• Depression can look different in kids who have ADHD.

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 even anger 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 taking antidepressant 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. So watch 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.

Key Takeaways

• Experts think some kids with ADHD may be “pre-wired” for depression.
• Parents need to be especially vigilant when kids with ADHD talk about suicide.
• Medication and behavioral therapy can be very effective ways to treat kids who have ADHD and depression. Attention deficit hyperactivity disorder is a brain disorder that involves inattention, hyperactivity, impulsiveness or a combination of these symptoms. It is usually diagnosed in childhood, and it can last into adulthood.
  Attention deficit hyperactivity disorder (ADHD) affects brain development and it can be diagnosed from 3 to 6 years of age. Children with ADHD often display hyperactivity and impulse action, and some may have trouble paying attention in school.
  As they get older, the symptoms may become more prominent, making academic achievement difficult. Adolescents may find relationships difficult, display antisocial behaviors, and experience inattention and impulsivity.
  According to the Centers for Disease Control and Prevention (CDC), approximately 11 percent of American children aged 4 to17 years live with ADHD. In 2011, around 6.4 million children in the United States were diagnosed with ADHD.
  According to the Anxiety and Depression Association of America (ADAA), 50 percent of children with ADHD in the U.S. still have the condition as adults. This represents about 4 percent of the adult population, or 8 million American adults.
  
  Contents of this article:
  

  1. What are ADHD and depression?
  2. ADHD and depression in children and adults
  3. Diagnosis
  4. Supporting a child with ADHD

  What are ADHD and depression?

  People with ADHD may be more likely than others to have another type of anxiety or mental health illness such as depression.
  
  
  Children with ADHD may also experience depression.
  Depression is a common yet serious mood disorder. It affects a person's feeling, thinking, and actions. It can cause strong feelings of sadness, loneliness, and a lack of interest in life activities.
  The National Alliance on Mental Illness (NAMI) estimate that around 16 million American adults, or 7 percent of the U.S. population, had at least one major depressive episode in 2015.
  Women are 70 percent more likely than men to experience depression. Younger adults aged 18 to 25 years are 60 percent more likely to have depression than people aged 50 or older.
  People with ADHD have a higher risk of depression due to the stress it causes and the challenges they face. Up to 70 percent of all people with ADHD will experience symptoms of depression at some time.
  Since the problems related to ADHD will persist if they are not treated, the individual can feel as if they are losing control as things may not seem to get better.
  

  Identifying symptoms

  The symptoms of depression and ADHD can be similar. Depression in people with ADHD may appear differently from how it appears in people without ADHD. As a result, the depression is sometimes misdiagnosed as ADHD.
  The use of medication for ADHD can also make a diagnosis of depression more difficult.
  The effects of the medication can sometimes mimic the symptoms of depression. The drugs for ADHD can also make the symptoms of depression worse.
  As a result, it can be difficult to distinguish the two conditions and to treat them properly.
  Depression and ADHD do have some common symptoms but for different reasons. Both can involve difficulty concentrating or a loss of motivation.
  A person with ADHD may lose motivation because they think their efforts will not be noticed or make a difference. A person with depression may not complete their work because they feel there is no purpose.
  A person with ADHD may also have problems starting projects or keeping up with schoolwork. They may leave a project incomplete because they tune out, do not listen, or do not learn the material. A person with depression may be unable to focus due to distraction or fatigue.
  Sleeping difficulties, mood changes, and irritability are features of both ADHD and depression.
  However, ADHD is normally a lifelong disorder, whereas depression can come and go.
  

  ADHD and depression in children and adults

  ADHD can be challenging for children who are still developing emotionally, mentally, and physically, partly because they may not understand what is happening.
  
  
  Children with ADHD may struggle with depression because they do not understand what is happening.
  Issues with behavior and self-esteem can lead to depression. "Being different" may cause a child to be teased or to feel isolated by classmates.
  Signs of depression in children with ADHD include:
  
• Feeling very low
• Losing interest in favorite activities or withdrawing from family and friends
• Changes in sleep and eating patterns
• Failing grades or not doing homework
• Not attending school
• Feeling hopeless, helpless or suicidal

Depression may cause an increase in ADHD-related behaviors. A child may begin to act out more, be particularly inattentive, or become extremely overwhelmed and disorganized. Sometimes, ADHD may be mistakenly identified as bipolar disorder in children.
Older children may want to stop taking their medication, or they may begin to self-medicate with drugs or alcohol.

In adults

Signs of depression in adults with ADHD include:

• Trouble concentrating and staying focused
• Excessive attention to one activity
• Disorganization and forgetfulness
• Impulsivity
• Emotional difficulties, including the inability to manage emotions such as anger or frustration
• Hyperactivity or restlessness

The ADAA note that fewer than 20 percent of adults with ADHD have been diagnosed or received treatment. Only 1 in 4 adults seek help for ADHD.
About 50 percent of adults with ADHD also have an anxiety disorder.
Depression is estimated to be 2.7 times more prevalent among adults with ADHD than among the general population. Signs of depression in adults include:

Noticeable change in appetite or sleeping patterns

Loss of interest and pleasure in activities formerly enjoyed

Feelings of worthlessness and hopelessness or guilt

Recurring thoughts of death or suicide

Physical symptoms such as headaches or stomachaches

Diagnosis

Diagnosing ADHD can be difficult because no single medical, physical, or genetic test can detect it. Instead, a series of questions and information is collected.

Fast facts about ADHD

• Fewer than 33 percent of children with ADHD have both medication treatment and behavior therapy
• Half of children aged 4 to 5 years with ADHD received behavior therapy
• About 50 percent of 4 to 5-year olds with ADHD use medication, and around 25 percent receive only medication

Learn more about ADHD

The new edition of the Diagnostic and Statistical Manual of Mental Disorders offers some guidelines for diagnosing ADHD. These guidelines focus on patterns of inattention, hyperactivity, and impulsivity.
Diagnosis includes documenting the behavior of the child, with input from parents, teachers, other school officials, and mental health specialists.
To be diagnosed with ADHD, a child must exhibit at least six specific behaviors by the age of 12, according to the DSM-5 criteria.
Adult evaluation of ADHD includes a detailed account of their medical and behavioral history. Adults should exhibit at five or more of the DSM-5 criteria for ADHD to be diagnosed.
ADHD and depression can both be treated with medication and psychotherapy. For children aged 6 years and over, behavior therapy and medication are recommended, and for those aged 5 and under, behavior therapy is the preferred treatment.
Antidepressants are used to treat depression, and stimulant drugs can help to curb ADHD behaviors, such as hyperactivity and impulsivity. Examples of drugs to treat ADHD include Adderall and Ritalin.
These medications can help the individual to focus better so that they can work and learn.
Individuals may react differently to the drugs, so it may be necessary to try several combinations before finding the right one.

Supporting a child with ADHD

Parents of children with ADHD should monitor behavioral changes in case the child is developing depression or another behavioral or mood disorder. 

It is important for parents to stay in touch with their child's teacher, and to keep track of the child's behavior in the classroom.
Structure and routine can help with organizational skills and time management. Parents may need to help the child to complete tasks.
It is important that the child should know that they are not alone. Family or individual counseling can provide an outlet for the individual with ADHD to express their feelings.
It is also important that the person should learn to manage their mood and stress levels, as emotional stress can lead to an increase in anxiety and depression.
Following a healthy lifestyle can help to reduce symptoms. This includes nutritious food, sufficient sleep, and exercise.
Appropriate diagnosis and treatment can help people with ADHD to manage their symptoms.