ADHD and Depression in Teens
By Staff Writer
Being diagnosed with attention deficit/hyperactivity disorder (ADHD) makes growing up difficult. What's worse, children with ADHD are as much as three times more likely than other kids to develop depression. But the symptoms of ADHD and depression overlap and are difficult to differentiate, so how are parents to know if their child is struggling with attention deficit disorder, depression or both?
Recognizing Teen Depression
All teens, especially those with ADHD, are likely to feel sad or isolated at times. Depression becomes a major concern when a child displays the following symptoms over a sustained period of time:
- Extreme sadness or irritability (most of the day, nearly every day)
- Loss of interest in previously enjoyable activities
- Frequent school absences or a significant drop in grades
- Sleeping too much or too little
- Change in eating patterns
- Fatigue or extreme restlessness
- Feelings of worthlessness or guilt
- Frequent complaints of physical ailments like stomachaches or headaches
- Poor concentration
- Thoughts or comments about death and/or suicide
Although the core symptoms of depression are the same in adults and children, some subtle differences exist. For example, children and teens are more likely to appear irritable than sad, and may suddenly start to struggle in school. Depressed teens may start to complain about difficulty sleeping or they may become especially self-critical and disparaging.
Depression or ADHD?
Depression shares certain symptoms with ADHD, such as inability to concentrate, mood swings, irritability and agitated behavior, making it difficult to know whether a child is suffering from depression, ADHD or both. The following are a few of the ways in which depression and ADHD differ:
- ADHD is characterized by hyperactivity and inattention, while depression more commonly involves mood swings and feelings of sadness.
- Depressed teens feel consistently sad for weeks on end while teens with ADHD usually have shorter, less intense bouts of "the blues" that come and go.
- Teens struggling with depression have difficulty focusing or concentrating because they've lost interest, while kids with ADHD are simply unable to pay attention.
- Teens with ADHD generally have normal reactions to life experiences while depressed teens often react in ways that are disproportionate to the event.
Accurate diagnosis by a mental health professional is critical to rule out depression as an explanation for what appears to be ADHD, or to determine if a child is experiencing co-occurring disorders.
If a child has both depression and ADHD, the depression likely is not simply the result of the frustration and discouragement that can result from the daily struggles of having ADHD. Although those feelings are a risk factor for developing depression, in most cases, depression is a distinct disorder and not merely a sign that a child is struggling with ADHD.
Research shows that the biggest predictor of major depression in children with ADHD is interpersonal difficulties (for example, conflict with peers or family), rather than academic failure or trouble coping with ADHD symptoms. In fact, in studies, reducing ADHD symptoms did not necessarily improve depressive symptoms, suggesting that the two disorders are distinct and require separate, but simultaneous treatment.
When a child suffers from co-occurring disorders like depression and ADHD, there is also a greater likelihood that their symptoms will persist into adulthood.
Help for Teens with ADHD and Depression
Depressed children and teens have shown marked improvements in their symptoms after participating in talk therapy and using antidepressant medications, if needed. Because social struggles both predict and exacerbate depression and other mental health disorders, ADHD schools and treatment programs that help teens develop social competence and confidence are particularly effective.
The message for parents is to be alert to the symptoms of depression in teens rather than assuming that difficulty concentrating and completing tasks and feelings of despair, isolation and worthlessness are a normal part of ADHD. If initiated promptly, treatment of depression can help teens manage their ADHD, and treatment of ADHD symptoms can lessen the impact of depression.
In short, treatment that targets both depression and ADHD symptoms, rather than either disorder alone, can improve your child's mental and emotional health both now and as they grow into adulthood.