The Correlation Between ADHD, Depression, And Anxiety

The American Psychological Association defines Attention Deficit Hyperactivity Disorder (ADHD) as “a behavioral condition that makes focusing on everyday requests and routines challenging.” While most people associate the symptoms of ADHD with a person’s ability to concentrate and “sit still,” there are many others that sometimes go unrecognized. 

For example, one common, but under-discussed sign of ADHD is emotional dysregulation — the tendency to “overreact” to things, such as speaking loudly, or being quick to anger and/or cry.

Another major sign of ADHD is executive dysfunction. Executive function is the term used to describe the brain’s capacity to plan something, focus one’s attention on it, and carry out that plan. However, those with ADHD often find this extremely difficult, especially without the help of stimulants. As a result, they often lack “follow-through,” leaving tasks unfinished or not attempted at all.

Executive dysfunction may also cause problems with multitasking, which can lead to issues in school and employment later in life. One of the hallmarks of adult ADHD is a blemished work history and repeat terminations of employment.

Living with ADHD can be a very frustrating experience. Many people with ADHD struggle with time management and staying organized. The condition is also often ill-understood, with many even questioning its legitimacy as a diagnosis. This can make life both personally and professionally a real struggle for people coping with it. Treatment for ADHD is usually through a combination of medication and therapy. Learning how to manage the condition is vital, especially in children.

How are ADHD, depression, and anxiety connected?

ADHD has a high comorbidity rate with other mental health issues. The word “comorbid” means that a person has two or more illnesses, conditions, or diagnoses occurring at the same time. 

Comorbid conditions of ADHD often include anxiety and depression. This comorbidity is sometimes easy to overlook in patients; a doctor may diagnose a person with anxiety or depression, but not comorbid ADHD as well. For example, two signs of ADHD - emotional dysregulation and executive dysfunction - could easily be mistaken for signs of anxiety or depression. 

They’re also sometimes difficult to catch in children because they may have more difficulty controlling their emotions or accomplishing tasks as it is. And, since ADHD can cause a person to feel anxious and become depressed, without finding and treating the ADHD diagnosis, the root cause of the other disorders will not be treated. This can result in ineffective treatment.

ADHD and depression

Many people think of depression as being “sad,” but it is a lot more than that. Depression is a mental illness in which a person feels hopeless, lonely, and empty over a prolonged period. They may also suffer from irritability and a lack of motivation.

Up to 30% of children with ADHD may experience comorbid depression. Meanwhile, a 148-person study of adults with depression found that 12.8% also presented comorbid adult ADHD symptoms and 3.5% were clinically diagnosed with adult ADHD. The study also found that severity of adult ADHD symptoms tended to correlate with more severe depression.

Other symptoms of a depressive episode can include:

• Loss of interest in previously enjoyed activities

• Withdrawal from others

• Disrupted sleep patterns

• Eating issues

• Fatigue

• Feelings of worthlessness

To have major depressive disorder (also known as major depression), depressive symptoms must be present for more than two weeks.

Depression can be treated with a combination of treatment methods, just like ADHD. There are antidepressant medications that can help to balance out chemicals in the brain and lessen the symptoms of depression. Therapy like cognitive behavioral therapy (CBT) can be very effective as well as practicing self-care.

ADHD and anxiety

Anxiety is most often thought of as worry. It's perfectly normal that everyone will have things that they worry about at different times in their lives. However, a diagnosis of an anxiety disorder is much more than simply worry. Anxiety disorder is when stress and worry have become such a large part of a person's life that it impacts their daily functioning.

Clinical anxiety symptoms can include the following:

• Difficulty concentrating and making decisions

• A sense of impending danger

• Sleep issues

• Sweating

• Rapid breathing

• Increased heart rate

• Digestive issues

Adult ADHD and various anxiety disorders have a 25% comorbidity rate. One study found that those diagnosed with anxiety who have comorbid ADHD symptoms tend to have more severe anxiety. 

There are several different types of anxiety disorders such as generalized anxiety disorder, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder. When it comes to treating anxiety, some people are prescribed medication. Therapy is also very effective, just like with ADHD and depression. Learning how to identify thoughts that lead to an anxiety response is very important to manage the condition.

How ADHD can lead to anxiety or depression

The difficulty associated with living with untreated ADHD can contribute to the development of depression and anxiety over time. For instance, a person may struggle to get projects completed on time, keep their home clean and organized, and interact with others. If they struggle to listen and constantly interrupt, making a relationship work can be difficult.

If a person struggles to get their work completed on time or keep themself organized, it can contribute to anxiety about performance at work. They may wonder if they’ll eventually be fired.  Difficulty with having relationships can cause worry over finding and maintaining a long-term relationship with someone.

As the anxiety continues to build, it can add additional struggles. When the symptoms of ADHD and anxiety become so overwhelming, depression can be a direct result. People may struggle with feelings of hopelessness that the situation is never going to change. It may be hard to properly describe the feelings, emotions, and symptoms, making it more difficult for a doctor to diagnose.

There may be links in the brain between these conditions that we don't yet fully know. Likely, both family history and environment play a role. Alongside anxiety and depression, ADHD is one of the most heritable mental health conditions. That means that a child for whom one or both parents have ADHD is likely to have the condition themselves.

Therapy for ADHD, anxiety, and depression

The field of psychiatry has made great advances in treating all three of these mental health challenges, with effective treatment available for each. If you think that you have the symptoms of ADHD, it's important that you talk to your primary care physician or mental health professional so they can determine if you meet the criteria for a diagnosis. They will likely examine your symptoms, as well as your family history. When discussing forms of treatment, it's important to be honest with the therapist about your experience. Doing this can help them to identify if you need more than one diagnosis.

When looking for a doctor or therapist to treat your ADHD symptoms, it's important to look for someone who is educated and has the credentials and training to provide the help and guidance that you need. A therapist can teach useful coping skills and behavior modification techniques to help you better manage your symptoms.

When you start treatment, your therapist will continue to monitor your symptoms. Remember that just treating ADHD alone may not be enough to cope with your symptoms of anxiety and depression. Or, if you're being treated for anxiety and depression and find that your symptoms are not improving, it could be that you also have a comorbidity such as ADHD. 

The rise in popularity of online therapy provides people with a convenient, easy, and effective way to get help from a mental health professional. Platforms like BetterHelp match clients with licensed, qualified therapists skilled in using techniques such as CBT to treat ADHD, anxiety, depression, and more. You can speak to a BetterHelp counselor online on your schedule from the comfort of home via phone, text, online messaging, and video chat. 

Online therapy is often more affordable than conventional therapy without insurance, and studies indicate it’s equally as effective. For example, a literature review of multiple studies published by the APA revealed the detail shows that online CBT is as effective as traditional therapy for treating depression, anxiety, panic disorders, PTSD, and phobia.