What Is the Connection Between ADHD, Depression, and Anxiety?

Attention-deficit hyperactivity disorder (ADHD) and depression are both mental health conditions that affect the way that you feel and behave. People with ADHD have problems with concentration and hyperactivity, which can make it difficult to control behavior. It often causes problems at work and school, since these places usually require a lot of attention. 

Depression involves feeling sad and apathetic, and it can affect your eating and sleeping habits, motivation, and concentration. And to make it more complex, both ADHD and depression can also cause anxiety — especially if they go undiagnosed or untreated.  

Many people struggle with both ADHD and depression, which can be very challenging. But there are different therapies and medications to help relieve symptoms of both conditions.

Can you have ADHD and depression at the same time?

Yes, it is possible to have both ADHD and depression at the same time. In fact, one survey found that 18.6% of adults with ADHD also had major depressive disorder, a type of depression that involves feeling sad almost every day for at least 2 weeks. Around 12.8% of adults with ADHD in the survey also had dysthymic disorder, which is a milder but more chronic form of depression that lasts at least 2 years and is now referred to as persistent depressive disorder. Depression can often make ADHD symptoms worse.

Recognizing whether or not a person with ADHD also has depression can be difficult, because some of the symptoms of ADHD and depression overlap. People with both conditions can experience difficulty with concentration and focus. However, people with ADHD can typically focus on things that they find interesting, like a television show or video games, while people with depression may find it hard to focus on most things. Both conditions can also cause people to appear restless and agitated. But people with depression may seem restless because they feel anxious, while people with ADHD tend to be so restless that they can’t stop themselves from moving around, climbing, fidgeting, and sitting still.

In some cases, a person taking medication for ADHD may show signs of depression, like sad mood, irritability, and a flat affect or facial expressions. These medication side effects can sometimes be confused for depression. 

If you’re concerned that someone you know may have depression and ADHD, avoid jumping to conclusions. If you’re concerned about an adult, ask them how they’re doing and whether they feel depressed. In the case of children, having them evaluated by a mental health professional can help you determine whether they are also suffering from depression. 

Can ADHD cause depression? 

For some children and adults with ADHD, the challenges of living with ADHD can actually lead to depression. ADHD can cause problems at work, school, and in relationships with other people, who may become frustrated dealing with the person’s symptoms. This can lead a person to develop negative thoughts about themselves, like “I’m not good enough” or “I’m a failure,” and feelings of guilt and worthlessness.

Experiencing negative thoughts and feelings is a sign of depression. Relationship problems or conflict due to ADHD can also lead to isolating from other people, which can contribute to feeling depressed. 

Professionals are unsure why some people with ADHD develop depression and others don’t. However, they have found that certain risk factors are linked to having both conditions. If you fall into one or more of the following categories, you may have a higher risk of developing major depressive disorder along with ADHD:

• Female

• Being obese

• Experiencing an anxiety disorder

• Having substance abuse problems

If you have both major depressive disorder and ADHD, you’re also more likely to develop: 

• Conduct disorder

• Oppositional defiant disorder

• Generalized anxiety disorder

• Substance misuse

• Obesity

Can depression cause ADHD?

Since ADHD can contribute to depression, you might be wondering if the opposite is also true. That doesn’t seem to be the case. Research has not found that depression can cause ADHD. In order to have ADHD, at least some of a person’s symptoms must begin before age 12 — even if they don’t get a diagnosis until adulthood. On the other hand, depression can develop at any point in time. 

The fact that ADHD usually develops before depression suggests that depression most likely does not cause ADHD.

Are people with ADHD and depression more at risk for suicide?

There’s an increased risk for suicide among people with ADHD who also suffer from depression. This is true for males and females of all age groups. People with ADHD often have trouble controlling their impulses, making them more likely to act on negative thoughts and feelings without considering the consequences of their actions.

Warning signs that you or a loved one may be at risk for suicide include:

• Feeling sad, moody, or irritable

• Thinking or talking about death 

• Hopelessness

• Giving away important items

• Withdrawal from family and friends

• Engaging in risky and dangerous behavior

• Self-harming

• Acquiring means for suicide, like purchasing a gun or pills

If you’re feeling suicidal or concerned about a loved one, contact the National Suicide Prevention Lifeline at 1-800-273-8255. You can also chat online with a trained counselor. The Lifeline is completely confidential and open 24 hours a day, 7 days a week. 

Treatment for ADHD and depression

Treatment for ADHD and depression can help reduce the risk of suicide and prevent other conditions people can develop if their symptoms aren’t treated. Treatment may include therapy, medication, or a combination of both. The type of treatment you choose may depend upon the severity of your symptoms, how severely your symptoms are impacting your life, your personal preferences, and your provider’s recommendations.

Therapy

Therapy is a popular treatment for both ADHD and depression. 

There are many different approaches to therapy available for depression. Cognitive behavioral therapy (CBT) and interpersonal therapy (ITP) are two evidence-based approaches that have been shown to be effective in research studies.

CBT focuses on helping you identify and change unhealthy thinking patterns and learning new ways to cope with stress. ITP assumes that there is a strong link between depression and relationship problems, so it focuses on helping you improve the quality of your relationships, which can help alleviate your depression.

CBT is also effective for treating ADHD. In people with ADHD, therapy typically focuses on developing skills to improve attention, focus, organization, and behavior control. Because therapy works for both depression and ADHD, it’s a good treatment approach for people living with both conditions. 

If you have ADHD and depression, try to find a therapist who specializes in working with both conditions. When searching for a therapist, don’t hesitate to ask about their experience with ADHD and depression and the type of therapy they use to treat these conditions together.

Stimulant medications

ADHD may be connected to how certain messenger chemicals (neurotransmitters) work in the brain, like norepinephrine and dopamine. Stimulants are a type of medication that boost these neurotransmitter levels, which may help your brain function more efficiently. 

Stimulants are a first-choice treatment for ADHD. Common examples include:

• Amphetamines (like Adderall and Vyvanse)

• Methylphenidates (like Concerta, Focalin, and Ritalin) 

If you have ADHD, research shows that taking these medications reduces the risk of developing depression in the future.

Non-stimulant medications

The only non-stimulant medication that is FDA approved for ADHD is atomoxetine (Strattera). It affects levels of the neurotransmitter norepinephrine, which is also linked to both ADHD and depression. People who have both conditions at the same time may benefit from this medication, which can also be combined with stimulants. Antidepressants are another non-stimulant option.

Antidepressants

Antidepressants are a type of medication most commonly used to treat depression and anxiety. There are several different types of antidepressants, including:

• Selective serotonin reuptake inhibitors (SSRIs)

• Serotonin-norepinephrine reuptake inhibitors (SNRIs)

• Tricyclics (TCAs)

• Monoamine oxidase inhibitors (MAOIs)

SSRIs are the most commonly prescribed antidepressants and include sertraline (Zoloft), fluoxetine (Prozac), and paroxetine (Paxil). These medications may also be prescribed along with ADHD stimulant medications to help alleviate symptoms of both. 

Some antidepressants can actually be used to treat either depression or ADHD. These include:

• Bupropion (Wellbutrin) 

• Nortriptyline (Pamelor)

• Desipramine (Norpramin)

Can ADHD stimulant medications like Adderall help with symptoms of depression and anxiety?

It depends. Stimulant medications aren’t used on their own for treating depression. But they are sometimes used as an add-on treatment for depression to boost an antidepressant that’s not working well. Adding a stimulant can sometimes help to get rid of lingering depression symptoms, like fatigue and poor concentration. 

Stimulants aren’t used on their own for treating anxiety, either. Though they can help reduce symptoms of ADHD, they don’t seem to do much for anxiety symptoms. And, in some people, they can even cause anxiety as a side effect.

But, just like depression, stimulants can sometimes be used as an add-on treatment for anxiety in people who take an antidepressant. This approach may be especially helpful if you have both ADHD and an anxiety disorder.   

Can you have ADHD, anxiety, and depression at the same time?

Yes. It’s possible to be diagnosed with ADHD, an anxiety disorder, and major depression at the same time. In fact up to 9 in 10 adults with ADHD have at least one other mental health condition — especially anxiety and mood disorders. 

And here’s the reality: It can be hard to tell these conditions apart. That’s because ADHD, anxiety, and depression have many symptoms in common, including:

• Concentration problems

• Physical restlessness

• Irritability

• Feelings of guilt, hopelessness, or failure

If you want to know more about ADHD, anxiety, and depression, check out our article on how they compare. Learning about the differences and similarities between these common conditions can help you get the right diagnosis — and the right treatment.

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Written by:

Emily Guarnotta, PsyD

Emily Guarnotta, PsyD, is a licensed clinical psychologist and certified perinatal mental health professional with over 10 years of clinical experience.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

Reviewed by:

Sarah Gupta, MD

Sarah Gupta, MD, is a licensed physician with a special interest in mental health, sex and gender, eating disorders, and the human microbiome. She is currently board certified by the American Board of Psychiatry and Neurology.

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