What it’s like to have adult ADHD & depression

The closer I came to graduation, the more I felt like I was drowning.

It was 2019, and on top of a full graduate level course load, I was working two jobs. Three if you include the mandatory internship. Add to that a divorce and heated custody battle, and I had the perfect recipe for a major bout of depression on my hands.

And yet, despite it all, I still felt like my depression was actually pretty well-managed. I couldn't figure out why I was still floundering, unable to motivate myself to work on papers and presentations, to keep up with progress notes and case conceptualizations for my internship. The doctors had always attributed these challenges to depression. So why, when the depression was in check, was I still struggling?

This question led to my ADHD diagnosis, which not only helped me get the medication I needed to function, but completely changed my career trajectory. But one last question left me feeling frustrated and confused: how did it take this long to figure it out?

My story is not unique. Many individuals with ADHD, especially those with co-occurring conditions like depression, find themselves asking similar questions. The journey to diagnosis and understanding can be long and winding, filled with misconceptions, misdiagnoses, and moments of clarity. It's these shared experiences that highlight the critical need for awareness, education, and community support.

That's why we're launching this special series for ADHD Awareness Month. Throughout October, we'll be shining a spotlight on the lived experiences of individuals navigating ADHD alongside various co-occurring conditions. Our goal is to provide insights, foster understanding, and build a sense of community among those affected by ADHD.

In this first installment, we're honored to share the story of Bellomy Illif, LPC, a therapist from St. Louis, MO. In our interview, we discussed her experience with ADHD and depression - including misconceptions and challenges, coping strategies, and her advice for juggling them both.

Overlooked ADHD diagnosis and the gender effect

Bellomy's journey with ADHD began early in life, but like many women and girls, her symptoms were initially overlooked. "I thought I had it all the way back in grade school, but my mom didn't believe me because I didn't act like my brother,” she recalls. “He was diagnosed with ADHD, but was later diagnosed with ASD as well. He was always moving, and we had to change his whole diet in order to help manage his behavior. So, my mom knew that presentation of ADHD,” she explained. “But I could sit and read for hours. She was unfamiliar with the hyperfocus, and the more distracted presentation of ADHD.”

This experience highlights a common misconception about ADHD: that it always presents as hyperactivity. That’s a big part of why ADHD was considered for so long to be much more common in boys; research shows that in boys, the hyperactive type of ADHD is more common, while girls are more likely to have the inattentive or combined types.

ADHD can manifest in various ways - including hyperfocus on engaging activities like reading - something Bellomy and I shared. It felt like she was describing my own childhood, in a way. I remember my parents commenting on how I would “get lost” in a book for hours, and how difficult it was to get my attention. My sister, on the other hand, was much more hyperactive - she was diagnosed with ADHD, and I was not.

The tangled web of ADHD and depression

Depression is one of the most common co-morbid conditions that hitch a ride with ADHD. In fact, according to CHADD, those with ADHD are six times more likely to be diagnosed with depression. And living with both can create a complex web of symptoms and experiences.

Bellomy's depression diagnosis came later in life, following her grandmother's death in 2015. One of the misconceptions she encountered centered around emotional regulation - a key symptom of ADHD that gets far too little attention

“When you have both ADHD and depression, emotional regulation looks different,” Bellomy explained. “Sometimes, it can look to others like you’re ‘emotionally unstable.’ I can go from crying one moment to being seemingly fine the next. When I experience an emotion, I experience it BIG, and then I’m over it. On the other hand, I’ve had family members describe me as cold or unfeeling because I didn’t dwell long enough on some sad event that we experienced.”

Bellomy’s experience highlights a serious challenge in the interplay between depression and ADHD: the risks and long-term impacts of misdiagnosis. In a 2017 study, the authors explained that “emotional dysregulation is a distinctive attribute of adult ADHD psychopathology, however these symptoms may be misdiagnosed as a mood disorder.”

Other ways that ADHD and depression interact, for Bellomy, included:

1. **Rejection Sensitive Dysphoria (RSD):** Rejection sensitivity is a common experience for those with ADHD. Throwing depression into the mix complicates things. “RSD can kick off a depressive spiral,” Bellomy shared. “I find myself thinking that I’m broken or a failure due to the negative thoughts of depression.”
2. Impact on Eating Habits: “Both ADHD and depression make it difficult to eat - I forget due to ADHD, and depression reduces appetite. Medications can also contribute to lack of hunger/appetite suppression.”
3. Task Initiation Struggles: ADHD often makes starting tasks difficult, and depression can amplify this struggle. In Bellomy’s case, “Depression magnifies my struggle with task initiation and causes a lot of negative self-talk. For example, I’ve needed to complete some paperwork for a while. ADHD means I’ve misplaced the paperwork a few times, forgotten that I need to do it, and also can’t force myself to sit down and do this work. When I am reminded of the work, there’s a visceral response in my body of being unworthy/lazy/“bad.”

Professional impact and adaptations

Living with ADHD and depression has significantly shaped Bellomy's professional life, leading to unique challenges and adaptations. Some of these have been positive; for example, managing her own challenges has broadened Bellomy's perspective. "I have a lot more compassion for others when they're at less than their best," she reflects.

But there have also been challenges, like making frequent mistakes - something Bellomy struggled with, at first. "I've realized I need to be very organized to avoid mistakes," she shared. Organization is not something that comes natural to many people with ADHD - and yet, mastering the organizational strategies that work for you can have a profound impact on other symptoms.

For Bellomy, that meant developing a system that was not only effective, but that was simple enough to keep up with regularly. "While I'm organized, my system can't be too complicated or I won't use it," she admits. Through trial and error, she's found a method that allows her to complete tasks efficiently while minimizing mistakes and resistance from task avoidance.

Bellomy shared a few more of the things she struggled with most, and how she manages:

1. Struggles with impulsivity: Like many with ADHD, Bellomy grapples with impulsive tendencies. For her, this manifests as "oversharing and taking on too much" - a common challenge for many professionals with ADHD.
2. Need for flexibility: Traditional work structures proved challenging. "I've realized I can't work a 9-5 job," Bellomy admits. "I also need more autonomy - though, that autonomy still needs to exist in a sort of sandbox, so that I have some structure to play around in."
3. Adjusting masking strategies: The coping mechanisms that worked in academic settings didn't always translate to professional environments. "In college, I masked my ADHD behind a fun-loving personality," Bellomy explains. "This doesn't work well with most corporate positions. I worked as a teacher’s aide in a classroom with 7 other aides and a teacher. My fun-loving personality annoyed my coworkers and contributed to my being blamed for things I didn’t do. "

Bellomy’s favorite coping strategies and resources

Managing ADHD and depression requires a multifaceted approach. Bellomy shared the strategies that have made the biggest difference in her ability to manage ADHD and depression:

1. Organized planning: Bellomy utilizes both calendars and planners with a color-coding system. "My color-coding has looked different for each phase of my life," she explains. "When I was in college and grad school, each course was a different color. At home, each person has a different color assigned to them." This visual system allows her to quickly identify information she's looking for.
2. Digital vs. physical tools: While she's experimented with both digital and physical planners, Bellomy notes a key difference: "Digital versions require more intentionality because you have to go into the app to access your planner. But with a paper planner, I can leave it open on my desk." She combines approaches, using a digital calendar for future planning and a paper planner for daily visibility.
3. Routines and habit stacking: While challenging with ADHD and depression, routines are crucial. Bellomy employs various tools: "I use timers, alarms, and 'habit stacking' to help me create and stick to a routine." She explains habit stacking as "using something you currently do to pair with a new habit," like saying affirmations while brushing teeth.
4. Family meetings: To manage household coordination, Bellomy holds regular family meetings. "These will look different for every family," she notes. In her home, they discuss upcoming appointments and meal planning. "They don't have to be long, but having the meeting allows children/teens to know that they have events coming up that week and roughly when…even if they also have ADHD and can't remember the specifics."
5. Overcoming task paralysis: When feeling stuck, Bellomy asks herself, "What is one tiny thing I can do today that will make my tomorrow self successful?" This approach helps her find motivation for small tasks. "I also try to make that task less than 2 minutes and an easy-win. I use the win to fuel more action sometimes," she adds.

Bellomy also shared a few of the apps she’s found most helpful, and how they helped her navigate daily challenges:

1. Music for focus: "I listen to music that's 60bpm, plus white noise or coffee shop sounds, to mask distracting ambient noise," she shares.
2. Gamifying self-care: Bellomy uses the Finch App to turn daily tasks into a game. "I'll put things I need to do daily (take meds, brush teeth, etc) in my Finch task list to help me make sure I do them," she explains.
3. Digital note-taking: For quick reminders, she relies on her phone's Notes App. "When someone gives me a phone number or confirmation number, it goes in my Notes app," she says. Having a single space for keeping notes means less losing track of information.

Words of wisdom

Bellomy offers this advice to others navigating ADHD and depression:

"Get to know your ADHD. Don't be afraid of how your brain works. You can experiment to hack it - a healthy dose of gentle curiosity is key. Like, 'huh, what need am I trying to meet here?' Also - let go of perfectionism. It's easier said than done, but the more you practice letting go, the easier it becomes."

She also emphasizes the importance of self-awareness and self-compassion: "Being aware of your own internal self-talk and monitoring it really helps me to know when my ADHD or depression are flaring up. Then I can use self-compassion or other mindfulness techniques to soften the harsh thoughts."

Navigating ADHD and depression

As Bellomy shared her story, felt over and over the eerie sense that on some level she was narrating my own. The struggles with emotional regulation and being misunderstood; task paralysis and the motivation dilemma; the exhaustion and confusion of adapting to unwritten expectations in different environments; pleading with someone to just believe you when you say something is wrong…

Stories like Bellomy's are not at all unique. Not only did I resonate personally with what she shared, but I recognized so much of her story in the clients I see every day for ADHD coaching. When Bellomy talks about her color-coding system or her method for overcoming task paralysis, I’m reminded of both the creativity and ingenuity of the ADHD brain. Each of us encounters experiences which are somehow at the same time both exactly the same, and wildly different.

Every time we open up about our experiences - the triumphs, the setbacks, the daily grind of living with ADHD, depression, and other conditions - we're not just unburdening ourselves. We're creating a space for others to feel seen and understood. We're challenging the misconceptions and stigmas that have kept so many of us in the shadows for too long. We’re a grassroots movement: a catalyst for change.

This ADHD Awareness Month, keep talking. Keep sharing. And if you need a little help - whether you're still searching for the right strategies, or you're looking to fine-tune your approach - don't hesitate to reach out. Our ADHD coaches are here to help you write the next chapter of your ADHD story.

‍