How to spot depression in teens with ADHD

Have you ever wondered if your teen's struggles are just the usual teenage angst, or something deeper? That their irritability, withdrawal, or sadness may be more than just their ADHD?

Think back to your teenage years—the emotional rollercoaster, the ups and downs that felt like they’d never end...sound familiar?

Now, imagine that same rollercoaster--but with hundreds of crisscrossing tracks, and carts that careen around those tracks at 90mph. That overwhelming, chaotic image is often what it feels like to have ADHD. Now multiply that confusion by ten, and you might understand what it's like to be a teen with ADHD.

And amidst that chaos, there’s something deeper, something that can quietly creep in without warning: depression. Depression is more common in teens with ADHD than you might think--but it often goes unnoticed.

Understanding this connection is the first step toward supporting your teen through what can feel like an overwhelming maze of emotions. In this post, we cover why it happens, what it looks like, and—most importantly—what you can do to help.

Is depression more common in teens with ADHD?

Growing up with ADHD means facing a higher risk of depression. Nearly two thirds of children and teenagers diagnosed with ADHD struggle with a co-occurring mental health issue like depression.

It's estimated that for every 100 teenagers with ADHD, nine to thirty-eight have experienced depression. Depression of this nature is usually caused by ADHD related problems in teenage activities, relationship with friends or family members.

When depression isn't a standalone condition, it's known as secondary depression. This means the depression results from another issue–in this case, ADHD. On the other hand, primary depression happens due to genetic factors and is not directly caused by external problems.

Why is depression more common in teens with ADHD?

Many researchers believe that over time, the difficulties and negative reactions from others as a result of ADHD can pile up, causing some teens with ADHD to become depressed as they get older. Teens with ADHD face increased vulnerability to depression resulting from a number of factors, including:

• Functional impairments: Teens with ADHD often have trouble with daily tasks, keeping things organized, and managing their time. This can lead to frustration and feeling inadequate, which can sometimes be a trigger for depression.
• Neurobiological factors: Teens with ADHD may have brain chemistry that's more emotionally reactive. There are also genetic links which may increase depression risk.
• Social Challenges: Making friends can be a bit more difficult for teens with ADHD, who often feel misunderstood. They are more likely to be rejected by peers, leading to loneliness and low self-esteem, which may lead to depression.
• Academic difficulties: Teens with ADHD struggle to complete homework, keep track of assignments and due dates, struggle with inattention during class, and face other learning challenges. These challenges often lead to lower grades, anxiety, and shame, all of which may contribute to depression and low self-esteem over time.
• Gender: While all teens with ADHD are at a higher risk for developing depression, this risk is highest in girls.
• Co-morbid mental health conditions: Teens who were also diagnosed with anxiety, oppositional disorders, or conduct disorders are also more likely to experience depression.

Are there specific symptoms of depression that are more common in teens with ADHD?

Diagnosing these overlapping conditions presents a unique challenge, as several symptoms characteristic of both ADHD and depression may occur. This makes it difficult enough to determine which condition is to blame. On top of that, typical symptoms of depression may look different in ADHD teens vs neurotypical teens, making it more challenging to diagnose. When ADHD and depression co-occur in teens, certain symptoms may stand out. Here's what to look out for:

• Focus and concentration: Focus is already tough for teens with ADHD; depression compounds its effects and makes it even tougher.
• Mood swings and irritability: Frustration is very common when ADHD and depression overlap in teens, worsening emotional dysregulation.
• Hyperactivity can mask depression: Some teens with ADHD and depression might seem more restless or hyperactive instead of withdrawn and tired.
• Self harm & suicidal thoughts: Teens with both ADHD and depression are more likely to experience suicidal thoughts and behaviors. This is especially true for teen girls.

How does combined ADHD & depression impact teens?

When ADHD and depression co-occur in teenagers, the challenges can be particularly daunting. Increased risks of academic failure and social difficulties can create a vicious cycle in which ADHD symptoms worsen teen depression, resulting in declining grades and overall life struggles which make the depression worse.

Social challenges are another common culprit. Impulsive behaviors and emotional dysregulation common in ADHD make friendship more difficult to find and maintain. This social isolation may foster feelings of worthlessness and hopelessness – common signs of depression in teens.

What are the most effective treatments for teens with both ADHD and depression?

Dealing with both ADHD and depression can be tough, but there is hope. Since these conditions can fuel each other, it's crucial to address them together. A right mix of treatment options are more effective to help your teen regain control, improve their mental health, and start living the life they deserve.

• ADHD Coaching & Therapy: ADHD Therapy and ADHD coaching are both essential for helping teens manage symptoms and develop effective coping skills for ADHD. Family therapy is also valuable, as it enhances communication within the family and provides a support system for the teen.
• Medication: Stimulant medications are commonly prescribed for ADHD, while antidepressants are used to treat depression. For teens dealing with both conditions, a combination of these medications often provides the most effective results.
• School-Based Interventions: Academic success can be supported through behavior management plans and accommodations like Individualized Education Programs (IEPs). These interventions help address the specific challenges faced by teens with ADHD and depression in a school setting.
• Lifestyle Modifications: Incorporating regular exercise, maintaining a balanced diet, and establishing structured daily routines are critical for improving overall well-being and managing symptoms more effectively.
• Parent Education and Support: Educating parents about ADHD in teens and providing them with strategies to manage the condition at home significantly enhances treatment outcomes. These programs also improve family dynamics by fostering a better understanding of the teen’s challenges.

The path forward

Support is key when dealing with the challenges of ADHD and depression. Teens may not have the knowledge or words to explain what it is they’re dealing with, so working with a teen ADHD coach or therapist can help them develop the skills and strategies necessary to manage their symptoms, improve their mood, and succeed in school and personal life.

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