How Untreated ADD/ADHD Can Cause or Worsen Depression

Untreated ADHD

Here’s a sad statistic: Having attention-deficit disorder (ADD), more commonly referred to as attention-deficit hyperactivity disorder (ADHD), increases the risk for mood disorders such as depression. Even worse, when a child or an adult has these co-existing disorders, both conditions are intensified. When ADD/ADHD goes untreated, young people who struggle with co-occurring depression, especially girls, are at higher risk of suicide. And adults with undiagnosed or untreated ADD/ADHD and depression may lose jobs, struggle in relationships, and are at greater risk for substance abuse and addiction.

For those who currently struggle with ADHD, there’s positive news. Research indicates that when ADD/ADHD is properly diagnosed and successfully treated, the risk of depression significantly decreases.

Having ADD/ADHD increases the risk for mood disorders such as depression. And when a child or an adult has these co-existing disorders, both conditions are intensified. Click To Tweet

BASICS ABOUT ADD/ADHD

Currently, it is estimated that 9.4% of children and 4.4% of adults in the U.S. have ADD/ADHD, according to Centers for Disease Control and Prevention data. However, experts believe there are millions more that remain undiagnosed.

ADD/ADHD is a neurodevelopmental disorder characterized by issues with attention, and in many cases, impulsive and hyperactive behavior as well. Although the disorder affects millions of people, it continues to be highly misunderstood and is often incorrectly treated, if it is treated at all. Research estimates that roughly 40% of kids with ADD/ADHD symptoms don’t receive proper diagnosis or treatment, and a review study on ADD/ADHD underdiagnosis estimates that 80% of adults with symptoms of the condition do not get the treatment they need. The implications are far-reaching.

THE ADD/ADHD-DEPRESSION CONNECTION

The link between ADD/ADHD and major depressive disorder in medical research is strong. Studies indicate that among youths with ADD/ADHD, rates of concurrent depression range from 12% to 50%, and additional research suggests the rate in adults to be from 16% to 31%.

ADD/ADHD and depression “travel together” in several ways. The most obvious connection is that the consequences of living with the core symptoms of ADD/ADHD—which include short attention span for common everyday tasks; poor organization; being easily distracted; procrastination; lack of follow-through; and poor impulse control—lead to depression. These symptoms can and do create a lot of problems in children and adults. They can adversely affect school or work performance, leading to a poor self-image and low self-esteem, which can contribute to depression, studies have shown. Relationships, finances, and even driving are negatively impacted by ADD/ADHD, which may contribute to low mood.

Those with ADD/ADHD have more difficulty regulating emotions. They often experience emotions more intensely than others without the condition, and they can struggle to soothe themselves and transition out of difficult emotions, which factors into a low mood. Further, research in the Journal of Abnormal Psychology shows that for inattentive ADD/ADHD types, social problems with peers and dysfunctional parent-child relationships can trigger depression.

One study that controlled for poor academic performance and social problems with peers found that adolescents with ADD/ADHD remained at high risk for depression, suggesting that additional factors are at play. Indeed, there are other factors involved, including what’s happening in the brain.

The combined symptoms of ADD/ADHD and depression include inattentiveness, being easily distracted, disorganization, chronic low mood or negativity, a “glass half empty” perspective, low energy, a tendency to be more isolated socially, and general feelings of hopelessness and worthlessness a majority of the time. Those with ADD/ADHD and depression may or may not be hyperactive.

ADD/ADHD, DEPRESSION, AND THE BRAIN

ADD/ADHD brains work differently. Brain SPECT imaging scans have revealed that ADD/ADHD is associated with biological changes in the brain. When neurotypical people (those without ADD/ADHD) concentrate, blood flow increases to the prefrontal cortex, the area of the brain that controls focus, planning, judgment, empathy, and impulse control. However, in those with ADD/ADHD, scans reveal decreased activity in the prefrontal cortex during concentration. This physiological difference may explain why it is difficult for people with ADD/ADHD to focus. In fact, the harder they try to focus, the worse it gets.

Similarly, when people are depressed, SPECT scans reveal decreased activity in the prefrontal cortex (especially on the left side) at rest, although it improves with concentration—and increased deep limbic activity at rest and during concentration. The limbic system is the brain’s emotional center.

What’s more, a 2021 neuroimaging study has shown that both conditions are associated with dysregulation of the brain’s reward system.  Dopamine, the neurochemical that drives motivation and plays a role in reward systems and moods is typically in short supply in people with ADD/ADHD.  It’s not surprising then that research indicates those with the condition have a harder time realizing rewards and staying motivated. One study in the Journal of Clinical Psychology on college students with ADD/ADHD revealed that this dysfunction in reward responsivity is evident in both ADD/ADHD and depression (although not for hyperactive types).

UNTREATED ADD/ADHD AND DEPRESSION

There are reasons ADD/ADHD often goes undiagnosed and untreated. Unfortunately, the stereotype of ADD/ADHD to be a childhood affliction limited to hyperactive boys with poor impulse control causes other less obvious symptomology to fly under the radar. According to a 2016 paper in The ADHD Report the condition is likely underdiagnosed in girls because they more frequently exhibit inattentive symptoms, which are internalized rather than externalized and more difficult to catch.

Additionally, symptoms are misinterpreted in childhood, especially the ones having to do with focus and attention, distractibility, procrastination, and disorganization. Kids (and their parents) may simply believe they are not smart, lazy, or not trying hard enough. Many of those undiagnosed in childhood continue to struggle as adults. And adults are more prone to overlook these symptoms. In fact, the condition is so unrecognized in adults that research in the Journal of Psychiatric Research shows it’s usually the accompanying depression that gets people to seek treatment, not the ADD/ADHD.

UNDERSTAND THE SIGNS OF ADD/ADHD AND DEPRESSION

It’s important for parents and adults to understand the signs of both ADD/ADHD and depression and what the risk factors are for them occurring together. Getting the correct treatment for both conditions is essential.

Here are some risk factors to keep in mind:

  • Being female: Girls and women are more likely to have co-occurring ADD/ADHD and depression.
  • Inattentive ADD/ADHD type: Of the 7 types of ADHD, those with inattentive ADD/ADHD more frequently have depression.
  • The mental health of the mother: When a mother is depressed during pregnancy, she’s more likely to give birth to a child who will develop ADD/ADHD, depression, or both.
  • ADD/ADHD diagnosis in childhood: A childhood diagnosis of ADD/ADHD is associated with a greater risk of depression and suicidal ideation later in life.
  • Untreated ADD/ADHD: When people don’t get treatment for ADD/ADHD, they are more likely to suffer from depression due to issues such as a negative self-concept.

If you suspect you or a loved one may have undiagnosed or untreated ADD/ADHD and related depression, it is important to identify and address both conditions. With proper diagnoses, these brain-based disorders can be treated successfully.

ADD/ADHD, depression, and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.

13 Comments »

  1. So what’s the positive side? What happens when ADD/ADHD is recognized and treated?

    Comment by Detra — July 1, 2022 @ 3:44 AM

  2. I have ADD and have been taking Focalin. Which has helped but I'd like to get on something more natural. Any recommendations?

    Comment by Kim McKenna — July 1, 2022 @ 4:03 AM

  3. I believe I may have add/adhd and that my Mother has it as well (undiagnosed). My family doctor told me when I mentioned it that an adult cannot be diagnosed. How do you suggest I proceed if my doctor won’t help me?

    Comment by Tanya Scott — July 1, 2022 @ 5:31 AM

  4. I have already been diagnosed with ADD several years ago. I'm 68 years old and female. Not interested in taking medicine. Do you take Care Credit?

    Comment by Lisa Keener — July 1, 2022 @ 10:36 AM

  5. would you have any clinics in Toronto, Canada?

    Comment by marilu — July 1, 2022 @ 3:41 PM

  6. Since I can’t make it to one of your clinics what would you suggest for a 62 yr old female with most probably Add or ADHD? Any supplements that could help?

    Comment by Laura — July 1, 2022 @ 4:48 PM

  7. Saying that a childhood diagnosis presents a greater risk of depression later in life, seems to contradict the very next point, that untreated (ie. undiagnosed) ADD makes one more prone, and confuses the issue. For if an early diagnosis increases chances, that would imply that a later diagnosis doesn't, but it does, very much so. For living most of one's life, with all the challenges ADD presents, yet having no idea why, defaults as personal flaws & character defects, resulting in beating oneself up for constantly coming up short.

    Comment by Steven Cee — July 2, 2022 @ 10:46 AM

  8. I know I have ADHD and probably depression or Anxiety but do to high blood pressure and Heart issues I can’t take the correct meds. Most of the time now when I try and concentrate on things my brain feels heavy. I need help I believe but don’t know what to do.

    Thanks

    Comment by Christopher Caldwell — July 2, 2022 @ 11:12 AM

  9. Do you also consider the possibility of an undiagnosed, untreated sleep disorder (Not neccessarily OSA) with your depressed or ADD/ADHD diagnosed patients? I've read a lot about this, and have seen symptoms improve when a sleep disorder is diagnosed and treated appropriately .

    Comment by Linda G Cannon — July 2, 2022 @ 1:14 PM

  10. Dr Amen,
    People with ADHD are also known to have allergies, inflammation (mast cell activation), a defect of DAO activity, and iron deficiency anemia, all of which causes high histamine. High histamine, causes depression and antidepressant nonresponse.

    According to Ken Blum and many others, people with ADHD have the Taq1A SNP which, as you said, cases low dopamine. It also causes low Vitamin D, and studies have shown that suicide attempters and completers have low Vitamin D. So it's important that you tell people about all this. You. could be saving lives.

    Comment by Silvia Hinojosa — July 3, 2022 @ 9:41 AM

  11. Adam Jones had testing at your Reston, VA site in 2015. He was found to have severe ADHD. He's on about 5 meds that are not helping, and still is struggling with depression and a lot of anxiety. Any help would be appreciated!

    Thanks,
    Marilynn Deegan

    Comment by Marilynn Deegan for Adam Jones — July 4, 2022 @ 1:14 PM

  12. I have been treated for ADD by my medical doctor. I have had a number of different medications but I am on 70 mg of Vyvanse, currently for my ADD, I still have issues with getting fired from jobs. I recently got fired from my job that makes 8 for my career. My wife is about to divorce me due to not being able to trust me. I sent out mean texts that make no sense or are mean or just to get attention to family members as she calls it. I get so mad at her for treating me like I am her child but I can't blame her eather. I get depressed and just have two live with it or shake it off. I get anxious and have to shake it off. I am tired of not getting respect from wife and kids but I see I deserve none. I will start my new job soon but as my wife says how long before I get fired form this one. My longest job I have ever had was a 7 year stint and then one over 5 years and this one was just 3 months shy of 5 years. I could retire in 5 years but not sure I can make it that long.

    Comment by Santa Sofia — July 7, 2022 @ 8:41 AM

  13. There is no treatment for ADD you just take our money before we off ourselves. Those who are okay with being on pills their entire life like mediocrity and could hardly be called people. We are nothing more than cattle to you

    Comment by Juan Gallo — October 23, 2023 @ 4:35 PM

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