ADHD & Depression
Children with ADHD are five times as likely to have depression as children who don’t have ADHD, and around 14% of children with ADHD also have depression. Conversely, children diagnosed with depression are at a higher risk for also having ADHD.
In children with ADHD and Oppositional Defiant Disorder or Conduct Disorder (ODD/CD), depression rates are substantially higher.
What is Depression?
Depression is far more serious than ordinary sadness. It is a mood disorder that causes feelings of sadness, hopelessness and a loss of interest in activities that used to be pleasurable. It affects the way you think, feel and behave and causes a range of emotional and physical symptoms.
It can manifest as increased irritability, decreased ability to concentrate, indecisiveness, agitation, slow thought processing, decreased ability to think clearly, fatigue or loss of energy, loss of appetite, sleep disturbances and feelings of worthlessness. This may create a sense of being unable to deal with everyday tasks and/or that life isn’t worth living.
Some people with depression also have suicidal thoughts and may act on them if they don’t get appropriate treatment.
Signs of Depression in Children with ADHD
Symptoms might include:
- Low mood or feeling ‘down’
- Losing interest in previously enjoyable activities
- Withdrawing from friends and family
- Feeling extra tired
- Decreased or increased appetite
- Falling grades
- Not wishing to do homework or attend school
- Talking about feeling hopeless, worthless, helpless or suicidal
Depression may also exacerbate existing ADHD behaviours so children may:
- Become more inattentive than usual
- Feel completely overwhelmed by organisation and everyday tasks
- Become angrier, more aggressive or disruptive in class – lashing out at people or property or blowing up over small issues
- Want to discontinue with medication
- Attempt to improve their mood with drugs or alcohol (especially older children)
Why is There a Link Between ADHD and Depression?
ADHD creates many challenges for children. In a typical day, an ADHD child may struggle with time-keeping, organisation, focusing in class, impulsive behaviour, learning difficulties, how to study for a test or problems with friends.
Working memory, organisation and time management difficulties may make it hard to follow daily routines, leading to chronic stress.
Kids with ADHD often have more trouble managing stress than other kids due to emotional regulation difficulties. Anxiety and depression often go hand-in-hand, with chronic anxiety often leading to depression. Therefore, anxiety needs to be managed to avoid progression to depression.
Children with ADHD may feel discouraged and lacking control over their environment because of their symptoms or repeated failures/negative interactions, leading to depression. They can also experience depressive illness unrelated to ADHD. ADHD and depression can co-occur and be misdiagnosed for each other.
There is an overlap of symptoms, which makes depression difficult to diagnose. For example, poor concentration and physical agitation occur in both ADHD and depression, but feelings of hopelessness, sadness or suicidal ideation point to true depression.
Depression Misdiagnosed as ADHD
Ways depression and ADHD can be confused:
- Low self-esteem – children with ADHD may have low self-esteem due to difficulties; a child with depression may have low self-esteem for no apparent reason.
- Low motivation – ADHD-related low motivation may stem from feeling efforts don’t matter; depression-related low motivation stems from hopelessness.
- Difficulty with schoolwork – ADHD makes focus difficult; depression affects focus due to negative thoughts or lack of sleep.
- Resistance to school – ADHD-related dislike of school vs. depression-related emotional incapacity to manage school.
- Social withdrawal – ADHD children may feel isolated but still crave socialising; depression removes the desire to socialise entirely.
To minimise depression in children with ADHD, it’s important to support self-esteem and reduce challenges. Therapy should help them express and cope with feelings, and teach coping skills. Cognitive Behavioural Therapy (CBT) can help reframe negative thoughts. Family counselling or parenting classes can improve empathy and outcomes.
ADHD & Suicide
Teens, and sometimes younger children, may have suicidal thoughts. Children with ADHD have a slightly higher risk of acting on these thoughts due to impulsivity.
Research in 2010 found teens with ADHD were twice as likely to attempt suicide as those without. Parents must watch moods closely and take any suicidal talk seriously.
Some ADHD medications carry a slight risk of suicidal ideation; monitor mood when starting or adjusting medications. If concerned, do not leave your child alone — contact a doctor, mental health professional, or a helpline.
What to Look Out For
Monitor changes in mood and behaviour, keep notes on symptoms and patterns, and share these with a mental health professional. Check with teachers to see if they’ve noticed anything and request a meeting with the school psychologist or counsellor if needed.
What Causes Symptoms of Depression?
Causes are varied and may be correctable. Possible root causes include:
- Traumatic life experiences
- Current life situations (e.g. bullying)
- Stress and other psychiatric conditions
- Chemically induced (drugs, alcohol, medications)
- Genetic susceptibility
- Chronic inflammation
- Poor diet (including blood sugar imbalances)
- Digestive disorders
- Neurotransmitter imbalances
- Allergies
- Environmental toxins (heavy metals, plastics, pesticides)
- Hormonal imbalances
- Infections
- Seasonal Affective Disorder (SAD)
Inflammation is now recognised as a cause of depression; anti-inflammatory diets rich in healthy fats, quality protein, vitamins and antioxidants are beneficial. Gluten is linked to inflammation and depression, and high blood sugar can contribute to mood disorders.
Nutritional Factors
Micronutrients like zinc, vitamin B6, calcium, magnesium, omega-3s and vitamin D are critical for mental health. Deficiencies or imbalances can lead to depression and anxiety. Iron deficiency can also mimic depression symptoms.
Sleep & Blue Light
Poor sleep increases depression risk and worsens ADHD symptoms. Get natural daylight exposure and reduce artificial/blue light at night. See Sleep Problems for more information.
The Gut-Brain Connection
90% of serotonin and 50% of dopamine are produced in the gut. Disruptions to the microbiome can impair mood, cognition and behaviour. Poor gut health, yeast overgrowth and toxins can cause inflammation linked to depression.
Genetic Susceptibility
Mutations like MTHFR C677T are linked to depression and other disorders. While genes can’t be changed, diet and lifestyle can support methylation and reduce risk. Poor methylation affects detoxification, inflammation control, immunity and hormone balance.
Medication Side Effects
Some ADHD and prescription medications can cause depression, anxiety or suicidal ideation. Monitor closely when starting, changing or increasing doses and check for drug interactions via Drugs.com.
How You Can Help
- Ask your child if something is worrying them and look for patterns.
- Acknowledge and validate their feelings.
- Seek psychological counselling.
- Monitor anxiety levels, as chronic anxiety can lead to depression.
- Support them at home with empathy and help with tasks.
- Spend quality time together outdoors.
Children with ADHD should be evaluated for both anxiety and depression. Possible professionals to consult include:
- Naturopath/Integrative GP
- School counsellor
- GP or paediatrician for referral to a psychologist or psychiatrist
Health Tips
- Check gut health
- Identify food sensitivities/allergies
- Correct nutritional deficiencies
- Check for environmental toxins
- Balance hormones
- Ensure optimal thyroid function
Diet Tips
- Reduce sugar/carbohydrates
- Balance blood sugar with small, regular low GI meals
- Consider gluten-free/dairy-free or grain-free diets
- Eat adequate protein
- Consume high magnesium foods
- Avoid excessive alcohol
- Eat oily fish 2–3 times a week
- Consume flax and linseeds
- Avoid known allergens
Lifestyle Tips
- Epsom Salt baths
- Massage
- Essential oils
- Optimise sleep
- Acupuncture
- Regular exercise
- Spend time with friends and family
- Yoga, Tai Chi or relaxation activities
- Deep breathing
- Meditation
- Spend time in nature
- Get adequate sunlight
- Limit screen/blue light exposure
- Avoid recreational drugs
- Kinesiology/Neuro-emotional techniques
- Keep a gratitude diary
Where Can I Find Professional Help?
See the ADHD Directory for practitioners.
The Good Therapy website lists various therapies for mental health.
Register here to join our monthly Expert Speaker Series for expert advice on different topics.