Guest Blogs

“I Live With Both ADHD and Depression”

Are my frustrating behaviors caused by adult ADHD, depression, or a combination of both?

As a woman who struggles with both ADHD and depression, I’m never sure which of my frustrating behaviors can be explained by ADHD, by depression, or by a combination of the two.

Let’s take my bed. I haven’t made it in a month, and I haven’t washed the sheets in two months. This might say something about my personal hygiene, but it says more about my mental state. When I see my bed through the lens of ADHD, I think: “OK, I’m scattered. I’m having trouble keeping track of basic tasks. Every time I try, I get distracted.” But my depression also gives a good explanation for my inability to throw my sheets in the washing machine: “I don’t feel well. I don’t want to get out of bed. I’m going to eat a pizza.”

I was diagnosed with ADHD at age 21, which is relatively late in life, considering that most diagnoses are made during childhood, when symptoms first emerge. My ADHD was detected late because many of its symptoms overlap with those of depression, which I’d struggled with for years before the ADHD. I had difficulty concentrating, sleeping, staying organized, accomplishing simple, routine tasks, like making the bed. I’d long been treating the depression with antidepressants and therapy. Yet a piece of the puzzle was missing. Until the ADHD was found, my treatment plan was not complete, as is often the case for girls who aren’t diagnosed until later in life.

Managing Two Conditions

ADHD and depression express themselves similarly, resulting in frequent misdiagnoses (or late diagnoses) for both conditions. They rear their ugly heads in the same place — it is estimated that depression is roughly 2.7 times more prevalent among adults with ADHD than without. Whether you are genetically predisposed to depression or not, living with unchecked ADHD can lead to a profound sense of failure, shame, and, ultimately, depression. Before I was diagnosed with ADHD, my chaotic mind and my inability to concentrate — resulting in lost keys, missed appointments, and a cluttered room — caused serious anxiety. These symptoms, common to ADHD, aggravated my already-present depression.

New research shows that there may be more to the ADHD-and-depression connection than similar symptoms. The two conditions are connected on the genome level. A groundbreaking study, published in the online edition of The Lancet, shows that five of the most serious mental health conditions — autism, major depression, ADHD, bipolar disorder, and schizophrenia — share genetic commonalities. Scientists have identified four places in genes, mostly related to the regulation of calcium in brain cells, that lead to an increased risk of having all five of these disorders.

[Could You Be Depressed? Take This Symptoms Test to Find Out]

These findings focus on a few genetic overlaps, and there are likely hundreds of genes involved in each condition, as well as forces unrelated to genetics. But this research is a step in the right direction. Identifying common gene variants among these disorders could lead to new targets for prevention and treatment, or at least an improved comprehension of risk factors.

Until we understand the connection between ADHD and depression — and how we can successfully treat both in conjunction — the task of managing ADHD and depression at the same time is overwhelming. Both conditions rob us of the will, energy, and organization to make the effort in getting better.

Women who struggle with both ADHD and depression are particularly at risk. A study in last year’s Journal of Consulting and Clinical Psychology showed that women diagnosed with ADHD as young adults, as opposed to during childhood, are more likely to attempt suicide or engage in self-harm. Since many women aren’t diagnosed until later in life — keeping their symptoms in check until they experience overwhelming and disorienting life changes, like college or pregnancy — they are at risk for the serious psychological implications of a late diagnosis.

Awareness proved to be my most powerful tool. Once over the hurdle of an ADHD diagnosis — at last! — I understood my enemy better and could devise a precise plan of attack, targeting both depression and ADHD, with the help of medication, therapy, and loads of positive self-talk (the last one felt ridiculous at first, but it helped me disassociate myself from my ADHD).

[Click to Read: Recognizing and Treating Depression]

Confronting the Shame of It All

Combatting depression isn’t easy, nor is it easy to reverse years of internalizing ADHD symptoms as personal failings. For most of my life, I’ve felt stupid, lazy, and incompetent, doomed to fail at school and jobs before I began. Many women with ADHD are overcome with shame when they can’t meet society’s expectation of the ideal woman, who is tidy, responsible, attentive, punctual, and sociable. On the other hand, the “boys will be boys” mentality minimizes the shame experienced by males with ADHD. If a boy can’t sit still during a math lesson or doesn’t clean his room regularly, it is considered typical “boy behavior.” The inability of girls to meet their gender standard can be crushing, particularly without an ADHD diagnosis explaining why. Indeed, a 2002 study, in The Journal of Attention Disorders, concluded that girls with ADHD internalize their struggles with the disorder more than boys do.

In high school, I lost homework and textbooks regularly, I had trouble following lessons, and I missed club meetings. As a girl who deeply cared about succeeding at school, I blamed myself for my missteps and oversights. I felt powerless and depressed.

In order to confront my deep-seated feelings of inadequacy, I needed to challenge the negative self-talk I’d used to separate myself from my ADHD. I needed to change the title of my narrative from “The Perpetual Screwup” to “The Awesome, Smart Lady Who Is Unorganized and Messy but Working on It.”

How does this work in practice? Let’s say I lose my keys, which is a routine occurrence. Instead of thinking, “I’m such an idiot. I can’t believe I lost my keys again! What’s wrong with me?” I am gentler with myself. I reason: “It’s OK. It happens. I’m going to come up with a new system for keeping track of them — maybe I’ll buy a bigger keychain.”

Shame and negative thinking are so tempting to indulge, yet challenging these feelings — which takes practice, believe me — is an instant mood brightener. Just as negativity feeds on negativity, positivity feeds on positivity. It must become a habit.

With medication targeting the chemical foundations of both my ADHD symptoms and chronic depression, the rest is up to me. I’ve found that outdoor exercise, a walk or run in the park, staves off restless energy, boosts endorphins, and gives me much-needed perspective. Journaling, too, helps me to identify patterns of negative thinking and stay motivated.

Although the war against depression is made more brutal by ADHD, it doesn’t have to be a losing battle.

[Read This Next: The D-Word How to Talk Back to Your Depression]

Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

5 Comments & Reviews

  1. Quote: “I was diagnosed with ADHD at age 21, which is relatively late in life, considering that most diagnoses are made during childhood, when symptoms first emerge.”

    You are speaking from the perspective of your generation. There are many older adults with undiagnosed (and/or untreated) ADHD.

    What is the average age of diagnosis for someone who is currently over 40 or over 50 or over 60 years old?

    I can tell you that “most” of those diagnoses weren’t in childhood.

    I am in my late 50s. I wasn’t diagnosed until I was 40. After reading an article by Dr Ned Hallowell in Prevention magazine about adult symptoms of ADHD, I went to a doctor who specializes in treating ADHD.

    I’m thankful I did that because I too deal with depression. Knowing *all* of what I’m dealing with (including other chronic illnesses) lessens the burden.

  2. And it never occurred to me until I was about 60 that I “might”have a problem – – lucky I was seeing a good Psychiatrist for monitoring my depression treatment ( that was diagnosed as an adult, but not treated successfully with med until my 40’s). A funny story ( tome) is that someone I supervised burst out laughing when I told her about the ADHD dx: like, “you didn’t KNOW you were ADD?” I managed to do my work – well the paperwork was always a challenge, but I felt respected.

    One of the things I still have trouble with is in respecting myself and not calling myself names. I have a good friend who sometimes reminds me to stop the self blame. I think that it became a habit in the far past – because it was. like if you say out loud what “they” are thinking ( they – teachers, bosses,family, even friends) you are showing humility, and maybe staving off their verbal attack. Stopping it is one of the big positive self-help things you can do, along with exercise, replacing negativity with positive actions and comments

  3. As for the workplace and all other social interactions except for close friends, I would keep a tight security lid on the ADD or ADHD condition. Your boss is the LAST person you want to bare your soul to. Your boss, by definition, is someone who determines if your career lives or dies.

    Going public with this curse will send your associates and coworkers scurrying to the internet, look up ADD or ADHD and assume that you check ALL the boxes.
    You will be looked at askance by your peers and your HR director might put your name on his secret layoff list. There are 30 million people out of work right now and taking any kind of reckless chances is not smart.

    I’ve had a successful 40 year career as an engineer and I got there by being good at my job and not being careless and stupid with my private information, so don’t let your own mouth be your worst enemy. You won’t stave off an attack but you could put a death sentence on your career.

    If you need help, get help and read ADDitude for its valuable advice and guidance.

  4. I completely relate, I am 17 but see myself in you very much. Depression and ADHD often blend way too much into themselves and it’s so hard to figure out which is causing which!
    Thank you so much for sharing your story, it is definitely the confirmation and encouragement that I needed today.

  5. I was diagnosed at 48 years old. When I was a young child in the 70s and early 80s, few people were talking about ADHD. I was the quiet kid with no friends (ever in my K-12 education) who never got in trouble and yet loathed himself. I was the kid with a mom who had undiagnosed ADHD. She was constantly screaming and it felt like walking on eggshells around her. I was the kid who would zone out during class but never told anyone because I thought it was normal. I was the kid who was picked on because he was different (turned out to be gay). I grew to be the high school student with mediocre grades. My guidance counselor had to call the state university where I applied and vouch for me since my grades were average and my SAT scores were miserable. I was the college student who refused to talk to anyone and hid away in his room all the time. I was the college student who wanted to study acting, but was too afraid to audition for anything and end up having to change his major. I was the college student who chose elementary education because I could not imagine trying to interact with adults all day long and I believed I was so math stupid that I would not go into anything that required higher math. I was the young adult who moved 1000 miles away from home believing that he was escaping a miserable childhood and an emotionally abusive mother only to realize that the misery followed. I moved 11 times after college – once each year. I was the adult who hated his teaching job the very first year yet stuck with it for 23 years until a nervous breakdown forced me to leave lest I kill myself. And after all of that – did I or anyone else see ADHD in me? No! After that nervous breakdown (March, 2020), I spent a year being treated for major depression with SSRI medications – all of which made me more depressed and think about suicide even more. During that time I saw a counselor. I wanted a psychiatrist but my doctor told me I didn’t need one – that my problems were not that serious. But then I ignored his advice and spent over 6 months on a waiting list to see what I THOUGHT would be a psychiatrist – but turned out to be a psychologist. And then FINALLY someone thought to say to me, “Have you been tested for ADHD?” So I got tested. And I was told that I have one of the most severe cases of ADHD this doctor had ever seen and that were it not for a very high intellect I would never have even made it through college let alone managed to make it to 48. He had been in the profession for decades – so that says a lot. Now I find myself the adult with ADHD/combined; unemployed for two years; unable to do just about anything; and trying to navigate a medical system where the psychiatrist that was designated to prescribe my ADHD medications for me is less than welcoming. I am having to overeducate myself about ADHD and stimulant medications so that I can be certain that I am getting appropriate treatment – because I cannot trust that my doctor has all of the current information. I am tired of the stigma that I have dealt with my whole life – of feeling worthless – of not living up to my potential. I am tired and I just want relief from the endless battle that goes on in my head. So, you are VERY LUCKY to have been diagnosed so YOUNG.

Leave a Reply