ADHD and Depression

ADHD and Depression
By CWK Network Producer

“I try to do something, but I can’t because of the ADD, and it frustrates me. Then that makes me very nervous and anxious and that goes to the anxiety. And then when I get like that, I’ll go ‘Oh my god! I can’t do anything! I can’t do anything!’ And that leads to the depression.”
–Ariel, 20

New research published in the Archives of General Psychiatry shows that children with ADHD are at an increased risk for depression and suicidal thoughts — and very well may need treatment for both. This reinforces the belief that parents and educators of even young children with ADHD should pay close attention to their child’s behavior.

Twenty-year-old Ariel has been living both with anxiety and depression since the eighth grade. She says, “It got so bad where I just slept all day, I didn’t get out of bed, I didn’t do anything.”

That is in addition to attention deficit disorder. Ariel says, “I was already upset and depressed about the fact that I had ADD and had to take medications for that. When I found out I had two more things, I was like, ‘Oh my God! What’s going on?’”

Research from Harvard University shows girls with attention deficit are 19 times more likely to be depressed…and 15 times more likely to have bi-polar disorder than other girls.

Dr. Richard Winer, an Atlanta-area psychiatrist, says, “There is a very high likelihood that there will be something else besides ADHD going on, probably at least a 70 percent chance if not more.”

Why is one person so likely to have several disorders? Researchers say the conditions are genetically linked…and tend to aggravate each other.

Ariel says, “I try to do something, but I can’t because of the ADD, and it frustrates me. Then that makes me very nervous and anxious and that goes to the anxiety. And then when I get like that, I’ll go ‘Oh my god! I can’t do anything! I can’t do anything!’ And that leads to the depression.”

Experts say girls like Ariel often need one medication for ADHD and another for depression.

Dr. Winer says, “I generally will try to treat ADHD first if I think there is also mild to moderate depression alongside. If the depression appears to be extremely severe in nature, then that takes precedence over treating ADHD in terms of what do you treat first.”

Ariel often skips her medication. She says it’s a crutch, but it does work. Her mom Arlene says, “She started taking some anti-depressants, and all of a sudden she was back to the way she had been six months earlier.”

Another study out of Harvard University shows boys with ADHD are also at risk for having another mental health problem, but the statistics are slightly less dramatic than they are for girls.

What Parents Need to Know

Many parents seem to be ignoring medical advice when it comes to treating their child’s attention deficit hyperactivity disorder (ADHD). A study conducted at New York University reveals that of 500 parents whose children have ADHD, 45 percent say behavioral therapy has been recommended, but less than one-quarter (21 percent) say that their child actually participates in it. In addition, 89 percent of parents with an ADHD child say medication has been prescribed for their child to help manage symptoms, but only 55 percent report their child is taking medication.

The study also included the following findings:

• More than twice as many parents of children with ADHD (43 percent) than parents of children without ADHD (18 percent) believe their child is likely to be picked on at school.
• Nearly half (49 percent) of parents of ADHD children say their child is likely to have difficulty getting along with other neighborhood children (compared to 18 percent of parents of children without ADHD).
• Seventy-two percent of parents of ADHD children report their child has trouble getting along with siblings or other family members, compared to 53 percent of parents of children without ADHD.
• Less than half (48 percent) of parents of children with ADHD say their child adapts easily to new situations, compared to 84 percent of parents of children without ADHD.
• According to their parents, children with ADHD are half as likely to have many good friends (18 percent vs. 36 percent) and are less likely to play with a group of friends (38 percent vs. 50 percent), compared to children without ADHD.

If you believe your child may have ADHD, keep an eye out for the following symptoms listed by the American Academy of Child and Adolescent Psychiatry:

• Has trouble paying attention
• Shows no attention to details and makes careless mistakes
• Easily distracted
• Loses school supplies and forgets to turn in homework
• Has trouble finishing class work and homework
• Has trouble listening
• Has trouble following multiple adult commands
• Blurts out answers
• Demonstrates impatience
• Fidgets or squirms
• Leaves seat and runs about or climbs excessively
• Seems “on the go”
• Talks too much and has difficulty playing quietly
• Interrupts or intrudes on others

Depression is not limited to kids with ADHD, although having ADHD may lead to depression in some cases. According to the Mental Health America, depression among teenagers is increasing at “an alarming rate.” Experts say as many as one in five teens suffers from clinical depression at some time during their teenage years. Depression can take several forms, including bipolar disorder (formerly known as manic depression). Depression can be difficult to diagnose in teens because adults often expect teens to be moody, and they often are. But depression is more than typical moodiness.

The following symptoms may indicate depression, particularly when they last for more than two weeks:

• Poor performance in school
• Withdrawal from friends and activities
• Sadness and hopelessness
• Lack of enthusiasm, energy or motivation
• Anger and rage
• Overreaction to criticism
• Feelings of being unable to satisfy ideals
• Poor self-esteem or guilt
• Indecision, lack of concentration or forgetfulness
• Restlessness and agitation
• Changes in eating or sleeping patterns
• Substance abuse
• Problems with authority
• Suicidal thoughts or actions

It is extremely important that depressed teens receive prompt, professional treatment. Depression is serious and, if left untreated, can worsen to the point of becoming life threatening. If depressed teens refuse treatment, it may be necessary for family members or other concerned adults to seek professional advice. Contact your local mental health association or a school counselor for suggestions on treatment.

Some of the most common and effective ways to treat depression in adolescents are:

• Cognitive-behavioral therapy – Helps teens change negative patterns of thinking and behaving; several studies support the effectiveness of this treatment
• Psychotherapy – Provides teens an opportunity to explore events and feelings that are painful or troubling to them; psychotherapy also teaches them coping skills
• Interpersonal therapy – Focuses on how to develop healthier relationships at home and at school
• Medication – Relieves some symptoms of depression and is often prescribed along with therapy