Comparing The Co-Existing Conditions Of Depression and ADHD

Depression and ADHD are both mental disorders of the brain involving imbalances in brain messenger chemicals. It is not surprising that with an estimated 10 percent of school aged children and 5 percent of adults having ADHD and over 130 million people worldwide suffering from depression that eventually someone would put depression and ADHD together. Let’s take a look at the definition according to the AMA of each condition first and then try to put the pieces of the puzzle together. 

Depression is an abnormal and persistent mood state characterized by sadness, melancholy, slowed mental process, and changes in such physical patterns such as eating and sleeping. Medically, depression is defined as the daily presence for 2 weeks of a least 5 of 9 symptoms. Here are some of these: irritability, loss of pleasure in almost all activities, eating irregularities, insomnia, fatigue, feeling of worthlessness, low self esteem, morbid or suicidal thoughts, and difficulty concentrating. 

ADHD is characterized by difficulty paying attention and a high degree of restlessness and impulsive behavior with symptoms beginning before the age of seven, lasting for at least six months, and causes substantial difficulties in at least two settings (normally home and school/work). The primary symptoms are inattention/distractibility, impulsivity, and hyperactivity/restlessness. Secondary symptoms include anticipation of failure, low self esteem, insomnia or sleep disturbances, worry, boredom, loss of motivation, frustration, and hopelessness. 

So in looking at the symptoms that are common to depression and ADHD we come up with inattention or failure to focus, low self esteem, sleep disturbances, and possibly anticipation of failure, loss of motivation, and hopelessness. 

So it is quite easy to see why these conditions are often diagnosed as coexisting. The question is which one should be treated first and how? 

The conventional thinking is to use antidepressant SSRI medications to treat the depression first and if ADHD is still present once the depression clears up add ADHD stimulants such as Ritalin or Cylert to the mix. 

Both approaches focus on the biological aspects of each condition. Antidepressant SSRIs focus on raising the levels of the neurotransmitter serotonin while stimulants raise the levels of dopamine and/or norepinephrine. While effective the side effect risks are well documented and worth talking to your doctor about is this is an option you are considering. 

Another popular approach that seems to be effective is that of behavioral therapies such as cognitive behavioral counseling. This approach tries to find the root cause and isolate your motivations and the circumstances under which they appear. Once determined strategies are developed for changing and coping with problem behaviors. This therapy has shown to be effective for both depression and ADHD. 

The bottom line is that distinguishing between depression and ADHD can be easy with some people and very difficult with others. The difficulty exists partly because the conditions share many similar symptoms and also because the co-occurrence of depression and ADHD is very common. 

What Next? For those struggling with depression and ADHD finding the best treatment option that can help them manage their symptoms should be their main priority. The most common form of treatment for ADHD are stimulant medications such as Ritalin or Cylert. While effective all stimulant medications come with a number of serious label warnings. The risk of side effects or perhaps lack of success with stimulants has prompted many to investigate other options. A couple examples of this are cognitive behavioral counseling (discussed above) and/or homeopathic remedies. Homeopathic remedies for ADHD are a side effect free way to address such problematic symptoms as inattention, distractibility, impulsivity, erratic behavior and hyperactivity and can be used both as a standalone treatment or as a compliment to other nonprescription alternatives.