If you’ve been diagnosed with ADHD or are wondering if you have ADHD you’re probably familiar with the struggle of parsing out your experiences, differentiating between overlapping symptoms, and trying to figure out what means what. This may be even further complicated when struggles with your mood seem to overlap with your struggle with ADHD. A few questions you may be frustratingly familiar with - is this my ADHD, anxiety, or depression? Is it a combination of all three? Which came first? What do I try to treat? In this article, we’ll help differentiate between depression, anxiety, and ADHD and develop some understanding of how these disorders may interact.
People with ADHD are three times more likely than the general population to develop a mood disorder and nearly 50% of adults with ADHD have also been diagnosed with an anxiety disorder (CHADD, 2019; Kessler et al., 2006). If you are wondering about which of these diagnoses may fit your experiences best, you may have found yourself in one of the following situations:
- You have been diagnosed with ADHD but it doesn’t seem to sufficiently account for all of your symptoms.
- You have been diagnosed with depression or anxiety but something significant still seems to be missing.
- You’ve been diagnosed with ADHD and a mood disorder (or two) and have been able to get treatment for all of the above.
Undiagnosed ADHD
Living with ADHD can cause significant stress. Difficulties with executive functioning impact time management, the ability to initiate tasks and activities, organization, procrastination, trouble following up or completing tasks, and sensory sensitivities. Living with undiagnosed ADHD presents unique challenges and can lead to significant struggles with anxiety and depression due to additional stress of confusion, shame, or unrealistic expectations that you should be able to do everything without additional support. Having ADHD and not having treatment for it can be so difficult, in part, because there is no direction on how you can manage your symptoms. Without an ADHD diagnosis, some medical and mental health professionals may misinterpret your symptoms as anxiety or depression. There is often overlap in symptoms between these disorders, but the underlying causes of these symptoms are typically different.
You Have Been Diagnosed With ADHD, But Something’s Missing
Maybe you’ve been diagnosed with ADHD but also experience struggles that feel independent from the ADHD. It is possible that these experiences are better represented by depression and/or anxiety.
Depression, in the form of a major depressive disorder or persistent depressive disorder, is characterized most significantly by persistent sadness, irritability, or a sense of feeling “low,” “blue,” or “numb.” Depression can be an intense experience that lasts a relatively short time (two weeks) or it can show up with less intensity and more chronicity, persisting for years at a time. Anxiety is broadly defined as a feeling of unease, tension, or nervousness related to stressful or uncertain situations. An anxiety disorder is diagnosed when anxious thoughts, feelings, and behaviors become more persistent rather than temporary and cause significant distress and interference in your daily life. Generalized anxiety disorder, social anxiety disorder, obsessive compulsive disorder are anxiety disorders commonly found to be co-morbid with ADHD.
A complicating factor is that for those who grow up with ADHD, whether diagnosed or not, it is common to develop ways of “masking” their natural behaviors to try to better fit in with neurotypical family, friends, and societal expectations. Patterns of masking can lead to hyper-monitoring your own behavior around others and ignoring or hiding your needs or feelings in ways that can contribute to persistent anxiety and depression as well. We’ll dig into the phenomena and impact of masking in ADHDer’s lives in a future blog post. While the difficulties of ADHD and living in a society developed around neurotypical norms can cause mild to clinical levels of anxiety and depression, there can also be numerous non-ADHD-related causes for developing depression or an anxiety disorder. This can get really tricky because people may attribute your anxious behaviors as a part of ADHD-related difficulties with executive functioning and miss an aspect of you in the process. Issues with sleeplessness and a sense of being on edge may be confused with hyperactivity. Your low engagement with things you used to love may be attributed to moving on from a hyperfixation. Without the understanding of the true cause behind these symptoms, they may go untreated.
Let’s compare the symptoms of anxiety, depression, and ADHD and look at differences in the contributing factors of each symptom:
You Have Been Diagnosed and Treated for ADHD and Anxiety and/or Depression
If you have both a mood disorder and ADHD, obviously the ideal situation is to be diagnosed and treated effectively for all of it! Next step is to determine how your symptoms interact and what focus would be most effective for your treatment. At times, your ADHD symptoms may be in the most need of attention, while at other times certain symptoms or causes of anxiety and depression may need the most immediate care. To help manage these symptoms, determine if you are interested in individual or group psychotherapy, support groups, ADHD coaching, or are curious about looking into medication options with a primary care provider or psychiatrist.
Symptoms Are Hard to Differentiate
Differentiating between symptoms of ADHD, anxiety, and depression can be tricky - especially because they often co-occur. We hope this article has helped shine some light on the differences between these disorders and given you a better understanding of how they may interact. While it can be confusing and frustrating to try and figure out you’re experiencing, know that you are not alone in your journey. If you think you may be struggling with any of these disorders, reach out to a mental health professional for help. A great place to start could be speaking with a therapist at Relational Psych or having a comprehensive psychological evaluation!
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
CHADD. (2019, January 4). ADHD and Co-occurring Conditions. https://chadd.org/about-adhd/co-occuring-conditions/
Kessler et al. (April 2006). The Prevalence and Correlates of Adult ADHD in the United States: Results From the National Comorbidity Survey Replication, American Journal of Psychiatry 163(5):71.
