Addressing ADHD Alongside Co-Occurring Mental Health Symptoms

Young adult with long hair and glasses works at table with books and computer holding mugMany children and adults with ADHD (attention-deficit hyperactivity) also have co-occurring mood- and anxiety-related concerns. In many instances, ADHD symptoms strongly contribute, and sometimes even cause, symptoms associated with depression or anxiety. Many people do not think about this possibility when seeking treatment for (or treating) symptoms of ADHD, which is why it is important for those who have this condition and those who help treat it to be aware of this.

In individuals who do not have ADHD, depression and anxiety symptoms can strongly hinder overall happiness, life satisfaction, and daily functioning. But people who have been diagnosed with ADHD are also likely to experience difficulties focusing and regulating impulses and emotions, and they also often struggle with time management and organization. When these challenges are combined with symptoms of depression or anxiety—which can be significant—the result may be significant limitations in life, unless the individual receives adequate and timely assistance.

Understanding the Symptoms

Whether depression and anxiety develop in relation to difficulties associated with ADHD or symptoms are present independently of ADHD, either condition is likely to exacerbate ADHD-related challenges. Sometimes these symptoms develop out of repeated setbacks in life, such as continued academic struggles, poor job performance or lack of job prospects, difficulty in relationships, and others.

It’s important to understand what symptoms might occur with depression and anxiety and how they differ between the two conditions.

Depression symptoms may include, but are not limited to, the following:

  • Feelings of sadness, isolation, hopelessness
  • Withdrawal
  • Increased or decreased appetite
  • Trouble focusing
  • Sleep issues (too much or too little)
  • Irritability
  • Loss of interest in activities previously enjoyed

Anxiety symptoms may include the following, among others:

  • Feelings of nervousness
  • Difficulty concentrating
  • Ruminating on negative things or the possibility of negative things occurring
  • Nervousness about or in social situations
  • Performance anxiety (at school, in the workplace, etc.). This can also impact functioning on a daily basis.

The Importance of Thorough Evaluation and Treatment

When considering seeking treatment for ADHD, for yourself or for a family member, be sure you are targeting all possible issues that are impacting functioning. The following suggestions may be helpful in achieving this goal:

When seeking an evaluation for ADHD, be sure it is thorough and examines other possible issues, such as depression or anxiety.

Some individuals may find symptoms of anxiety and depression diminish when symptoms of ADHD are adequately addressed, but this is not the case for everyone, and working with a mental health professional to treat any co-occurring issues is an essential aspect of treatment for many individuals.

This will help ensure, if and when ADHD is diagnosed, the symptoms observed are indeed due to ADHD and not anxiety, depression, or another issue. While a differential diagnosis is important in people of all ages, it is especially essential for children, since symptoms in childhood overlap even more between different conditions. Recognizing, in a timely manner, whether co-occurring depression, anxiety, developmental delays, learning difficulties, or other issues are present can have a significant impact on a child’s future well-being and school progress.

Seek treatment that addresses any and all co-occurring issues along with ADHD. 

Behavioral treatment such as therapy should directly address both symptoms of ADHD and any co-occurring issues such as anxiety, depression, or other concerns. Some individuals may find symptoms of anxiety and depression diminish when symptoms of ADHD are adequately addressed, but this is not the case for everyone, and working with a mental health professional to treat any co-occurring issues is an essential aspect of treatment for many individuals. Some people diagnosed with ADHD find it helpful to work with an ADHD/executive functioning coach (a person who is not necessarily a mental health professional). When mood and anxiety issues co-occur with ADHD, it is highly recommended individuals also work with a mental health professional in order to address these concerns, as well.

In terms of pharmacological services, it is important to make sure, when medication is prescribed, all conditions are being effectively treated—if it makes sense to treat all of them with medication as part of a comprehensive treatment plan. Any thoughts or concerns about medications should be brought to the attention of the appropriate medical professional as soon as they arise.

Whether you or a family member has ADHD alone or ADHD with anxiety, depression, or any other mental health or medical issue, it is always advised and encouraged to discuss any concerns with the appropriate professional to ensure you or your family member is receiving the right combination of interventions to address the difficulties.

It may take time to determine the correct intervention or combination of interventions. In many cases, a combination of treatments, including medication and psychotherapy, can provide the most comprehensive approach to effectively treating specific issues.

If you are considering seeking treatment, or would like to readdress your existing treatment and intervention plan, please consider reaching out to a qualified, compassionate professional.

© Copyright 2017 GoodTherapy.org. All rights reserved. Permission to publish granted by Carey A. Heller, PsyD, therapist in Bethesda, Maryland

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Melody

    Melody

    September 21st, 2017 at 10:33 AM

    I know that many of these things can happen with one another concurrently so I always wonder how you then determine what needs to be treated first, and what would help alleviate the other symptoms more quickly?

  • tripp

    tripp

    September 22nd, 2017 at 2:02 PM

    There are probably a whole lot of people who have been diagnosed with one thing, and yes they probably do exhibit the symptoms of that illness, but no one ever digs quite deep enough to discover where that is coming from.
    I get it that sometimes these things can be genetic in nature but there are probably just as many times when there is something external that is causing this and when you don’t even know where to start looking then how can you get help for that?
    This is just one more reason why it is so critical for everyone to have access to resources that can help them when they are suffering with any form of mental illness.

  • Morgan

    Morgan

    September 23rd, 2017 at 9:13 AM

    Knowing that I needed medication for my ADHD and that other people knew that I needed that do to effectively make it through any school day made me even more anxious and worried about what they would then think about me.

  • Jan

    Jan

    September 24th, 2017 at 5:24 AM

    2 questions. How to get therapists to make room for the possibility of a co-occuring ADHD diagnosis. I’ve brought up the serious possibility, but get a response that it’s all about the depression/anxiety. What type of professional can diagnosis Adult ADHD.

  • Ned R

    Ned R

    September 25th, 2017 at 3:24 PM

    This also brings up a good conversation about why for many is seems to be “okay” to have ADHD but they would never want to admit if there was a different diagnosis?

  • Carey Heller

    Carey Heller

    October 2nd, 2017 at 7:44 AM

    Thank you for reading this article and sharing your thoughts.

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