Anxiety, Depression, and ADHD
Adult ADHD has been strongly associated with positive screening results for depression, anxiety, and mood disorders. The pressure of trying to cope with the organisational, social, practical, and emotional complexity of adult life as we transition from our teen years to our twenties and beyond, gradually accumulates and becomes harder and harder to deal with.
ADHD, anxiety and depression are three distinct conditions, but about half of adults with ADHD also have anxiety disorder, and some experts estimate that up to 70% of people with ADHD will seek treatment for depression at least once in their lifetimes. The good news is, the right treatment can improve ADHD symptoms and ease anxiety and depression, too.
The Trouble With ADHD and Mood Disorders
ADHD and Anxiety
When an anxiety disorder is present in addition to ADHD, the worries are usually about a wide variety of things and not just tied to ADHD struggles.
Left untreated, anxiety about ADHD can become embedded as a generalised anxiety disorder. The anxiety in this case is often about being overwhelmed by the symptoms of ADHD.
This type of anxiety can also act as a "mask" for ADHD symptoms. For example, anxiety develops from being told to try harder, but those of us with ADHD are already trying our hardest, so the anxiety makes us try even harder... at the cost of our health.
In either case, it's a good idea to talk to a doctor or therapist to find out where the anxiety is coming from.
ADHD and Depression
Some adults with ADHD become depressed for no obvious reason. The condition appears even in the absence of unpleasant life circumstances or events. Risk for this form of depression, known as primary depression, seems to be largely inherited.
In other cases, depression arises as a direct consequence of the chronic frustration and disappointment of living with untreated or poorly managed ADHD. By some estimates, 25% of adults with ADHD haven't received appropriate treatment for it. Such cases of depression are said to be secondary to ADHD.
Why are we More Prone to Anxiety and Depression?
It's not clear why those of us with ADHD are more likely to have other conditions such as anxiety and depression. It's also often difficult to separate the symptoms of each of these conditions, as they overlap significantly; for example, depression can cause sleep disorders and difficulty concentrating, but so can ADHD, and so can anxiety.
What we do know is that trying to cope with the symptoms of ADHD, particularly if it's left untreated, can either cause anxiety and depression, or exacerbate them if they are already present.
We exert a lot of pressure on ourselves from constantly "failing". We feel inadequacy as a result of our inability to do things that seem so simple for neurotypical people, we experience guilt over letting people down when we miss deadlines or are late for appointments, and frustration that results from our poor executive functions hampering our ability to meet our goals.
We see our peers surpass us academically or get high-flying careers, while we seemingly languish in a series of understimulating jobs or struggle at school. Sometimes our careers are just fine but our home lives or relationships are chaotic and unhappy. We often feel (or are told by others) that we could be just as successful as our peers if we just tried harder.
Combined with these feelings is one major ADHD symptom that's often overlooked; emotional dysregulation, which means we have a hard time regulating and moderating our emotional responses to situations.
We take everything that much more personally, we strive that much harder to please others, and when we fail, we blame ourselves. This leads to shame.
Unlike guilt, where we feel bad about our behaviour, shame means we feel bad about who we are. When we experience shame, we see ourselves as inherently worthless, unlovable, unworthy. Much shame is also carried from our childhood years of being told outright that we were lazy, unmotivated, or unintelligent.
In short, we feel shame for having ADHD.
This is how the cycle of anxiety and depression can begin, and it's highly destructive.
What To Do About It
It's likely that treating the ADHD will help ease the anxiety and/or depression. ADHD treatment will often ease stress and help with self-regulation, which will make it easier to stay on top of things and not feel overwhelmed.
Some treatments can work for ADHD, anxiety, and depression, such as cognitive behavioural therapy, relaxation techniques, mindfulness, meditation, and prescription medications.
Talk to a doctor or therapist about any feelings of anxiety or depression, and they can help you come up with an effective treatment plan involving some or all of the above remedies.
In addition to talking to your doctor or therapist, try recording (in your Bullet Journal, for example) the occasions that make you feel particularly anxious or depressed. Write down the situation which triggered the negative feelings, how you felt, and what you did to try to cope. Discuss with loved ones.
Remember that you don't have to tackle anxiety, depression, or ADHD alone. There are many strategies and techniques you can try to help alleviate the symptoms of all these conditions.
Talk to your family, friends, doctor, and therapist about the difficulties you're having. With these allies, you can come up with a treatment plan to help ease these negative feelings, and begin to take charge of your life again.