ADHD and Depression, Anxiety Disorders or Bipolar Disorder
Margaret V. Austin, Ph.D., edited by C. E. Zupanick, Psy.D.image by Liz (lic)ADHD and Depression
It is estimated that 10 to 30% of children with ADHD have a co-occurring mood disorder such as Depression. Although many depressed adults move, think and talk slowly, children often demonstrate different symptoms when depressed. For example, depressed children be extremely impulsive. They may demonstrate hyperactive behavior, as well as irritability.
Depression may be a reaction to the everyday stress associated with living with ADHD. It is hard to remain hopeful and optimistic when the world seems so unpredictable. Peers seem unfriendly, and school is one drudgery after another. In such cases, a separate depression diagnosis is unnecessary because the depression is occurring in response to ADHD. This is called situational depression. The symptoms will abate once the ADHD symptoms improve.
In other instances, both diagnoses are warranted. When depression runs in the family it may be more directly rooted in biological/genetic causes, rather than situational ones. In such cases, a separate diagnosis and specific treatment for symptoms of depression might be more appropriate. Distinguishing between the emotional complications of ADHD and a separate depressive disorder can be very difficult. A therapist charged with this task would try to determine which came first. If depression preceded the ADHD, it is less likely to be situational depression. Likewise, if there is a family history of depression, it may warrant a separate diagnosis. The clinician would also conduct an evaluation of the severity of symptoms. It is very important to take depressive symptoms seriously, regardless of their cause. Children with ADHD and depression can have suicidal thoughts. Any suicidal comments, jokes, or thoughts should be monitored and immediately addressed by a mental health professional.
ADHD and Anxiety Disorders
Approximately 25% of individuals with ADHD also have anxiety disorders. Common symptoms of anxiety in children include: unpredictable mood swings (i.e., someone is happy one minute and miserable the next); excessive irritability; frequent angry outbursts; a noticeable lack of energy; and, low self-esteem. Low self-esteem becomes particularly problematic during puberty and adolescence. This is then when children begin to compare themselves to their peers. During this time, children with ADHD can become painfully aware of their own limitations.
Other anxiety symptoms include frequent school absenteeism; somatic (physical) complaints; unwillingness to attempt new tasks; and, a sense of resignation regarding their decreased ability to perform various tasks. Children with ADHD and anxiety disorders seem to lack motivation. This is often termed, learned helplessness. Because their efforts to improve do not produce fruitful results, they begin to feel that nothing they do will matter anyway. So, why try? Of course, this sets up a vicious cycle. The lack of effort ensures a lack of improvement, further solidifying the idea, "nothing I do matters anyway."
It is very important to distinguish between an actual anxiety disorder versus children that are experiencing anxiety in response to ADHD. This distinction is important because treatment options are very different. Stimulant medications, while helpful for ADHD symptoms, may actually worsen the symptoms of an anxiety disorder. Medication treatment becomes more complex for those with ADHD and an anxiety disorder.
ADHD and Bipolar Disorder
Bipolar Disorder is a condition that mimics ADHD. Both disorders have symptoms of impulsivity, mood instability, and hyperactivity. Research shows that about 50% of boys and 25% of girls with bipolar disorder also meet the criteria for ADHD. Children and adolescents with bipolar disorder often show impulsive inattention and hyperactive behavior. They may express extremely strong feelings and carry an overbearing or irritable manner. They may find it difficult to wake up in the morning. Children and adolescents with severe bipolar symptoms may have excessive and lengthy temper tantrums that are destructive. These tantrums are often prompted by gross distortions of real events. For example, when a friend wants to play a different game, the bipolar child may think that his friend is trying to purposefully be mean. The child's anger and indignation at such mistreatment may result in an extreme temper tantrum.
As with other disorders already discussed, it is critically important to reach an accurate diagnosis. The stimulant medication used to treat ADHD is not usually helpful for bipolar disorder. It may even worsen symptoms. Lithium is one of the most frequently used medications to treat Bipolar Disorder. Lithium seems best for children who are truly bipolar.
Resources
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Articles
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Childhood ADHD Overview
- Introduction to Attention Deficit Hyperactivity Disorder (ADHD)
- Signs & Symptoms of ADHD
- ADHD Signs and Symptoms: Attention Difficulties
- ADHD Signs and Symptoms: Hyperactivity
- ADHD Signs and Symptoms: Impulsivity
- Are There Different Types of ADHD?
- The Social, Educational, Financial & Occupational Impact of ADHD
- What are the Legal Rights of Caregivers and Their Children with ADHD (USA)?
- A Positive Spin: Is There Anything Good about ADHD?
- Signs of ADHD in Children at Home
- Signs of ADHD in Children at School
- Signs of ADHD in Children in Peer Relationships
- How Do I know if My Child Needs an ADHD Evaluation?
- What Should I Do If I Think My Child Might Have ADHD?
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ADHD Discoveries and Controversies
- ADHD: New and Exciting Brain Research
- ADHD: New and Exciting Brain Research - Part II
- Neurotransmitter Changes with ADHD
- Executive Functions
- Neurodiversity: Is ADHD a True Mental Disorder?
- ADHD Statistics
- Cultural and Gender Differences in Prevalence Rates
- Should Children with ADHD Be Medicated?
- New and Promising Areas of Research
- Causes of ADHD in Children
- ADHD or Another Condition?
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Diagnosis of ADHD in Children
- Who Can Diagnose ADHD?
- How Does ADHD Multi-Source Assessment Work?
- Assessment Instruments: Behavioral Checklists
- Assessment Instruments: Intelligence Tests
- Assessment Instruments: Achievement Tests (or Academic Tests)
- Assessment Instruments: Tests of Attention
- Assessment Instruments: Memory and Other Common Tests
- Step 2: Clinical Interviews
- Step 3: Physical Exam and Medical History
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ADHD Treatment in Children
- Multimodal ADHD Treatment Approach
- ADHD Medications
- Treating ADHD with Stimulant Drugs
- Commonly Prescribed ADHD Stimulant Medications
- Treating ADHD with Non-Stimulant Drugs
- Risks of ADHD Medication
- Risks of ADHD Medications - Part II
- Benefits of ADHD Medication
- Side Effects of ADHD Medications
- Medication Decisions and Medication Management
- How Long Should ADHD Medication Treatment Last
- Psycho-Education about ADHD and Its Management
- Family Therapy
- Individual and Cognitive Behavioral Psychotherapy for the Child with ADHD
- Skills Training
- Social Skills Training and Coaching
- Supports
- Alternative ADHD treatment: What Does NOT Work?
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Family and Personal Supports
- Effective Disciplinary Techniques
- Learn about Resources and Be Proactive
- Manage Stress, Self-Regulation & Provide Order
- Develop Routines, Organization and Expectations
- Communicate and Collaborate with Schools
- Express Confidence in Your Child's Abilities
- Help Children Improve Social Skills and Peer Relationships
- Avoid Homework Battles and Monitor Medication
- I Think I have ADHD. What should I do?
- I Think I Have ADHD - Part II
- Famous People with ADHD
- Adult ADHD Overview
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Diagnosis of Adult ADHD
- How is Adult ADHD Diagnosed?
- Diagnostic Challenge 1: Looking into the Past
- Diagnostic Challenge 2: ADHD versus Similar Disorders
- Diagnostic Challenge 2 - Part II
- Diagnostic Challenge 3: ADHD Symptoms
- Diagnostic Challenge 3 - Part II
- Diagnostic Challenge 4: A Concealed Disorder
- Specialized Tests and Tools
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Adult ADHD Treatment
- ADHD Medication Treatment
- Stimulant and Non-Stimulant Drugs for Adult ADHD
- Medication Timing, Dosage, Monitoring, and Duration of Treatment
- Weighing the Risks and Benefits of Adult ADHD Medications
- Psychotherapy for ADHD
- Coaching/Supported Employment for Adult ADHD
- Social Skills Training for Adult ADHD
- Psycho-Education and Cognitive Behavioral Therapy (CBT)
- ADHD Resources and References
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Childhood ADHD Overview
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Questions and Answers
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- 16 year old girl with Attention Deficit Disorder
- Thoughts
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- ADHD in Twins
- Inherited ADHD
- How to get off Focalin
- new diagnosis
- am i off my head i feel i have no feelings and want to harm ppl
- 17 yr old refuses help with bi-polar disorder
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- heightened sexual behavior in my 8 yr. old with adhd
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- my 7 year old nephew
- my daughter
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- Fantasy land for attention
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Tests
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- Attention-Deficit/Hyperactivity Disorder
- Buzz
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- Driven to Distraction
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- Joey Pigza Swallowed the Key
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- Making ADD Work
- Medicating Children
- Mind Fields
- New Look at ADHD: Inhibition, Time, and Self-Control
- Non-Drug Treatments for ADHD
- Overcoming ADHD
- Parenting Children With ADHD
- Reclaiming Our Children
- Rethinking ADHD
- Ritalin is Not the Answer Action Guide
- Ritalin Nation
- Running on Ritalin
- Should I Medicate My Child?
- Taking Charge of ADHD, Revised Edition
- The Explosive Child
- The Gift of Adult ADD
- The Little Monster
- The Science of ADHD
- Thumbsucker
- Treating ADHD and Comorbid Disorders
- What Would Joey Do?
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Links
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- ADHD and Eating Right
- Tourette Syndrome and ADHD
- Homework, Organization, and Time Management Strategies to Help Kids with ADHD
- Nutrition in Support of ADHD Treatment
- Behavioral Therapy: What it is and finding a therapist
- Project-Based Learning and ADHD
- Conditions May Mimic ADHD
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- Department of Education Guidance Broadens Understanding of 504 Rights for Kids with ADHD Part I
- Treating ADHD in the African American Community
- How to Build Self-Motivation in Teens with ADHD
- Goal Setting and Keeping for the ADHD Brain
- Neurofeedback Treatment for ADHD
- ADHD in Preschoolers: What to Look For and How to Help
- FYI on ADHD Evaluations
- Teaching Grit, Perseverance and Frustration Tolerance to Students with ADHD
- Does my Child Have ADHD?
- How to Start Eating Well When You Have ADHD
- 5 Solutions for Common ADHD Social Struggles
- Is My High School Student Ready for College? (And Is My College Student Ready to Go Back?)
- Understanding and Applying the Science of Time Management
- ADHD Medication and College Students: Prevent Misuse, Abuse, and Diversion
- Improve Homework Time with Strategies That Work For ADHD
- Student Voices: What Really Matters to Young Adults With Learning and Attention Issues
- 5 Ways Nutrition can Impact ADHD Symptoms
- 3 Tips for Adjusting to a New Diagnosis of ADHD
- Creating the Best Learning Environment for Students with ADHD
- ADHD & Executive Functioning
- Department of Education Guidance Broadens Understanding of 504 Rights for Kids with ADHD Part II
- Ask The Expert: Neurofeedback Treatment for ADHD
- ADHD and Suicide Risk Factors
- The Choice is in the Details: Medication Options for ADHD
- Understanding and Supporting Young Adults with ADHD
- Helping Your Young Adult Become Independent
- Creating Structure and Routines for Children with ADHD
- When You and Your Child Have ADHD - Communication Skills to Resolve Conflict
- Guidance for Uncertain Times: Navigating Relationship Challenges
- Guidance for Uncertain Times: Mindful Parenting
- Couples with ADHD: Creating Caring Connection amid the Chaos
- Disclosure and Workplace Accommodations for Individuals With ADHD
- A Summer At Camp
- Self-Advocacy Tips For Teens With ADHD
- ADHD and Curbing Impulsive Spending to Help Your Relationship
- ADHD: Signs, Symptoms, Research
- ADHD & Risk of Adult Drug Use
- Health and Life Expectancy in ADHD
- Focus on ADHD
- Pediatrics: ADHD and Food Allergies
- ADHD: It's a Family Affair
- Does Your Child Have ADHD?
- ADHD in Children
- Living with ADHD
- Rise in ADHD Cases in Children
- Why is Dating Difficult When You Have ADHD
- Video Games, Screens, and ADHD A Potent Mix
- Ask the Expert Helping Children with ADHD LD Conquer Chronic Stress
- Ask the Expert: Mindfulness, Stress, & Emotion
- Attention Deficit Hyperactivity Disorder
- Ask the Expert Educator Edition: ADHD & Executive Functioning
- Ask the Expert - Academic Evaluations - What Parents Need to Know
- ADHD and Sibling Relationships
- Medication Treatment for ADHD
- Using Time Out
- Treating Childhood ADHD
- ADHD-friendly Summer Family FUNdamentals
- Preparing Older Teens for the Road Ahead
- Tips for Teachers: Tailoring homework to make a difference
- Your Active Preschooler: Could it be ADHD?
- Tips for Teachers: Creating a positive dialogue with parents of students with ADHD
- Helping Parents & Kids Understand the Social & Emotional Aspects of ADHD
- Social and Emotional Concerns of Children with ADHD: Strategies to Help
- Holiday Gifts for Children with ADHD
- Behavior Management and Combined Treatment for Children with ADHD
- Setting Realistic School Expectations for Students with ADHD
- On Their Own: Helping College Students with ADHD
- Children's Communication Challenges: Is it Attention, Language or Both?
- Out-of-School: Parenting During the Summer
- ADHD in the Workplace: Finding Success
- Emotions and Motivation in ADHD
- The Role of Medication in Managing Children's ADHD Symptoms
- Top Tips for Combating Stigma and Addressing Myths about ADHD
- Facts and Myths about ADHD
- What To Do If Your Child Has ADHD?
- How Common is ADHD?
- Children, Meds, and Heart Safety: A Tale of ADHD and Public Health
- ADHD & Your Child’s Transition to College
- Your Teen with ADHD: Challenges and Strategies for Success
- Ask the Expert - No more homework battles
- A Frontline to ADHD
- Understanding Girls with ADHD
- What is ADHD?
- What To Do When Your Child With ADHD is Bullied
- Stop the Chaos! Tips for Creating a Peaceful Household When Mom has ADHD
- Is It ADHD?
- Ask the Expert - What else can I do? Complementary approaches to ADHD treatment
- All in a row: Getting your kids with ADHD organized
- Your Student With ADHD Was Admitted to College, Now what?
- Evidence-based treatment for ADHD in young children
- Home life when Mom or Dad has ADHD: Succeeding with your family
- How does technology affect ADHD?
- Diagnosing ADHD
- Helping Your Child Successfully Handle Change
- Recognizing challenging behaviors in young children: Could it be ADHD?
- Classroom Managment Supports for ADHD Behaviors in Preschool Settings
- Getting through to your teenager with ADHD
- What Everyone Should Know about ADHD
- Make Learning Exciting: Apps for Executive Functioning
- Teenagers, ADHD, and Substance Abuse
- Past Procrastination -- Get Your Kids Organized, Focused and Motivated
- Ask the Expert: Late, Lost, and Unprepared: How to Help Your Child with Executive Functioning
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