ADHD vs depression: can ADHD be mistaken for depression?

Often, symptoms of attention-deficit/hyperactivity disorder (ADHD) and depression overlap, which can make it difficult to get the right diagnosis. If mental health symptoms affect your daily life — including work, relationships, and even eating and sleeping habits — you may wonder if you’re facing ADHD vs depression.  

In this post, we explore how ADHD can be mistaken for depression. Compare symptoms and risk factors, and learn how providers diagnose and treat each disorder.

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ADHD vs depression — how they’re alike and different

Depression misdiagnosis is common — a study of major depressive disorder (MDD) reported that is is misdiagnosed 65.9% of the time. One key reason for this is that symptoms of depression overlap with other mental health disorders. This makes it difficult to pinpoint a the disorder at play. 

While ADHD can be mistaken for depression, there are key differences in how the overlapping symptoms present.

Mood differences in depression vs ADHD

Both depression and ADHD cause changes in mood, but how and when these changes occur provides insight into which disorder you’re experiencing.

Depression is generally more sporadic. If you have depression, you likely experience periods of depressed mood and otherwise feel like yourself. In comparison, the mood symptoms of ADHD tend to occur steadily and chronically when not treated. 

Sleep differences with ADHD vs depression

Depression and ADHD both affect a person’s sleeping habits. And in turn, poor-quality sleep can worsen the symptoms of both disorders. Sometimes sleep symptoms overlap, but other times they’re distinct. 

The difference can offer some insight into whether you’re experiencing ADHD or depression. Some people with depression sleep too much or spend too much time in bed. This typically isn’t the case if you’re experiencing ADHD symptoms — instead, you may have insomnia or trouble falling asleep due to racing thoughts and other distractions, like noises or lights.  

Motivation differences with ADHD and depression

On the surface, depression and ADHD affect a person’s motivation to perform everyday tasks. But when you look a bit closer, the cause of motivation issues with depression differs from those of ADHD. 

If you have ADHD, you likely struggle to start or complete tasks due to inattention and lack of focus. Feeling overwhelmed by upcoming tasks can often lead to ADHD paralysis — an inability to start or switch tasks due to apprehension or feeling like you don’t know how. On the other hand, if you have depression, you may struggle to engage in activities you once enjoyed due to low mood or feelings of sadness.

Again, we see a difference. ADHD motivation issues are chronic — without treatment, you always struggle with paralysis. In contrast, motivation issues with depression are intense — you don’t behave the way you used to.

Do I have ADHD or depression? Or both?

Depression and ADHD have a unique relationship. They can be comorbid, meaning you can have both depression and ADHD at the same time. 

While you may be born with ADHD, studies show having the disorder can cause depression to develop. A long-term study of children with ADHD that followed them into young adulthood suggested that ADHD increases the risk for depression later in life, and that genetics play a role. Though research has yet to reveal the exact mechanism or reason.  

A neurological connection between the disorders could explain why ADHD is sometimes mistaken for depression. Both people with depression and people with ADHD have low levels of certain brain chemicals, like norepinephrine, serotonin, and dopamine. These chemicals help regulate your mood, metabolism, and brain function — an imbalance can cause a variety of physical and mental health symptoms, like those of ADHD and depression.

Depression diagnosis and untreated ADHD

It’s estimated that 18.6% of adults with ADHD also have depression. But, what if you’ve been diagnosed with depression and it’s actually a symptom of untreated ADHD? Only a qualified healthcare professional can help you determine that, but it may be worth considering if you have other symptoms of untreated ADHD, like restlessness or trouble focusing.

Untreated ADHD in adults

According to the National Institute of Mental Health (NIMH), 4.4% of adults have an ADHD diagnosis, but the actual number is projected to be double that — around 8.8%. That means half of U.S. adults with ADHD live without a diagnosis and proper treatment. 

Symptoms of ADHD

If you have untreated ADHD, the following symptoms can impact you at work, school, and in relationships.

• Difficulty managing attention (lack of focus or hyperfocus)
• Difficulty concentrating
• Restlessness
• Forgetfulness
• Trouble falling asleep
• Excessive fidgeting
• Impulsive behavior
• Difficulty regulating emotions
• Irritability
• Racing or intrusive thoughts
• Inability to calm down or relax
• Trouble remembering where you put your keys/other items
• Difficulty managing a schedule/keeping appointments
• Sleep disturbances
• Anxiety disorders 

Comorbid ADHD and depression

Since you can have both ADHD and depression at the same time, it helps to know the risk factors.

Risk factor: genetics

ADHD is one of the most inheritable mental disorders, meaning you’re much more likely to have it if a family member has it. Some studies suggest that if 1 of your parents has ADHD, there is a 91% chance you have it too. Depression is inherited 40% to 50% of the time — less frequently than ADHD but still significant. 

Risk factor: biological sex 

ADHD in women often looks different than ADHD in men. Studies show females with ADHD are more likely to experience comorbid depression than males. This is likely due to difficulties in social-emotional functioning, like low self-esteem and emotional dysregulation, that affect women in society more than men. 

Risk factor: environment 

Studies show that people with ADHD often live in a more stressful environment than those who don’t have the disorder — and that this is a risk factor for comorbid ADHD and depression. While people with ADHD live in the same world as those without the disorder, their sensory processing differences can make normal environmental stimuli — like lights, smells, and sounds — lead to ADHD overstimulation. The stress of living in an overwhelming environment can put some people with ADHD at risk for depression.

Diagnosing ADHD vs depression

To be diagnosed by a mental health disorder, like ADHD or depression, you need to see a qualified mental health professional. Board-certified, licensed physicians (MDs), physician assistants (PAs), and nurse practitioners (NPs) can diagnose and treat ADHD and depression. You can even see a specialist, like an ADHD psychiatrist or psychiatric NP. 

When diagnosing ADHD and/or depression, your provider will ask you about your current symptoms and health history. They’ll also conduct physical and psychological testing to rule out other potential health issues. And you’ll likely be asked to complete self-assessments and/or performance-based tests to demonstrate your symptoms. 

Criteria for diagnosing ADHD vs depression

While the process for diagnosing ADHD and depression is similar, the criteria for diagnosis differs between the 2 disorders. 

To be diagnosed with depression, you need to experience at least 5 of the following symptoms nearly every day for 2 weeks or more:

• Lasting feelings of sadness, anxiety, or emptiness
• Loss of interest in normal activities
• Changes in appetite and weight
• Changes in sleep patterns
• Slowed movement, thought, and speech
• Decreased energy
• Trouble concentrating or making decisions
• Ongoing feelings of worthlessness or excess/undue guilt

To be diagnosed with ADHD, you need to currently experience 5 or more symptoms of ADHD and show that several symptoms were present before you turned 12.

Treatment for ADHD, depression, and both

Effective treatment for ADHD, depression, or both often includes a combination of medication and therapy. 

Only board-certified, licensed healthcare professionals can prescribe medication for ADHD, depression, or both. While many first-line ADHD medications, like Adderall (amphetamine/dextroamphetamine) are stimulants, some antidepressants are used off-label as non-stimulant ADHD meds. For example, studies show antidepressant Wellbutrin (bupropion) effectively improves ADHD symptoms. This means that, for people with comorbid ADHD and depression, it’s possible to treat both disorders with 1 drug.

If you want to try therapy, a licensed depression therapist or ADHD therapist, social worker, or psychologist can help. Many techniques used in therapy to help depression and ADHD both, like cognitive behavioral therapy (CBT) and mindfulness-based exercises. If you have both disorders, your therapist will help you determine which techniques best address your symptoms.

Key takeaway

• ADHD and depression are both mental health disorders with overlapping symptoms. Sometimes ADHD is mistaken for depression. Or you can have both disorders at the same time.
• To diagnose ADHD vs depression, or both, a qualified mental health provider will evaluate your health and current symptoms. Identifying whether you have 1 or both disorders involves looking into the exact causes and manifestations of your symptoms.
• Treating ADHD and/or depression typically involves medication and therapy. Some antidepressants are used off-label to treat ADHD and can be helpful for people who have both disorders. Likewise, many therapy techniques are useful for both ADHD and depression.

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If you think you have depression, ADHD, or both, see a licensed mental health professional for an evaluation and diagnosis. It’s easy to find a provider on Klarity Health and have an appointment in as little as 24 hours.*