ADHD and Mental Health

ADHD is one of the most common neurodevelopmental disorders. The disorder, typically diagnosed in childhood, affects millions of children in the United States.

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According to the Centers for Disease Control, the number of children ages 3 to 17 years old who have ever been diagnosed with ADHD is about 6 million, or 9.8%, according to data collected from 2016 to 2019.

With that in mind, many parents may also see their child’s ADHD alongside other mental health conditions typical for kids and teens—such as depression and anxiety. Data for the same period showed about 5.8 million children were diagnosed with anxiety and 2.7 million children were diagnosed with depression, the CDC reports.

With mental health a key concern for developing kids and teens, Isbell Oliva-Garcia, a licensed mental health counselor for Grow Therapy, explains what children with ADHD can expect, and some ways in which various mental health symptoms may present differently with ADHD.

Responses below were edited for style and clarity.

In relation to children, how might ADHD interact with other mental health concerns like depression or anxiety?

When ADHD combines with anxiety or depression, it can lead to more complexities for both the child and their caregivers. It’s important to first understand each condition.

ADHD is a neurodevelopmental disorder characterized by persistent patterns of inattention, hyperactivity and impulsivity.

Anxiety can stem from difficulties in managing the demands of school, social interactions and daily life. It may also result from a fear of failure or criticism.

Depression involves a depressed mood or loss of pleasure or interest in activities for a long period of time. It can lead to symptoms of hopelessness, increased irritability, trouble concentrating or
sleeping and changes in appetite.

All three conditions can have symptoms in common, and that overlap. Comprehensive assessments are needed by healthcare providers to provide proper interventions and care for all symptoms. Many times, multimodal treatment plans and approaches are developed. Examples might include behavioral therapy along with medication management, or one-to-one talk therapy along with behavioral therapy
for conduct.

In the classroom and at home, a child can be supported with encouragement and development of proper coping skills to help support positive self-esteem. Social skills training is also important so the child can develop social skills in engaging in structured social activities to facilitate positive peer interactions.

Can Depression complicate ADHD?

First noting that each child is unique, and different interventions need to be tailored to each child, depression can complicate ADHD. ADHD and depression are two distinct mental health conditions, but they can coexist, and their symptoms may overlap with each other, which can make them difficult to diagnose.

Both ADHD and depression share symptoms such as difficulty concentrating, irritability and changes in sleep and appetite. These overlapping symptoms can make it hard to differentiate between the two conditions. The presence of depression in a child diagnosed with ADHD can bring about concerns with functioning. Depressive symptoms such as prolonged sadness, fatigue and feelings of worthlessness can add an extra dimension of impairment.

Further impairments can include social implications, such as isolation and withdrawal, along with risks to self-esteem due to the child internalizing negative feelings of self—specifically, if they see themselves falling short of academic or societal expectations.

What are some signs that a child who has ADHD may be struggling with their mental health?

Keeping in mind that all kids are different, and not all will show the same signs, it is important to be aware of how these symptoms might present themselves.

A child that may be struggling with their mental health might show early changes in their behavior, such as increased agitation or irritability to include mood swings.

They might show difficulty concentrating and focusing, with noticeable deterioration in their ability even beyond the typical challenges of ADHD.

Social withdrawals and isolation are also observable signs that a child might be struggling with their mental health. If a child is known to be friendly and social and starts withdrawing and not wanting to do what they once enjoyed, it’s a sign that some internal struggles are occurring.

Sleep and appetite will change as well—with changes in sleep patterns to either sleeping too much or not sleeping enough. Appetite will show changes in normal eating habits.

A child struggling with mental health may also experience unexplained aches and pains, such as headaches, stomach aches or other unexplained physical problems.

Academic decline can also be seen amid mental health concerns, with sudden declines in school performance from lack of turning in assignments to struggles with organization and time management.

Negative self-talk can be an indicator of internal and underlying emotion distress.

If you see persistent and alarming changes in a child’s behavior, it is very important to reach out for professional guidance and support.

Isbell Oliva-Garcia, an LMHC at Grow Therapy, has worked in the mental health field for nearly 20 years. Grow Therapy is an online therapy and medication management platform that also offers in-person services. It offers access to licensed therapists in Maryland and others states throughout the U.S.

About Heather M. Ross

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