Depression is one of the conditions that most often coexists with ADHD — about
one in seven children with ADHD also experiences depression. Recognizing it can
be tricky, because a child's low mood is easy to attribute to ADHD alone. Knowing
what to look for, and treating both conditions together, gives children the best
chance to feel and function better.
Recognizing depression in a child with ADHD
Depression is more than ordinary sadness. Clinicians look for a period of at
least two weeks in which a child shows either a persistently low mood or a loss
of interest or pleasure in activities they used to enjoy, along with several
additional changes — in sleep, appetite or weight, energy, concentration, or
feelings of self-worth, sometimes with thoughts of death or suicide. These
changes must represent a shift from how the child usually functions.
Children don't always look like the textbook adult picture of depression. In
younger children especially, depression often shows up as irritability, anger,
or increased activity rather than obvious sadness — which is one reason a careful
evaluation matters, particularly when ADHD is already part of the picture.
How ADHD and depression are connected
In most children, ADHD comes first and depression develops later. Ongoing
struggles at school, at home, and with friends can wear a child down over time;
repeated setbacks and negative feedback can erode self-esteem until low mood
takes hold. The risk is higher when other conditions are also present — for
example, children who have both ADHD and a disruptive behavior disorder
(oppositional defiant disorder or conduct disorder) have notably higher rates of
depression.
Treatment: one integrated plan
The goal is to treat both conditions together and to ease the pressures in a
child's life that feed the depression. An effective plan usually combines talk
therapy with careful attention to the ADHD, delivered by a professional
comfortable managing both.
Talk therapies
- Behavioral therapy — targets current behaviors and how to change them
- Cognitive therapy — reshapes negative thought patterns
- Interpersonal / family therapy — addresses family relationships and stressors
- School-based support — brings help into the classroom
When medication is part of the plan
Medication may be needed for the ADHD, the depression, or both. It works
best as one piece of a comprehensive plan — alongside talk therapy, not instead
of it.
Any child starting medication should be followed closely; if symptoms
worsen or new ones appear, tell the prescribing clinician right away.
Antidepressants, when used, call for extra caution and close monitoring in
children and adolescents, especially in the first few months.
For parents and families
Identifying and treating both conditions at once takes coordination. If you're
seeking help for your child, keep these in mind:
- Find a qualified mental health professional, such as a psychologist or psychiatrist.
- Seek a second opinion if you're unsure which treatment path to take.
- Choose a clinician experienced in diagnosing and treating both ADHD and depression in children.
- Take any suicidal thoughts or plans seriously — seek help immediately.
- Learn what you can about both conditions so you can partner in your child's care.
If your child may be in crisis: If you're worried about your
child's immediate safety or they've expressed thoughts of suicide, call or text
988 (the Suicide & Crisis Lifeline, available 24/7) or go to
the nearest emergency department. In a life-threatening emergency, call 911.
Adapted by the Louisiana Chapter of the American Academy of Pediatrics from
ADHD and Depression, an information sheet from the National Resource
Center on ADHD: A Program of CHADD, included in Caring for Children With
ADHD: A Resource Toolkit for Clinicians, 2nd Edition. © 2010 CHADD; toolkit
© 2012 American Academy of Pediatrics. Current source:
chadd.org/about-adhd/depression.
This adaptation uses current (DSM-5) diagnostic framing and has not been reviewed
or endorsed by CHADD or the AAP. It does not indicate an exclusive course of
treatment or serve as a standard of medical care; variations accounting for
individual circumstances may be appropriate.
