ADHD is one of the most misdiagnosed conditions because many ADHD symptoms cause challenges that resemble other mental health disorders, leading to the treatment of symptoms without addressing the root cause of suffering.  

Internal hyperactivity can cause or exacerbate anxiety as thousands of emotions and thoughts viciously interact in your brain with the speed of bullets. Mood swings, emotional outbursts, and meltdowns due to emotional dysregulation can be diagnosed as a personality disorder.

In particular, periods of intense burnout, lack of motivation, and mental exhaustion can lead to symptoms of depression. 

Treatment of any of those conditions under medical supervision can alleviate the challenges and discomfort caused by your symptoms. However, that's not enough to turn your life around because treating the symptom often won’t address the underlying cause - ADHD. 

This article will offer an in-depth look at the connection between ADHD and depression, exploring how ADHD can feel like being depressed, contribute to symptoms of depression, and how both conditions can exacerbate each other's symptoms. 

How Does Depression Feel?

The most broadly accepted standard for depression assessment is the criteria set by the DSM-5. The minimum for official diagnosis requires having 5 out of the 9 depression symptoms listed below, with one of them necessarily being anhedonia.

Anhedonia, a pervasive form of apathy, leads to a lack of motivation, loss of interest, and inability to experience pleasure and joy like before. It is one of the most unique symptoms clearly connected to depression, which is why it must be present for you to get diagnosed with clinical depression.

Anhedonia is especially dangerous because it can create a slippery slope effect. The chronic numbness, apathy, and disengagement from work, hobbies, social connections, and other activities lead to other symptoms - loss of appetite, trouble sleeping, inability to keep up with tasks, anxiety, suicidal thoughts, etc. 

This is one of many depression symptoms. Here are the rest. 

Symptoms list:

1. Depressed mood, making you feel sad, hopeless, bleak, and empty. 

2. Loss of interest, motivation, and pleasure for usually enjoyable activities (hobbies, passions, social connections, work, sex, etc) and feeling numb, indifferent, and apathetic. 

3. Chronic lack of physical vitality and mental energy. 

4. Constantly feeling lethargic and slowed down, or physically agitated and restless.

5. Executive dysfunction leads to concentration, organization, decision-making, memory, and thinking speed issues. 

6. Feelings of worthlessness, being unloveable, shame, and guilt. 

7. Feelings of hopelessness and nihilism accompanied by thoughts of death & suicide. 

8. Alterations and disruptions in sleep patterns - insomnia and inability to stay asleep or sleeping too much. 

9. Loss of appetite or intense cravings resulting in noticeable weight changes, like weight loss or weight gain. 

This is how the current scientific consensus describes clinical depression, but an abstract list of symptoms is not enough to capture the unique type of suffering caused by each individual. For some, depression can be like a persistent feeling of sadness, emptiness, and nihilism that you can't shake off.  For others, it can be a lack of motivation and energy to do the simplest things, like getting out of bed and taking care of your basic needs. 

Individual experiences can differ so much that the DSM-5 does not comprehensively cover all possible symptoms. For example, depression is often accompanied by irrational overthinking of past events, unnecessary worrying, and constant rumination, as well as physical and somatic symptoms like brain fog, muscle pain, headaches, etc.

If any of that sounds familiar, but you still find yourself capable of keeping up with day-to-day responsibilities, you may have a form of high-functioning depression, like dysthymia. If your depression symptoms are deliberating to the point where you struggle to get out of bed, sleep enough, and eat, then you have clinical depression and need professional treatment as soon as possible (1) 

You are not entirely safe from the threat of depression even if you have a well-paying job, happy long-term relationships, a great social network, and lots of hobbies.

The ADHD And Depression Connection

The conclusion of a meta-analysis of almost 30 individual studies shows that there is a very strong correlation between having ADHD and being in the high-risk group for depression disorders (2)

44 percent of people with ADHD will experience a depressive episode before the age of 30. Adolescents diagnosed with ADHD who have developed depression have a 42% higher chance of making a suicide attempt. In general, depression is almost three times more likely to occur in adults with ADHD than neurotypical people. 

There is no way to deny the connection. ADHD, especially if untreated, often co-occurs with symptoms of depression. Research clearly proves that the connection exists, but the specific reason why one leads to the other is often unclear. 

The reasoning provided below is a personal attempt to make sense of the connection, using personal experiences and anecdotes from neurodivergent people to make up for the lack of conclusive scientific data. 

Disruptions in Brain Chemistry

The most straightforward explanation offers a connection between brain chemistry that is common to both conditions. 

Executive dysfunction is caused by issues with neurotransmitter production, impairing your levels of dopamine, norepinephrine, and other key brain chemicals (3)

Neurotransmitters are brain chemicals responsible for sending signals across brain circuits, which is essential to keep your mood, emotions, and motivations under control. 

There is a close connection between the affected neurotransmitters in ADHD and symptoms of depression. Low dopamine levels can reduce alertness, motivation, and mental energy while increasing brain fog, fatigue, and mental exhaustion. This slump can feel like a depressive episode, and it may also disrupt other healthy habits and self-care practices, leading to worse symptoms over time. 

Furthermore, having ADHD makes you prone to problems with brain chemistry balance, then serotonin and other neurotransmitters responsible for your mood may also be disrupted.

Childhood Turmoil And Trauma

Here’s a real kicker - if you have ADHD, then by the age of 12, you are likely to receive 20,000 more negative messages from painful interactions compared to a neurotypical person (4).

It’s no surprise that many people with ADHD experience their first major depressive episodes during their childhood and adolescence. The likelihood is even higher if you weren’t diagnosed while young because you are fighting against an enemy you don’t understand. A lack of ADHD diagnosis means no identifiable root cause that can explain what’s going on.

When you are a child, your life is dictated by other people like your parents. They may not understand what's different about you, even if they have the best intentions.

Many ADHD symptoms can lead to problematic situations: impulsively lashing out at people, feeling overwhelmed, zoning out during conversations, and performing poorly in school. Sometimes, the very fact that you have been diagnosed leads to bullying, stigmatization, and feelings of shame, guilt, and self-loathing.

At that age, you are still learning who you are and struggling in the journey of self-discovery. Growing up, it's hard to properly assess the emotions you have and the problems you are facing. 

Trauma is often repressed, and sharing with others is very challenging. Problematic gender stereotypes, like boys being tough and strong or girls remaining polite and docile no matter how they are treated, further contribute to the repression of emotions.

If unresolved, adverse childhood experiences and trauma can cause negative patterns of thought and behavior that last into adulthood. This can increase the chance of succumbing to depression in the future. 

For example, thinking you are not enough can grow into a deeply rooted belief that stops you from taking the initiative and trying altogether, leading to a lack of personal growth and social isolation. 

A strong feeling of inadequacy and low self-worth means you constantly question your decisions, fear that you are nothing compared to others, and excessively focus on mistakes you've made, even if they are negligible. Over time, the stress and mental pressure build up. Low self-worth can create a self-fulfilling prophecy where you stop trying because you do not believe you can be better. 

Emotional Dysregulation

Redefining negative emotions into positive ones, controlling the intensity of your emotions, being able to distract yourself successfully, and remaining calm even when intense emotions come knocking are all essential to preserving your mental health. 

However, the ADHD brain often struggles with control of how it feels due to emotional dysregulation. The impaired emotional control can intensify existing instances of personal trauma and grief, making it much harder to take control of your emotions and overcome those periods (5)

Emotional dysregulation can also be responsible for conflicts and instances where you mistakenly hurt other people or embarrass yourself, leading to more stress, sadness, and trauma. 

For example, it's much easier to plunge into a depressive episode if you are more sensitive to confrontational conversations and tend to perceive constructive feedback and well-intentioned critiques as harsh attacks. It may have been constructive and neutral talk, but your ADHD brain can panic and catastrophize to a point where it falsely believes the situation will end in rejection and abandonment by the people you care about.

Low Self-Esteem and Self-Loathing

Low self-esteem leads to feelings of self-loathing, guilt, and shame that continue into adulthood.

Low self-worth and perfectionism often dance together, which is why many people with ADHD are perfectionists at heart. Every day, they feel a burning sense of inadequacy, whispering that they ought to be better and do more. If you falsely believe you are inherently flawed, it's only natural to continuously push the limits and over-compensate for personal failure. 

If low self-worth and perfectionism are a fire, ADHD is the provider of fuel due to the higher likelihood of making mistakes that cause negative responses from others. This can include impulsively hurting friends with their words, missing important meetings due to forgetfulness, or thinking of themselves as lazy and stupid because of the difficulty studying and working as much as others can.

Not feeling enough is an emotion coming from a belief that is formed based on specific experiences. However, low self-worth can turn into a chronic state of mind due to the alienation and isolation many neurodivergent people feel in our often hostile, neurotypical society. 

People may minimize your struggle by saying that they also struggle with procrastination from time to time. Friends and family might condescendingly tell you how they wish you tried harder because you have so much potential. You may face the impossible task of being productive in a world obsessed with working yourself to death despite being more sensitive to burnout and motivation fluctuations. 

The issue with low self-worth is that it's hard to stop once you get the self-loathing ball rolling. A few horrible memories begin to constantly spin in your mind, and negative and self-sabotaging rhetoric becomes the default. 

The emotional burden not only grows with time but begins to affect your future interactions as well. If you think of yourself as someone who’s fundamentally flawed, then it becomes much harder to fight for what you want, protect your boundaries, advocate for appreciation, respected, and loved, and treat yourself with the kindness and acceptance you deserve.

Challenges in Maintaining Healthy Habits

Having ADHD often gets in the way of maintaining healthy habits.

Having a healthy diet, sleeping enough, and exercising regularly can considerably improve your ADHD symptoms and reduce stress. Unfortunately, many of the symptoms ADHD carries can disturb your ability to maintain healthy habits.6

• Hyper-focus - This can be productive if you are working on your assignment, but not as much if you are playing video games or going down a rabbit hole on a random internet topic. No matter your current target, hyper-focusing makes you forget about eating, going to bed at a reasonable hour, or going for that essential walk to release some of the pent-up pressure.

• Executive dysfunction - It can stop you from functioning altogether. Getting out of bed, making breakfast, and walking the dog seem trivially easy for most people, but there are days when completing them feels harder than running a marathon. Feeling like you are always behind can be very demoralizing, and the mental exhaustion of always trying your hardest can significantly wear you down. 

• Impulsivity and craving for stimulation - The desire for excitement and novelty often directly clashes with routine, repetitiveness, and proper planning. You rationally know that you should stick to your diet, go to sleep early, and do your cardio, but it can be so boring and soul-sucking that you can't make yourself do it. 

• Sleep issues - The ADHD brain's heightened sensitivity to stress, constant rumination due to anxiety, and emotional dysregulation can make it harder to shut off and relax during the night. Furthermore, anomalies in your circadian rhythm can cause sleep disruptions and periods of insomnia for people with the condition.

Vitamin, mineral, and macronutrient deficiencies, sleep disruptions, and lack of exercise directly harm your brain's ability to produce neurotransmitters and stabilize your mood. 

Your symptoms will obviously still be there even if you do everything right, but they exist on a spectrum, and not taking care of yourself consistently tips the scale toward the negative extreme. 

Not taking care of yourself comes with other more subtle harms that also hurt your mental health, like lower cognitive function and inability to be productive, which create additional problems on their own. The more you struggle to finish tasks, the more likely you are to stay up late, creating a vicious cycle of sleep deprivation and unproductiveness that worsens over time.

It's not only falling short of being productive and healthy that can lead to symptoms of depression. The immense amount of mental effort and personal sacrifice required to keep up with that can be very emotionally draining and mentally exhausting. It can feel like you have to give 250% effort to do everything right for the day.  

Boredom 

When you have ADHD, the production, distribution, and sensitivity of your neurotransmitters are all impaired. As a result, your brain is not producing enough dopamine, norepinephrine, and a host of other essential neurotransmitters required for optimal cognitive function.

Dopamine and other neurotransmitters are released if you anticipate or do something fun, exciting, novel, and challenging. The anticipating part of dopamine release is very often neglected. Just like a dog wiggles its tail in excitement when you are about to go for a walk, you are very likely to get a burst of motivation and alertness when looking forward to something you really want. 

Chronic under-stimulation creates intense pressure to satisfy your cravings with hobbies, creative outlets, passions, and other hyper-fixations or obsessions. Unlike neurotypical people, physical, emotional, or intellectual stimulation and enjoyment are not optional. They are crucial for optimal cognitive function. 

However, just because stimulating activities can alleviate the restless feeling of under-stimulation doesn't mean they will. Many people with ADHD have long periods where they find no joy in their current hobbies, struggle to find new passions, or don't have the time or money to chase their dreams.

The result is a chronic, persistent, and painful sense of boredom, always looming and gnawing at the back of your mind. 

The Stigma Against Boredom

When you have a problem, you naturally want to share your struggle and ask for advice from people. This often doesn’t work if the problem is boredom. On the topic of boredom, most people become total assholes. If you were to complain about boredom being painful, you'd get a reply from a friend, family member, or your partner that says it is totally normal.

When talking about boredom, most people suddenly get possessed by a ghost with a protestant work ethic. They call your suffering whining, reduce your pain to a lack of discipline to endure the "mild discomfort," and encourage you to be more responsible and proactive and find something to do instead of complaining. 

Most people talk about boredom as if it were a tiny scratch. Yes, it might itch and sting a bit, but you can live with it, so there is no point making a big fuss out of it, right? 

However, the intensity with which people experience boredom exists on a spectrum, and people with ADHD usually lean towards the negative half of the extreme. For many people with ADHD, boredom is not just a scratch but an infected wound that keeps itching. No matter what treatment you try, you can only stop the pain for a little while. 

Boredom is an ever-present feeling of frustration and anxiety in the present. A subtle yet powerful tug toward anything that could give you dopamine. It kind of feels like being a cursed seaman who can only drink seawater to survive, giving them temporary relief but never quite satisfying the thirst.

In extreme cases, boredom can even lead to suicidal thoughts – not because you are necessarily sad and miserable, but because you begin to question the point of living. Is life really just subtle yet infuriating psychological pain, with short and fleeting moments of relief before plunging right back into the torture?

How Boredom Can Plunge You In a Depressive Episode

Boredom is an even bigger issue in today's society because of your ability to over-indulge in many things that technically satisfy your cravings in the present but make life more boring over the long term. 

Binge-watching shows, browsing social media, playing video games, watching pornography, or sometimes doing many of them simultaneously can become so over-saturating that everything else grows boring in comparison. 

After a certain point, it's not even that stimulating. It's barely enough to keep you from being painfully bored. Just enough to keep you coming back because it's so easy and accessible, you can become numb, desensitized, and somewhat overwhelmed despite not feeling much. 

This chronic psychological pain due to boredom accumulates over time, making mental exhaustion more likely and burnout more frequent. 

If you are easily bored, then many tasks that would be easy for neurotypical people will require you to put in 3 times more effort than others. Having to force yourself constantly creates additional mental fatigue, creating a vicious cycle that grows worse over time. 

ADHD can make you feel miserable. But it can also make you act in ways that further worsen your misery. Exhaustion and boredom combined with impaired impulse control lead to poorly thought-out actions that put relationships on the line, threaten your financial stability, and ruin your mood when thinking about how you got yourself into this situation. 

Finally, ADHD not only dampens your mood but can also overwhelm you with negative thoughts. If you are internally hyperactive and prone to racing thoughts and anxiety, in many cases, your thoughts will not be positive. Just thinking about your current circumstances, with ADHD making you a prisoner of your own brain over and over again, can worsen the situation even further. 

Nihilism

For the sake of simplicity, nihilism will be defined as a belief and state of mind according to which life has no inherent purpose and meaning. Other views on nihilism also claim that finding meaning by yourself is very challenging, if not impossible. 

If boredom is an ever-present feeling that constantly nags you in the now, nihilism is a perpetual sensation in the back of your mind that shapes your long-term outlook on life.

Having a sense of meaning and purpose is often directly tied to having a clear and well-defined sense of self. This sense of self may be based on your hobbies, career, values, personal connections, and many other factors. For many people, it's defined by how they sustain themselves and contribute to society. 

So, how you feel about your career and how society judges, you can significantly influence the meaning you find in life. After all, the average person spends almost 100,000 working hours. Spending most of your awake hours at work will shape your perception of life around the effort you put into your career. 

Here is the problem: people with ADHD often feel like imposters in their careers and struggle to specialize for long enough to develop a strong sense of purpose. 

Whether it’s your career, hobbies, or creative projects, the commitment you must make is common to every activity you spend time on. Sure, you can enjoy an activity for a few weeks, but it's only through extensive effort and time spent over and over again that it becomes a major part of your life and identity.

This is because finding purpose in what you are doing, enough for it to become part of your core identity, usually means you've made a lot of sacrifices, consistently worked, and remained firmly committed no matter what. 

For example, aspiring doctors go through grueling medical school to prepare and sacrifice countless sleepless nights and thousands of hours to qualify because they feel a sense of duty to protect the health of others in their community. You can also think of lawyers who slowly, with excruciating effort, grind for over a decade from being an intern to associate and eventually a partner in law firms. 

The problem is that ADHD brains are terrible at consistency over the long term due to the intense desire for novelty and variety. Commitment for months, or even years, is extremely challenging. 

Having ADHD makes a person much more likely to switch degrees, bounce between different jobs, and experiment with tons of hobbies by picking them up for a few days or weeks and getting all hyped up, only to move on to the next fun thing while completely forgetting the rest.

Sometimes, the interest remains. You know that you want something, and you really believe it's in your best interest. However, having ADHD makes organizing, creating habits, and crafting routines feel like playing a video game switched to the highest difficulty. This makes it very hard to sustain effort over the long term, consistently find the time, or figure out how to return to an activity after taking a sizable break due to personal circumstances. 

For example, many people with severe ADHD cannot finish their degrees because current teaching methods are not accommodating or are actively hostile toward the neurodivergent way of thinking. They may have hobbies and passions, but struggling to manage time effectively and constantly falling behind on work can make it very hard to find the opportunity to become better at them. 

It's no coincidence that people with ADHD are often called jacks of all trades but masters of none. You've likely practiced countless hobbies and have all sorts of niche facts and knowledge in endless fields. Still, nothing quite feels like the thing that defines you. None of that may be strong enough to anchor you and give you a powerful sense of meaning

It's infuriating and depressing to know you have so much potential to fully dedicate yourself toward a career, hobby, or any other opportunity that'd define your life, but you struggle immensely due to fluctuating motivation, boredom, and executive dysfunction. 

ADHD creates chaos where everything is always changing, and no single constant can serve as an anchor. It feels as though there's no solid foundation to fall upon and no clear answer to the existential questions that emerge from the back of your mind. 

That's why many neurodivergent people experience constant existential dread, chronic insecurity over their identity and direction in life, and imposter syndrome – even if they do find success in what they are doing. 

Key Takeaways

You can treat depression by going to therapy and getting prescription medicine, but some of the symptoms may not go away if you have a co-occurring ADHD that remains undiagnosed. 

Understanding the complex connection between ADHD and depression is crucial for effective and holistic treatment that addresses the underlying causes and symptoms of both conditions. Without an approach that treats both conditions, depression and ADHD can feed off one another, which exacerbates the negative symptoms of both.