Attention-deficit hyperactivity disorder (ADHD) almost always emerges during childhood — and that’s typically when it’s diagnosed. But what about those who grow up without understanding why they sometimes feel as they do? For starters, undiagnosed ADHD is associated with issues like relationship and job-related problems, substance abuse, suicidal ideation, and depression.

Eighteen percent of those with diagnosed ADHD are also diagnosed with a major depressive disorder. Who knows how many people with depression also have ADHD without knowing it? After all, ADHD can have far more serious effects when its presence evades notice. Fortunately, when the co-morbidity is diagnosed, effective treatments for both disorders exist.

How and Why Does ADHD Go Undiagnosed?

Needless to say, each person and each case is different. Even so, two common root issues occur during childhood.

1. Stereotype

Mention ADHD and the first image conjured up in someone’s mind could be the hyperactive, impulsive boy. This is definitely one of the images, but what about those (child or adult) who exhibit symptoms like inattention? This is more common with girls — and also less obvious.

2. Jumping to the Wrong Conclusions

If someone — again, child or adult — is easily distracted, struggles to focus, and tends to procrastinate, they may be judged rather than diagnosed. What they need, we think, is a pep talk to get their act together. After all, goes the conventional thinking, motivated people are more successful than those who are “lazy.”

In both cases, the person with ADHD is made to feel ignored or shamed. Such emotions can lay the foundation for depression. Despite being smart, bright, and ambitious, undiagnosed ADHD makes them appear to be slackers (by society’s skewed standards). As a result:

  • Self-esteem decreases in people with undiagnosed ADHD
  • Individuals feel resentment and anger for being misjudged
  • They become hypersensitive to feedback and expect to be criticized

It’s no coincidence that people with depression will exhibit these same three symptoms.

Undiagnosed ADHD and Its Complicated Relationship with Depression

ADHD Symptoms Are a Daily Challenge

If you have trouble staying on task, paying attention, maintaining organization, and controlling your impulses, you will experience more frustration and irritability in your life. As a child, teachers and parents accuse you of not caring. In adulthood, romantic partners don’t think you’re present with them. At work or in school, you have to work twice as hard just to keep up. This is enough to lower anyone’s mood and depression is nothing if not a mood disorder.

Emotional Regulation

Another factor that creates a low mood is an inability to regulate your emotions. Everything is a potential trigger for someone with ADHD, and this rarely goes unnoticed. You feel unfairly judged and the ensuing frustration just adds to your emotional regulation problems.

Fear of Failure

Children and adults with ADHD may avoid or delay trying hard tasks. They know they need a little more time or perhaps a more ideal environment to succeed. Unless such accommodations are made, they will do anything to evade being noticed. When this becomes your daily reality, it’s natural that you’ll begin feeling depressed.

It’s Harder For Women

Studies show that females of all ages are at a greater risk of depression. This carries over to females with undiagnosed ADHD who are twice as likely to develop depression than peers without undiagnosed ADHD.

Our Take-Home Message

Clearly, we need far more work and effort to be delegated to the co-morbidity of depression and ADHD. Clinicians need greater awareness and more effective measurement-based tools. If you found yourself nodding along as you read this post, you can benefit from a consultation with a mental health professional who gets it. To learn more about our approaches working with adults with Depression and ADHD please follow the link: Depression Treatment | Dr. Sacarin Listening Center | Seattle, WA