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Children may sometimes feel sad or down, but if these feelings become too strong and start to affect their daily life, they might be diagnosed with a depressive disorder. This quick fact will help you:  

1. Recognize the symptoms of depression in your child with ADHD
2. Know what to do if you suspect your child with ADHD may have depressive disorder 
3. Learn how your child’s doctor will diagnose and treat co-occurring depression and ADHD 

What are the signs and symptoms? 

• Feeling sad, hopeless, or numb mood for most of the day, nearly every day 
• Losing interest or pleasure in activities they previously enjoyed 
• Significant weight loss or weight gain, usually with appetite change 
• Having difficulty sleeping or sleeping too much 
• Loss of energy 
• Talking about thoughts of suicide 

Symptoms of ADHD and depressive disorder can overlap. For example, feeling restless and fidgety and struggling to pay attention can be symptoms of both ADHD and depressive disorder. 

How common is depression in children with ADHD? 

Nearly one in five children with ADHD also have depression. For some children, depression can make ADHD symptoms worse. For other children, struggling with ADHD symptoms can lead to feelings of frustration and helplessness. Over time, this can lead to the development of a depressive disorder.  

What causes depressive disorder? 

There is no single cause for depressive disorder, but several factors may play a role including genetics, environment, stress from illness, trauma, family relationships, and major life changes like death of a loved one or divorce.  Careful diagnosis and treatment are needed to understand if a child has both conditions.   

Strategies for helping your child with ADHD and depressive disorder 

Take the following steps if you think your child with ADHD may have depressive disorder. 

• Keep your face, voice, and body calm. Be reassuring and hopeful. Show your child how you cope when you feel sad, hopeless, or low energy. Children learn by watching the behaviors of those around them.  

• Show your child how to deep belly breathe to help them stay calm and relaxed.  

• Help your child practice mindfulness, a strategy that helps them learn how to stay present in the moment and sit with their thoughts without feeling bad or reacting. 

• Teach your child to catch thoughts that are not helpful, check the thought, and then change them.  

• Encourage them to do things they enjoy doing, especially if it includes physical activity, and make sure they get enough sleep and good nutrition   

• If your child’s depression is severe, or keeps them from school or play, ask your health care provider about diagnosis and treatment.  

• Be aware that depression with suicidal thoughts or plans is very serious.  Watch for signs like your child collecting things that could be used for self-harm. Immediately contact a professional and make sure any weapons, especially guns in the house are locked up and ammunition locked separately. Keep all medications out of your child’s reach.  

Diagnosis  

Your child’s doctor will do a thorough evaluation that includes: 

• Looking at your child’s developmental, educational, social, medical and mental health history  

• Considering ongoing or past ADHD treatment 

• Looking at your family’s developmental, neurological and mental health history   

All this information will be collected from interviews with parents and the child, teacher behavior ratings, observations, and clinic-based psychological testing.  

Treatment 

Non-medication treatment for children with ADHD and depressive disorder may include: 

• Behavioral therapy that focuses on current behaviors and ways to change them 

• Cognitive Behavioral Therapy (CBT) that is focused on changing negative thoughts and thinking patterns 

• Interpersonal (family) therapy that works on current family issues and relationships 

• School-based mental health support 

Medication may be needed to help reduce symptoms of either ADHD or depressive disorder or both. Some antidepressants can also help with ADHD symptoms, but they are not officially approved by the FDA for treating ADHD. It’s best to use medication together with behavioral therapy, CBT, family therapy, or school-based mental health support as part of a complete treatment plan.  

The treatment plan needs to be watched carefully so changes can be made when needed to get the best results. 

Additional reading and references 

• CDC. Anxiety and Depression in Children. 
• NIMH. Depression.  
• National Academies. Tools for Supporting Emotional Wellbeing in Children and Youth.