Attention-deficit/hyperactivity disorder (ADHD) may be an even bigger predictor of depression and anxiety in adulthood than autism is, a new study finds — highlighting the mental health side of the disorder.
It's known that kids and adults with ADHD often have co-existing conditions, including depression and anxiety. Research suggests that about 14% of children with ADHD have depression, while up to 30% have an anxiety disorder, according to the National Resource Center on ADHD.
Adults with ADHD, meanwhile, are even harder-hit — with each of those conditions affecting up to half.
The new study, researchers said, adds to what's known by showing that ADHD is even more strongly linked to anxiety and depression than "autistic traits" are. Autism, which impairs communication and social skills, is itself tied to higher-than-normal rates of those mental health conditions.
The findings spotlight the mental health component of ADHD, according to Richard Gallagher, an associate professor of child and adolescent psychiatry at NYU Langone Health in New York City, who reviewed the findings.
"There's a notion that people with ADHD have a 'simple' problem with paying attention," he said. "They just need to learn to sit down and focus."
But like autism, ADHD is a neurodevelopmental disorder, and it can cause significant problems at school, work, home and in relationships, Gallagher said.
"Over time, it can impact quality of life," he said. If, for example, young people with ADHD become convinced they're going to "fail" at completing tasks or doing them well, that could feed anxiety or depression.
It's also possible that some people are more vulnerable to all three conditions, said Punit Shah, the senior researcher on the new study.
"We know there are some shared genetic factors that make people susceptible to both ADHD and anxiety and depression," said Shah, an associate professor of psychology at the University of Bath in the United Kingdom.
Gallagher agreed that could play a role, too, noting that difficulties with emotional regulation are a feature of ADHD. That could mean there's some overlap in the brain areas involved in the different conditions.
The findings — published online Jan. 16 in the journal Scientific Reports — are based on 504 British adults who completed standard questionnaires gauging traits of ADHD and autism, as well as depression and anxiety symptoms.
Overall, Shah's team found, ADHD traits and depression/anxiety symptoms rose in tandem in the study group: The more severe the ADHD traits, the more severe the mental health symptoms. There was a correlation between autism traits and mental health, too, but it was weaker.
"ADHD is more strongly statistically linked to anxiety and depression than autistic traits are," Shah said.
The study did not look at whether participants had ever been formally diagnosed and treated for ADHD or autism, and whether that affected the likelihood of depression/anxiety in adulthood.
According to Gallagher, kids being assessed for ADHD should also have their emotional well-being evaluated. Attention problems are seen in depression and anxiety disorders, too, so those causes should be ruled out, he noted.
Even if ADHD is the diagnosis, though, Gallagher said, mental well-being needs to remain on the radar. Ideally, young people with ADHD should have their mental health assessed over time.
"It's important to be aware that neurodevelopmental conditions, like ADHD, can come with emotional issues that need attention," Gallagher said.
The standard treatments for adulthood ADHD typically involve medication, training in skills like organization and time management, and psychological counseling. If depression or anxiety are also present, Gallagher said, the standard psychological therapies for those conditions can help.
According to Shah, more research is needed to understand why ADHD is so strongly linked to depression and anxiety. He said his team is "running a range of studies" on ADHD, autism and mental health.
The Mayo Clinic has more on ADHD in adults.
SOURCES: Punit Shah, PhD, MSc, associate professor, psychology, University of Bath, United Kingdom; Richard Gallagher, PhD, associate professor, child and adolescent psychiatry, NYU Grossman School of Medicine, director, Organizational Skills and Executive Function Treatment Program, NYU Langone Health, New York City; Scientific Reports, Jan. 16, 2023, online