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Old 10-25-04, 11:26 AM
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Do you think ADHD is a form of depression?

I ask that because when people are depressed they tend to have problems with concentration/attention and staying on task. Also, antidepressants like Wellbutrin are helpful for many with ADHD.

My 10 year old daughter was only mildly hyperactive (though she was dx'd with ADHD at the time) when her sister died 2 years ago. She has been much more hyperactive since that time. Her attention is about the same-- maybe slightly more of a problem. I realize that this is subjective but the increase in her hyperactivity was very notable after the tragic accident.

ADHD has been renamed and re-categorized many times now. There are many similarities with it and Bipolar Disorder and depression is common in ADHD as well. Do you think it will some day be considered an "affective" or "mood" disorder ?
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Old 10-25-04, 02:20 PM
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Interesting possibility. I have wondered this before, and I'm interested in finding out what others think of this.

Given the lack of self-awareness that is so common among ADDers, I was intrigued when I read about Gary Schwartz's work (you can find a discussion of this in the book Emotional Intelligence). Certain facial muscles are activated depending on the emotion being experienced. Schwartz identified some people as "supernormals". They were activating "grief muscles" in their faces that corresponded to depression, but didn't think they were depressed. The same held true for anxiety.

So, I do wonder how many ADDers would say that they aren't depressed, when in fact they are but don't realize it. This might account for the fact that sometimes, an antidepressant medication is all that is needed.

I don't think this would apply to all ADDers, but it does seem to harmonize with the old ADD problem of not knowing how much you can handle, basically overestimating (or underestimating) your skill, your ablity to cope, and the pace you can maintain. Why would this tendency not carry over into other estimations of oneself?

I would guess that a great many of ADDers are also "supernormals".

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Old 10-25-04, 02:54 PM
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I like the theory of this, but I know in my case it isn't depression. If any of us think our AD/HD is depression, then if the depression is medicated and the ADHD goes away, then it must be a diagnosis of depression, and not one of ADHD.

If the AD/HD remains, despite treatment with anti-depressants, then it has to be ADHD. I was as fluff headed after depression therapy was underway as ever.

I like the idea of this, but for me it wouldn't work. I was happily in dream land and being my usual hyperfocused/inattentive self......with no depression.

One thing I will add; I do tend to be a depressive, but it appears to be rather seasonal....so perhaps there is something to your theory, Salsa

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Old 10-25-04, 02:57 PM
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The research that has been done shows that ADD affectsa different part of the brain than depression does.
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Old 10-25-04, 03:43 PM
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Tara is right.

Major Depression is often a result of hyperreuptake of serotonin. ADHD is not caused by this. Though the exact cause of ADHD is not known, it is believed to be caused by hypoactivity of the frontal cortex and low levels of Dopamine.

Depression sometimes mimics the symptoms of ADHD, however, (and this is a pet peeve of mine), showing symptoms of ADHD while having Depression does NOT mean that you have Depression and ADHD. It means that you have Depression. ADHD is not present in everyone who shows ADHD-like symptoms. Many anxiety, somatophoric, affective, and behavioral disorders that are NOT ADHD can mimic the effects of ADHD, because ADHD primarily affects activity and attention, which are two very basic functions of the brain, and therefore can be affected by many, many things.

I believe far too many times people who have depression are diagnosed ADHD with Depression, when in reality the Depression is simply mimicking ADHD like symptoms. That is why it is important in diagnosis of ADHD to demonstrate that the symptoms have been present since before age 7. Even then, other disorders that can mimic ADHD, such as Anxiety Disorders, Major Depressive Disorder, or BiPolar Disorder, must be ruled out.

Just because it looks, walks, and talks like ADHD does not mean it is ADHD.

Therefore, I would conclude that ADHD is not a form of Depression, in fact, if ADHD is being "caused" by Depression, it's not ADHD at all, just a symptom of Depression. Depression and ADHD are two very different things with very different causes and very different treatments. They should never be treated as the same thing, and while Depression, Anxiety Disorders, or Inferiority Complexes CAN arise from ADHD, ADHD can NEVER be caused by another disorder.
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Old 10-25-04, 04:05 PM
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i concur completely with your statement miller
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Old 10-25-04, 05:18 PM
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Quote:
Originally Posted by livingwithadd
The research that has been done shows that ADD affectsa different part of the brain than depression does.
I'm thinking that ADHD is primarily related to the frontal lobe, but I believe I've also read where the hippocampus (which is a part of the limbic system) can also play a part.
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Old 10-25-04, 11:18 PM
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Interesting posts, all, here. I just want to address a couple of points from KMiller's post.

There is little evidence that depression is caused by a deficiency of serotonin. In fact, if that were true, antidepressants should be almost instant-acting, since they do immediately begin to affect neurotransmitters in the brain. Specifically, SSRI's begin act on the serotonin system in the brain within hours of the first dose. Yet, we don't see effects from them for at least days and generally weeks.

A theory which takes this into account is that antidepressants work by altering the way receptors respond to neurotransmitters. This process would be a gradual result of reuptake inhibition (and therefore increased presence) of neurotransmitters. That said, there is little to no evidence for this theory as well.

Practically the only evidence that depression is caused by any deficiency of neurotransmitters is the fact that antidepressants known to affect reuptake of said neurotransmitters work. To conclude that there is a causal link between serotonin levels and depression is flawed logic. I'll use my best example here: Albuterol is a very effective med used to treat acute asthma attacks. In most cases, it is effective within minutes. Yet, noone claims that asthma attacks are caused by a drop in albuterol levels in the body! If that's not convincing, then substitute "Ritalin" or "methylphenidate" for albuterol and "ADHD" or "ADD" (whichever you prefer) for "asthma."

The alternative hypothesis is that depression is the cause of decreased neurotransmitter levels/activity. Antidepressant meds fit into this theory by kicking off a feedback loop that starts by modifying neurotransmitter reuptake and ends by elevating mood.

Also, while KMiller is 100% correct that the ADHD diagnosis from the DSM IV explicitly requires that symptoms are not accounted for by any other mental or medical disorder, there is controversy about that as well. For example, if I am depressed and highly distractable, does my distractability "belong to" the ADHD or the depression?

Response to medication is not an effective diagnostic tool here. Remember that amphetamines have antidepressant properties, too, and were prescribed in the past to treat depression. If I'm depressed and have ADHD and the distractability responds to antidepressants, does that then mean I didn't have ADHD? Conversely, if the distractibility does not respond to antidepressants, does that mean I do have ADHD? What if it responds to neither? What do I have then?

Finally, as a psychiatric patient, an extremely relevant question to me is "Does it matter?" My personal answer to that question is "No, as long as I feel better, the diagnostic label does not matter."

I have struggled with the question of whether I have ADD and nonverbal learning disorder or just nonverbal learning disorder. Both syndromes present similar symptoms, just like ADD and depression can mimic each other. I am convinced (for reasons I won't get into for fear of dragging the thread offtopic) that I do have at least the LD. I've also been chronically dysthymic probably since adolescence or even childhood.

My meds (Strattera and Wellbutrin) help me feel better. I've also seen huge improvements in my ADD-type symptoms since starting medication. For me, that's the most important thing.
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Old 10-26-04, 12:20 AM
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As far as the causal relation, I stand corrected. This is true, that the causal link has not been established. A lot of that, however, is due to the fact that we not only don't know the causes of the disorders, but we don't know the mechanisms of action of most drugs, either. We have no idea why psychostimulants help ADHD, but they do. Likewise, we have no idea why SSRIs help a vast array of depression and anxiety disorders, but they do. So while it is true that there is no causal relation, I stand adamantly by the assertion that if different drugs that do different things cause different results, there must be different problems.

Now, as to whether your distractability "belongs to" ADHD or depression, I would answer that like this. If you were distractable because of ADHD before the onset of depression, it "belongs to" the ADHD. If you were not distractable until after the onset of the depression, it "belongs to" the depression. If both depression and ADHD have been comorbid since birth, then if the distractability is responsive to ADHD medications, and not to antidepressants, it "belongs to" the ADHD. If it is not responsive to ADHD medications, but is responsive to SSRIs, then it "belongs to" the depression. If it is not responsive to medications for either depression or ADHD, it's time to start looking for additional comorbid conditions that could be causing it.

As a psychiatric patient, you're just about right. If the medication is working, who cares what it's working against? However, as a person who is training to become a diagnostician and therapist, these things are extremely relevant to me. They are also very relevant to people who don't know what they have, and therefore don't know how to begin going about treatment.

As far as NLD and ADHD, they do have similar symptoms. However, NLD has a much broader range of symptoms along with it. Provided that Strattera and Wellbutrin are functional, and they put the ADHD symptoms and dysthymic symptoms in remission, we can conclude that there is an NLD, and also ADHD. How? Because unlike stimulants, to which _everyone_ is responsive, Strattera is only really effective in treating ADHD, and then only in patients who have hyperreuptake of Norepinephrine. While it is true that it is irresponsible and untrustworthy to make a diagnosis based solely on responsivity to medication, it is also true that responsivity to medication can be very useful in _verifying_ whether the already made diagnosis is valid.
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Old 10-26-04, 09:29 AM
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No.They're often comorbid but there are different neurotransmitters involved.
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Old 11-21-09, 04:15 AM
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Re: Do you think ADHD is a form of depression?

I'd say that ADHD and depression are different 'illnesses', but the ADHDer's tendency to make a total mess of their life (and then hyperfocus on their failures), means that a person with ADHD is far more likely to suffer with depression, which, by its very nature, is a condition that would itself negate most of the symptoms of ADHD. If you are depressed, you aren't creative etc.

I have full-blown ADHD (hyperactive, inattentive and just plain crazy), and have had depression. Funny thing is, I had depression right up until the moment I found out about my ADHD - after that I was able to exactly pinpoint 'what's wrong' and do something about it. So, the reason I was depressed was because I knew I was a social misfit but didn't know why. (7 different psychiatrists couldn't figure it out!)

Interesting topic.
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Old 11-21-09, 08:17 AM
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Re: Do you think ADHD is a form of depression?

I'm no clinician, but I'd say from the examples you've given and more I'd lean towards them being distinct disorders:

A) Correlation does not equal causation. Think about it, the mean roughly 25.5% comorbitidy (according to some studies) with mood disorders makes pretty good sense: Children with ADHD are more prone to maladaptive coping strategies, and impulsive/hyperactive behaviors which result in social difficulties and occasionally trouble with the law, plus a whole other plethora of impairments such as low academic achievement which all would promote low self esteem, low ratings of self-efficacy and an external locus of control.

B) The original predecessor of MBD proposed, at one point, it had about 99 symptoms. We've narrowed this down quite a bit, and still are trying to decide whether predominantly inattentive ADHD should even be classified as ADHD. The varying terms often have basis in influential research at the time, and the categories tend to change with new research and subsequent shifts in the popular consensus of the time.

C) ADHD is a fairly pervasive disorder, usually stemming from before the age of seven. I can't say the same about mood disorders. Can you?

D) Remember that Wellbutrin (bupropion) is a NDRI, which means it inhibits re-uptake of norepinephrine and dopamine, the same two neurotransmitters believed to contribute to the biological etiology of the disorder.

E) Very strong genetic basis remains for ADHD, ( 0.8 in identical twins) as well as an increasing amount of specific versions of genes which occur in conjunction with the disorder, exclusively. These same genes aren't present in depression, thus they indicate separate biological causes.

F) Structural abnormalities + genetics:

Taken from the national institute of mental health:

Children with ADHD who carry a particular version of a certain gene have thinner brain tissue in the areas of the brain associated with attention. This NIMH research showed that the difference was not permanent, however, and as children with this gene grew up, the brain developed to a normal level of thickness. Their ADHD symptoms also improved.

This explains why about 65% of children seem to have a dramatic reduction of symptoms by late adolescence.

Same thing for depression? I think not!


Sorry, would cite more resources properly, but I'm lazy. Do a google scholar search and you'll find ample data which suggests ADHD as a distinct disorder.


But you'd be right in asserting that the gap between predominantly inattentive and other subtypes is large enough that it may be better to consider it a distinct disorder on its own.
Additionally, it is widely believed that the defining characteristic of ADHD is a deficit in behavioral control stemming from neurological causes.
That doesn't sound like a mood disorder to me! But the effects of it, especially if untreated or comorbid, can definitely cause depression, for good reason!


Oh right, and lastly, depression often can enters periods of complete remission, ADHD does not (ever). When remissed, the depressed patient's symptoms of inattentiveness go away. They can go off the antidepressants and (hopefully) not become depressed again, whereas if you have ADHD and your core symptoms are being treated with stimulants, once the stimulants go the symptoms come back really quickly.

I suggest you read some Russell Barkley, he's awesome. He gives ample empirical research data from journals do back up his assumptions to.
(unlike me, as you can see, haha)

Oh yeah, and my GP and psychiatrists decided not to make any diagnosis other than major depression until it remissed successfully on bupropion.
And remember that stress exacerbates all things, as a general rule. Maybe recent trauma could be exacerbating ADHD symptoms?
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Old 11-22-09, 05:56 AM
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Re: Do you think ADHD is a form of depression?

I have both and they are two seperate problems, one being a mental illness and one being what i simply refer to a disorder, or neuro disorder. They can overlap in symptoms, as pointed out here, and my depression may very well be the result of a living a life with undiagnosed and probably quite severe ADD, but still, two different things. ADD, or mine anyway, has some quite distinct 'symptoms' that don't belong to Depression, such as affecting the speech part of my brain.

I do think that its possible, however, for Depression to be mistaken for ADD, given the affect Depression has on memory, focus, concentration and the mess this can create for someone trying to perform tasks that should be simple, but aren't. Especially for people who have had Depression long term, which would equal long term poor performace and problems that we associate with ADD (not holding down a jobs, relationship probs etc.)

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Old 11-28-09, 10:34 PM
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Re: Do you think ADHD is a form of depression?

I don't think it's a form of depression but I do feel a misdiagnosis or no diagnosis or lack of proper treatment/medication/therapy can certainly mimic depression.My life story is a testimonial to that
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Old 01-25-10, 03:38 AM
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Re: Do you think ADHD is a form of depression?

Quote:
Originally Posted by Salsa View Post
I ask that because when people are depressed they tend to have problems with concentration/attention and staying on task. Also, antidepressants like Wellbutrin are helpful for many with ADHD.

My 10 year old daughter was only mildly hyperactive (though she was dx'd with ADHD at the time) when her sister died 2 years ago. She has been much more hyperactive since that time. Her attention is about the same-- maybe slightly more of a problem. I realize that this is subjective but the increase in her hyperactivity was very notable after the tragic accident.

ADHD has been renamed and re-categorized many times now. There are many similarities with it and Bipolar Disorder and depression is common in ADHD as well. Do you think it will some day be considered an "affective" or "mood" disorder ?
I personally think that ADD should be classified in the same group as anxiety/depression/bipolar etc. They're so similar that they're mistaken for one another all the time. ADD causes major concentration problems, and so does anxiety/depression. ADD causes emotional problems (low self esteem, social problems, short temper, mood swings, acting out or being withdrawn) and so does depression/anxiety. ADD makes it hard to do anything for long periods of time, makes you daydream a lot- and so does anxiety/depression. They have almost identical symptoms. The only thing is, with depression the focus is put on how you feel. With ADD the focus is on your attention. When in reality, both of those things are affected in both disorders.

Many people think depression is just feeling sad, and it's not. It is much much more than that. And ADD/ADHD is much more than just a lack of concentration.
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