March 13, 2024

Hello Darkness My Old Friend—was it ADHD or Depression this time Around?


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{This article is written in partnership with BetterHelp. They’re dedicated to helping folks get easier, more affordable access to mental healthcare, and we’re proud to work with them. ~ ed.}

This is so stupid!

I’m camping on a beach with views of mountains and a gorgeous blue-green sea, surrounded by locals enjoying a weekend of fun with their families, and yet I’m so sad!”

Sobbing uncontrollably, I couldn’t understand how this was even possible. How could I still be depressed in such a beautiful place? I was traveling again, something I wish for and daydream about often.

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It was our third night in Mexico and instead of feeling grateful for the privilege to be there—I was a hot and emotionally confused mess.

Luckily, BetterHelp makes it so dang easy to connect with my therapist whenever I have internet service. I was able to have our scheduled therapy session on my phone to cry on her virtual shoulder, right from my campsite.

I was so distraught and stuck in a negative thought loop that I almost skipped therapy that day—feeling in no mood to talk to anyone—but as I started to send the message to cancel, I changed my mind at the last minute.

I’m glad I decided to talk to my therapist and not isolate myself, something I instinctively do whenever I feel down, because I really needed her.

She helped me get unstuck and thinking clearly again.

She was kind and patient, allowing me to let it all out, and she sympathized with my distress.

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She knew that for months I’d been excited and dripping with anticipation to start our two-month road trip down to Baja California. I let myself get lost in the research, watching many videos and reading countless blogs of travelers who went on the same adventure.

I was so focused on planning that I procrastinated doing other important things, like packing up the van or practicing basic Spanish. I also neglected to get things in order at home, like reaching out for help checking our mail and watering the plants, or cleaning up the house before we left.

My therapist knew this was happening and gave me advice to take breaks with the fun stuff and set timers to tackle the boring work.

I didn’t listen though, making for a few frantic days of rushing to be ready, forcing myself to shift my focus to accomplish the undesirable things at the last minute. It became a mad and stressful dash to finally hit the road.

Then there was the stress of crossing a foreign border for the first time, getting lost trying to find the immigration building, and not being able to communicate with officials. Plus my husband’s bad heart raced alarmingly as we waited to get our tourist permits.

The stress had given my mental state a severe beating. I felt irresponsible and berated myself as a disrespectful, ignorant gringo thinking I could wing it in a foreign country.

I felt like no matter what I do or where I go, my depression would always follow, but my therapist helped me see that my downward mood swing was likely ADHD at play this time.

She suspected I was crashing from the buildup of dopamine while planning for our big Baja trip.

Dopamine, also called the pleasure chemical, is the neurotransmitter responsible for our brain’s reward system and causes the desire to seek out and accomplish goals that bring value to us. This is believed to be dysfunctional in people with Attention Deficit Hyperactivity Disorder (ADHD). [2]

She told me it was okay to feel what I was feeling, that the stress of the last few days had overwhelmed me too.

She helped me get out of my head and brought me back to the reality of the extraordinary experience I had created for myself. She reminded me that I had accomplished what I set out to: I was on my Mexican adventure! I could relax and enjoy it now. She was proud of me.

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Seeking Therapy for ADHD and Depression

When I first signed up for online therapy with BetterHelp, I was feeling low and disappointed that my depression was back. Just a few months before, I thought I’d figured out how to keep it under control.

I’d learned healthy coping strategies to keep myself from falling into a depressive episode even while major life changes and grief were threatening to consume me.

I had joined the Elephant Academy’s spring and summer sessions and was writing again. I was thrilled to be active in the community, feeling fulfilled and focused on helping my friends succeed too.

Then my writing began to get some recognition. I was in a glorious, rewarding flow state and working hard to share my story with determination to help others dealing with depression. 

Things were going so well. It felt wonderful contributing something positive to the world. But soon after the Academy was over, it all came crashing down again and the depression came back.

In the beginning, BetterHelp had me fill out a questionnaire so they could assign a therapist who specialized in what I needed help with. I wondered if ADHD was the actual cause of my depression after experiencing such a crash in my mood and motivation after Elephant Academy ended. It wasn’t the first time something like this had happened after a big event or project was over, and I began to connect the dots.

I wanted a formal diagnosis to give me a missing piece of the puzzle of my lifelong struggles with mental health.

I thought an ADHD diagnosis would also prove to others (and myself) that I wasn’t simply a lazy loser who didn’t care enough to have a lasting career, remember birthdays, or clean my house regularly.

It might explain why I felt broken, struggled so much to stay on my game, and couldn’t seem to regularly function like “normal” people.

In less than 24 hours, BetterHelp assigned to me an amazing therapist that had experience in helping people manage depression and ADHD. I was excited to get my diagnosis and get to work on finally fixing myself.

Full disclosure—it turns out that BetterHelp therapists cannot diagnose ADHD, but what they can do is help us make sense of our experience and manage our symptoms. 

My therapist asked me if I needed a formal diagnosis to move forward so I contemplated how important it really was for me.

Based on my own research, which included online diagnostic tools, reading loads of articles, and watching many videos from reputable ADHD experts, I didn’t question that I had this neurological disorder.

Deep down, my desire for a diagnosis was truly about proving to others that my difficulties in functioning normally were more than a choice. I’m not lazy dammit! It was a way to explain that my struggles were real because my brain was actually different.

I’m a recovering people pleaser and still relapse from time to time. Once I realized that my desire for a diagnosis was mostly to eliminate the judgment of others, I knew I didn’t need it. What I needed was validation for myself—that my symptoms existed and were not all in my head. 

I needed to know my mental health wasn’t doomed to suffer from the ups and downs of temporary success and endless failures forevermore. I needed to believe I could stick to things, accomplish my goals, and count on myself, and my therapist has been helping me do that.

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She’s helping me learn to live with and navigate the sometimes-turbulent waters associated with this disorder.

She’s helping me distinguish the difference between ADHD shame and self-esteem issues versus my recurrent depressive episodes that are caused by other things.

She shows me empathy when I’m so distraught I can’t speak or even form coherent thoughts. And she reminds me that I can overcome my challenges no matter how hopeless it seems.

I always feel better after talking to her, no matter how emotional or overwhelmed and crazy I’m feeling.

I’m so grateful to BetterHelp for connecting me with her. I have a lot to learn and still stumble, but having my therapist in my corner, encouraging me when I do well and showing me love and kindness when I don’t, has meant the world to me.

The ADHD and Depression Connection

Statistics show that one in three people who have been diagnosed with ADHD also have depression and 18.6 percent of adults are affected by both disorders. 

For some people, the depression is a result of their ADHD symptoms causing them to feel overwhelmed with life. At the same time, the two conditions are often mistaken, and many people are misdiagnosed with depression because the symptoms can mimic those of ADHD.[1]

I had already determined that my depression tends to be heavily influenced by external circumstances. It makes sense that I get sad when bad things happen, and a lot of bad things have been happening throughout my life. I also knew that depression runs in families, and mine has it on both sides. 

But after learning ADHD can cause low self-esteem and that adults can develop a poor self-image, an extreme sensitivity to criticism, intolerance to stress, and a tendency to heavily criticize themselves—I thought, wow, does that sound familiar![2]

So, I’ve been hit with a double whammy: my ADHD sometimes causes my depression, but I also suffer from the disorders on their own and at the same time.

The times they co-occur is when it gets really hard to function.

Research has shown that the more severe the symptoms of ADHD, the more severe the symptoms of depression, and the people whose disorders co-exist tend to be more significantly affected by their symptoms than those with either disorder alone.[5]

It’s no wonder that I experience recurring depressive episodes, especially when life is throwing a lot at me. 

I get lost and consumed with negative thoughts and can’t pull myself out of it. I cope in negative ways through numbing and escapism, completely avoiding the bad feelings of inadequacy and my inability to just do the thing. I isolate and hide from the world.

These avoidant coping strategies are common for ADHD and only makes things worse, which might explain how it can lead to depression.[5]

ADHD symptoms can also wax and wane throughout a person’s life.[4]

Sometimes I don’t notice them as much and am able to function somewhat normally, especially when nothing particularly bad is happening in my life. But my ADHD symptoms have gotten worse lately.

I misplace things more than I ever remember doing in my life. It drives me crazy when I lose my phone and tear the house apart, eventually finding it on a random shelf or on top of the bathtub.

I can’t handle stress the way I used to, sometimes not at all.

I struggle to make decisions and constantly second-guess myself.

I hyper-focus on things I want to be doing and interruptions or distractions from those things can cause intense feelings of rage.

It doesn’t take much to feel completely overwhelmed until I become paralyzed into inaction and begin to feel down when I can’t handle the big feelings.

I’ve always thought the times of feeling down in my life were due to my depression, but now I know that having a desire to do something fun and rewarding (and avoiding the things I should or need to be doing) means that it’s not.

Or rather, it can be depression, but it’s my ADHD that caused the episode.[3]

Depression on its own is different. It makes me desire nothing at all. It makes me not care one lick that I’m doing absolutely nothing, eating very little, and drinking too much alcohol to shut out the pain.

This kind of depression always comes on from something external, like when there’s family drama and fighting or when my husband gets sick—and I’ll shut down completely.

ADHD has likely been the cause of my feelings of sadness and worthlessness more often than just being depressed.

I can only feel like a failure when I’ve actually tried or want to try something. When it’s depression alone, I can’t and don’t care to even make an effort.

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I can’t thank my therapist enough for the insights and help she’s given me with my ADHD and depression. Every week she teaches me more about these sometimes debilitating, but totally manageable disorders. I’d be lost without her.

If you are suffering from ADHD or depression, or both, I encourage you to sign up with BetterHelp to start getting help managing your symptoms today. You do not have to suffer alone.


[1]  When Depression Co-occurs with ADHD

[2]  What’s the Relationship Between ADHD and Dopamine?

[3]  Am I Depressed? Symptoms of Depression and ADHD, Untangled

[4]  Does ADHD Go Away?

[5]  ADHD And Depression: Exploring The Connection

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