Depression, Anxiety, and ADHD: A Daily Treatment Guide

Girl with ADHD and depression sitting on floor by wall

Many adults who have attention deficit disorder (ADHD or ADD) also struggle with anxiety or depression.

Sometimes these comorbid conditions arise independently of ADHD. Yet they can also be the result of the chronic stress and discouragement that come from living with ADHD. In women with ADHD, sad, anxious feelings — as well as ADHD symptoms — tend to increase during the pre-menstrual phase. Symptoms also tend to flare up in the years leading up to and during menopause.

What’s the best way for adults with ADHD to overcome anxiety or depression?

The first step is to make sure that you’re getting appropriate treatment for your ADHD. If there are no complications, having your primary-care physician prescribe stimulant medication can work very well. But watch out: ADHD is a nuanced disorder, especially in adults, and many otherwise competent doctors aren’t very good at determining the proper type or dosage of ADHD medication.

If a primary-care physician has prescribed medication for your ADHD but you feel it’s not working well, consult a psychiatrist who is experienced in treating adults with ADHD. In addition to making good choices regarding medication, a psychiatrist may be better able to help you manage side effects and to determine whether you suffer from any comorbid conditions.

In addition to medication, certain changes in your lifestyle can go a long way toward alleviating anxiety and depression, leading to happier living.

Many adults with ADHD have trouble falling asleep, and sleep deprivation can worsen symptoms of the disorder. Sleeplessness reduces your ability to cope and leaves you feeling demoralized.

To improve your sleep patterns, go to bed at the same time every night, and avoid exercise and other stimulating activities for at least an hour before turning in. A hot shower or bath just before bedtime can also help. If sleep problems persist, consult a doctor.

Recent studies have shown that when children with ADHD spend more time in natural settings, their symptoms are less severe. I suspect that the same is true for adults, though it’s unclear precisely why adults with ADHD benefit from “green time.”

For millennia, humans lived in close proximity to nature. Now we’ve largely shut out nature — spending our days in climate-controlled, synthetic environments. We’re just beginning to understand that living this way may have a negative effect on how we feel and function.

I recommend at least 30 minutes a day of green time. That’s easy to do on weekends. During the week, you might walk or bicycle to and from work. If that’s impractical, pick a scenic route for your commute. Eat lunch in a park. After work, take a walk.

Getting more green time increases your exposure to sunlight — a terrific mood-booster. Yes, we all know that overexposure can cause skin cancer and premature aging of the skin. Yet recent studies suggest that a certain amount of sunlight can help people feel happier and less anxious.

In recent years, there’s been a lot of talk about seasonal affective disorder, or SAD, a form of depression associated with winter’s shorter days. In reality, all of us experience some degree of seasonal blues. Our brains seem to be “programmed” by sunlight. It affects not only our moods, but also our patterns of sleep and wakefulness.

If you suspect that a lack of sunlight is affecting your mood, ask your doctor if you might benefit from using a high-intensity, full-spectrum light. Twenty minutes of exposure a day is usually enough. But don’t confuse “light therapy” with sunbathing. The important thing is to expose your eyes to light.

A daily workout does more than produce the natural mood-boosting compounds known as endorphins. It makes it easier to fall asleep at night, and more sleep means better moods. And if you go outside to exercise, you’ll be getting exposure to sunlight. For a triple benefit, try taking a daily 30-minute walk in a natural setting.

Adults often turn to high-carb treats when they’re feeling down — a candy bar in the afternoon, chips or crackers during the day, ice cream after dinner. These foods can make you feel a bit better in the short term. But eventually, they lead to weight gain and fatigue. Better to stick with a low-carb, protein-rich breakfast and to snack on fruits and nuts instead of sugar and starch.

Consume protein with every meal of the day. This doesn’t necessarily mean meat — eggs, peanut butter, and cheese are all good sources of protein.

Sometimes we’re so caught up in our daily routines that we fail to step back and analyze sources of stress. Whenever it starts to affect your moods, get out paper and pen and list the biggest stresses in your day. Then look for ways to reduce or eliminate them.

Even if you believe that the strategies outlined above will help you feel better, you may have trouble making the move from “knowing” to “doing.” Charting your progress can help. Create a monthly chart — 31 days across the top, with categories for sleep, exercise, sunshine, green time, nutrition, and stress along the left-hand margin. Each day, rate your anxiety or depression on a scale from one to 10, and give yourself a check for each category in which you succeed:

The first month you try this, set a goal of earning at least three checks every day. In the second month, aim for four daily checks. Your ultimate goal, of course, is to make all of these mood-boosting habits a regular part of your daily routine.

People who can’t be bothered to exercise for their own benefit will often make the effort if there’s a dog that needs walking. Dogs feel better after an outdoor romp. So do people!