Beyond ADHD

ADHD tied to teenage substance abuse and depression

/ Author:  / Reviewed by: Joseph V. Madia, MD

ADHD, or attention deficit hyperactivity disorder, can cause a variety of behavioral problems among children on its own. However, new research is showing a potential connection between ADHD and other issues as these children enter adolescence.

By being aware of how ADHD typically expresses itself, as well as the possible connections between the disorder and issues like depression and substance abuse, parents and teachers can help teens stay on guard against these problems.

ADHD Alone

According to the US National Library of Medicine, ADHD affects three to five percent of children and is the most frequently diagnosed behavioral problem in kids.

In ADHD, which PubMed Health reports is seen much more often in boys, the symptoms can be separated into three groups: lack of attention, hyperactivity and impulsive behavior.

On example of an inattentive symptom is avoiding or disliking activities like school work, These tasks that require prolonged attention or mental effort can prove difficult for children with ADHD.

Children suffering from these symptoms may also often lose items, including tools needed to complete such tasks. Additionally, they may not appear to pay attention when being spoken to.

Children who display hyperactive symptoms may run around when they shouldn’t. They might fidget, squirm and talk excessively and often have difficulty playing quietly.

Impulsive symptoms can include interrupting or intruding when it is inappropriate. Children with impulsive symptoms often have problems with patience and waiting for their turn.

The type and combination of these symptoms varies from child to child, as does the severity of their expression.

Ties to Depression

A study published in 2010 in the Archives of General Psychiatry explored the ties between depression and ADHD.

To explore this, lead author Benjamin Lahey, PhD, followed 123 children with ADHD starting at ages four to six until ages 18 to 20. For a control group, they followed 119 kids matched demographically, but not diagnosed with the disorder.

Throughout the duration of the study, the children were assessed and interviews completed with both the subjects themselves and their caregivers.

Upon completion, the researchers found that of the ADHD children, 18 percent dealt with depression in their teenage years, near ten times the percentage from the control group.

Furthermore, the kids diagnosed with ADHD from an early age were five times more likely to have thought about committing suicide at least one time than their non-ADHD counterparts.

The rates for both depression and thoughts about suicide were especially marked among girls with ADHD.

However, the authors did take care to stress that though highest among girls with ADHD, the presence of suicide attempts relatively rare, with over 80 percent of the children with ADHD studied never acting on suicidal behaviors. While not cause for panic, these differences were significant and do need to be explored in greater depth to understand the cause.

According to Dr. Lahey, "This study is important in demonstrating that, even during early childhood, ADHD is seldom transient or unimportant.” Further study will help researchers develop a greater understanding of the connections between ADHD and depression.

Substance Abuse Connection

Another study, published in 2003 in the Journal of Abnormal Psychology examined potential ties between ADHD in childhood and drug use later on in life.

The study, completed by Brooke S.G. Molina, PhD, and William E. Pelham, Jr., PhD, examined the drug use of 142 adolescents between the ages of 13 and 18 who had been diagnosed with ADHD as children and compared them to a group of 100 teens the same age, but with no history of the behavioral disorder.

While all of the teens studied seemed to show no significant difference in their likelihood of trying alcohol, cigarettes or marijuana, the subjects who had been diagnosed with ADHD as children showed significantly higher frequency of use of the substances.

For example, 23.2 percent of the ADHD group reported being drunk more than once in past six months, compared to a rate of 12 percent among the non-ADHD group.

Furthermore, those with ADHD were three times more likely than their non-ADHD peers to report trying at least one non-marijuana illicit drug (20.4 percent compared to 7 percent).

The results also suggested that the severity of childhood ADHD was a predictor of the degree of substance abuse as teenagers, as more severe symptoms during childhood seemed to correlate with more drug and alcohol use during adolescence.

The subjects who still dealt with the disorder as teens (around 72 percent of the ADHD group) reported higher levels of drunkenness and cigarette smoking than those who no longer displayed symptoms.

According to Dr. Molina, one hypothesis for why these differences exist could be that "a child may begin having poor academic performance and peer difficulties and then gravitate toward nonconformist peer groups as an adolescent where substance abuse is accepted as a way of life.” However, causation between the two issues still needs to be explored in greater depth.

The Big Picture

It should be noted that both this study examining substance abuse and Dr. Lahey’s study focusing on depression drew from relatively small subject pools and should be researched on larger scales before complete conclusions can be drawn.

However, the studies do show potential connections and may be reason for parents and teachers to be on alert. As Lahey suggested, “It reinforces our belief that parents of young children with ADHD should pay close attention to their child's behavior and its consequences and seek treatment to prevent possible long-term problems."

As more research is completed, understanding of the possible connections between ADHD and emotional problems like depression and other behavioral issues like substance abuse will grow, along with ideas on how to curb these problems.

In the meantime, family members should stay vigilant and seek help if they see their child struggling with difficult obstacles. 

Review Date: 
August 13, 2012