When It Is More Than ADHD: Teens With Anxiety or Depression

When a teen with ADHD is also anxious, low, irritable or shutting down, the problem is often more than ADHD. Anxiety and depression can sit alongside ADHD, look like it, or grow out of years of feeling behind. Sorting out which is which matters, because the plan is different. Blackburn Clinical Services offers ADHD and neuropsychological testing and one-on-one therapy for teens 13 to 17 in our West Los Angeles office, with family sessions for parents.

Who this page is for

Parents of high schoolers ages 13 to 17 across Los Angeles, including families at private and independent high schools, Catholic high schools, boarding schools and college prep schools, whose teen has an ADHD diagnosis, or seems to, but something about the picture does not add up.

How often ADHD comes with something else

Often. The Centers for Disease Control and Prevention reports, from a 2022 national parent survey, that nearly 78 percent of children with ADHD had at least one other condition, about 4 in 10 had anxiety, and almost half had a behavior or conduct problem. CDC also lists depression among the conditions that commonly occur with ADHD. The National Institute of Mental Health notes that ADHD often occurs with conditions such as learning disorders, sleep problems, anxiety or depression, which can make them harder to diagnose and treat.

Signs it may be more than ADHD

• ADHD treatment helped, then stopped helping. Focus improved, but your teen is still stuck, avoidant or unhappy.
• Worry, not distraction, is the main problem. Your teen cannot start because they are afraid of doing it wrong, not because they cannot sit still.
• Mood changes. Irritability, tearfulness, losing interest in favorite things or saying “I am just stupid.”
• Sleep problems that go beyond staying up late on a phone.
• Symptoms that started recently. Attention problems that first appeared in high school, after a stressful event, deserve a closer look.
• Shutdown at school. Missing assignments piling up, avoiding teachers or not wanting to go. See school refusal and anxiety-related absences.
• New substance use, such as vaping or cannabis, to calm down or feel better.

Why an evaluation helps

A comprehensive evaluation looks at attention, memory, executive functioning and emotional functioning together, so you are not guessing whether the problem is ADHD, anxiety, depression, a learning difference or a combination. Our ADHD and learning evaluations for private school teens explain the process for high schoolers, and our main ADHD and neuropsychological testing page covers what testing looks at. Testing is done in person at our office, followed by a written report and a feedback session with next steps.

What care at Blackburn looks like

• An assessment or full evaluation, depending on what your family already knows.
• One-on-one therapy in our office or by secure video (for clients located in California) for the anxiety, low mood, frustration and self-esteem that often come with ADHD, using CBT, ACT, DBT skills and other approaches.
• Family sessions to reduce conflict over homework and help parents support without taking over.
• Psychiatric care can be arranged if an evaluation for medication is appropriate, coordinated with therapy. See ADHD treatment.
• More support if needed through the Blackburn Concierge Outpatient Program, typically 3 to 5 hours a week of one-on-one therapy, with no groups.
• Hours: Monday to Friday, 9 AM to 5 PM, scheduled within those hours around the school day.

What parents can do now

• Write down a timeline. When did the focus problems start, and when did mood or worry change? Bring it to the first appointment.
• Gather what you have. Past evaluations, report cards and teacher comments help show patterns.
• Ask about feelings, not only grades. “How are you feeling about school lately?” can open a different conversation than “Did you turn it in?”
• Consider structure outside therapy. Some teens benefit from coaching for planning and follow-through; our sister brand Blackburn Mentoring works with high school students and up.
• Call for an assessment. You do not need to know the answer before you ask.

When to get urgent help

If your teen is in danger right now, call 911. If your teen talks about wanting to die, is harming themselves or you are worried they might, call or text 988 to reach the 988 Suicide and Crisis Lifeline, any time of day. Parents can call 988 too, for advice about what to do next. For more on mood, see teen depression signs parents miss.

Questions

Can a teen have ADHD and anxiety at the same time?

Yes. The CDC reports that about 4 in 10 children with ADHD also have anxiety. Each can make the other harder, so it helps to treat both.

Could anxiety or depression be mistaken for ADHD?

Yes. Worry, low mood and poor sleep can all make it hard to focus. A comprehensive evaluation looks at attention and emotional functioning together to help tell them apart.

My teen was tested years ago. Do they need testing again?

Sometimes. Results from earlier grades may not reflect how your teen learns and feels now, especially if new symptoms have appeared in high school. We can help you decide at the first call.

Do you offer therapy as well as testing?

Yes. Teens can have one-on-one therapy in our office or by secure video for clients located in California, with family sessions for parents, and psychiatric care can be arranged if an evaluation for medication is appropriate.

Will you share results with my teen’s school?

Only with your written permission. When clinically appropriate, we can provide documentation for your teen’s school.

More for families: therapy for private school students, teen anxiety treatment and executive function struggles in high school.

Get started

You can also email info@blackburnclinical.com or contact us. Parents usually make the first call; your teen does not need to be on the line.

Sources

• Centers for Disease Control and Prevention: Data and Statistics on ADHD
• National Institute of Mental Health: Attention-Deficit/Hyperactivity Disorder
• 988 Suicide and Crisis Lifeline