ADHD or Depression: Why the Right Diagnosis Matters More Than You Think

Dr. Scott Eilers, PsyD, LP
Oct 24
3 min read

If you’ve been pushing through brain fog, missed deadlines, and a constant sense that you’re underperforming, you may have wondered whether it’s ADHD or depression. The two can look almost identical from the outside but the label matters. Because the brain systems (and treatments) behind them are different. Get the wrong one, and you might not just stall, you might get worse.

As a clinical psychologist, I’ve seen this countless times. Two people show up with the same symptoms: low motivation, poor focus, a messy apartment, low confidence. One responds quickly to a stimulant that boosts brain activation. The other improves with antidepressants, therapy, or both. The difference lies in understanding why things feel the way they do, not just what they look like.

That’s where clarity changes everything.

Understanding the Overlap Between ADHD and Depression

Both conditions share surface traits, procrastination, forgetfulness, fatigue, overwhelm. In both, you know what to do but can’t make yourself do it. The difference is what’s happening underneath.

ADHD: A problem of engagement. The brain craves stimulation, and motivation collapses when a task doesn’t provide it.
Depression: A problem of reward. Even when you finish something, it doesn’t feel good, so it’s harder to start again next time.

When you identify which system is misfiring, treatment can finally target the right problem and that’s when things begin to shift.

Signs That Help Differentiate the Two

Patterns I’ve seen over years of practice:

Before the task: ADHD often blocks initiation. The brain predicts boredom or frustration and shuts down.
After the task: Depression blunts satisfaction. You complete it … and feel nothing.
Mood swings: ADHD lows tend to follow triggers (a missed deadline, forgotten meeting). Depression’s lows arrive uninvited.

These distinctions matter because the right help depends on them.

What Helps No Matter What You’re Dealing With

If you’re unsure which one fits or suspect both focus on the fundamentals that strengthen any brain system:

Protect your sleep. Consistent rest regulates neurotransmitters and focus.
Move daily. Physical activity boosts blood flow, oxygen, and mood.
Build small rewards. Short-term wins keep motivation alive when long-term goals feel abstract.
Reduce your scope. Simplify commitments and clutter to create space for clarity.

These habits don’t replace treatment but they make any treatment work better.

ADHD and depression both make life heavier than it should be but with the right understanding and plan, that weight can lift. Real change happens when your treatment matches what’s truly happening in your brain.

You can’t shortcut your way out of it. But you can find a clearer path forward and it starts with the right diagnosis and the right support.

-Scott

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FAQ

Q: Can anxiety routines be a sign of depression?Yes. Many people with high-functioning depression use anxiety routines as coping strategies. These routines often mask deeper struggles but also keep people stuck.

Q: What’s the difference between healthy preparation and an anxiety routine?Preparation helps you engage with life. Anxiety routines prevent you from living it. The difference is whether the habit expands or shrinks your world.

Q: What if I’ve tried therapy and it hasn’t helped?You’re not broken. Traditional therapy often overlooks people who need practical, science-based strategies. That’s why I share tools that most mental health providers aren’t teaching.