Is it depression, burnout or executive dysfunction?

This year is the 10th year of my ADHD diagnosis. Before my diagnosis, I had been treated for anxiety and depression a few times in my life. Some I feel in hindsight, definitely depression on it’s own based on varying events in my life leading up to that episode. But some were definitely in direct result of having undiagnosed and untreated ADHD.

I have since my diagnosis, been able to generally tell the difference between my executive dysfunction making me feel down, versus being depressed. The reason why I am writing about this today is because I have recently realized I am probably depressed (more about the probable part in a moment) and I want people to understand how this can look like depression, or lead to depression. Especially if you are undiagnosed, this may be particularly relevant to you.

But before I unpack that there is something else that can look like both depression and executive dysfunction. Burnout. Something I felt fitted my circumstances well, given how much my page has grown and the extra mental load it has added to my life, on top of everything else I had going on which was high in stress. Burnout is often induced by stress, from over working, over compensating – it can be emotional stress, or labour stress. We all need to rest and if you are not allowing yourself that rest, burnout happens. You become exhausted, listless, it can get harder to cope with your situation.

I figured, surely that is what this is. And it may have well been what I was experiencing at the time I had this thought. It naturally made sense. If you couple it with executive dysfunction which makes it hard to “execute certain tasks” sometimes as it was, burnout from fighting through that when you have no other choice also made sense in my situation. And I did realize at the time that not addressing this could lead to depression.

So I did the usual baseline care things, took care of my sleep, nutrition and hydration, got more exercise, lightened my work load, took a break. Did some really good self care things. It helped a bit, for awhile. But suddenly 6 months went by from the triggering event that started this until it hit me and I realized, this isn’t burn out. It’s depression.

Given the complicated nature of executive dysfunction and how it looks like in all those experiences, it can be tricky to tell it apart from typical symptoms of depression. But depression too has a sneaky way of not always looking or feeling the same as the last time you might have experienced it. It wasn’t until I realized I was not recovering from my burnout that it occurred to me this is probably depression.

Executive dysfunction often makes it hard for us to action stuff, that inability to do what we need or have to do because of it can often be mistaken for depression. But as any ADHDer can tell you, it’s not that we don’t want to do stuff, we just can’t. Even when it’s something we really love and enjoy. And that’s what depression looks like too, we lose interest in what we normally enjoy doing. And just that overlap is partly reason for misdiagnosis for undiagnosed ADHDers, especially if you lack the language to articulate the difference, of course it’s going to be seen as depression first. And naturally having an untreated mental health condition leaves a chance to develop anxiety or depression.

It’s also common practice to treat someone for depression and anxiety first before investigating any further medical conditions. Especially if you are requesting to be looked at for a psychiatric disorder. But when it persists, and you can’t seem to “get over it” that’s a reasonable indicator for a professional to investigate further, while ruling out other medical conditions like conditions with the Thyroid, especially if it runs in your family. It’s routine and a good thing to check all these out to get the best picture as possible and rule out that it isn’t those things.

Something else depression can look like is a deficiency in vitamins or similar, so often a blood test is done to rule this out as well. And that’s the stage I am at. I am saying my depression is probable because I haven’t seen a doctor yet, but from my self observation, current circumstances and making sure I had taken measures to look after my physical health, I started to suspect that it’s more likely to be depression. I will be seeing my Doctor for all these tests within the next couple of weeks to get that help.

I want to encourage anyone who reads this to always investigate these suspicions, take that chance while you are first getting clues that something isn’t quite right. For me it felt like my executive dysfunction was really flaring up. I made sure I had been passed my usual PMS symptoms, which often makes me feel like my meds aren’t working. But when my stimulant meds stopped helping with my ability to get stuff done, that should had been a red flag to see a Dr and look into it. Don’t leave it till you hit a wall (if possible) like I have. Reach out to family, friends or even an online community for support. Give your Dr a call. Prioritize your mental health, you deserve wellness. There is no need to struggle unnecessarily. Also depression sneaks up on you, it’s not always so obvious until you do get to a wall too and that’s OK but that’s when it’s time to get help.

If you are feeling like this too, please know you are not alone. You matter, you deserve wellness and to look after yourself.

Further reading:


Published by Jenn has ADHD

Jenn Parker, New Zealand. ADHD Advocate and Peer.

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