Blues Qs: Am I Lazy, Depressed, ADHD, or all of the Above?

Blues Qs is an advice column covering all things clinical depression, written by Bezzy Depression community guide Sam Dylan Finch. Diagnosed with clinical depression over a decade ago, Sam has seen it all — from medication mishaps to grippy sock “staycations.” He’s here to help you navigate your own depression journey with a little humor and a lot of heart.

For most of my life, I believed I was a lazy, unmotivated person. Getting myself to do anything — get out of bed, clean something, run errands, do homework, you name it — felt like pushing a large boulder up a steep hill.

I knew something was wrong, but I always assumed that whatever it was had to be my fault.

Fast forward to getting my diagnoses. So many of my struggles began to make more sense, and I quickly realized that I wasn’t lazy at all: I was living with ADHD and depression.

This 2017 research review says between 18–53% of people with ADHD also have depression. With so much overlap between the two, it can be difficult to figure out which is causing what, and by extension, how to treat them both.

It’s also true that misdiagnoses are quite common because ADHD can mimic a lot of other mental health conditions, including anxiety, depression, and behavioral disorders. This makes it all the more crucial to be educated about ADHD — to ensure that the right treatment decisions are being made.

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So what is ADHD really?

While most people recognize ADHD as being an issue of inattention, it’s actually a neurodevelopmental disorder that’s much more complex than that.

Other signs and symptoms of ADHD include:

• difficulty paying attention or being easily distracted
• interrupting others when they’re talking or having difficulty with active listening
• difficulty sitting still for a long time
• finding it challenging to start or complete tasks
• having issues with executive dysfunction
• having trouble organizing daily tasks
• making frequent mistakes or missing details when studying or working
• losing items frequently
• finding it challenging to regulate emotions
• avoiding mentally taxing or boring tasks

Like many adults with ADHD, I was stuck in a spiral of shame for a long time before I sought out any help.

I looked at my lack of focus, unfinished tasks, and difficulty getting started on anything as a personality flaw. I just lacked the willpower, I figured. I needed to try harder. I needed to stick to a routine, buy a nice planner, get more organized, and push a little more.

But no matter what lifestyle changes I tried to make, it still felt like I was stuck pushing the same large boulder up that big hill.

When I finally had access to stimulant medication, my entire life changed.

I found myself able to start and complete tasks without mental fatigue and struggle. I wasn’t constantly bored and restless. I wasn’t losing things all the time and forgetting important meetings.

Life was no longer set to “hard mode” — I could direct my attention to the things that mattered, and follow through on the tasks in front of me.

What about clinical depression?

Many people think of depression as persistent sadness or emptiness for much of the day, nearly every day. And it can be that — but it can also result in:

• a loss of interest in activities you used to enjoy
• changes in your appetite (increased or decreased)
• difficulty sleeping or sleeping more than usual
• a lack of energy and motivation
• feelings of worthlessness or guilt
• difficulty concentrating
• recurrent thoughts of suicide
• withdrawal from others or self-isolation

…do you see what I see?

I see “difficulty concentrating,” “lack of energy and motivation,” mood changes, and more in depression, but you could just as easily say these are symptoms of ADHD, too. So how do we parse out which is which?

The differences are actually subtle:

If you have both ADHD and depression, it may not be as easy to determine what’s causing your lack of motivation or difficulties with concentration. It might be a mixture of both.

That’s why it’s important to work with a clinician who has expertise in ADHD and depression, so they can keep an eye out for which treatments you respond best to.

The bottom line

It could be depression or ADHD or both. But I’ll tell you what it isn’t: laziness.

Whether you have depression, ADHD, or both, it’s important to remember that struggling with “doing the thing” is not a sign that you’re lazy. More than likely, this means you need more support with your mental health. (For some bonus reading, I’d recommend checking out the book “Laziness Does Not Exist” by Dr. Devon Price.)

It took me a long time to learn that it wasn’t normal for me to struggle with basic things like getting out of bed, cleaning up my apartment, taking a shower, or cooking myself a meal. When “basic” feels impossible, it’s a sign that something isn’t right.

Luckily for me, a combination of antidepressants and stimulant medications has made my boulder feel lighter, and my hill a little less steep. With the right support and diagnoses, both ADHD and depression are treatable — so hold onto hope, and know that help is out there if you need it.