Elaine Taylor-Klaus: Welcome back, everybody, to another conversation on the Parenting with Impact podcast.

Diane Dempster: Hi, it’s Elaine and Diane. You get just us today.

Elaine Taylor-Klaus: And today, we’re going to talk about a really, really, really, really important issue—one that’s very close to home for me and my family—which is ADHD and depression, and all the other stuff that comes with ADHD and depression. That might mean anxiety or all kinds of other things.

Diane Dempster: So, listening to this, you probably have some kind of connection to this topic. I wonder if it makes sense, Elaine, to start with how we typically see this. Like, where does this show up? When? What are the most common themes we see when people are talking about ADHD and depression?

Elaine Taylor-Klaus: Okay, so here’s what’s coming up as I’m hearing you just say that: let’s frame it, right? Most of you listening, if you’re in our community, have some experience with ADHD. You know it manifests in a lot of different areas of executive function: challenges with attention, emotional regulation, energy management, memory— all kinds of things.

And what happens in this realm of ADHD and other mental health conditions is that there’s a lot of confusion about what’s underlying or causing the behavior that people are struggling with.

Part of what makes these really difficult diagnoses is that when you have—let’s just look at kids—a kid who manifests some of these symptoms, they could be caused by attention deficit, ADHD. But they could also be caused by anxiety. And they could also be caused by depression.

So, if we look at it from that angle, part of what’s challenging about these differential diagnoses is that a lot of the symptoms and challenges overlap—or are the same, really.

Diane Dempster: Right? Well, and so that’s the first part—it’s this sort of knowing what’s going on in the first place, right? So there are two parts. First, it’s about knowing what’s going on. The other piece, just at a high level, is that sometimes one is causative—is that the right word?—of the other, right?

So, you might have ADHD that goes unmanaged or undiagnosed, which creates anxiety because the child or the adult isn’t performing to the level that they expect they should or want to be able to. That can create anxiety, which can even go further than that. So, talk about that a little bit.

Elaine Taylor-Klaus: Well, the way I’ve always said it very succinctly is: if you can’t get yourself to do what the world expects you to do—whether you’re a kid or an adult—and ADHD means I’m not able to execute on the things I’d like to be able to do, it’s going to make you anxious. Over time, that anxiety is going to lead to depression if you don’t manage it.

So, part of what we’re saying is that all of these things overlap. Sometimes untreated, unmanaged ADHD can cause anxiety and/or depression, or a combination of both. And sometimes the depression or anxiety may be separate from the ADHD. Or, sometimes the depression can cause symptoms that look like ADHD, right?

So, it’s really about understanding. This is why we often talk about how, on the one hand, the diagnosis matters a lot when it comes to medication treatment. But when it comes to behavior management, the diagnosis isn’t as important sometimes. It’s really about looking at: what are the challenges? What are the thoughts and feelings behind the challenges? And how can we support people in managing and addressing them?

Diane Dempster: So, does it make sense to talk about the differences between anxiety and depression particularly? Or is it really that you’ve got to go to a professional to know which one you’re dealing with? I mean, is it helpful to talk about how they manifest differently?

Elaine Taylor-Klaus: I think yes and yes. All right, so in my family, we have what you guys have heard me describe as an “ADHD plus plus” family of five—now six. Every one of my family members has different diagnoses with their ADHD.

So, one’s got ADHD and anxiety and dyslexia. Another has ADHD and anxiety and depression. Another one has ADHD and depression and maybe a little anxiety. And, you know, I had what we thought was anxiety for years, but it turned out it was mostly ADHD.

And so, again, these things often travel together. From a medication perspective, if you’re trying to treat with medication, it really does make a big difference what the underlying cause is or what issue you’re trying to treat medically.

You might start with a general practitioner for that. But if it’s complicated, or if you’ve got a lot of coexisting conditions, you may benefit from being with a specialist—whether it’s a psychiatrist or a practitioner who specializes in these more complex cases.

Diane Dempster: I might actually say that a little bit stronger. And I know there are plenty of amazing primary care physicians out there. But if you have a child who’s struggling with both anxiety and ADHD—or you’re noticing they’re struggling with anxiety—you really want somebody who can help you figure out who’s on first and what’s on first.

Because there’s a clear distinction, especially for kids, in terms of how to treat it—particularly if you’re looking at medication.

Elaine Taylor-Klaus: And so, for sure. I mean, when I think about the years when—and I guess I qualify it, Diane, because not everybody has access to a specialist.

That’s true. And so that’s where, if you can go to a specialist and you’ve got a complex situation, you really want to do that. But what you’re pointing to, I think, is really important.

So right now, we’re talking about medical treatment. In a little while, we’re going to talk about some other stuff, right? But right now, focusing on medical treatment, I remember having this conversation with one of my kid’s psychiatrists about, “Okay, right now, the lead issue is the anxiety.” So, we were going to try to help manage the anxiety first because that was compounding everything else.

But sometimes, there were phases where the anxiety wasn’t so bad, but the ADHD was the lead issue. And so, that needed to be the focus for medication at that point.

Yes, a lot of our kids—and a lot of us as adults—end up on multiple medications because we are treating a number of different factors. And the complexity of that makes it really important to have someone who truly understands it and specializes in these areas.

Diane Dempster: And even at the beginning, right? It’s sort of like ADHD and anxiety take the lead at different phases.

We have one person in my family who has both ADHD and anxiety. At first, we thought it was just ADHD, so we were treating just the ADHD. But then the anxiety started getting worse. The psychiatrist had to say, “Okay, let’s pause for a second. Let’s see what happens.”

They took them off the ADHD meds, tried them just on anxiety meds, then tried both. It was this sort of mix-and-match process of figuring out what was really going on.

And so, it’s really important to have a prescribing partner who understands both conditions and how they interact.

I also want to emphasize that we say this all the time: you need to feel confident and have a good relationship with the prescriber. It has to be someone you can have open conversations with about what you’re noticing at home, someone who’s open to feedback and willing to adjust based on what you’re seeing.

That iterative process—of figuring out what’s really going on from a diagnostic perspective—

Elaine Taylor-Klaus: Absolutely. Yeah, that’s one of the most important things. It doesn’t matter as much whether they’re a specialist or a general practitioner—what matters is if they’re really working with you, understanding what’s going on, and helping prescribe based on that.

I’m thinking about the example you’re using with one of my kids who has ADHD and anxiety. Sometimes, the research isn’t as clear as I think it will be in the future. For some people with anxiety, ADHD stimulants can amp up the anxiety a little bit.

We were testing with one of my kids to see if they could tolerate stimulants to manage the ADHD—because, you know, it was high school, and we needed that. The doctor suggested chocolate-covered coffee beans as a way to see if they could respond positively or negatively to stimulants.

That simple test allowed us to make some decisions about medication moving forward. That’s a great example of a provider really working with us to address what was the most important issue for that child at that time.

Diane Dempster: So, we’ve talked about the medical management piece of it. Let’s talk about how it looks different—and kind of how you know when, how, and where to involve the medical practitioner.

Because there’s that step before involving them, which is: how do I know if it’s not just ADHD? How do I know if it’s anxiety? Or if it’s moved into depression? I mean, you’re talking about how they might want to sequence...

Elaine Taylor-Klaus: Yeah, yeah. So that’s a great, great question. And, you know, as we were talking about how to have this conversation, I feel like it’s really important to talk about ADHD and depression. I think we don’t talk about it enough.

In my family, it showed up really early—much younger than, in hindsight, I realized. Looking back, I see how young it really was when it started to show up in some of my kids and in my spouse.

The thing about depression is that it’s not about being sad or feeling sad. It’s about feeling bad, sad, hopeless, or whatever that feeling is—even when things are good around you, even when you have love and positivity. It’s being in that space and just feeling listless, lost, hopeless, or pointless, even when there’s no reason to.

We want to talk about the difference between chronic depression, which is a lifelong experience of living with a mind that’s challenged by depression—a mental illness—and acute or situational depression, which is caused by something specific.

Acute depression could go on for months and still require support to manage, but it’s different. Situational depression might arise because of something like unmanaged ADHD, the loss of a family member, or another external event. Both types of depression need to be managed, but they’re fundamentally different experiences.

What’s your face?

Diane Dempster: Yeah, no, the face I was making was about the phrase you used—“without an apparent reason to.” I think one of the things I want to put a plug in for here is this: as parents, a lot of times, our kids internalize what’s going on for them.

They might be completely stressed out about something happening at school, in a relationship, or somewhere else, but they may not be saying anything to you about it. To you, it might seem like, “This kid has no reason to be so listless or lethargic,” but they’re struggling internally.

So, that’s one piece—keeping the channels of communication open as much as possible, creating an environment where they feel comfortable sharing what’s going on.

The other piece is recognizing behaviors. Depression can look different in different kids. For one, it might look like playing video games all night as a way of masking, hiding, and avoiding. For another, it might look like laying in their room listening to music all the time.

Elaine Taylor-Klaus: Or whatever it looks like, right? Let’s talk about how depression manifests, because I think this is really important.

We often think of depression as being sad, as just feeling depressed. But sometimes, depression looks really angry—particularly with teenagers.

I’ve certainly seen it—and he would agree with me—in my spouse. Sometimes depression manifests as being reactive, angry, aggressive, or defensive. It may come across as just rude behavior, but it can actually be another way depression is showing itself.

It’s not just sadness—it’s also anger, frustration, intolerance, or reactive behavior. Those can all be manifestations of depression.

Diane Dempster: That kind of makes me think—how do you know when it’s more than just... you know, because all those things you just described—reactive behaviors—could also be caused by stress, or being overwhelmed, or emotional management challenges from ADHD.

It’s like, all of those things. So how do you know when it’s bigger than a breadbox, so to speak?

Elaine Taylor-Klaus: Well, I think part of it has to do with duration—how long it’s lasting, right?

If you’re dealing with a kid who’s having a rough time with a group of kids at school, or is reactive or defensive because of struggling with a class, and then the semester ends and it’s over, that’s very different from when it’s ongoing.

If they’re continuing to struggle—if their mood remains a challenge, if they’re finding it difficult to get motivated, to get up and do things—and I’m not just talking about procrastinating on homework because they don’t want to do it, but genuinely not caring about it, that’s a sign of depression.

There are a couple of great articles on this topic that I’ll make sure we include in the show notes. I consulted Dr. Michael Banov to outline exactly what symptoms to watch for, and we’ve got resources for identifying depression and where to seek help. We’ll share those links in the show notes.

Some signs to watch for include a loss of interest in activities they used to enjoy, or if their behaviors change significantly. That could indicate depression.

If their friendships change dramatically, that might be another sign something is going on. Of course, changes in friendships can happen naturally—especially in middle and high school—but if it’s compounded by changes in mood, energy, or increased secrecy and privacy, it’s worth paying attention to.

Issues around body image are also important to monitor. This applies to all kids, not just girls—though we are seeing more of this in girls. Concerns about body dysmorphia, feeling “too skinny” or “too fat,” talking about it excessively, or avoiding food altogether can all be symptoms of depression or anxiety. Eating disorders often overlap with these conditions and are something to watch for.

Diane Dempster: There are a couple of directions I want to take this. You were talking before about behaviors versus medication, and we just touched on recognizing what’s going on. But again, how do you figure out when it’s bigger than a breadbox?

And what do you do when these are kids who might not want to get help, or might not even realize they’re struggling? How do you, as a parent, step into that?

Elaine Taylor-Klaus: So, before we answer that—because it's a great question—what I want to address is that we've talked about body issues and eating disorders, but we haven’t really covered suicidal ideation, and I think it’s important to talk about. Kids who feel so hopeless that they don’t see a reason to live, whether they express it to you, to their friends, or even if they’ve considered whether or not they want to take their life, it is much more common than people realize. Suicidal ideation is something that needs to be taken seriously. I’ve heard it from parents of kids as young as eight or nine years old. It's more common in teenagers, of course, but when there's a sense of hopelessness, it can lead to dangerous and risk-taking behaviors, whether that’s cutting, suicidal ideation, suicide attempts, thoughts, eating disorders, or aggressive behavior. Kids can also develop these behaviors from being bullied. So, a lot of these things are connected.

Diane Dempster: I was just going to say, not all of those behaviors necessarily mean your child is depressed or suicidal. A kid might be cutting and not be suicidal at all, or may be experiencing any of these behaviors. It’s just that you need to look for signals to dig deeper and not jump to conclusions based on one behavior alone—that's what I mean by "unfair."

Elaine Taylor-Klaus: Yeah, that’s great. And to return to the question you just started to ask—what’s most important is communication and relationship. How do we know? We know by staying in relationship with our kids, by staying connected, and by keeping the communication open within the family. I’m a big believer in not hiding topics—talking to kids about things like when we hear about suicide in the media or from other people. Let them know we understand that this is a risk in the world, and that we are a safe place for them to talk about it. A lot of people are afraid to bring it up because they don’t want to give them the idea, but trust me, you’re not the one giving them the idea. If you create a safe space for them to talk about it, like, "I have a kid who struggled with severe depression," and part of why I know that kid is alive today as a young adult is because we had some very direct conversations. We talked about things like, "If this happens, will you agree to talk to me about it? Will you agree to seek help?" We were very clear about it. My husband also struggled with depression, and he had very direct conversations with the kids. So, it wasn’t just about having a direct safety plan—like, "This is what I’ll agree to do if I’m feeling or thinking this way,"—but there was also an environment where it was okay to say, "I’m not feeling safe right now. I need help."

Diane Dempster: Well, and I think this brings up one of the big challenges in this world. If you have a kid with depression or anxiety—or both—often as a parent, you feel like you're walking on eggshells. You don’t want to push too hard, or say the wrong thing, or make things worse. Let’s talk about that for a minute, because it’s so important to have these agreements in place. I’ve used the term "safety agreement" with some of my parents whose kids are struggling with suicidal tendencies or challenges. The question is, how do you push enough to get the conversation going, but not feel like you’re going to say the wrong thing that will push your child over the edge? It’s a really scary feeling for us as parents.

Elaine Taylor-Klaus: So, we’re talking about walking on eggshells, and the importance of creating an environment that allows us to have open conversations with our kids. As I’ve mentioned before, there are a lot of articles on the website, and we’ll pull some of those for the show notes. What’s important here in this conversation, Diane, is when parents feel like they’re walking on eggshells, they need to assess why. Are we walking on eggshells because we don’t want to deal with an explosion or bad behavior? Or are we walking on eggshells because we’re afraid of pushing them over the edge? Those are very different situations.

Diane Dempster: As you’re talking about this, let's go back to the fact that we’re talking about ADHD, depression, and anxiety, particularly ADHD and depression, right? What I hear a lot is that parents with kids who have ADHD and executive function challenges are trying to push their kids to be more independent, do more, take more responsibility—whatever it is.

But when depression or anxiety shows up, it becomes, "Oh my gosh, I don’t want to push my kid too hard because I’m afraid they might cut, or that they might have suicidal ideation, or I might trigger a suicidal episode." All these things come up. It may have nothing to do with the depression or anxiety directly, but with the challenges of ADHD.

So, how do we help parents hold their kids accountable while also pushing them to stretch? We always talk about meeting kids where they are and raising the bar from there. What does raising the bar look like when a kid is struggling with depression and anxiety?

Elaine Taylor-Klaus: And there are so many directions we could go with this. One of the things to remember is that when we’re dealing with ADHD, we’re dealing with executive function issues, and when we’re dealing with depression and/or anxiety, we’re dealing with mood issues. So, you’re not going to manage ADHD by sending a kid to therapy, but you are going to manage depression and anxiety by engaging in therapy.

And if you can invite your child to be part of the conversation, that’s key. The word that came up for me as you asked that question, Diane, was “invitation.” It’s about continually inviting our kids to be part of the problem-solving process and to take part in their own success and solutions. For some kids, their success may not be getting through a class; it might just be getting out of bed and going to school that day.

So really, as you say, meeting them where they are, understanding, and showing them how hard it is for them—whatever it is—helps them trust us, work with us, and allows us to try to raise the bar. And for some kids dealing with depression, raising the bar might not be about achieving something academically. It might be helping them figure out how to get through the day, navigate their depression, which is very different from achieving in school.

Diane Dempster: Right? Well, yeah, it is. And I mean, the phrase “baby steps” comes to mind. The other part of this is that a lot of times, these kids don’t want help. So even finding a way to hold them accountable to going to therapy—like, I have a client right now, and they managed to get their kid into the car, but then the kid just said, "I’m not going in."

It’s like they hit a wall, right? They just refuse. And getting them into the car was the first baby step. So maybe next time, you can try to go a little further. But we’re talking about this fine line between holding our kids accountable and doing it in a way that honors their struggles. I think we could model some of that language, maybe. Because I think the hard part is this—"I get how hard this is for you, and I know it’s not okay to do nothing.

We’ve got to figure out what action is realistic, and try something." And at the same time, "I don’t want to push you too hard, but I can’t, in good conscience, just sit here and watch you slowly crash." That’s the kind of language that comes to mind for me.

Elaine Taylor-Klaus: Where do you go with that? I think you have to be careful because that language might work better with anxiety but not so much with depression. Yeah, right. So, again, it’s about meeting them where they are and inviting them into a collaborative conversation about managing it. And some days, managing it might look like you got up and ate breakfast today—awesome, well done.

Some days, that's the success. But what you started with is so important: acknowledging their experience. We teach a strategy called ACE, right? That’s a great one to learn—acknowledge their experience with compassion. “I get that this is hard for you. I can’t imagine what it must feel like to be where you are right now, dealing with what you’re dealing with.

I’m so sorry you’re going through this, but I’m here with you, and I’m going to support you however I can, in whatever way I can. I’m confident we’ll get through this, and there’s going to be light on the other side. I’m going to be with you through the darkness to get to that brightness.”

You know, I recently came back from a trip, and I saw my husband struggling with some depression. One of the things I said to him was, “You know, the one thing we know is that it does always get better. It takes time, but it always gets better.” The challenge with kids who have depression is that they don’t have enough experience yet to know that, to truly trust it.

Sometimes we have to know it for them until they’re ready to know it for themselves. So, language like that might sound like: “I get that this is really hard, and I know it might even be hard for you to believe that you won’t always feel this way. But I know you won’t because I’ve seen people get through it. And it’s okay if you can’t believe that right now. I’ll believe it for you, and I’ll hold onto that belief and support you until you can believe it for yourself.”

There’s something really powerful about deeply acknowledging their experience with compassion, and I think it’s often missed because we get a diagnosis and think, "Okay, let’s fix this. Let’s take care of it." But depression is the kind of diagnosis that you have to slowly glide into and glide out of. It’s not a fix—it’s a shift, if that makes sense.

Diane Dempster: Well, yeah, it feels like there’s this layer of trust that you have to build, right? It's about rapport. You really have to get it, and then I guess the next question is: you want to challenge them to do something, even if it’s just getting up in the morning. What does that language sound like—something inspiring, not pressuring, right?

Elaine Taylor-Klaus: I think the key, and I go back to that term "invitation," is that you want to invite them to identify one thing they can envision doing. This is when it’s really important for us not to give them the solution—like, "You just need to get up and go to school" or "You just need to eat your breakfast." It's about inviting them to say, "What’s one thing you can imagine trying to do tomorrow? What’s one thing you’re willing to commit to?" If we go back to asking our kids, "What’s in it for you? What’s valuable to you? What’s important to you?"—that helps them identify their own goals.

My kid often says, "I’m out of spoons today, Mom, I’m done. No more spoons to give." So, acknowledging when they’re out of spoons—"Okay, what replenishes your spoon drawer?"—and helping them identify that is key, rather than giving them the solutions ourselves.

Diane Dempster: And I think we need to take it a step further. There are parents who will say, "My kid says, 'I can’t do anything,'" and they’re literally stuck in a place where they say, "Yeah, I’ll try this tomorrow," and then they don’t succeed. So, let’s take it to the next level, because I think invitations work when they do, but when they don’t, we often get stuck.

Elaine Taylor-Klaus: So let’s use a concrete example. Let’s say, "I’m going to start that project tomorrow, that school project." You might want to break it down with them, like, "Okay, if that’s your commitment, let’s set you up for success." Ask them, "What kinds of things have helped you get started on something before?" It’s not just about letting them commit to something, but also problem-solving with them around what will help them succeed in doing it. What do they want to do to make it happen?

Maybe it’s about helping them identify their motivators and making sure they’re setting an incremental step—something small enough that they can succeed. Because, as we always say, success breeds success. So, it’s really important to help them find that. We often say that kids, especially those struggling with depression, need a win. Let’s help them find a win, even if it’s small, because that’s where the momentum will start building.

Diane Dempster: Well, what you were saying about starting on a project— I want to be really cautious here because if you have a kid who’s struggling so much that they can’t even get out of bed, trying to get them to just start a project might not be the right move. I had a client with a kid who completely shut down.

He had this big project for science or history or something, and it just pushed him into this state of "I can’t even get out of bed in the morning. I don’t want to go to school. I don’t want to do anything." So if you push them by saying, "Hey, just start the project. Just do a little bit of it," that actually can make things worse. The project itself could be what’s shutting them down.

Deflecting and encouraging them to do other things—getting their body moving, getting their brain moving—those things might be more effective than continuing to focus on the project, which is actually making the anxiety or depression worse. Is that fair?

Elaine Taylor-Klaus: Absolutely, absolutely true. I chose that example because it’s something the kid might choose to do, not something we’re telling them to do. But you’re right. Sometimes, it’s just like, "Let’s put this away for now. Let’s stop, and let’s go do something else." Because if it’s not helping, it’s not worth pushing through.

And when you see your kids shutting down, it’s really important to step back and do something that’s more nourishing, whether that’s connection, nutrition, or whatever it might be. Sometimes, that means certain things won’t get done. That’s just part of living with depression: sometimes all you can manage is getting up, breathing, and living another day without hurting yourself or anyone else. That’s a hard thing to say, but it’s the reality. Honestly, it’s tough to live with depression.

As someone who doesn’t really suffer from it, but whose family members do, I can tell you that on the rare occasions when I feel low or depressed, it reminds me how hard it must be for them, living with that all the time. It helps me connect to compassion for them and realize how difficult it is for them to be in their own skin. I learned early on with one of my kids, who was into dark and horror stuff, that it wasn’t something I needed to shut down.

I used to worry about it, but then I realized that’s their outlet for expressing those dark thoughts. So, I stopped trying to shut it down and instead gave them a safe space to express it. I think that’s the key part of understanding depression, especially: it’s dark, lonely, isolating, scary, hard, and real.

Diane Dempster: We’ve covered a lot, and I know we could talk about this for another hour, but I think we’re getting close to the end. What did we forget to talk about?

Elaine Taylor-Klaus: We’ve discussed coexisting conditions, how sometimes they are separate and other times they influence each other. We’ve also covered how these issues can either be chronic or situational. We touched on safety agreements, which are so important. We’ll be sending you some resources in the show notes, so you’ll know where to go for help if you’re concerned about a child struggling with depression or anxiety. We really encourage you to seek support.

If you’re unsure and part of our community, you can talk to us—we’ll help guide you to the right place. You don’t have to do this alone. That’s the most important message. In fact, this is when it takes a village more than ever. Sometimes, you may not be the ideal person for your kid to talk to about these issues—they may need someone else. But you may be the one who helps them get there.

Diane Dempster: Yeah, exactly. There are two parts to this. First, getting help for your kid—and it may not always be you who’s best suited to provide it. Second, it’s crucial to get help for yourself, because this is tough.

As a parent, it’s a tricky situation: you want to push, but you also don’t want to push too hard. It’s scary to see someone in this state. Don’t do it alone. Get support for yourself, too. This may be independent of the help your kid needs, but it’s important to have someone guiding you through this journey because it’s really hard.

Elaine Taylor-Klaus: What I’ll say about what we offer with the coach approach is that it provides a framework for you to understand things better and learn how to understand your kid. Through that, you might discover that this is a way to support yourself, or you may realize you need a different type of support for yourself, like therapy.

We’re here to help guide you in that direction. There’s a big difference between therapy and coaching, and both are valuable. It’s important to know when you need what, and sometimes you may need both. Support for yourself can take many forms, and if you have any questions or aren’t sure, we’re happy to help guide you.

Diane Dempster: I think that’s great. This is a tough topic, and there’s so much more to it. Go back and listen again because you’ll get more out of it the second time. We really appreciate that you’re here and doing this for yourself and for your kids. At the end of the day, it makes a huge difference.

Elaine Taylor-Klaus: Absolutely. We’ll see you on the next one, y’all.