Breaking the Cycle: The Link Between ADHD and Depression and How EMDR Can Enhance Workplace Performance
Guest Blog Post by Joel Kouame, LCSW
Attention-Deficit/Hyperactivity Disorder (ADHD) and depression are increasingly recognized as conditions that not only coexist but also often interact to create a reinforcing cycle of struggle (Kessler et al., 2006). The impact of these mental health conditions is far-reaching, affecting daily life, self-esteem, and especially workplace performance. Individuals with ADHD commonly experience challenges with organization, focus, and follow-through—issues that, when compounded by depressive symptoms, can lead to feelings of hopelessness, lethargy, and lowered self-efficacy. This blog post explores the intricate relationship between ADHD and depression, examining how each condition exacerbates the other and how Eye Movement Desensitization and Reprocessing (EMDR) therapy can offer a unique and effective approach to breaking this cycle. By addressing the underlying negative self-beliefs and cognitive blocks, EMDR has the potential to improve workplace performance and overall quality of life.
ADHD: Symptoms and Self-Esteem
ADHD is a neurodevelopmental disorder typically characterized by symptoms of inattention, hyperactivity, and impulsivity (American Psychiatric Association, 2013). These symptoms can vary in intensity, but common manifestations include difficulty sustaining attention on tasks, frequent forgetfulness, disorganization, and a tendency to make careless mistakes. While these behaviors can appear harmless or manageable at first glance, they can lead to repeated instances of unmet expectations for those with the disorder, whether in school, work, or personal life (Daley & Birchwood, 2010).
For individuals with ADHD, failing to meet expectations repeatedly can contribute to a growing sense of inadequacy. Each unfinished project, overlooked detail, or unmet deadline can chip away at self-confidence, establishing a self-image of being “incompetent” or “lazy” (Barkley, 2015). Over time, these negative self-perceptions become ingrained, making individuals more likely to enter a state of psychological “freeze” where they feel unable to initiate tasks for fear of failure. This cycle of avoidance and frustration directly feeds into depressive symptoms, particularly when individuals begin to internalize these perceived failures (Kessler et al., 2006).
Depression: Hopelessness and Lethargy
Depression is a complex mood disorder characterized by persistent sadness, feelings of hopelessness, lack of motivation, and often, physical symptoms such as fatigue and sleep disturbances (National Institute of Mental Health, 2022). For individuals with ADHD, the constant struggle to complete tasks or meet personal goals can evoke a strong sense of helplessness. When efforts to achieve goals are continually thwarted by ADHD symptoms, individuals are more prone to internalize these failures, creating a self-defeating mindset that fuels depression. Studies suggest that approximately 50 percent of adults with ADHD also experience depression, underscoring the frequency of this co-occurrence.
Neuroscientific research helps to explain this connection, showing that both ADHD and depression involve disruptions in dopamine regulation, particularly in brain areas associated with reward processing and motivation. Dopamine dysfunction contributes to the characteristic lack of motivation and low energy levels seen in depression and ADHD. The chronic depletion of motivation can make even routine tasks appear insurmountable, creating a vicious cycle that reinforces low productivity and self-esteem. These symptoms not only hinder personal achievement but also make it difficult to concentrate on or complete tasks, further reinforcing the ADHD symptoms and perpetuating a continuous cycle of inattention and demotivation (Daley & Birchwood, 2010).
The Impact of ADHD and Depression in the Workplace
The challenges associated with ADHD and depression can have particularly detrimental effects in the workplace settings. Jobs across all industries are designed to involve the successful completion of tasks, ranging from simple administrative work to complex project management. For individuals dealing with ADHD, tasks that require sustained concentration or attention to detail can become overwhelming (Barkley, 2015). When depression is also present, the individual may struggle even to initiate tasks, experiencing a sense of lethargy and hopelessness (National Institute of Mental Health, 2022).
The workplace can be understood through the lens of object relations theory, where individuals interact with tasks or “objects” that require them to apply their skills and execute actions. For people with ADHD and depression, these tasks can become symbolic of personal failure, acting as reminders of inadequacy each time they are confronted. This association can be so strong that it triggers an automatic negative response, reinforcing avoidance and emotional distress. Thus, tasks that should ideally foster a sense of accomplishment instead exacerbate feelings of defeat and incompetence, further entrenching the cycle of ADHD and depression.
Breaking the Cycle with EMDR Therapy
Eye Movement Desensitization and Reprocessing (EMDR) therapy is an evidence-based therapeutic intervention initially developed to treat trauma. However, research has increasingly shown its effectiveness for a broader range of mental health conditions, including anxiety and depression (Shapiro, 2018). EMDR therapy addresses the negative cognitions and emotional distress that become associated with certain memories, behaviors, or beliefs. EMDR helps individuals with ADHD and depression develop a healthier self-image and improved coping strategies by reprocessing experiences that have been linked with negative thoughts about self and allows a more adaptive connection with positive views of the self
One of the most beneficial aspects of EMDR in treating ADHD and depression is its ability to process deeply embedded self-schemas. For example, individuals who struggle to complete tasks may internalize the belief that they are “incapable” or “worthless.” These self-beliefs, when left unaddressed, reinforce the cycle of avoidance and low motivation. In EMDR therapy, patients might work to identify experiences linked to these beliefs, allowing the installation of new positive cognitions and the increase of self-understanding. EMDR’s reprocessing phases are instrumental in helping individuals to link to self-affirming beliefs, fostering confidence and a willingness to engage in tasks, even when they are challenging.
A fundamental principle in breaking the ADHD-depression cycle is reinstating the belief that change is possible and achievable. With EMDR, clients can begin to see themselves not as failures but as capable of managing tasks, handling workplace responsibilities, and overcoming setbacks. As they work through negative memories and reshape self-concept, individuals with ADHD and depression are more likely to approach tasks proactively. Improved self-confidence is pivotal, as it creates a psychological buffer against depressive symptoms and fosters resilience in the face of workplace demands.
A Promising Approach That Breaks the Cycle
The relationship between ADHD and depression is a complex and cyclical one, where symptoms of each disorder exacerbate the other. In the workplace, this dynamic can lead to underperformance, chronic stress, and deteriorating mental health. Addressing the negative self-perceptions at the root of this cycle is essential to improving both personal well-being and professional productivity. EMDR therapy offers a promising approach by targeting these ingrained beliefs and enabling individuals to break free from the ADHD-depression cycle. Through reprocessing negative cognitions and establishing positive beliefs, individuals with ADHD and depression can gain the self-confidence and motivation needed to perform effectively at work. By embracing interventions like EMDR therapy, employees with ADHD and depression can begin to view tasks as opportunities for success rather than as reminders of failure, creating a healthier and more productive workplace environment.
Joel Kouame, LCSW, MBA, CAMS-II, is a New York-based mental health specialist and owner of JK Counseling. He specializes in anger management, trauma, depression, and anxiety, using interventions like EMDR, IFS, and the Gottman Method. Kouame offers a trauma-informed, evidence-based approach to help clients build resilience and emotional well-being.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
Barkley, R. A. (2015). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment (4th ed.). Guilford Press.
Daley, D., & Birchwood, J. (2010). ADHD and academic performance: Why does ADHD impact on academic performance and what can be done to support ADHD children in the classroom? Child: Care, Health and Development, 36(4), 455-464. https://doi.org/10.1111/j.1365-2214.2009.01046.x
Kessler, R. C., Adler, L., Barkley, R., Biederman, J., Conners, C. K., Demler, O., Faraone, S. V., Greenhill, L. L., Howes, M. J., Secnik, K., Spencer, T., Ustun, T. B., Walters, E. E., & Zaslavsky, A. M. (2006). The prevalence and correlates of adult ADHD in the United States: Results from the National Comorbidity Survey Replication. American Journal of Psychiatry, 163(4), 716-723. https://doi.org/10.1176/ajp.2006.163.4.716
National Institute of Mental Health. (2022). Depression. https://www.nimh.nih.gov/health/topics/depression
Ogden, P., Minton, K., & Pain, C. (2006). Trauma and the body: A sensorimotor approach to psychotherapy. W.W. Norton & Company.
Shapiro, F. (2018). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures (3rd ed.). Guilford Press.
Volkow, N. D., Wang, G. J., Newcorn, J., Kollins, S. H., Wigal, T. L., Telang, F., Fowler, J. S., Goldstein, R. Z., Klein, N., Logan, J., Wong, C., & Swanson, J. M. (2011). Motivation deficit in ADHD is associated with dysfunction of the dopamine reward pathway. Molecular Psychiatry, 16(11), 1147-1154. https://doi.org/10.1038/mp.2010.97
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Date
January 17, 2025
Contributor(s)
Joel Kouame
Topics
ADHD/Autism/Neurodiversity, Depression
Practice & Methods
Your EMDR Practice