Summary: Young people with ADHD are significantly more likely to experience “internalizing” problems like anxiety and low mood, but until now, the exact links between these conditions remained unclear. A landmark study analyzing data from over 5,000 adolescents, has identified low self-esteem and parental mental health as two of the most critical factors driving this risk.
The research highlights that ADHD doesn’t exist in a vacuum; its impact on a teen’s emotional health is shaped by their social environment and their own self-perception. For girls specifically, peer difficulties also play a major role in the transition from ADHD symptoms to clinical anxiety or depression.
Key Facts
- The Risk Factor: Approximately 25% of young people with ADHD have an anxiety disorder, and 40% experience depressive episodes.
- Core Mediators: Low self-esteem and poor parental mental health were identified as statistically significant links between ADHD and subsequent emotional issues.
- Gender Specifics: For girls, social struggles and “peer difficulties” act as a distinct catalyst for developing anxiety and low mood.
- Targeted Support: The findings suggest that mental health interventions for ADHD teens should focus on boosting self-worth and providing psychological support for the parents as well.
Source: University of Edinburgh
Scientists have shed light on some reasons why young people with attention deficit hyperactivity disorder – known as ADHD – are prone to anxiety and depression.
Young people with ADHD symptoms are more likely to experience emotional issues such as anxiety and low mood partly because ADHD puts them at risk of low self-esteem and having a parent with poor mental health.
The study, led by the University of Edinburgh and funded by the Medical Research Foundation, is the first to study a wide range of factors which link ADHD symptoms and mental ill health symptoms over time.
It is estimated that ADHD affects around five per cent of children and young people in the UK. One in four young people with ADHD have an anxiety disorder and 40 per cent experience depressive episodes.
Researchers from the University of Edinburgh examined survey data from over 5,000 adolescents aged 11 to 17 from the UK Millennium Cohort Study, which follows young people born between 2000 and 2002 across the UK.
They tested fourteen possible factors linking ADHD and mental ill health, including relationships with family and friends, behaviour issues and low self-esteem.
Other factors assessed were behaviour at school, general health and if their parent had mental health difficulties.
The team analysed questionnaires which surveyed parents and the young people on ADHD symptoms and emotional problems such as low mood and anxiety symptoms at ages 11,14 and 17.
Findings showed that self-esteem and parental mental health had a small but statistically significant link to both ADHD and mental ill health risk. Among girls difficulties with peers had a small but significant link.
This was the case even when other factors such as any pre-existing neurodevelopmental and mental health issues were taken into account.
The results suggest that several different factors may be working collectively with a small effect to connect ADHD and other emotional issues during adolescence.
The study could help in tailoring targeted wellbeing support systems for young people with ADHD, experts say.
Professor Aja Murray, of the University of Edinburgh’s School of Philosophy, Psychology and Language Sciences, who led the study, said: “The findings suggest that to help reduce the risk of adolescents with ADHD symptoms developing other mental ill health symptoms, two things are supporting parents to improve their mental health, and supporting adolescents to foster high self-esteem. For girls in particular supporting social skills development is also important.”
Dr Angela Hind, Chief Executive of the Medical Research Foundation, said:
“ADHD can have a profound impact on a young person’s life, yet relatively little is known about the mental health challenges they might face as they grow up. This important research sheds new light on why teenagers with ADHD are at greater risk of anxiety and depression than those without, highlighting self-esteem and a parent’s mental health as two of the most crucial factors that shape their wellbeing.
“These findings demonstrate the importance of funding medical research into children and young people’s mental health, and bring us a step closer to developing more targeted support for teenagers with ADHD, ensuring they can thrive during some of their most formative years.”
Key Question Answered:
A: It’s often a “snowball effect.” ADHD can lead to struggles in school or social settings, which then tanks a teen’s self-esteem. When a teen feels they are “failing” at daily tasks, that low self-worth quickly turns into anxiety or low mood. The study found that self-esteem is one of the strongest bridges between the two.
A: The research suggests a strong link. Parental mental health was identified as a key factor in whether an ADHD teen develops further emotional issues. Supporting the parent’s wellbeing isn’t just good for the parent—it’s a direct intervention that protects the child’s long-term mental health.
A: Yes. While self-esteem and home life matter for everyone, girls with ADHD are particularly vulnerable to peer-related stress. Social skills support and help navigating friendships can be a vital “shield” against depression for adolescent girls with ADHD.
Editorial Notes:
- This article was edited by a Neuroscience News editor.
- Journal paper reviewed in full.
- Additional context added by our staff.
About this mental health research news
Author: Joanne Morrison
Source: University of Edinburgh
Contact: Joanne Morrison – University of Edinburgh
Image: The image is credited to Neuroscience News
Original Research: Open access.
“Identifying Candidate Mediators Linking ADHD Symptoms and Internalising Problems in Adolescence: An Exploratory Longitudinal Mediation Analysis” by . Journal of Attention Disorders
DOI:10.1177/10870547261419589
Abstract
Identifying Candidate Mediators Linking ADHD Symptoms and Internalising Problems in Adolescence: An Exploratory Longitudinal Mediation Analysis
Objective:
ADHD and internalising symptoms such as anxiety and depression are known to be associated in adolescence and understanding the mechanisms linking them is important for improving mental health outcomes for adolescents with ADHD symptoms. Our objective was to examine these mechanisms.
Method:
In this study, we leverage a high-quality longitudinal dataset, the Millennium Cohort Study (n = 2,607 male, n = 2,791 female) to simultaneously evaluate a range of hypothesised mediating mechanisms. These include indirect effects via peer problems, conduct problems, self-esteem, injuries and accidents, relationships with parents, academic performance, risky decision-making, parental mental health, educational motivation, and general health. We used exploratory longitudinal mediation analysis with regularised structural equation modelling (regSEM) to examine 14 candidate mediators of the ADHD-internalising association across ages 11, 14 and 17.
Results:
Regularisation with lasso did not result in the de-selection of any of these mediators; however, only two were statistically significant.
Conclusion:
Results suggest there may be many mediators of small effect involved in the relation between ADHD symptoms and later internalising problems but point to self-esteem and parental mental health as priority mechanisms for further study in future causal and interventional research.
