Children diagnosed to have ADHD face challenges more often than normal children do. Socially, peers may ostracize or even ridicule the child for his or her behavior. Forming positive peer relationships is difficult because the child cannot play cooperatively or take turns and constantly interrupts others (APA, 2000) Studies have shown that both teachers and peers perceive children with ADHD as more aggressive, more bossy and less likable (McCracken, 2000a).
This perception results from the child’s impulsivity, inability to share or take turns, interruptions and failure to listen and to follow directions. Thus peers and teachers may exclude the child from activities and play, may refuse to socialize with the child, or may respond to the child in a harsh, punitive or rejecting manner.
Studies say that children with ADHD are at a higher risk of depression and other mood disorders. Quite significantly, the rate of depression is significantly higher in children with ADHD than in other children. Studies show that up to 70 percent of children with ADHD will be treated for depression at some point in their lives.
Children with ADHD are more likely to suffer from low self-esteem as a result of the child’s personal perception of being a failure at home and in school. They are more often at the receiving end of harsh criticisms and punishments for being extremely active, talkative and restless; or for their difficulty to pay attention, forgetting important things, and for interrupting others. They may also be labeled “not normal,” “weird,” or are “incapable of behaving” or worse, their peers avoid them altogether.
As all these build up over time, these children feel frustrated and demoralized. At times, they are overwhelmed with the things that happen around them and become discouraged as they face repeated failures in school, at home, and in other settings. When these negative experiences accumulate, the child with ADHD may begin to feel depressed.
Further, children with ADHD reported themselves to be significantly more angry than non-ADHD children and to also be significantly more depressed. Differences between children with and without ADHD on these measures were not extremely large, but clearly indicate that, on average, children with ADHD experience greater levels of anger and depressive feelings. No significant differences were found in the amount of anxiety that children in each group reported.
Children with ADHD are more likely than others to be troubled by feelings of anger and depression. This has several important implications for the evaluation and treatment of children for ADHD.
In addition to being distressed or demoralized as a result of ADHD, children may also experience a true depressive illness. Unfortunately, symptoms of ADHD and depression may at times overlap thus making it more difficult for the doctor to diagnose a mood disorder like major depression.
Treatment may need to address issues of anger management and depressive symptoms, in addition to managing the primary ADHD symptoms of inattention and hyperactivity/impulsivity. It is important to be aware that improvement in the core ADHD symptoms will not necessarily translate into comparable improvements in these other areas. Should this be the case, these aspects of a child’s difficulties will need to be addressed directly, and specific treatments to deal with anger and depression in children have been developed. Although some would certainly disagree, specific psychological treatment approaches have so far proven to be more helpful to children with difficulties in these areas than has medication treatment. This, is different from what studies comparing medication and behavioral treatment for ADHD have suggested.
It is an important study in that it reminds parents and health care providers about the importance of attending to the emotional experience of children with ADHD.