Much has been written about undiagnosed ADHD in adults. All too often, patients have suffered for decades and may have been treated for comorbid conditions first, including depression, anxiety, bipolar, and other mood disorders. Patients with ADHD may have had a long history of treatments focused on the symptomatology of comorbid conditions rather than addressing the causative factors of ADHD itself. Some have already tried numerous medications, as well as ketamine, esketamine, or transcranial magnetic stimulation (TMS).

The 2017 National Comorbidity Survey reported that adults with ADHD are three times more likely to develop major depressive disorder (MDD), six times more likely to develop dysthymia, and more than four times more likely to have any mood disorder. Another study in 2017 found that one third of patients who were referred for treatment resistant depression (TRD) met criteria for ADHD.1

Treating ADHD is straightforward using stimulants like Adderall or Ritalin, and the patient often experiences life-changing relief almost immediately. But with comorbid conditions, which do you treat first, ADHD or the mood disorder?

The NIH recommends treating the mood disorder first until the patient is........

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