When Anxiety or Depression Comes Alongside Autism or ADHD

Anxiety and depression often come alongside autism and ADHD in teenagers, and they are easy to overlook because their signs can blend into traits a family has lived with for years. A teen who has always preferred to be alone may withdraw further, a teen who has always struggled to focus may stop trying altogether, and both changes can be written off as "just how they are" when something new is going on underneath.

Many parents of neurodivergent teens have spent years advocating at school and at the doctor's office, and it's normal to feel worn out at the idea of one more concern. Noticing anxiety or low mood doesn't mean you missed something earlier, and naming it gives your teen a better chance at support that fits who they are.

How common is anxiety or depression in teens with ADHD?

Anxiety and other co-occurring conditions are common in children and teens with ADHD. According to the Centers for Disease Control and Prevention (CDC), a national parent survey found that nearly 78% of children with ADHD had at least one other co-occurring condition, almost half had a behavior or conduct problem, and about 4 in 10 had anxiety (CDC, 2026). The CDC lists depression among the other conditions that often affect children with ADHD, though its data page doesn't give a figure for it. Those numbers come from 2022 survey data and cover children and teens ages 3 to 17, so they aren't specific to teenagers.

Living with ADHD can feed anxiety and low mood in ways that make sense. A teen who has heard "you're not trying hard enough" for years, keeps losing assignments they actually finished, or feels a step behind friends socially can start to dread school or doubt themselves, and that strain can build into something heavier over time.

How common is it in autistic teens?

Anxiety and depression are common in autistic teens, though estimates vary a lot depending on how a study was done. A 2024 study in the Journal of Autism and Developmental Disorders analyzed National Survey of Children's Health data from 2016 to 2019 for U.S. adolescents ages 12 to 17 and found that rates of anxiety and depression among teens with autism or ADHD were up to ten times higher than among teens with neither (Accardo, Pontes & Pontes, 2024). Autistic teens who also had ADHD had the highest rates, with anxiety in 72% of girls and 69% of boys in that group, and depression in 38–39% of both. The same study found that 57% of autistic girls and 49% of autistic boys also had an ADHD diagnosis, so many teens are dealing with both.

Older research points the same way. A 2011 meta-analysis in Clinical Child and Family Psychology Review, which combined 31 studies of 2,121 young people under 18, found that 39.6% of children and teens with autism had at least one anxiety disorder (van Steensel, Bögels & Perrin, 2011). That analysis is now more than a decade old, and studies drawn from clinics, surveys, and the general population produce different numbers, so treat any single figure as a rough guide rather than a prediction for your teen.

Why can anxiety or depression be missed in neurodivergent teens?

Anxiety and depression are often missed in neurodivergent teens because their signs overlap with autism and ADHD traits. Pulling away from people, irritability, poor sleep, trouble concentrating, and big reactions to change can all be part of autism or ADHD, and they can also be signs of anxiety or depression. When a teen already has one diagnosis, parents, teachers, and even clinicians can assume every new struggle belongs to it. The authors of the 2024 study cautioned providers and educators not to misinterpret symptoms of anxiety and depression as other disability-related characteristics (Accardo, Pontes & Pontes, 2024).

Communication differences can make it harder too. Some autistic teens find it difficult to put feelings into words or describe them in the way a standard questionnaire expects, and some teens with ADHD are so used to being told they're the problem that they don't recognize a low mood as something separate. Many neurodivergent teens also work hard to hide their differences at school, sometimes called masking, which can leave them exhausted at home while teachers report that everything looks fine.

The 2024 study also noted earlier research estimating that about one-third of adolescents had mental health symptoms their parents hadn't recognized (Accardo, Pontes & Pontes, 2024). That isn't a failure on anyone's part, and it's a good reason to ask your teen directly, in whatever way works for them, how they've been feeling.

What changes might point to anxiety or depression?

The most useful signal is a change from your teen's own baseline rather than a behavior on its own. A teen who has always been quiet isn't necessarily depressed, while a teen who used to talk for an hour about trains and now barely mentions them may be telling you something. The table below compares what might be part of a teen's usual pattern with changes worth raising with a professional.

The table is a starting point for a conversation with your teen's doctor, and plenty of teens won't fit it neatly. Our guides to telling normal teen stress from anxiety and signs of depression in teens describe these signs in more general terms, and our article on meltdowns versus tantrums can help if outbursts are part of what you're seeing.

How do you find a clinician who understands neurodivergent teens?

Finding a clinician who understands neurodivergent teens usually means asking direct questions before the first appointment. Anxiety and depression can show up differently in autistic and ADHD teens, and some common therapy approaches need adjusting to work well, so general experience with teenagers isn't always enough.

When you call a therapist, psychologist, or psychiatrist, ask:

1. How many autistic teens or teens with ADHD they currently see.
2. How they adapt therapy for teens who think, communicate, or process information differently.
3. Whether they involve parents, and how.
4. Whether they will coordinate with your teen's school or other providers.
5. How they decide whether an evaluation for autism or ADHD should be updated or repeated.

Your teen's pediatrician, the clinician who did their original evaluation, and the school psychologist can often point you to local names. If your teen hasn't been evaluated yet, our guide on how to pursue an evaluation explains the paths, and how insurance works for teen mental health treatment covers coverage questions. A psychiatrist or your teen's doctor can discuss whether medication fits, which matters when ADHD, anxiety, and depression are all part of the picture.

When should you get help?

You don't need to sort out which condition is causing what before you ask for help. This guide can help you notice patterns, but only a licensed professional can evaluate your teen and tell whether anxiety or depression is part of what's happening.

If you've noticed a few changes from your teen's usual pattern that have lasted a couple of weeks, mention them to your teen's pediatrician or current therapist and ask specifically about anxiety and depression.

If your teen has stopped going to school, has dropped the interests that used to anchor them, is sleeping or eating very differently, or is having more frequent meltdowns or shutdowns, call your teen's pediatrician or therapist now. Our page on levels of care explained lays out the options if weekly therapy isn't enough.

If your teen talks about hurting themselves or not wanting to be alive, call or text 988 (the Suicide & Crisis Lifeline), or call 911 if they are in immediate danger. Our page on crisis options for parents covers what happens when you call.

For more on neurodivergent teens, our Neurodivergent Teens guide gathers everything in one place.

This article shares practical guidance for parents and is not medical advice. We're not clinicians or doctors. If your teen is struggling, contact a licensed mental health professional or your teen's doctor, and if you have a serious concern about their safety, call 911 or call or text 988. Editorial standards