ADHD Burnout vs. Depression: How to Tell the Difference (and Why It Matters)

Feeling exhausted, hopeless, and like nothing is working anymore? You might wonder if you’re depressed or if it’s just another round of ADHD burnout. The truth is, the symptoms can look nearly identical on the surface, but they come from very different places. And if you’re a woman in midlife navigating perimenopause with undiagnosed or late-diagnosed ADHD, you’re especially vulnerable to this confusion.

Let’s break it down: symptoms, causes, how to tell the difference, and what to do next.

What Is ADHD Burnout?

ADHD burnout isn’t an official diagnosis, but it’s a very real experience reported by countless adults, especially women, who’ve spent years masking, pushing through, and compensating for untreated ADHD. It’s what happens when your nervous system says, “I can’t do this anymore.”

Common signs of ADHD burnout:

• Overwhelming fatigue that rest doesn’t fix

• Emotional dysregulation or hypersensitivity

• Trouble starting even simple tasks

• Brain fog, forgetfulness, and executive dysfunction

• Feeling like you’re failing at everything, even when you’re trying so hard

• You want to do things, but you just can’t get started

ADHD burnout often flares up during life transitions (like perimenopause, parenting, career shifts), when executive function demands exceed your current capacity.

What Is Major Depressive Disorder?

Major Depressive Disorder (MDD) is a mood disorder characterized by persistent low mood and loss of interest in things that once brought joy. It affects your thinking, energy, motivation, and sense of self-worth.

Common symptoms of MDD:

• Depressed or flat mood most of the day, nearly every day

• Loss of interest or pleasure in almost all activities

• Feelings of hopelessness, worthlessness, or guilt

• Low energy or fatigue

• Sleep or appetite changes

• Suicidal thoughts or ideation (in severe cases)

📌 Unlike ADHD burnout, MDD isn’t usually improved by time off, external support, or stimulation. It requires clinical intervention.

Why the Confusion Is Common, Especially for Women

Women with ADHD are chronically underdiagnosed, often internalizing their struggles as personality flaws. Add in hormonal shifts during perimenopause (which worsen executive function), and you’ve got a perfect storm for burnout or what may look like “sudden onset depression.”

Many women are told they’re depressed or anxious when they’re actually burned out from years of unsupported ADHD.

What You Can Do About It

Get an accurate diagnosis

If you’ve never been assessed for ADHD, or suspect you may have both ADHD and depression, talk to a clinician who understands both. ADHD and MDD can also co-occur, which requires nuanced treatment.

Track your symptoms

Use a simple tracker to note:

• When symptoms are worse (time of day, hormonal cycle, work/life stressors)

• What helps (rest? structure? validation?)

• What you wish you could do but feel stuck on

This helps differentiate executive dysfunction from mood dysregulation.

Treat both if needed

Burnout may improve with:

• ADHD-specific tools (coaching, medication, structure)

• Hormonal support (especially in perimenopause)

• Nervous system regulation (mindfulness, sensory strategies)

MDD typically requires:

• Evidence-based therapy (CBT, etc.)

• Medication like SSRIs or SNRIs

• A higher level of clinical monitoring

Ditch the shame

Whether it’s burnout, depression, or both, none of this is your fault. Your brain is doing its best under pressure, and recovery starts with understanding what’s actually going on.

References

• Barkley, R. A. (2015). Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment.

• Ramsay, J. R. & Rostain, A. L. (2015). The Adult ADHD Tool Kit: Using CBT to Facilitate Coping Inside and Out.

• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th ed.

• Hinshaw, S. P. (2021). ADHD in Girls and Women: Recognizing and Treating a Hidden Disorder.

• Quinn, P. O., & Madhoo, M. (2014). A Review of Attention-Deficit/Hyperactivity Disorder in Women and Girls. The Primary Care Companion for CNS Disorders, 16(3).