When the Mind Never Shuts Off

ADHD, Depression, Anxiety, and the Fight Nobody Sees

By Chuck Banks

I write a lot.

Sometimes I write about football. Sometimes I write about coaching, culture, kids, communities, faith, life, wins, losses, and everything that seems to happen in between.

And sometimes I write because writing is how I process things.

This is one of those articles.

This one isn’t about who won Friday night.

There isn’t a scoreboard.

There isn’t a fourth quarter.

There isn’t a coach who can call timeout when everything starts moving too fast.

This is about ADHD, severe depression, and anxiety.

And what can happen when all three decide to occupy the same mind at the same time.

For some people this is research.

For others, this is life.

And I think we need to talk about it.

When Your Brain Doesn’t Have an Off Switch

People throw the term ADHD around pretty freely.

“I can’t concentrate today.”

“I’m so ADHD.”

Those who actually live with ADHD understand that it can be much more complicated than simply getting distracted.

Sometimes your brain just doesn’t shut off.

Past.

Present.

Future.

All happening simultaneously.

Something that happened ten years ago can suddenly feel like it happened yesterday.

Something that might happen six months from now can consume you today.

Meanwhile, there are five things you need to accomplish right now.

That’s exhausting.

Research also tells us something that needs to be taken seriously.

A systematic review and meta-analysis involving 57 studies found ADHD was associated with increased odds of suicidal ideation, suicide attempts, suicide planning, and suicide death. [1]

That does NOT mean someone with ADHD is destined to become suicidal.

Read that again.

Risk is not destiny.

But it does mean we shouldn’t dismiss what is happening inside someone’s head simply because everything looks fine from the outside.

Now Throw Depression Into the Mix

This is where things can get dark.

Depression doesn’t always look like someone sitting alone in a dark room crying.

Sometimes depression gets up and goes to work.

Sometimes depression teaches class.

Sometimes depression coaches football.

Sometimes depression laughs at somebody’s joke.

Sometimes depression posts something funny on Facebook.

Sometimes depression helps everyone else solve their problems and then goes home completely exhausted.

That’s something I think we misunderstand.

You can function and still struggle.

You can smile and still struggle.

You can love your family and still struggle.

You can have people who love you and still struggle.

And depression has an ugly way of changing perspective.

A problem becomes permanent.

A mistake becomes unforgivable.

A bad day becomes a bad life.

And eventually the mind starts asking questions that a healthy mind wouldn’t normally ask.

Research consistently identifies psychiatric comorbidities—particularly mood disorders—as an important part of the connection between ADHD and suicidality. [2][3]

That’s why depression combined with ADHD deserves attention.

Not panic.

Not judgment.

Attention.

Then Anxiety Walks Through the Door

If depression tells you:

“Nothing is ever going to get better.”

Anxiety answers:

“Yeah, and let me give you 37 reasons why everything could get worse.”

Then ADHD says:

“Great. Let’s think about all 37 at the same time.”

Welcome to the party.

Past.

Present.

Future.

All at once.

Your brain becomes a television with 15 channels playing simultaneously and somebody lost the remote.

That’s cognitive and emotional exhaustion.

Research into suicide has examined something called entrapment—essentially reaching a point where someone feels trapped inside circumstances or psychological pain and can’t see an escape.

That’s an important word.

Trapped.

Because sometimes someone isn’t thinking:

“I want to die.”

They’re thinking:

“I can’t keep feeling like this.”

Those aren’t necessarily the same statement.

But during severe depression and anxiety, the mind can have trouble recognizing the difference.

That’s when people need help.

Let’s Talk About That 80–90% Number

I’ve spent some time looking at the research because there is a statistic floating around suggesting that 80–90% of adults dealing simultaneously with ADHD, severe depression, and anxiety experience suicidal thoughts.

That number caught my attention.

It should catch anybody’s attention.

But there is a problem.

The research doesn’t support using that number as a blanket statistic.

One frequently referenced study reported extremely high lifetime suicidal ideation among participants with ADHD.

But researchers intentionally recruited a population heavily containing people who had already experienced suicidal thoughts.

In other words, you can’t take that sample and say:

“Nine out of ten people with ADHD, depression, and anxiety will become suicidal.”

That’s not how statistics work.

And this subject is too important to exaggerate.

We don’t need to.

The actual research is concerning enough.

A major meta-analysis found ADHD associated with significantly greater odds of suicidal-spectrum behaviors. [1]

Other systematic reviews show psychiatric conditions occurring alongside ADHD are important factors when evaluating suicide risk. [2][3]

So let’s say what we actually know.

ADHD + severe depression + anxiety can represent a serious mental-health burden.

That’s enough reason to pay attention.

Now Let’s Talk About Men

Especially middle-aged men.

This is where I think we have a problem.

Because men are really good at saying:

“I’m good.”

You know the answer.

“How are you doing?”

Good.

“Everything okay?”

Yep.

“You need anything?”

Nope.

End of conversation.

Meanwhile, inside that man’s head there may be a war taking place.

A man can go to work every morning.

He can provide for his family.

Teach kids.

Coach athletes.

Run a business.

Call a football game.

Make everyone in the room laugh.

Help somebody else through their worst day.

And nobody knows what happens when he gets home and the room gets quiet.

Functioning doesn’t always mean healthy.

That’s why the statistics surrounding men matter.

CDC data show that males account for nearly 80% of suicide deaths in the United States. [4]

In 2023, males ages 45–64 had a suicide rate of approximately 29.2 deaths per 100,000 people. [5]

Those aren’t numbers I’m sharing to scare anyone.

I’m sharing them because maybe we need to start asking each other a second question.

“How are you?”

“Good.”

“No, really. How are you?”

And then actually listen.

The Impulsivity Piece

ADHD often comes with impulsivity.

Depression can come with hopelessness.

Anxiety can create overwhelming fear and internal pressure.

That’s obviously a combination clinicians should take seriously.

But I’m also going to be careful here.

Research doesn’t give us a straight line that says:

ADHD → impulsivity → suicide.

It’s much more complicated than that. [2][3]

Depression matters.

Substance use can matter.

Trauma can matter.

Loss can matter.

Relationships can matter.

Physical health can matter.

Sleep can matter.

Access to lethal means can matter.

Previous attempts matter.

And perhaps most importantly, what someone is thinking right now matters.

You cannot type:

54-year-old male + ADHD + severe depression + anxiety

into some medical calculator and have it spit out:

“Here is your future.”

It doesn’t work that way.

Thank God it doesn’t.

The Scoreboard Doesn’t Know the Whole Story

Sports taught me something a long time ago.

A scoreboard tells you something.

But it doesn’t tell you everything.

It tells you who is ahead.

It doesn’t tell you who is injured.

It doesn’t tell you who is exhausted.

It doesn’t tell you what happened during practice that week.

It doesn’t tell you what adversity that kid went through just to put the uniform on Friday night.

Statistics work similarly.

They tell us something.

They don’t tell us everything.

A statistic can tell us that a group has increased risk.

It cannot tell us how one person’s story ends.

And that’s incredibly important.

Because statistics don’t know about tomorrow’s doctor’s appointment.

Statistics don’t know about the therapist somebody hasn’t met yet.

Statistics don’t know about a medication change that finally works.

They don’t know about the friend who answers the phone at 2:00 in the morning.

They don’t know about the family member who says:

“You’re staying with me tonight.”

And statistics certainly don’t know what God has planned for somebody’s tomorrow.

Maybe Asking for Help Is Actually Strength

We have spent generations teaching men how to tough things out.

Shake it off.

Rub some dirt on it.

Get back in there.

And there’s certainly something to be said for toughness.

Football has taught me plenty about that.

But there’s a difference between toughness and silence.

Sometimes the toughest sentence a man will ever say is:

“I need help.”

Maybe strength isn’t pretending everything is okay.

Maybe strength is recognizing when it isn’t.

Maybe courage isn’t carrying everything yourself.

Maybe courage is finally putting the weight down long enough to let somebody help carry it.

There Is Still Another Quarter

This might be the football coach in me.

But I believe this.

As long as there is time on the clock, the game isn’t over.

I’ve watched teams look completely finished.

Nothing working.

Momentum gone.

Everybody frustrated.

Then something changes.

One play.

One break.

One adjustment.

One person refuses to quit.

And suddenly everything looks different.

Life obviously isn’t a football game.

Mental illness isn’t something somebody can simply “tough out.”

ADHD isn’t cured by determination.

Depression isn’t defeated because somebody tells you to think positively.

Anxiety doesn’t disappear because somebody says, “Stop worrying.”

These are legitimate conditions that deserve legitimate treatment.

But there is something football gets right:

Don’t declare the outcome before the clock reaches zero.

If today is terrible, today is terrible.

That doesn’t automatically mean tomorrow will be.

Your Story Isn’t Finished

Research can identify risk.

Doctors can diagnose conditions.

Statistics can describe populations.

None of them can write the final chapter of someone’s life.

There are people walking around today who once believed they couldn’t survive another day.

They did.

There are families together today because somebody made a phone call.

There are people laughing today who once couldn’t imagine ever laughing again.

There are people helping others today because somebody once helped them.

That’s why this conversation matters.

And if you’re the person reading this who has mastered the art of saying:

“I’m good.”

when you know you’re not…

Maybe today is the day you give somebody the real answer.

If You’re Struggling Right Now

If this article isn’t simply interesting to you—if it sounds like what is happening inside your own head—please tell someone.

Today.

In the United States, call or text 988 to reach the Suicide & Crisis Lifeline.

If you believe you may hurt yourself, have developed a suicide plan, have begun preparing to act, or don’t believe you can remain safe, call 911 or go to the nearest emergency department.

Don’t sit alone trying to win that battle inside your own head.

Call somebody.

Sit beside somebody.

Tell somebody the truth.

And remember:

The scoreboard doesn’t determine the outcome until the clock hits zero.

There is still time.

There is still help.

There is still hope.

And there is still another chapter to write.

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References

[1] Septier M, Stordeur C, Zhang J, Delorme R, Cortese S. Association between suicidal spectrum behaviors and attention-deficit/hyperactivity disorder: A systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews. 2019;103:109–118. doi:10.1016/j.neubiorev.2019.05.022.

[2] Balazs J, Kereszteny A. Attention-deficit/hyperactivity disorder and suicide: A systematic review. World Journal of Psychiatry. 2017;7(1):44–59. doi:10.5498/wjp.v7.i1.44.

[3] Risk factors of suicidal spectrum behaviors in adults and adolescents with attention-deficit/hyperactivity disorder: a systematic review. BMC Psychiatry. 2023.

[4] Centers for Disease Control and Prevention. Suicide Data and Statistics. National Center for Injury Prevention and Control.

[5] National Center for Health Statistics. Changes in Suicide Rates in the United States From 2022 to 2023. CDC/NCHS Data Brief.

[6] Choi WS, Woo YS, Wang SM, Lim HK, Bahk WM. The prevalence of psychiatric comorbidities in adult ADHD compared with non-ADHD populations: A systematic literature review. PLOS ONE. 2022;17(11):e0277175.

Immediate Help

988 Suicide & Crisis Lifeline — Call or text 988, 24 hours a day, seven days a week.

If there is an immediate danger of suicide or someone cannot remain safe, call 911 or seek emergency medical attention.