Comorbid Conditions, Part 2
3. Problems regulating emotions. These include depression, anxiety disorders (including panic attacks), anger-control problems (intermittent explosive disorder), OCD, and, probably, bipolar disorder, as well.
Parents should recognize that depression can cause a range of symptoms beyond sadness and thoughts of suicide; these include irritability, reduced interest in activities that used to be pleasurable, sleep disturbances, decreased ability to concentrate, indecisiveness, agitation or slowness of thinking, fatigue or loss of energy, and feelings of worthlessness or inappropriate anger.
A child with intermittent explosive disorder doesn't just yell and stamp his feet. He's a "Jekyll and Hyde" child, who explodes so fast that you don't know what caused it, spending 30 minutes or more screaming, cursing, hitting, throwing, and threatening. During this time, he is irrational. The explosion ends almost as abruptly as it began. Once it is over, he might be tired and not want to discuss what happened. Later, he might feel remorse and say that he is sorry and that he does not know why he did it.
OCD can cause a need to count or repeat behaviors, a need to check over and over to make sure that something was done or that an answer given is correct, a need to collect or hoard objects, a need to arrange and organize things, a need to clean and wash, or a need to bite nails or cuticles, pick at sores or scabs, or twirl or pull out hair.
In some cases, OCD is confused with inattention—as when a child is so fearful of making a mistake that he is unable to move on to the next task or activity.
What about bipolar disorder?
Although bipolar disorder may not occur along the same continuum as cortical wiring problems, emotional regulatory problems, and tic disorders, individuals with ADHD do face an increased risk for this highly complex disorder.
Bipolar disorder is characterized by mood swings between depression and a "super-happy" state called mania. The mind races. It is difficult to stop talking or acting or to relax. Moods may swing from calm to rage and back again. Behavior is driven and may appear inappropriate.
Unlike the mood shifts that characterize ADHD (which are usually triggered by life events), bipolar mood shifts may appear to come and go without any connection to events, and may be sustained over longer periods of time.
This article comes from the April/May 2006 issue of ADDitude.