Mental Health & ADHD Comorbidities

Comorbid Conditions with ADHD: What Is Your Primary Diagnosis?

“ADHD feels the most like a core part of my personality, my way of being, while anxiety is this constant needling shadow.”

comorbid conditions, primary diagnosis, multiple diagnoses

There’s a saying that “ADHD loves company.” Roughly 80% of individuals with ADHD are diagnosed with at least one comorbid condition ranging from depression, anxiety, or learning differences to sensory processing disorder, substance abuse disorder, autism spectrum disorder (ASD), and beyond.

Managing multiple diagnoses means balancing disparate but dependent treatment plans, doctor appointments, coping strategies, symptoms, and more. This begs the question: Does one diagnosis take precedence over the others?

We asked ADDitude readers with one or more comorbid conditions if they consider one their “primary” diagnosis. And if so, which one, and why? Check out their responses below and share your story in the Comments section below.

“This is a tough one to unpack. For a long time, I thought of my depression as the primary diagnosis because it can speak the loudest. It certainly got my parents’ attention when my general anxiety, executive functioning challenges, daydreaming, and impulsivity did not. It took decades to realize that my anxiety had a daily impact and a bit longer to acknowledge and embrace the missing piece of ADHD. In hindsight, so many ADHD moments just fed my anxiety and depressive episodes. ADHD feels the most like a core part of my personality, my way of being, while anxiety is this constant needling shadow.” — Anastasia, Massachusetts

“I am a 44-year-old woman who was diagnosed with ADHD last week. Previously, I had been (incorrectly) diagnosed with bipolar 2 disorder and treatment-resistant major depressive disorder. I don’t think I can extricate my experience of debilitating depression from my previously undiagnosed (but obvious, in hindsight) debilitating ADHD. What came first — the chicken or the egg? Would I have become so crippled by depression if I had managed my ADHD as a child and teenager and experienced more regular adult successes in my life? I’ll never know. I do know that depression is deeply real. I’m starting to allow myself to hope for a brighter future once I’ve processed my life to date.” — Lara, Australia

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“Depression makes things harder to do. ADHD makes them worse to do.” — An ADDitude Reader

“I have surface dyslexia, mild depression, ODD (oppositional defiant disorder), and ADHD. I think of my ADHD as a primary condition because it irritates, annoys, and frustrates me the most. It’s in my face, whether I’m feeling up or down. It’s also how I deal with my other comorbid conditions: I forget about them until a trigger or wave hits me. Because ADHD filters into every part of my life, I can’t forget it. So, it feels the most prominent.” — Mizza, South Africa

“I consider ADHD my primary condition because it informs my living experience. My anxiety and depression come and go. However, they both manifest based on how I experience and interpret the world. My present understanding of myself: I have ADHD. I also struggle with anxiety and depression. My previous understanding of myself: I don’t know who I am, and I don’t know why. Parts of my puzzle seem to be missing.” — An ADDitude Reader, Canada

“I have ADHD, an anxiety disorder, and a social phobia. I think of ADHD as the primary condition that caused the other conditions due to how ADHD completely affects my life. Because of my ADHD, I don’t understand how to interact in a socially appropriate way. The potential for social rejection causes me anxiety. Then I must deal with my rejection sensitive dysphoria. It’s a feedback loop that never ends.” — Paige, Florida

“I’ve been diagnosed with anxiety, depression, addiction, and ADHD. Addiction is my primary because I still actively use illicit drugs. It’s been the primary focus of any professional help I’ve received, and it is the one condition for which I can be arrested. When using, it’s difficult to assess and treat other conditions. And, unfortunately, I’ve struggled with addiction for a very long time.” — An ADDitude Reader

[Self-Test: Do I Have ADHD? Symptoms In Adults]

“With both ADHD and ASD [Autism Spectrum Disorder], certain periods have their own primary condition. One condition will impact me more for hours, days, or weeks. The other condition will pop up again when it starts affecting me less. It’s like my brain is constantly swinging back and forth between the two, like a pendulum. —An ADDitude Reader

“My primary Dx depends on which diagnosis affects me most at any given time. My current primary condition is idiopathic hypersomnia — I’m about to fall asleep as I write this. Autism and inattentive ADHD rarely become my primary condition; they are just part of who I am.” — Melissa, Colorado

“My ADHD is primary. I blame every other issue — depression, anxiety, etc. — on it. I’ll say, ‘If not for this characteristic of ADHD, I wouldn’t be so depressed, or I could effectively deal with my depression.’ It is a vicious circle that usually results in me mentally spiraling into intense self-hate and disgust. I wish I could find a safety lever to grab and get off the merry-go-round.” — Katherine, Texas

“Before I wrote my answer, I thought that one of my physical, chronic conditions (immune deficiency, chronic pain, and permanent physical disabilities) would be my ‘primary’ condition. It’s often difficult to tell which condition (ADHD or physical illness) is causing me distress because the symptoms overlap, such as brain fog, severe fatigue, anxiety, depression, and chronic pain. Relief (when possible) often comes from the same methods, regardless of the condition. Having ADHD and multiple comorbidities makes it very hard to maintain a good schedule and organized home. This impacts my ability to manage appointments, insurance, medications, treatments, and other needs. I must improve my ADHD coping skills to survive it all. Therefore, I now think adult ADHD best describes my ‘primary’ challenge or condition.” — Panni, Ireland

“I have ADHD, bipolar 1 disorder, and PTSD [Post Traumatic Stress Disorder]. My bipolar 1 disorder is the most challenging to manage and certainly the most disruptive to my life. It negatively impacts the other two conditions. (My doctor takes me off my ADHD medication when my mood becomes extremely unstable due to stress.)” — An ADDitude Reader

“ADHD is my flagship condition because it checks the most boxes regarding traits and symptoms, and I was diagnosed with it earlier this year. I also have undiagnosed dyspraxia and dyscalculia (I call them the unholy trinity), which I find more disabling than ADHD. In certain situations, my ADHD symptoms are stronger. In other situations, all three contributed equally to my difficulties and made it difficult to achieve career and financial success. At 45, I’m still stuck doing entry-level, hourly positions. I can’t seem to move up.” — An ADDitude Reader

I think of my ASD as primary because it shapes my ADHD symptoms. Aspects of my ASD cause me to struggle more socially and economically because there is no direct medical intervention. There are more negative consequences from social deficits, which worsen and add to my experiences with ADHD because I struggle with social support.”— Allison, Kansas

“I’m a 56-year-old male who was diagnosed with major depressive disorder, generalized anxiety disorder (GAD), and ADHD (combined subtype) after my son was diagnosed. I have struggled most of my life. My childhood and adolescent years contributed to this because my parents reprimanded and punished me a lot. (They didn’t know I had ADHD.) I’ve tried — and failed — therapy multiple times. I’m too sensitive to discuss my past (rejection sensitive dysphoria). I can’t follow through on the ‘homework’ between therapy sessions (ADHD). Then I brutally beat myself up for failing again (depression). So, to answer your question about my ‘primary’ condition, it changes daily depending on what or who I deal with.” — Dan, Nebraska

Comorbid Conditions with ADHD: Next Steps

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