ADHD Guide

ADHD Comorbidity: An Overview of Dual Diagnoses

What is a comorbid condition? Here, find answers to common questions about ADHD comorbidity, when multiple conditions are diagnosed along with attention deficit disorder in the same patient.

An image of two brains symbolizes ADHD comorbidity, or dual diagnoses

What is comorbidity?

Comorbid conditions, or comorbidities, are two or more conditions that happen to occur in the same patient, at the same time. Another term for this would be “dual diagnosis.” Many people with attention deficit disorder (ADHD or ADD) have one or more comorbidity — additional diagnosis — such as depression, a substance abuse disorder, a learning disability, oppositional defiant disorder (ODD), or some other condition.

Can comorbid disorders mask one another?

Yes, comorbid disorders often mimic or obscure each others symptoms. For example, a person may be diagnosed with depression. After treatment, the depression is under control, but he still has the problems with inattention. Thus, the diagnosis would change to include ADHD as well as the original diagnosis of depression. The ADHD was there the whole time, but it was overshadowed by the symptoms of depression.

What is the most common ADHD comorbidity?

Depression is a  very common ADHD comorbidity. The numbers break down like this:

  • Seventy percent of adults with ADHD will be treated for depression at some time.
  • Some estimates are as high as 50% for ADHD people who live with either alcoholism or some form of substance abuse
  • Roughly 5-7% of people with ADHD also have bipolar disorder
  • Tourette’s, Dyslexia, ODD and other disorders are more common among ADHD people than among the general population.

How do you know which comorbid condition to treat first?

It depends on what is causing the most problems. Generally, if a person has depression, you would want to treat that before considering ADHD. This is because depression can look like ADHD, especially ADD without hyperactivity. The same could be said of substance abuse.

What is the most important thing to consider when dealing with a child who has multiple comorbid diagnoses?

Make sure that everybody knows what everybody else is doing. If you are seeing a psychiatrist and a neurologist, make sure that both doctors are aware of what the other is doing, and that they are especially aware of which medications are being prescribed. You will have to be the line of communication here — doctors tend to have these ego-based turf battles which sometimes don’t permit adequate communications.

Some people seem to collect comorbid diagnoses. What is behind that?

There are a couple of reasons why this happens. For one thing, it seems that many disorders travel in groups. Depression and ADHD, for example, very often appear together. It is possible that after some time in therapy, the patient would have a list of various things for which they had been treated.

What is a good book about ADHD and comorbid conditions?

Shadow Syndromes by John Ratey is probably the best book for adults living with two or more concurrent diagnoses. Another good book is Brainstorms by Joseph Horacek.