Is It Just ADHD? Comorbidities That Unlock an Accurate Mental Health Diagnosis
For patients with attention deficit, a mental health diagnosis almost always includes an ADHD comorbidity as well — autism spectrum disorder, generalized anxiety disorder, depression, and other conditions. To fully understand your mental health diagnosis and get the full benefit of ADHD treatment, you must factor co-occurring conditions into the medication equation.
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2 Comments: Is It Just ADHD? Comorbidities That Unlock an Accurate Mental Health Diagnosis
I was taught that the most common co-occuring conditions (I hate the term co-morbid) are sleep disorders (over 60 percent) Learning Disorders (76 percent) Anxiety and Depression (10 to 47 percent) and Oppositional Defiance Disorder (35-50 percent)
Of those, it’s understandable that sleep is disrupted and compromised – we have a really hard time shutting off our brains when they are working overtime to stimulate us and boost dopamine. I think that just assuming sleep issues are a common part of ADHD makes more sense than considering them a separate issue.
Learning Disorders – The rate of these co-occuring with ADHD is significant, but the most common one is Disability of Written Expression and I’ve heard Dr. Tom Brown explain his belief that this really just should be considered part of ADHD because the challenges with written expression are largely explained by challenges with executive functioning.
Anxiety – as above, is the anxiety a separate disorder – sometimes it is, but probably more often it’s because our brains have an abundance of information to deal with due to differences with our RAS and a brain that finds “what if” thoughts stimulating – even if our minds don’t find them all that pleasant. Depression – ok, sometimes, and sometimes what originally gets labelled depression turns out to be ADHD rumination and negative thinking. On top of that, throw in a big dose of ADHD emotional sensitivity. Historically, women in particular were told by Dr’s that they had anxiety and depression because their MD didn’t see the ADHD – it often takes years before women’s inattentive type ADHD is picked up on, if at all – and although I’m not a medical professional, I’ve been told by a leading Canadian psychiatrist specialising in this area that quite often if the ADHD is treated and managed the anxiety and depression symptoms resolve themselves.
ODD – there’s a movement on the part of enlightened professionals to have oppositional defiance disorder removed from the DSM, because they believe it’s more of an indicator of something else going on (ADHD, anxiety, etc…) than a separate disorder. Do you know how many adults a kid needs to be defiant with in order to meet the criteria for ODD? Just one… With that criteria, who doesn’t have ODD?
20-50 percent of people with ADHD have autistic tendencies which is not the same as having a diagnosis of ASD. However – the reverse is true, 30 to 80 percent of those on the spectrum have ADHD.
Part of the reason that there is such a high rate of co-occurring disorders with ADHD is that we seem to love a lot of separate labels, when just one label – ADHD – will explain most of what’s happening.
Definitely, there are co-existing mental illnesses or psychiatric disorders at times but this article makes it sound like most of us are walking basket cases of mood and personality disorders. That’s not the case for me and it’s not the case for most of the people with ADHD I work with.
Fantastic article, but what about the comorbidity of dyslexia? I’m a 52-year-old male with inattentive ADD and dyslexia. I realize that the chicken and the egg in my personal scenario is – do I have generalized anxiety and depressive tendencies or are they a manifestation of my two stated underlying conditions? I have and can accomplish great things; however, they typically take me much longer than most neuro-typical people. I don’t delegate well because of my difficulty in explaining information to others in a logical and concise manner. Because I am such a concrete thinker, I am not a good multi-task thinker. I can do one thing to near perfection but keeping multiple balls in the air is difficult to say the least. IQ tests put me in the top 1% of the general population – and although I’ve done reasonably well for myself throughout my working career, I almost always fall to the bottom or near the bottom of the pecking order. The reason for this is multi-pronged; first, I have very little ability to politicize my abilities, efforts, and accomplishments in the workforce (I am easily pushed out of the good-old-boy circles).
And, since things tend to take me a bit longer to muster through, in a dog-eat-dog world where speed is generally king, I’m not a top-tier (or most of the time even medium) performer anyway. The frustrating thing about all of this is the amount of effort needed to be average is exhausting. I feel like we are all treading the same water, but instead of having a speedo racer on like my peers, I have an all-cotton combination of sweatpants and hoodie that’s three sizes too large. I can do it but, in the end, I’m left exhausted with similar accomplishments. That’s all well and good – effort is a good thing, right? But what about the next endeavor – and the one after that – and the one after that – and so on? Sooner or later the inevitable complication of circumstances and exhaustion gets the best of me. This is when anxiety and depressive thoughts find their way into your consciousness. And really, how could they not find their way in? If I had an average IQ it would be easier to conceptualize (or lack thereof) because I wouldn’t be as intellectually aware. As it is, however, I am keenly in-tune with my pent-up capabilities. It takes a great deal of humility to keep things in perspective – and to allow the adversity to work for you instead of against you.