Research shows that ADHD comorbidity is very common. This term is a lot less alarming than it sounds, but it's still something we should be aware of.
Attention-deficit/hyperactivity disorder (ADHD) is a condition that affects millions of children, teens, and adults. According to experts, the likelihood that people diagnosed with ADHD also have other "comorbid" conditions is high. Understanding all of your diagnoses and how they interact can help you and your child better cope with your symptoms.
Here is what you need to know, because understanding will help you support them.
What is Comorbidity
Though the word may seem pretty big and intimidating, it's relatively simple. Comorbidity is the presence of more than one medical condition in one person. When a doctor diagnoses an individual with two conditions -- such as diabetes and heart disease -- they are dealing with comorbidity. The same holds true for conditions like ADHD. Patients diagnosed with ADHD and another psychiatric disorder have comorbid conditions.
It is important to know that ADHD does not necessarily occur in a vacuum. Comorbidity is very common. Having a comorbid condition can be confusing, but understanding what symptoms come from your child's ADHD as opposed to what is caused by another condition is the best way to take control of your own mental health.
There are three subtypes of ADHD, based on what kinds of symptoms are predominant:
- First, Predominantly Inattentive
- Second, Predominantly hyperactive-impulsive
- And finally, Combined
Symptoms of ADHD in Kids and Adults
Most experts divide the symptoms of ADHD into two main categories: inattention and hyperactivity-impulsivity. When looking at these symptoms, it is important to remember: Most healthy children display these characteristics to some extent as well. Children with ADHD display symptoms for at least six months. These symptoms will impact multiple areas of their lives, such as school and relationships at home. If a child is having trouble in only one setting, ADHD is probably not the cause.
- Not paying attention to details
- Making careless mistakes
- Trouble staying focused
- Not listening
- Difficulty following instructions
- Not finishing schoolwork or chores
- Difficulty organizing
- Losing items
- Easily distracted
- Forgetting to do daily activities
- Fidgeting with hands and feet
- Squirming in seat
- Difficulty staying seated
- In constant motion
- Running/climbing in inappropriate situations
- Trouble engaging in quiet play
- Talking too much
- Interrupting others
- Blurting out answers
- Difficulty waiting
If you are concerned that your child might have ADHD, it is important that you contact your doctor. A proper diagnosis is the first step towards helping your child learn to manage their symptoms.
Symptoms of true ADHD should begin early in life, primarily before the age of 12. The process of diagnosing ADHD will involve a medical exam and the physician will carefully take your medical history. School records also play an important role in the diagnosis process. Additionally, doctors will use some combination of questionnaires and ADHD rating scales along with the ADHD criteria from the Diagnostic and Statistical Manual of Mental Disorders DSM-5 (published by the American Psychiatric Association).
ADHD comorbidity is a very common reality. Anxiety disorders occur in 47 percent of people diagnosed with ADHD. Thirty-eight percent of people with ADHD also have a mood disorder. Disorders involving impulse control occur in 20 percent of those who have ADHD, while substance use disorders are present in 15 of the ADHD community. ADHD comorbidity can also involve other psychiatric conditions, including personality disorders, and not surprisingly, comorbidities can complicate the diagnosis process.
It is possible for a person with ADHD to also have an anxiety disorder. In fact, anxiety can even be caused by ADHD and dealing with fallout that often results from the symptoms. There are several types of anxiety disorders, including panic disorder, social anxiety disorder, and generalized anxiety disorder as well as specific phobias. The symptoms of anxiety include the following:
- Restlessness or feeling wound-up or on edge
- Being easily fatigued
- Difficulty concentrating or having their minds go blank
- Muscle tension
- Inability to stop worrying
- Sleep problems
- Sudden and repeated attacks of intense fear
- Feelings of being out of control during a panic attack
- Intense worries about when the next attack will happen
- Fear or avoidance of places where past panic attacks have occurred
- Feeling highly anxious about being with other people
- Difficulty talking to other people
- Feeling very self-conscious in front of other people
- Fear of feeling humiliated, embarrassed, or rejected, or fearful of offending others
- Intense fear of being judged by other people
- Worrying for days or weeks before an event with other people
- Avoiding places where there are other people
- Difficulty making and keeping friends
- Blushing, sweating, or trembling around others
- Feeling nauseous or sick to your stomach when around others
ADHD commonly occurs with mood disorders such as depression and bipolar disorder is a particularly likely occur simultaneously with ADHD. These disorders can be difficult to diagnosis when they are comorbid because they share many of the same symptoms, including:
- Mood instability
- Bursts of energy
In order to distinguish between bipolar disorder and ADHD, a physician will carefully consider the following six factors:
- Age of onset
- Consistency of impairment
- Mood triggers
- Rapidity of mood shifts
- Duration of moods
- Family history
Impulse Control Disorders
ADHD comorbidity often involves various impulse control disorders. People who have an impulse control disorder are unable to resist the urge to do something, even if it is harmful to themselves or others. Impulse control disorders include eating disorders, compulsive gambling, paraphilias, kleptomania, pyromania and intermittent explosive attacks of rage. Although ADHD itself can involve difficulty controlling impulsivity, in those with impulse control disorders, this impulsivity is the main feature of the condition.
Substance Use Disorders
Multiple studies have found that people with ADHD are more prone to abuse alcohol and drugs. It has also been discovered that people with ADHD have a faster progression from initial use to abuse and their substance use disorders are more likely to follow a particularly aggressive pattern.
Understanding a Comorbid Diagnosis
ADHD comorbidities are very common. Although ADHD shares many symptoms with other disorders, which can complicate diagnosis, it is not the least bit unusual to have multiple comorbid disorders. Understanding the various diagnoses you or your child have received helps you. Knowing can finally help you to better manage symptoms and deal with this condition. Remember to always consult your doctor and follow any medical advice they give, as this is the single most important step to managing your condition.