TLDR
- About two-thirds of people who have ADHD also have one or more comorbidities
- Anxiety is the most common comorbidity of ADHD, followed by depression
- Diagnosing ADHD can be tricky, as other conditions may mask ADHD - and vice versa
- Some ADHD comorbidities are more common in childhood, while others are more common in adulthood
I didn’t find out I had ADHD until my last semester of grad school.
This experience - late diagnosis of ADHD - is becoming more and more common as awareness grows. The irony, for me, was that my graduate degree was in mental health counseling. When I was first diagnosed, I felt incredibly frustrated. Shouldn’t I have figured it out sooner??
Problem is, ADHD isn’t just a stand-alone condition; it often shares space with other conditions, or “comorbidities.” And those other conditions - in my case, anxiety, depression, and OCD - often make ADHD difficult to spot.
Whether you or someone you love is navigating the landscape of ADHD, understanding its interconnectedness with other conditions isn’t just academic trivia; it's a key part of seeing the full picture.
In this article, we're going to explore these connections, delve into the most common comorbidities of ADHD, and offer some insights to help light your way. Hopefully, by the end, you’ll feel more empowered and informed to face the challenges and celebrate the unique strengths that come with adult ADHD and its companions.
What Is a “Comorbidity?”
In the world of mental health and medical conditions, comorbidity means having two or more conditions at the same time. About two-thirds of people who have ADHD also have one or more comorbidities. A new term, called “complex ADHD,” is sometimes used to describe this phenomenon.
It's important to remember that just because two conditions often show up together, it doesn’t automatically mean one caused the other - though this can be the case. It’s also possible that they arise independently. Getting away from the ‘blame game,’ though, no matter which comes first, dual diagnoses can play off each other in a terrifying kind of snowball effect.
Understanding comorbid conditions is like having a map of the entire ‘rail network’ of the brain. With this map, we can better navigate the challenges, anticipate potential roadblocks, and make smoother connections. Recognizing and addressing comorbidities isn't just about slapping on more labels; it's about offering a comprehensive guide to understanding one's experiences and finding the most effective treatments and strategies.
What Is the Most Common ADHD Comorbidity?
In the world of ADHD, common comorbidities include anxiety, depression, substance use, learning disabilities, and more. Of these, anxiety is the most common - it shows up in about a quarter of adults with ADHD.
Anxiety and ADHD, though distinct in nature, share several overlapping symptoms. For instance, both conditions can lead to:
- restlessness
- trouble focusing
- impulsiveness
- forgetfulness
Someone with both ADHD and anxiety might find that their anxiety exacerbates ADHD symptoms. On the flip side, the challenges of managing ADHD might amplify feelings of anxiety. (That was the case for me.) Recognizing this interplay means we can tailor treatments and strategies that address both conditions.
Common ADHD Comorbidity List
Curious about which other conditions tend to jump into the ADHD sidecar? Here’s a list of the most common ADHD comorbidities:
- Generalized Anxiety
- Obsessive Compulsive Disorder (OCD)
- Bi-Polar Disorder
- Learning Disabilities (Dyslexia and Dyscalculia are most common among these)
- Depression
- Autism Spectrum Disorder (ASD)
- Substance Use Disorder
- Sensory Processing Disorder
- Sleep disorders
- Chronic Pain and Fibromyalgia
- Chronic Fatigue Syndrome
- Hypermobility disorders like Ehlers Danlos Syndrome (EDS)
- Obesity
- Epilepsy
- Migraine and headaches
- Restless Leg Syndrome (RLS)
Can ADHD and Other Conditions Mask Each Other?
Absolutely. In fact, one of the reasons diagnosing adult ADHD can be so tricky is because so many other conditions have similar symptoms.
The masking effect works both ways. For instance, the structured routines of someone with OCD might momentarily counteract ADHD's impulsivity, making the latter seem less pronounced. Similarly, the deep focus in specific subjects seen in Autism might overshadow ADHD's characteristic distractibility.
Why does this blending occur?
- Overlap in Symptoms: As we've seen, many of these conditions share common signs, making it challenging to distinguish one from the other.
- Shared Biological Pathways: Genetic and neurological factors can sometimes predispose an individual to multiple conditions.
- Compensatory Mechanisms: One condition might develop as a coping strategy for another, further blurring the lines.
Despite these complexities, all hope isn't lost. With detailed assessments, a keen observational eye, and understanding the individual's unique experiences, clinicians can disentangle these overlapping conditions, making ADHD management much easier.
Differentiating Symptoms of ADHD & Comorbidities
Since comorbid conditions are so common in ADHD, and because they can make diagnosis tricky, it’s important to be able to distinguish if one condition is “primary,” or if there are two full-fledged conditions at work. Primary diagnoses are the conditions that are most severe or resource-intensive.
While there is no clear-cut, 100% accurate way to determine this, there are a couple clues that can help your physician distinguish which condition is which:
- Secondary symptoms frequently start at a specific time, or show up only in specific contexts. For example, maybe you’re only anxious at work; in that case, anxiety is likely secondary to ADHD, meaning the anxiety symptoms are probably a result of untreated ADHD.
- However, just because one condition started after the other doesn’t automatically make it secondary. For example, you may experience a trauma and develop PTSD. Just because you were born with ADHD, and the PTSD started later, doesn’t mean the PTSD isn’t also a primary diagnosis.
- A comorbid condition, on the other hand, is more widespread. Using the same example of ADHD and Anxiety, that would mean that even if you treat one of the two, you’d still be experiencing significant symptoms. It would mean that both conditions are present in most situations, and it may be hard to pinpoint when one or the other began. In fact, that how we discovered my ADHD in the first place - it seemed like nothing we tried was making a significant difference in my anxiety. Once the ADHD was diagnosed and treated, my anxiety symptoms were much easier to manage.
In short - it’s complicated. Thankfully, determining which diagnoses are primary or secondary, and which symptoms go with which diagnosis, is a collaborative effort between you and your therapist or physician. There are a number of assessments and diagnostic tools that can help clarify this.
Do ADHD Comorbidities Change with Age?
They do - sort of. While there are certain comorbidities of ADHD that occur more often in childhood, and others that occur more often in adulthood, it’s not always a person’s age that causes the comorbidities to change. Sometimes, it’s more a matter of environment. For example, adults with ADHD are much more likely to also have anxiety or substance use disorder (SUD). Children, on the other hand, are more likely to experience behavior and conduct disorders like Oppositional Defiant Disorder or Conduct Disorder.
What Should I Do If I Think I Have ADHD Comorbidities?
If you have ADHD and suspect you may also be dealing with coexisting conditions, it's essential to take a thoughtful and systematic approach to address your concerns. Here are some steps you can consider:
- Self-Assessment. Conduct a self-assessment of your symptoms. Make a list of specific behaviors or challenges you're facing that lead you to believe you might have ADHD. Note when these symptoms occur and how they impact different aspects of your life.
- ~Bonus Tip: Try using a symptom tracker app like Bearable, ADHD Health Storylines, or CareClinic
- Research and Education. Learn more about ADHD and its common comorbidities. Understand the symptoms and challenges associated with both ADHD and the potential comorbid conditions. This knowledge can help you communicate effectively with healthcare professionals.
- Consult a Healthcare Professional. Schedule an appointment with a healthcare professional, such as a psychiatrist or psychologist, who specializes in ADHD and related conditions. They can conduct a thorough assessment, which may involve interviews, questionnaires, and possibly input from family members or close friends.
Remember, seeking professional help is crucial for an accurate diagnosis and effective treatment. ADHD and its comorbidities can be complex, and a tailored approach based on your specific needs is essential for successful management.
Can ADHD Coaching Help?
An adult ADHD coach specializes in helping clients develop strategies and skills to manage their challenges more effectively. Here's how an ADHD coach could be beneficial:
- Understanding ADHD: ADHD coaches are knowledgeable about ADHD and its various manifestations. They can help individuals understand their unique ADHD profile, including strengths and challenges.
- Goal Setting and Planning: Adult ADHD coaching assists clients in setting realistic and achievable goals. Coaches work collaboratively to break down larger goals into manageable tasks and create step-by-step plans for implementation.
- Time Management: Time management is often a significant challenge for individuals with ADHD. Adult ADHD Coaches can provide strategies to help clients better manage their time, set priorities, and create routines that align with their strengths.
- Organization and Planning: ADHD coaches help clients develop organizational systems tailored to their needs. This may involve creating strategies for managing paperwork, setting up effective workspaces, and using tools like planners and digital apps.
- Skill Building: Coaches help clients develop coping skills for ADHD in areas such as focus, attention, and impulse control. They may employ techniques to enhance executive functioning skills, which can be challenging for individuals with ADHD.
- Accountability: An ADHD coach serves as an accountability partner, providing regular check-ins and feedback. This can help individuals stay on track with their goals and make adjustments to their strategies as needed.
- Emotional Regulation: Many individuals with ADHD struggle with emotional regulation. ADHD coaching can help adults with ADHD develop personalized strategies for managing emotions, handling stress, and developing resilience in the face of challenges.
- Communication and Interpersonal Skills: Coaches may work with clients to improve communication and interpersonal skills, which can be impacted by ADHD. This includes strategies for effective listening, social cues, and conflict resolution.
- Education and Advocacy: Coping with adult ADHD is tough without a full understanding of what it is, and how it impacts your day-to-day. ADHD coaching can provide information and resources, helping clients better understand their condition. They may also assist in advocating for accommodations in academic or work settings.
- Transition Support: An ****ADHD life coach or ADHD career coach can be particularly helpful during times of transition, such as starting a new job or entering a new phase of education. They provide support and guidance to navigate these changes successfully.
In short, coaching can be a valuable adjunct to traditional interventions, offering practical strategies and support tailored to the individual's unique needs.
Ready to find a virtual ADHD coach? Finding an ADHD coach online is as easy as searching “ADHD coach near me.” Or, even easier - try out Shimmer’s online ADHD coaching! Our coaches come from a variety of backgrounds, and bring with them a wide array of experience in different fields, so you’re sure to find one who’s s great fit for your needs.
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