It is thought that around half of all people diagnosed with ADHD also have a secondary condition, which highlights just how interconnected our physical and mental health really is. Symptoms of inattention, hyperactivity and impulsivity can profoundly impact daily life, then combine this with comorbid conditions such as anxiety, depression and learning disabilities, not only can gaining an accurate diagnosis become extremely difficult it can make daily life for the individual incredibly hard.

What Are Comorbid Conditions?

A comorbid condition refers to the coexistence of two or more medical or psychological conditions that are present alongside ADHD. It is common for the comorbid condition to either exacerbate or mask ADHD symptoms and often, when the primary condition is being treated, in this case, ADHD, the symptoms of the comorbid condition do not go away.  

5 Most Common ADHD Comorbidities

There is a long list of conditions that exist alongside ADHD, highlighting just how complex our mental health can really be. Below are five common comorbidities that coexist with ADHD: 

Anxiety Disorders

Generalised anxiety disorder and social anxiety disorder, often go hand-in-hand with ADHD. The difficulty in focusing and constant restlessness for individuals with ADHD can contribute to heightened anxiety, while the persistent worry associated with anxiety can worsen ADHD symptoms.

Depression

Individuals with ADHD are at a higher risk of developing depression. The struggles they face academically, in the workplace and personally can take a toll on their self-esteem and emotional well-being, potentially leading to depressive episodes.

Learning Disabilities

Learning disabilities, such as dyslexia or dyscalculia, are frequently seen alongside ADHD. The cognitive difficulties associated with these disabilities can overlap with ADHD symptoms, making accurate diagnosis and tailored interventions crucial.

Obsessive-Compulsive Disorder (OCD)

OCD is a mental health disorder characterised by recurring, intrusive and unwanted thoughts that lead to compulsions or repetitive behaviours or mental acts that an individual feels compelled to do to “undo” the obsession. OCD can be a debilitating, lifelong disorder and one whose causes are neither fully understood nor easily controlled.

Oppositional Defiant Disorder (ODD)

ODD is a childhood behavioural disorder that is defined by a persistent pattern of hostile, vindictive and defiant behaviour toward people of authority. It is difficult to differentiate between normal childhood behaviour and ODD, but it is thought that 4 out of 10 children with ADHD will also show signs of ODD and it is often diagnosed if the behaviour lasts longer than 6 months.

Comorbidity Categories and their Symptoms.

There are three common comorbidity categories that are diagnosed alongside ADHD, all of which occur along a spectrum of severity. The symptoms of each category are as varied as their causes which include genes, exposure to environmental toxins, prenatal trauma and much more.

1.     Cortical Wiring Problems.

This category of comorbidity is caused by structural abnormalities in the cerebral cortex, a part of the brain responsible for high-level brain functions and leads to learning and language disabilities, fine and gross motor skills, and executive functioning difficulties.

2.     Emotional Regulation Problems.

Depression, anxiety disorders, OCD, bipolar disorder, and anger-control problems including ODD are all problems that can be found in this comorbidity category. Emotional regulatory issues often respond to SSRIs (selective serotonin reuptake inhibitors) and can usually be used in conjunction with ADHD medication. 

3.     Tic Disorders.

Tic disorders can vary in severity and refer to sudden twitches of whole muscle groups causing an involuntary reaction. They range from:

• Motor tics which include persistent eye-blinking, head jerking and other repeated gestures.

• Oral tics, which can include grunting and random blurting out of noises and in rarer cases, the blurting out of obscene words or phrases.

• Tourette’s syndrome, which is a multiple motor and vocal tic that has been present for over a year. 

How to Differentiate Comorbidity Symptoms from ADHD

If you or your child has begun treatment for ADHD but continues to struggle, the next step would be to determine whether the symptoms are secondary to ADHD, meaning they are likely to dissipate with a few tweaks of your treatment plan, or there is evidence of a fully-fledged comorbid disorder which would require additional treatment. Careful observation of when and where symptoms arise is the only way to determine this. If secondary problems typically start at a particular time or in a specific setting, then the comorbid condition is likely to be secondary to ADHD. However, chronic, and pervasive comorbid disorders are generally apparent from early childhood and appear in every life situation. For example, ADHD-related mood shifts are usually triggered by life events, a bipolar mood shift on the other hand appears to come out of nowhere and disappear without any connection to surroundings.

ADHD Assessment, Diagnosis and Treatment Alongside Comorbid Conditions.

The intricate relationship between ADHD and comorbid conditions highlights the importance of a comprehensive and individualised ADHD assessment. Diagnosing ADHD requires careful consideration of the individual's full clinical history, including the presence of comorbidities. Treatment plans need to be tailored to address both the challenges posed by ADHD and any comorbid conditions that exist alongside.

A multimodal treatment approach including a combination of behavioural therapies, medication, psychoeducation, and lifestyle modifications is highly recommended. For instance, addressing anxiety through cognitive-behavioural therapy can indirectly alleviate ADHD symptoms by reducing stress and enhancing coping skills. 

How Beyond, a Private ADHD Clinic in Manchester Can Help

At Beyond, we offer the most comprehensive ADHD assessment process available today, by employing the three fundamental testing tools required to give the most accurate diagnosis, the results of which work together to form a clear picture of each individual case. Only with this unique ADHD assessment process can we ensure we understand the entirety of your condition, comorbidities, and all.

If you would like to speak to a member of your team at our private ADHD clinic in Manchester, about gaining a clearer picture of ADHD and other underlying conditions, and how we can work together to help you understand and ultimately manage your symptoms better, call us today for a confidential chat with one of our expert team.