ADHD comorbidity: Common conditions and treatment strategies

Having a mental health condition can be challenging, but being diagnosed with more than one can feel downright overwhelming. Mental health comorbidity, meaning you have multiple mental health conditions at once, is common among people with attention-deficit hyperactivity disorder (ADHD). Here, we review five leading categories of ADHD comorbidities and the importance of learning how to identify and manage the symptoms of each condition. 

What is comorbidity?

Comorbidity is when you have two or more health conditions at the same time. For example, you may have ADHD and an additional mental health condition. 

ADHD comorbidities are usually chronic conditions that require professional mental health support to effectively manage symptoms. They may interact with one another, but they can also exist as two entirely separate conditions. When left untreated, comorbidities can reduce quality of life and negatively impact your long-term health.

Why identifying comorbid conditions in ADHD matters

Getting an accurate diagnosis of ADHD and any comorbid conditions is an essential first step toward getting the right treatment. Unfortunately, ADHD remains largely underrecognized and undertreated among adults. According to one national survey, only 11% of adults with ADHD receive the necessary treatment.

One reason for this is that many comorbidities share similar symptoms with ADHD, making it difficult to distinguish and diagnose each condition. For example, ADHD paralysis can cause brain fog and trouble concentrating — which are also possible symptoms of anxiety disorders and major depression. And although emotional dysregulation is a key symptom of adult ADHD, it’s often misdiagnosed as a mood disorder.

The challenges of identifying and diagnosing comorbid conditions can make it difficult to effectively treat and manage each condition. When a comorbidity goes unnoticed, it can complicate the diagnosis of ADHD and impact a person’s ability to get the help they need. In some cases, ADHD symptoms may mask comorbidity symptoms, which can lead to an inaccurate or delayed diagnosis. 

To best manage ADHD and comorbidities, it’s important to work with a mental health professional to create a comprehensive care plan that addresses each specific condition.

What are the most common ADHD comorbidities?

ADHD comorbidity is common among adults, with approximately 80% of adults with ADHD having at least one coexisting mental health condition. Some common categories of ADHD comorbidities include the following: 

1. Mood disorders

Adults with ADHD are three times more likely to develop major depressive disorder (MDD), six times more likely to develop dysthymia, and four times more likely to have any mood disorder. There’s also a high prevalence of ADHD comorbidity with bipolar disorder, specifically bipolar I disorder.

2. Anxiety disorders

Anxiety disorders are another common ADHD comorbidity. One study reported that more than half of people with ADHD have an anxiety disorder like social anxiety disorder, panic disorder, or post-traumatic stress disorder (PTSD).

3. Substance use disorders

People with ADHD are more likely to experience unhealthy substance use or dependence than those without ADHD. In fact, ADHD is 5 to 10 times more common among adults with alcohol use disorder. And approximately 25% of adults who are currently in recovery from substance use disorders also have ADHD. 

4. Other neurodevelopmental conditions

People with neurodevelopmental conditions are often called “neurodivergent.” The term “neurodivergence” means that a person’s brain functions differently from the “typical” brain. ADHD is a neurodevelopmental condition, as are autism, Tourette syndrome, and learning disabilities like dyslexia. Dyslexia is a condition that affects language processing and makes reading and language-related tasks more challenging. Research suggests that 50% to 70% of people with autism also have ADHD. And 20% to 50% of children with ADHD are also autistic. Similar trends occur with Tourette syndrome, with ADHD listed as the most common comorbid condition in people with Tourette’s. 

5. Other conditions 

Several other conditions often occur as ADHD comorbidities. Some research suggests that people with ADHD are more likely to have premenstrual dysphoric disorder (PMDD). PMDD is a severe form of premenstrual syndrome (PMS) that impairs people’s daily functioning. Obsessive-compulsive disorder (OCD) is another potential ADHD comorbidity, though there’s less available data on this comorbidity.

How are ADHD comorbidities treated?

If you have ADHD comorbidities, it’s important to meet with a mental health professional. Together, you can develop a comprehensive approach that’s specific to your diagnoses, symptoms, and challenges. Treatment typically involves close collaboration with various mental health professionals, including therapists and/or psychiatrists. For most people, the goal of treatment is to reduce symptoms, improve daily functioning, and increase overall quality of life.

• Talk therapy and counseling: Talk therapy can help people manage comorbidities. Your therapist will help choose the right type of therapy for you, but many people benefit from cognitive behavioral therapy (CBT). CBT is a collaborative, goal-oriented approach that’s designed to challenge negative thoughts and create positive change. 

• Medication management: Treating ADHD comorbidities often involves a combination of talk therapy and medication management. Incorporating medication into a treatment plan requires close collaboration with a psychiatrist or other qualified mental health professional. When managing more than one condition, it’s especially important to monitor side effects and concerns to ensure the medication is tolerable and safe. 

• Lifestyle and behavioral strategies: Healthy lifestyle habits are linked to overall better mental health, especially for those living with ADHD and other mental health conditions. Having a balanced diet, getting consistent sleep, and practicing mindfulness and relaxation are good places to start. Depending on your needs, you may also want to use organizational tools to track tasks and reduce distractions. You might also benefit from creating consistent routines to ensure structure, predictability, and balance.

• Patient and family education: Managing ADHD and comorbid conditions can be overwhelming for both the person with the diagnosis and their loved ones. Learning more about a condition can help family and friends recognize symptoms, understand their loved one’s needs, and offer support during tough moments. Education can also help people develop skills to better communicate, manage stress, and solve problems. 

Find a therapist with Rula

Having more than one mental health condition can make it difficult to understand and manage symptoms. So it’s important to find the right mental health professional to help you on your healing journey. 

Rula’s diverse network of therapists offers specialized care for all types of mental health concerns. And since we’re a virtual platform for online therapy, you can meet with your provider at a time and place that’s convenient for you. If you’re ready to explore treatment options, we invite you to visit our website to connect with a therapist who is accepting new clients and takes your insurance.

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