9 Biggest Coexisting Conditions in ADHD Kids
About 12 percent of children have ADHD — a chronic condition that’s associated with hyperactive behavior, attention problems, and impulsivity. While ADHD is usually easily treatable with a combination of behavioral therapy and medication, many affected children also have a number of coexisting conditions that may be underdiagnosed, in part because parents and doctors aren’t looking for them.
That’s why the American Academy of Pediatrics called for doctors to assess such common health issues — which range from depression to learning disabilities — in its latest guidelines for diagnosing and treating ADHD, the first update in 10 years.
If your child has been diagnosed with ADHD, be sure to look out for these other health concerns and discuss them with your child’s pediatrician.
Several of the most visible symptoms of ADHD — nervous energy, lack of focus, fidgeting — can affect children's sleeping patterns. A recent Australian study found that nearly three out of four children with ADHD also deal with sleep troubles. Children with ADHD may experience greater difficulty with self-regulating techniques such as calming and focusing, which affect their ability to fall (and remain) asleep. Stimulant medications for ADHD can contribute to insomnia as well.
If you're concerned about your child's sleeping troubles — which can also include sleep apnea, bed-wetting, and nightmares — talk to his doctor. Kids who don't get enough sleep (quality or quantity) are more likely to have problems in school and will have poorer control over their ADHD symptoms, creating a vicious cycle.
Approximately 18 percent of children with ADHD will suffer from depression in adolescence, recent research reports. Some experts believe there may be an underlying genetic link between ADHD and depression, making kids who are prone to one condition more vulnerable to the other. Adolescents may be especially vulnerable, as the challenges they may face socially or academically can contribute to their depression risk.
It’s not surprising that ADHD and anxiety go hand in hand, and it’s common for the conditions to be mistaken for one another. Some studies suggest that as many as 25 percent of children with ADHD also have anxiety disorders, and vice versa. Kids with anxiety issues may be shy and fearful, as can children with ADHD whose difficulty focusing or impulsivity can lead to problems relating to other kids. In addition, the medications used to treat ADHD can make kids more jittery and anxious. If you suspect your ADHD child may also have anxiety issues, let your doctor know. According to the NYU Child Study Center, children with both ADHD and anxiety may require different treatment (including medication and/or therapy) than those with either of the conditions alone.
While children can have both bipolar disorder and ADHD, these conditions are also likely to be mistaken for one another, with ADHD being overdiagnosed and bipolar disorder being underdiagnosed in kids. ADHD and bipolar disorder have many traits in common, including impulsivity and hyperactivity. However, differences between ADHD and bipolar disorder may be subtle — for example, a child in a depressive phase of bipolar disorder may have a problem paying attention due to a lack of interest or desire in participating in everyday activities, whereas a child with ADHD lacks the inability to focus for long periods of time.
Oppositional Defiant Disorder
About 40 percent of children with ADHD also experience oppositional defiant disorder, according to ADDitude magazine. ODD includes bouts of aggression, outbursts, and extreme stubbornness; about half of young children who are diagnosed with ODD will outgrow it by age 8. Children with ADHD may struggle to communicate, which can lead to feelings of anger. In addition, their hyperactivity could be construed as disobedience. Sticking to recommended ADHD treatment can often help manage ODD symptoms as well.
While ADHD isn't technically considered a learning disability, about 20 to 30 percent of kids with ADHD have such common learning difficulties as dyslexia. And the hallmark traits of ADHD, including difficulty concentrating and impulsivity, can contribute to behavioral issues in the classroom and challenges with homework and test taking. If a child has a specific learning disability, it needs to be distinguished from the behavioral and attention aspects of ADHD so that it can be addressed, child psychiatrist Richard L. Rubin, MD, adjunct associate professor at Dartmouth Medical College, tells Everyday Health.
Abuse of cigarettes, alcohol, and drugs unfortunately seems to be linked to ADHD in adolescents and teens. One recent Harvard Medical School study, which followed 268 kids diagnosed with ADHD for a decade, found that nearly one-third developed a substance abuse problem over the course of the study — a 50 percent greater risk than in kids without ADHD. The good news is that other research has found that successful treatment of adolescents with ADHD reduces their likelihood of substance abuse.
Another factor to consider, per the new AAP guidelines: Some tweens and teens who present with ADHD symptoms for the first time may actually have substance abuse problems instead. In fact, some may even fake ADHD symptoms to get prescriptions for stimulant medication that’s typically prescribed to treat ADHD. The AAP recommends that doctors assess adolescents who are newly diagnosed with ADHD for signs of drug and alcohol use before attempting to treat ADHD symptoms.
Some studies suggest that as many as 12 to 17 percent of children with epilepsy — a chronic seizure disorder — also have ADHD, according to a recent British population study. However, incidences of epilepsy in kids diagnosed with ADHD are much lower, although doctors don’t know whether kids with ADHD face a greater risk of epilepsy too. According to a recent study by the New York University Langone Medical Center, the very nature of seizure activity can lead to attention problems, due the effects on brain activity of both the seizures and the antiepileptic drugs used to treat them.
Tourette syndrome (TS), a neurological disorder characterized by physical and vocal tics, is rare — it affects less than 1 percent of the population. Most people with Tourette syndrome have been diagnosed with other health issues as well, and ADHD is a common one. According to government data, 64 percent of patients with Tourette syndrome have also been diagnosed with ADHD. Most Tourette patients start experiencing the telltale tics between 5 and 10 years old; in many cases the tics decrease during adolescence and can even disappear entirely into adulthood.
- Last Updated: 10/16/11
- Last Updated: 10/16/11