No symptom of ADHD is unique to ADHD. All the symptoms are pathological magnifications of aspects of human nature. Much like clinical depression is a pathological extreme of the sadness that we call experience from time to time, and generalized anxiety disorder is the pathological and maladaptive extreme of the anxiety/fear/worry that we all experience from time to time and that has held our species in good stead over the millenia by allowing us to survive.
In addition to the magnification of “normal” aspects of being human, ADHD symptoms could always, in isolation, be attributed to at least one other psychopathology. Anxiety avoidance looks very much like ADHD “procrastination.” Challenges with initiation can be a symptom of ADHD but can also be strongly associated with depression, particularly dysthymic depression. Hyperactivity can look a lot like a manic episode.
Of course, with at least 85% of ADHDers living with at least one comorbidity, often symptoms are being caused by two or more issues AT THE SAME TIME. And then there are other factors that can magnify our ADHD symptoms that have nothing to do with the core of the ADHD or another diagnosable psychiatric condition. I feel it important to differentiate other factors that may look like ADHD, create and ADHD-like “syndrome,” or simply multiply the symptoms and suffering of those of us with ADHD.
For some time it was fashionable to blame ADHD on food dyes. Nothing could be further from the truth. But, there is also not much argument that a very, very, very small percentage of the population may have had a bad reaction to certain food additives that looked like ADHD. If you are looking in less knowledgeable corners of the internet, you will still find folks touting ‘curing’ their ADHD with supplements and all sorts of other “natural” remedies. In fact, they are not curing ADHD. If vitamin D or magnesium or tumeric makes your symptoms go away, you didn’t have ADHD, you had a vitamin deficiency that looked like ADHD.
But what if you also have a vitamin deficiency? What if you also have a sleep disorder? What if you also have a food allergy? What if you are also menopausal or perimenopausal? From a practical standpoint, you are multiplying your ADHD by whatever other like symptoms are derived from your other issue(s.) And that stinks. But you may also be having a hard time from a diagnostic perspective. I can be hard enough to do what I believe is called a differential diagnosis, by identifying the cause of symptoms that can be cause by many different issues. But it can be really difficult as a patient to get “well” when “well” depends on addressing multiple issues contributing to the same symptom.
Sleep deprivation will make your ADHD “worse.” Or at least it will diminish your functioning in the same ways as your ADHD, above and beyond what your ADHD would be doing on its own. You may be optimally medicated for your ADHD but still not feeling great because you are chronically sleep deprived. In the same way that you may get a CPAP and not feel like you are getting any bang for your buck if you aren’t also effectively treating your ADHD.
Of course medicine is heavily siloed these days. Your pharmacologist may have little to no knowledge about sleep medicine. You may be in a situation where not all your meds are even prescribed by the same doctor. I did a consultation with a college kid yesterday. And, she’s getting her mood meds from the university health service. But the university psychiatrist refused to prescribe stimulant. And I have a client who’s primary prescribes her stimulants, but she has to go to the menopause clinic to deal with hormones, etc. In so many cases there isn’t any one doctor coordinating wholistic, whole person, whole brain, whole life care. That is a real burden on us, as patients.
I hope that the takeaway is to be diligent about advocating for yourself in getting ALL the care you need for your whole person. And, don’t give up on ADHD treatment if it doesn’t seem to be working 100%. Consider that the ADHD treatment might be doing its job, but that you may need to treat something else also to get 100% “well.”
Standard disclaimer: When posting my thoughts here, I feel that content is far more important than perfection. I try to practice what I preach that ‘done’ is better than ‘not done…perfectly.’ So, unlike with my book, I don’t edit much, if at all. I hope you can look past any small imperfections and find the content useful.