Studies have consistently shown that 80-85% of those of us with ADHD have AT LEAST one comorbidity. If you aren’t as accustomed to medical/psychiatric lingo as I am, that means that at least eight of of ten of us have at least one other psychiatric condition. This includes depression and anxiety. If you lump them together as one larger disorder, some studies have shown that as much as 65% of us have one or both. This overlap also includes, ASD, Tourette’s Syndrome, OCD, eating disorders, conduct disorders, mood disorder/bipolar, and just about everything else you could think of. We are also far more likely to have a co-occurring learning disorder like dyslexia, dysgraphia, expressive language disorder, and a myriad of processing disorders. We are also more likely to have sleep disorders and some other brain based or physiological issues like hypermobility or chronic inflammation. But, let’s stick with the brain stuff for now…
So…Wow! That was depressing. Why bring this up? Well, because it is really important to treat everything. Those of us who have more than one issue working often end up in front of a medical professional who really, really wants to treat one issue and leave the others be. There are certainly times this this is the correct course of action. For example, you will generally need to get a mood disorder under control before trying stimulants. Stimulants are not contraindicated for people with mood disorders. But, if the mood disorder isn’t under control, stimulants can induce manic episodes. Likewise, severe anxiety and/or depression usually need to be addressed before ADHD can effectively be addressed with medication.
And there is a certain merit to approaching medication with scientific practice by not changing too many variables at once. However, if you are suffering, and I mean that in the truest sense of the word, with more than one psychiatric ailment, there is a strong argument to address more than one at once, especially if they are actively feeding each other. If you have read me at all or are a client, you know that I love analogies. (And, I came up with this one yesterday.) Let’s think of this from the perspective of a parent. Imagine your child is a car. He (or she) has four wheels and four tires. If he has one flat tire, ADHD, you’ll need to deal with that. But what if he has four flat tires, ADHD, a mood disorder, anxiety, and dyslexia? Remediation for the dyslexia is essential. But will he be able to focus well enough to learn to read if his ADHD isn’t addressed. Maybe his ADHD is addressed, but is mood disorder is so severe that he spends most of his day dysregulated and isn’t “available to learn.” What if his anxiety is so bad that he can’t even go to school? The fact is that we need all four tires to drive our car. And, we will need all of our prominent psychiatric conditions effectively managed in order to be the best version of ourselves.
The reality is that it can be difficult to even know if a single intervention for a single disorder is even working if that disorder is being addressed in a vacuum. I often have clients who assume that their whole world is their ADHD diagnosis. More often than not, it isn’t. They might think that their Ritalin isn’t working, when, in fact, it might be doing a great job with the ADHD if they weren’t also experiencing crippling anxiety. I would encourage you to think about yourself holistically and to work with a doctor/prescriber who will also get to know and treat the whole you.