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ADHD in Children Health Center

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When It's Not Just ADHD

ADHD and depression, anxiety, learning disabilities, and oppositional defiant disorder.

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Sometimes, a second condition is diagnosed at the same time as ADHD, but often, it becomes apparent well after the initial ADHD diagnosis. That's why it's important for parents to share as much information with their child's doctor as possible.

"One of the things we really counsel parents about is: Don't assume everything going on is the ADHD," says clinical psychologist Ruth Hughes, PhD, CEO of the nonprofit organization Children and Adults with Attention-Deficit/Hyperactivity Disorder. "This is rarely a disorder that travels alone. Ask your physician very specifically, 'Do you think there are any co-occurring disorders?' If you think there are any symptoms that don't go with ADHD, bring it up."

Here are three conditions that are commonly diagnosed among children with ADHD:

Depression and Anxiety

Anxiety and depression are diagnosed among ADHD patients more often than in the general population. There may be genetic reasons for this, or it could be triggered by unhappiness at school, particularly if the child has poor social skills and feels lonely and friendless. Anxiety often appears at an earlier stage; depression tends to develop as children age.

Depression and anxiety could both cause ADHD-like symptoms. If you're not sure which came first, tell your doctor what you've noticed in your child to help him figure out what's going on. You are your child's advocate.

"Depression is less frequently identified in younger children in general, and that's true for a comorbid condition for ADHD; both anxiety and depression are increased," Wolraich says. "It's harder to diagnose because, to a greater extent, anxiety and depression are internal states, and that depends on the reporting ability of children, whether they are cognitively able to get that across."

Once depression or anxiety is diagnosed, your doctor may recommend bringing your child to a psychiatrist for antidepressants and therapy. But the initial diagnosis may be difficult, because children with ADHD often exhibit less obvious symptoms.

"Depression in children and adolescents oftentimes presents with irritability instead of sadness," Vitiello says. "The kid is not patient, gets really upset, has no tolerance for frustration. Antidepressants are not effective for inattention and hyperactivity, but they can be helpful for irritability."

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