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ADHD in Children Health Center

When It's Not Just ADHD

ADHD and depression, anxiety, learning disabilities, and oppositional defiant disorder.
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If your child is diagnosed with attention deficit hyperactivity disorder (ADHD) -- a common disorder that makes it difficult to pay attention, stay focused, or control behavior -- your lives can change: Your child will need medication, regular doctor visits, and therapy. You may also need to learn different parenting techniques to help your child.

You may feel overwhelmed if your child is then diagnosed with a second, related condition, complicating matters further. But it's common for people with ADHD to have concurrent conditions, such as depression or a learning disability. And remember, it is also common for these conditions to be confused with ADHD. So if you're not sure about either diagnosis, ask your doctor.

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"It's actually more of a rule than the exception," says Ben Vitiello, MD, chief of the Child and Adolescent Treatment and Preventive Intervention Research Branch at the National Institute of Mental Health. "In a study that we did back more than 10 years ago with a large sample of 600 kids with ADHD who were on average 8 years of age, only one-third of them had only ADHD. All the others had other conditions, like oppositional defiant disorder or anxiety."

Because it's so common, new guidelines from the American Academy of Pediatrics (AAP) recommend that physicians who evaluate children for ADHD should also look for conditions that commonly co-exist with the disorder. But it's often difficult for doctors to diagnose a second condition in ADHD patients, particularly among those who aren't old enough to describe their thoughts or feelings well.

"It becomes more challenging to try to determine what are the internalizing conditions in the younger children," says Mark Wolraich, MD, CMRI/Shaun Walters professor of pediatrics at the University of Oklahoma College of Medicine and lead author of the AAP's ADHD guidelines. "They're not going to be able to tell you much about what they're feeling. And a learning disability may not manifest in a younger child in preschool or kindergarten, especially if a child is bright. Maybe the child can compensate, but as their academic demands increase, the symptoms become more manifest."

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