Transcript
Announcer:
You’re listening to NeuroFrontiers on ReachMD. On this episode, we’ll hear from Dr. Roberto Olivardia, who will be discussing the importance of identifying comorbidities in patients with ADHD. Dr. Olivardia is a Clinical Associate in Psychology at the Mass General Brigham McLean Hospital, and he serves on the Professional Advisory Boards for Children and Adults with ADHD and the Attention Deficit Disorder Association. Let’s hear from Dr. Olivardia now.
Dr. Olivardia:
So with ADHD, it's important to know that it rarely travels alone. Most people with ADHD have what we call a comorbid or associated disorder or condition. 30 percent of people with ADHD struggle with significant anxiety or an anxiety disorder. Approximately 20 percent struggle with a mood disorder, such as depression or a bipolar spectrum disorder. People with ADHD are at much higher risk of any kind of addictive behavior, including substance use, eating disorders, and sleep disorders.
So particularly with anxiety and depression—or any comorbidity for that matter—it's important to assess how these disorders relate to each other because many times, it's really untreated ADHD that can lend itself to developing some of these conditions, and that doesn't mean that the condition isn't real. If somebody struggles with an anxiety disorder, it's a real thing that clearly needs treatment. However, a lot of times it can be through the lens of ADHD.
So to give you an example, a high school student that has untreated ADHD may have an un-remediated learning disability—because half of people with ADHD have learning disabilities such as dyslexia, which are often underdiagnosed. So let's say you have a high school student that is going to school every day, has a hard time regulating their attention, has a hard time getting assignments done on time, but they care about doing well; they’re working three to five times harder than maybe the average student to get the B or the A, and they really struggle to manage their attention. Maybe they had a hard time sleeping the night before. That's very stressful and very taxing to people physically. And so over time, it would be valid for people to understand how that individual could find themselves feeling stressed, and then that develops into anxiety—and anxiety being not just the impact of the daily things that are facing them, but ideas that they start to develop around the future, things like, “I will never succeed. Life is always going to be this way.” And that can really be hard, obviously, for an individual.
So now if that patient, let's say, has undiagnosed ADHD and they come into a therapist's office and they're saying, “Hey, I'm having problems falling asleep. I'm worried all the time. I'm having panic attacks after school,” that would point to an anxiety disorder. And it's not that the treatment for the anxiety disorder wouldn't be valid. However, if the ADHD is not properly identified and treated, it will undermine the treatment of that anxiety disorder or mood disorder in the case of depression.
So we always want to make sure we first see the story of how these disorders relate to each other. I always say to my patients, “Who's driving the bus?” Most of my patients with ADHD have one to three comorbid disorders, and they're actually quite articulate, I would say, at determining whether the ADHD is leading the anxiety, or it could be an independent anxiety disorder that just is parallel to ADHD. But even in those cases, when it's a mood or anxiety disorder, untreated ADHD will always undermine the treatment of a comorbid disorder. And I want to emphasize how important it is to make sure that we are properly identifying and treating the ADHD.
Announcer:
That was Dr. Roberto Olivardia talking about why it’s so important to identify comorbidities in patients with ADHD. To access this and other episodes in our series, visit NeuroFrontiers on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!
