There is a very important concept in ADHD called comorbidity. Comorbidity means that there is a co-existing disorder that causes more ‘morbidity’, or in other words difficulties in one’s life.
It is very common for people with ADHD to have comorbid (or co-existing) conditions. Only about 25-40% of kids and teens with ADHD have ADD or ADHD alone. Most of the time (i.e. 60-75% of the time), there is a second, or third diagnosis as well.
The most common comorbid conditions with ADD or ADHD in kids and teens are: Learning Disabilities, Behavior Disorders (including Oppsitional Defiant Disorder and Conduct Disorder), Anxiety Disorders, Mood Disorders (commonly Depression, rarely Bipolar Disorder), tic disorders (like tourette’s), etc.
In adults – comorbidity in ADHD is very common. Research has shown that only about 14% of adult ADHD is simple ADHD, meaning that 86% of adults with ADD or ADHD actually have a second or third disorder.
While the list of comorbid conditions in adults is similar to the one in kids, it is important to note that there are some significant additions. These include: substance abuse and dependences (i.e. drug and alcohol addiction/dependence), and personality disorders. Adults still have high rates of Learning Disabilities, Behavior Disorders, Anxiety Disorders, Depression and even Bipolar disorder.
The reason that comorbidity in ADD or ADHD is so important relates to the fact that often times, the comorbid condition can be so important that it can completely dominate or change the treatment for the whole condition.
For example, if one has ADHD and an Anxiety disorder, there is research that shows that the response to medication may be different. For example, some studies show that the use of a stimulant (like Concerta, Ritalin, Adderall, Biphentin or Metadate CD) may actually worsen the anxiety. There are other studies that show that they don’t worsen the anxiety, but don’t help it. However, Strattera, the non stimulant for ADHD, has been shown to help the anxiety and the ADHD at the same time.
Another example is if a child has ADD and a Learning Disability. If this occurs, one needs to treat both in order to get a good effect. If one were to only treat the concentration, then there could still be problems with processing information (i.e. the learning disability). If there were academic supports and treatment put in place for the learning disability, but there was not effective treatment in place for the ADHD, then the child could struggle to pay attention in order to benefit from the help in place for academics.
The bottom line: a thorough assessment for ADD or ADHD will review whether there are any comorbid (or co-existing) conditions present. Knowing about these comorbid conditions is crucial because it can actually affect the primary treatment of the ADD or ADHD.