A comorbid condition is a condition that lives alongside another condition in the same person. 

Comorbid isn’t a very cheerful term, but it simply means you have 2 or more medical conditions at the same time.

Comorbid conditions could be two or more physical conditions such as diabetes and high blood pressure.

Or mental health conditions such as depression and an anxiety disorder

Or a combination of physical and mental health. Perhaps high blood pressure and depression.

The conditions are usually long term (depression and diabetes), rather than a short term thing like a broken arm or the flu.

Other words that mean the same (and sound less ominous) are co-existing or co-occurring. 

Some co-existing conditions are known to occur together frequently. For example, if someone is overweight, they might also have high blood pressure, sleep apnea, and have a greater risk of type 2 diabetes. 

Of course, not every overweight person will have all of these conditions, but it’s helpful to be aware of common co-existing for early detection.

Now we have some general background about co-existing conditions, let’s look at ADHD and co-existing conditions.

ADHD and Co-existing Conditions.

There is a saying that ‘ADHD rarely travels alone”, which means if you have ADHD there’s a good chance you have another condition too.

This isn’t to depress you, more to normalize it if you discover you have another condition and help you know you aren’t alone.

In his book ‘Taking charge of Adult ADHD’ doctor Russell Barkley gets more specific and says 80% of adults with ADHD have at least one other disorder, and more than 50 % of adults with ADHD have 2 disorders.

Helpful reframe!

If you do have another condition, there’s a good chance you have been living with it for years. The only difference is now you officially know about its existence:)

 Any condition can co-exist with ADHD, but certain conditions are more commonly associated with ADHD.

Here are 6 conditions that frequently co-exist with ADHD.

1) Depression

Adult ADHD and depression often go together. The depression might be due to a genetic disposition or because ADHD can result in a stressful life that could result in depression. 

2) Anxiety

The most common form of anxiety in adults with ADHD is Generalized Anxiety disorder (GAD), which involves a constant feeling of worry. Often about things that are unlikely to actually happen but feel like they might when you are in that worried state.

Other anxiety disorders include Obsessive-Compulsive Disorder (OCD), Panic Disorder, Social phobia, or specific phobias, such as fear of flying or fear of spiders etc.

3) Bipolar Disorder

Around 20% of adults with ADHD also have Bipolar disorder (BPD).

On the surface, the ADHD and Bipolar disorder (BPD) share some similar symptoms, such as impulsivity, racing thoughts, and rapid mood swings. However, those symptoms play out differently with each condition. 

4) Sleep difficulties

 There are a variety of sleep disorders that are common in adults with ADHD, including sleep apnea, restless leg syndrome, and teeth grinding. People with ADHD also find it hard to fall asleep, stay asleep and wake up.

Sleep problems can be an unofficial symptom of ADHD, and it’s a catch-22 because lack of sleep makes symptoms of ADHD worse. 

5) Learning Disabilities

People with ADHD have an increased likelihood of also having a learning disability, such as dyslexia and Dyscalculia.

 This means it’s hard to learn in the same way as other people do. Having a learning disability is not reflective of intelligence, just that the wiring of their brain works differently.

Having ADHD also makes learning difficult as paying attention is key to being able to read, write and retain information however, ADHD isn’t a learning disorder.

6)  Substance use

 Adults with ADHD are more likely than adults without ADHD to develop an addiction to substances like alcohol or drugs.

Often someone with ADHD starts to use alcohol, cigarettes or drugs to help them deal with their symptoms. However, because these substances are addictive, it can be hard to stop using them even after this way to self medicate has been replaced with other types of treatment. There is often a lot of shame that comes with addiction.

The challenge of having ADHD and co-existing conditions

The challenge of having ADHD and other conditions is that they can mask each other, making diagnosing, management, and treatment trickier.

There is an emotional component too.

 Receiving a diagnosis can cause a roller coaster of emotions. These emotions often intensify when you discover you have additional conditions.

This article addresses diagnosing and treating ADHD when co-existing conditions are present, plus common feelings people experience when they have more than one condition.

Diagnosing.

It’s not possible to diagnose ADHD with a physical test like an x-ray or blood test.

Instead, the health professional carrying out your ADHD evaluation is like a detective.

They piece together information from your medical history, your childhood, school reports, your health, your family’s health, and your current life and challenges.

To accurately diagnose ADHD, the health professional needs to determine if other conditions could be causing attention problems.

If another condition is suspected, you might be referred to another specialist for more specific testing, such as a sleep clinic.

With this additional medical information, your ADHD evaluator will determine if you have ADHD and if there is an additional co-existing condition present too.

You might already know you have another condition or two BEFORE you are going through the process of getting ADHD diagnosed. 

These other conditions might have camouflaged your ADHD symptoms from medical professions in the past, which is why it wasn’t detected sooner. 

Another possibility is that AFTER you have been diagnosed with ADHD and start to treat and manage your ADHD symptoms, you realize another condition is present.  

Treatment.

 Each condition will have its own specific treatment plan. 

Your doctor will advise you on the best plan for you, taking into account your combination of conditions.

For example, if you have a history of addiction, your doctor might prescribe a non-stimulant medication for your ADHD rather than a stimulant.

Or, if you have low blood pressure, you properly wouldn’t be prescribed Intuniv or Clonidine for ADHD.

The good news is that there are some things you can do yourself, at home, that will help all your conditions. For example, exercise helps with ADHD, depression, anxiety, and some sleep issues.

Which to treat first?

If you were diagnosed with several co-existing conditions at the same time, a common question is which one to treat first?

Your doctor will be able to advise you, and there are several factors they will take into account, including

  • What conditions you have,
  • The severity of each condition,
  • The impact each one has on you and your life.

It could be that one of the co-existing conditions is treated first. 

Or your doctor might decide it would be most beneficial to treat your ADHD first or at the same time as another condition.

This answer might seem annoyingly vague! But there isn’t a one size fits all solution because each person is so different.

Anecdotally, ADHD coaching clients often report that when they started treating and managing their ADHD, they felt better positioned to treat their other conditions.

For example, they felt confident enough to pick up the phone to schedule a medical appointment. They trusted themselves to remember and arrive on time for their medical appointments and develop systems to remember to take any prescribed medication.

Emotions and co-existing conditions.

Having a condition like ADHD can make you feel less than perfect somehow. And if you discover you have more than one condition, that feeling can be amplified.

Even though it might feel uncomfortable if you suspect you might have another condition, be brave and explore that possibility.

Knowledge is power, and the more you know about yourself, the better your position is to find the best treatments for you.

Why is the second diagnosis hard?

In my nearly 17 years of being an ADHD coach, I have noticed a recurring theme: it’s the second diagnosis that hits people hard.

It doesn’t matter what the second condition is (ADHD, dyslexia, bipolar). It’s the discovery that there is a second condition.

The first one can feel like a relief because now you know why you are experiencing problems in your life.

However, the second condition can make people feel like something is wrong with them. That perhaps they are weak or flawed. Which of course isn’t true. 

If you have been living with undiagnosed conditions for years, it’s evidence of how resilient you are.

Even though you might know this intelligently, a second diagnosis can still feel hard emotionally.

‘It knocked the stuffing out of me.’

Or 

‘I felt like I’d been hit by a truck.’

Are common phrases people use to put words with how they feel after getting a second diagnosis.

If someone gets 3 or 4 conditions diagnosed, it’s still usually the second condition that they found unsettling.

It can take time to process a new diagnosis.

You might be grieving what could have been, either what your life could have been like if you didn’t have the conditions or if you’d known about it sooner.

Those feelings are completely normal. 

The more you learn about what conditions you have, how each one affects you, and the practical ways you can help yourself, those emotions turn into acceptance and hope.

Remember, you are much more than the conditions you have been diagnosed with, they are part of who you are, but not all of you.

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