Mental Health Diagnosis: ADHD Comorbidity with Autism, Anxiety, Depression

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ADHD rarely travels alone. Learn about the 4 most common co-occuring conditions.

but is experiencing so much anxiety that he or she has problems concentrating and managing daily affairs. The client’s mind never stops running, in rare cases, to the point of obsessions and compulsions. This preoccupation prevents a person from getting anything done. We refer to this as “anxiety-primary.” However, even when we hypothesize this condition, it is tough to prove without a medication trial.

Any differences in symptom presentation following a stimulant trial are critical for your prescriber to know about and understand. Unfortunately, we see many clients who started a stimulant trial with a previous prescriber, had poor results, and then had the prescriber errantly ignore the ADHD diagnosis and eschew a valuable course of treatment. Getting it right matters. Understanding how your anxiety and ADHD interact will make all the difference in successfully treating both conditions.

Mood dysregulation can be as problematic for those with ASD as it is for those with bipolar disorder. In fact, stimulants can be so irritating to people with ASD that, at one time, it was recommended that doctors forgo them. Yet we find, time and again, that the correct combination of stimulants and mood stabilizers improves client functioning. Like bipolar clients, ASD-ADD clients may do well with mood stabilizers plus a slow, careful, and well-integrated treatment plan.

In other cases, clients respond favorably to stimulants at first, only to have a quick drop-off in their impact. Stimulants raise energy and alertness, and increase productivity, which helps people feel better. However, that improvement may mask underlying depressive symptoms that exist in tandem with ADHD, and may last only as long as the stimulant is working, usually eight to 12 hours. Fortunately, these clients tend to be good candidates for adding an SNRI.

 

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