ADD/ADHD And Their Co-Disorders
As a parent, teacher, caregiver of a child with ADD (Attention Deficit Disorder) or ADHD (Attention Deficit Hyperactivity Disorder) we know the arduous task of caring for, raising, and teaching them.
What we may not know, and is if we didn't have enough on our plate, is that there are co-disorders that can exist along side ADD/ADHD. Often the symptoms of coexisting disorders rise above and beyond those of ADD/ADHD.
Studies show that approximately sixty percent of children diagnosed with ADHD have a second disorder, and approximately ten percent have multiple disorders.
The symptoms of Anxiety Disorder are:
- excessive anxiety and worry
- difficulty controlling the worry
- feeling restless or on edge
- difficulty concentrating
- muscle tension
- sleep disturbance
- bed wetting
- nail biting
Anxiety is also one of the more common coexisting disorders as much as 30 percent. In children this can often be difficult to determine and without proper diagnosis can lead to severe anxiety or panic attacks. Panic attacks can occur without warning and include difficulty breathing, accelerated heart rate and a feeling of imminent death.
Depression can also be a coexisting disorder with similiar symptoms as anxiety including:
- depressed or irritable mood
- decreased interest or pleasure in activities
- changes in weight or appetite
- insomnia or excessive sleeping
- physical agitation or retardation
- fatigue or loss of energy
- feelings of worthlessness or guilt
- decreased concentration
- thoughts of death or suicide
Bipolar is generally rare in children and can be difficult to diagnose primarily because the symptoms are not as recognizeable in the young as they are in adults. Bipolar symptoms usually begin to appear in adolescents and teens.
In children the symtpoms of Bipolar and ADHD are very similar, yet, where ADHD symptoms are chronic, Bipolar symptoms are episodic and worsen over time. Though the following symptoms can also be seen in children with ADHD they are different in how the 'episodes' manifest and their duration.
- extreme and unpredictable mood swings, more anger than euphoria as seen in adults
- anger is explosive and extreme (rage) and can be sustained for hours, where a child with ADHD can be calmed down quicker.
- destructiveness is intentional, where ADHD generally it stems from careless or impulsive activities.
Bipolar disorder is very complicated and there are subtypes of this disorder with different symptoms. It is important to have a proper diagnosis by a professional preferrably one specializing in mood disorders or Bipolar.
Obsessive Compulsive Co-Disorder (OCD)
OCD exists in approximately 10 to 17 percent of children with ADHD. Obsessive Compulsive Disorder is described as chronic anxiety provoking thought and repetitive rituals that the child cannot control. The needs described below are not just typical needs or desires but obsessions and compulsions.
- Need to count or repeat behaviors.
- Need to check and recheck to make sure that something was done correctly or an answer given correctly.
- A need to collect or hoard things.
- A need to arrange and organize.
- A need to clean or wash.
- Need to bite nails or cuticles or to pick at sores or scabs.
- Need to twirl or pull out hair.
In some cases, Obsessive Compulsive Disorder is mistakenly seen as ADD, for example when a child suffering from OCD is so consumed with or afraid of making a mistake that he/she is unable to move on to the next activity or required task.
Oppositional Defiance Disorder ODD and Conduct Disorder CD
ODD is the most common coexisting disorder in children with ADHD. A small percentage of children, less than ten, have ODD, but in children with ADHD the percentages rise dramatically to more than thirty percent. It is common for children to display defiance at one time or another, especially teens. However, in children with Oppositional Defiance Disorder the symptoms occur constantly throughout their childhood.
Symptoms of ODD:
- spiteful or vindictive
- loses temper easily
- angry and resentful
- argues with adults
- touchy and easily annoyed
- actively defies or refuses to comply with adults' requests or rules
- blames others for his/her mistakes or misbehavior
- deliberately annoys people
The criteria for diagnosis is the same as with the ADD/ADHD diagnosis criteria. Symptoms must be present for at least six months and occur more frequently than in children of the same age.
CD - Conduct Disorder
Symptoms of CD - Conduct Disorder
- Bullying, threatening, or intimidating others
- starting physical fights
- physical cruelty to people or animals
- deliberately engaged in setting fires to cause serious damage
- deliberately destroys others' property
- lies or cons others to gain something or avoid an obligation
- stays away at night despite parental rules, truancy, before age thirteen
Males are much more likely to have CD than females. The onset of this disorder usually begins with less severe behaviors but increases during adolescence.
Tics or Tourette's Syndrome
People who suffer from Tics show a ticking or spastic movement that he/she may not be able to control, often they are facial Tics.
People who suffer from Tourette's Syndrome may abruptly shout out words uncontrollably. Often they are vulgar and/or offensive words or phrases.
Tics and Tourette's Syndrome are the rarest of the disorders coexisting with ADHD, yet can be one of the most severe. Making social life very difficult in children, adolescents and teens.
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What to do if you think your child has a coexisting disorder.
As with the symptoms of ADD/ADHD the existence of coexisting disorders are chronic and disruptive in all settings; home, school, work, social situations. Medications often used for the treatment of ADD/ADHD can effect these coexisting disorders positively or negatively. If your child is currently on medication for ADD/ADHD and second disorder symptoms worsen or become apparent contact your doctor immediately.
If you suspect that your child may have a second disorder you should consult with a child or adolescent psychiatrist. Specific tests may necessary to determine, executive function, learning, motor or language problems. Clinical evaluations may be necessary for mood disorders or Tic disorders.
Trust your instincts and take action as soon as possible. Early intervention is crucial before the problems worsen or become ingrained.