Anxiety, depression and other disorders can resemble ADHD

The 6-year-old boy sitting across from Douglas Tynan, a child and adolescent clinical psychologist in Delaware, clearly did not have attention deficit hyperactivity disorder. Dr. Tynan was certain of that. But the boy’s first-grade teacher disagreed.

He could be inattentive in class, but at home his behavior was not unusual for a child his age. A voracious reader, Dr. Tynan said, he liked to bring his own books to school because the ones in class were too basic.

Dr Tynan said his teacher failed to take into account that the child was likely academically gifted, as was his mother as a child. (Studies (They found that black children, like the boy in his office, were less likely to be considered for gifted programs.)

Further testing revealed that Dr. Tynan was right. The child was not inattentive at school because of ADHD. It was because he was bored.

ADHD is a neurodevelopmental disorder that begins in childhood and typically involves inattention, disorganization, hyperactivity, and impulsivity that cause problems in two or more environments, such as home and school.

But these symptoms—in both children and adults—can overlap with many other features and disorders. In fact, difficulty concentrating is one of the most common symptoms listed in the American Psychiatric Association’s diagnostic manual and is associated with 17 diagnoses, according to test published in April.

Patients need a thorough evaluation to avoid misdiagnosis of ADHD or missed diagnosis of ADHD. Here are some common problems that can mimic ADHD

Behavioral and mood disorders

Mental health disorders such as anxiety, depression, and oppositional defiant disorder can present with symptoms similar to ADHD.

Symptoms can include a lack of concentration and motivation, emotional outbursts or difficulty planning and following through on tasks, said Max Wiznitzer, a pediatric neurologist at Rainbow Babies and Children’s Hospital in Cleveland and an expert in ADHD.

This applies to both adults and children. Among Dr. Wiznitzer’s patients, anxiety is most often confused with ADHD.

“Can a person with anxiety focus?” he said. “Well, no. The cause of destitute concentration is not the same as ADHD, but the end result is the same.”

To complicate matters further, people with ADHD often also suffer from behavioral and mood disorders.

Operate of substances

Excessive employ of psychoactive substances can lead to: lack of concentration and hyperactivityamong other issues. If someone has been taking drugs for years and then complains to a doctor about cognitive decline — such as difficulty concentrating, remembering information or remembering things — it’s crucial to look at how long the person has had those symptoms, said Dr. David W. Goodman, an assistant professor of psychiatry and behavioral sciences at Johns Hopkins University School of Medicine.

He added that if symptoms had not appeared before the age of 12, the patient would not meet the diagnostic criteria for ADHD.

AND 2017 study found that about 95 percent of participants who first developed ADHD-like symptoms at age 12 or later did not have the disorder, despite scoring positive on symptom checklists. In those who did develop disabling symptoms, the most common reason was actually ponderous substance employ, followed by disorders such as depression and anxiety.

Problems with sleeping

Adults need seven to nine hours of sleep a night. Teenagers and adolescent children need even more. But according to Centers for Disease Control and Preventionmore than one third American adults – and about 77 percent high school students — not getting enough sleep.

Studies To have have shown that sleep deprivation impairs a person’s ability to think clearly and perform certain tasks, and can also negatively affect mood.

One big study found that people who typically slept between three and six hours performed worse on cognitive tests that measured the brain’s ability to store information and the time it takes to complete a task. These impairments resemble typical ADHD symptoms, such as mental sluggishnessforgetfulness or a habit of leaving tasks unfinished.

Digital distraction

Anyone with a smartphone is constantly inundated with texts, notifications, and scrolling options—it may seem attention is constantly diverted or that our attention span has shortened. But that doesn’t mean we all have ADHD

Dr. Goodman says that by removing screens, a neurotypical person will be able to focus better, while someone with ADHD will still have trouble concentrating even if they remove all external distractions.

People who consider themselves ponderous users of digital technologies are more likely to report ADHD symptoms, tests indicatesHowever, not all ponderous Internet users have this disorder.

Physical conditions and stress

Therapists and researchers who study the disorder say it’s significant to get a medical evaluation before making a diagnosis of ADHD because there are many conditions that can cause symptoms similar to ADHD, such as inattention, memory problems or brain fog that can make people feel inactive, easily distracted and forgetful.

Examples include brain injuries, chronic diseases like fibromyalgia or POTS, diabetes, heart problems, or endocrine disorders like hypothyroidism.

Stress—both chronic and acute—can also mimic ADHD, causing difficulties with planning, organization, and self-regulation.

So how can you tell if it’s actually ADHD?

Properly diagnosing ADHD requires several steps: a patient interview, a medical and developmental interview, symptom questionnaires, and, if possible, interviews with other people in the patient’s life, such as a spouse or teacher.

Questionnaires alone are not enough. One study found that when adults completed an ADHD scale, they were often diagnosed with ADHD—even if they didn’t.

Diagnosing ADHD in adults can be more tough because they have longer life histories, which means more complicating factors, said Margaret Sibley, a professor of psychiatry and behavioral sciences at the University of Washington School of Medicine in Seattle. In addition, there are no U.S. clinical practice guidelines for diagnosing and treating patients after childhood.

This has led some patients to seek a quick diagnosis and prescription online. Others are trying to unravel their symptoms by researching the disorder on social media.

“There is a movement toward self-diagnosis and questioning whether a medical diagnosis is necessary,” Dr. Sibley said. “But you have to be careful because if you misdiagnose yourself, you could miss the right solution to your problems,” she added.

Ultimately, the best path is a comprehensive evaluation. Dr. Sibley suggested starting with a primary care physician and then seeking out a mental health specialist.

Dr. Tynan said he usually assumes a patient doesn’t have ADHD, then tries to look at anything else that might be causing the symptoms. “If I see robust evidence of anxiety, depression, and ADHD, I have to ask, ‘What’s going on here?’” he said.