Record numbers of children are being diagnosed with attention deficit hyperactivity disorder (ADHD), often incorrectly, and huge numbers are claiming benefits for this, as revealed by The Telegraph. But which other disorders or issues are most commonly mistaken for ADHD? How can you spot the difference?
Dr Deepali Misra-Sharp, a GP and partner at Lordswood House Group Medical Practice in Birmingham, explains that it can be challenging to distinguish ADHD from other disorders without a thorough and specialist assessment.
“The situation also becomes more complex because ADHD often coexists with other disorders, which can muddy the diagnostic waters,” she notes.
Charlie Faulkner, an ADHD coach, says the symptoms can also manifest differently in children and adults.
“In children, common symptoms include difficulty paying attention, impulsivity, hyperactivity, forgetfulness, trouble following instructions, and disorganisation. Whereas adults with ADHD often exhibit persistent challenges with organisation, time management, impulsivity, procrastination, forgetfulness, and restlessness.”
It can also present differently in girls, Faulkner adds.
“Girls often display more internalised symptoms than boys,” she explains. “Girls with ADHD may appear more daydreamy, disorganised, and forgetful, while boys may demonstrate hyperactivity, impulsivity, and disruptive behaviours. This gender difference can sometimes lead to underdiagnosis or misdiagnosis of anxiety instead of ADHD in girls.”
Here are some other conditions which ADHD can overlap with or, perhaps, be mistaken for.
Bipolar disorder
Some symptoms of ADHD, including impulsivity and inattention, are also features of bipolar disorder, says Dr Naomi Murphy, owner of Octopus Psychology.
“Someone with bipolar may have periods where their presentation resembles that of ADHD, including being impulsive, erratic, easily distractible and so on but crucially will also have periods when they do not present in this way,” she says.
Post-traumatic stress disorder (PTSD)
“A particularly important and often overlooked condition that can be mistaken for ADHD is post-traumatic stress disorder (PTSD), especially when stemming from relational traumas,” says psychologist Dr Louise Goddard-Crawley. “PTSD-related hypervigilance can be mistaken for ADHD hyperactivity, but hypervigilance is usually driven by anxiety and a constant sense of threat.”
Both PTSD and ADHD involve impulsivity and emotional dysregulation, she notes but in the former, these are linked to trauma reminders, whereas in the latter, impulsivity is unrelated to specific triggers.
Autism
Dr Punit Shah, an associate professor of psychology at the University of Bath, says that there can also be some similarities between ADHD and autism when it comes to cognition and behaviour.
“Over the past decade or so it has also become possible to have both a diagnosis of ADHD and autism, which is a good thing, but again adds to the complexity of their diagnosis,” he notes.
“While autism is specifically more related to social and communication challenges, hyperactivity is more specific to ADHD but they can overlap, mostly in terms of attentional strengths and difficulties. Some attributes, such as hyperfocus and difficulty switching between tasks, seem to be linked to both autism and ADHD.”
Sensory processing disorder (SPD)
Sensory processing disorder (SPD), a condition which affects how your brain processes sensory information, is more likely to be diagnosed in children who might find certain situations, such as noisy classrooms, overwhelming. It is also, Dr Goddard-Crawley says, another condition which could be confused with ADHD.
“SPD can cause hyperactivity and inattentiveness due to sensory overload, but these symptoms are usually triggered by specific sensory experiences, unlike the consistent behaviours seen in ADHD,” she adds.
Anxiety and/or depression
Dr Misra-Sharp says that some of the symptoms of anxiety disorders and depression can seem similar to ADHD. “Symptoms such as restlessness, difficulty concentrating, and irritability are common in both anxiety and ADHD,” she notes. “Similarly, a lack of focus, low energy, and poor concentration are also seen in depression.”
Hypoglycaemia
Dr Murphy says there can be an overlap between hypoglycaemia (low blood sugar levels) and ADHD and that scientists are interested in the relationship between the two. “Hypoglycaemia would tend to be managed through specific dietary requirements but researchers are exploring how diet can impact on other disorders such as ADHD and have suggested that a ketogenic (low in carbohydrate, high in fat) diet can be helpful in managing the symptoms.”
A sleep disorder
Dr Misra-Sharp says that sometimes ADHD symptoms can mask a sleep disorder. “Sleep apnea or other sleep disorders can lead to daytime sleepiness, inattention, and irritability, which might be mistaken for ADHD.
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