BERNEY WILKINSON: Is it ADHD, anxiety or depression?
One of the most common mental health conditions identified in childhood is Attention Deficit Hyperactivity Disorder (ADHD). Sometimes referred to as Attention Deficit Disorder (ADD), ADHD/ADD is a brain-based condition that leaves the affected individual unable to sustain focus and attention and has difficulty regulating their behavior and inhibiting impulsive actions.
When parents and teachers observe these symptoms, they often seek professional advice to determine if the child has ADHD/ADD. In many cases, if the symptoms are there, a diagnosis is made. However, while the symptoms of ADHD/ADD are readily observed, the problem with making the diagnosis is that ADHD/ADD is not the only health condition that can cause these symptoms. And while the diagnosis seems straightforward (if you have the symptoms, you get the diagnosis), there are many other reasons for a child (or an adult, for that matter) to have difficulty attending to task, remaining still, and inhibiting impulses. It is essential, therefore, that clinicians explore the possibility that the symptoms may be caused by some other condition.
One of the most common conditions that is mistaken for ADHD/ADD is anxiety. While we all know that anxiety makes us feel nervous and somewhat fearful, it can also make it difficult for us to concentrate, leaving us easily distracted and off task. Kids with anxiety may have a hard time getting started on assignments, which could appear — at least on the surface — like daydreaming or inattention. Anxiety can also make us fidgety or hyper reactive to things going on around us.
Another common problem that can mimic the symptoms of ADHD/ADD is depression. As anyone who has struggled with depression knows, symptoms can include lack of energy or avolition (a lack of motivation). It is easy to see how a student who is just sitting in his seat, not doing any of his work, could be seen as being inattentive, forgetful and distractible. Conversely, depression can manifest as irritability and fidgetiness (referred to as psychomotor agitation). Again, these symptoms could easily be misidentified as hyperactivity or impulsivity.
While anxiety and depression are common conditions that can be misdiagnosed as ADHD/ADD, there are many other conditions that can mimic these symptoms. Students with a learning disability or mild forms of Autism Spectrum Disorder, for example, can present with many of the behavioral characteristics of ADHD/ADD. Similarly, there are many medical conditions that can be easily mistaken as ADHD/ADD.
Anytime a child (or adult) struggles with inattention, distractibility, a heightened activity level, and/or impulsivity, we often look at ADHD/ADD as an explanation, almost by default. Dr. Google does not help, as a quick internet search of those symptoms would offer you with page after page of links to websites about ADHD/ADD. However, while Occam’s Razor may tell us that the most obvious answer is usually correct, that is not always the case.
In some cases, making the right diagnosis is relatively easy. In other cases, however, an accurate diagnosis is more difficult to make, and it may take more time and more information to arrive at the correct diagnosis. Therefore, when someone is struggling with the symptoms of ADHD/ADD, it is important to consult with a professional who is knowledgeable about competing diagnoses.
Diagnostic accuracy is critically important, because the only way to select an effective treatment is to have the right diagnosis. As with most psychiatric conditions, there is no test that can identify ADHD/ADD. Making the right diagnosis is not just about having symptoms. Accurate diagnosis requires clinical skill and clinical experience. If you know someone who is struggling with these symptoms, talk to a professional who can help guide you through the process of arriving at the right diagnosis. Only then can you consider interventions.
Dr. Berney, a licensed psychologist with Psychological Associates of Central Florida in Lakeland, is a national speaker and the co-author of "Handbook for Raising an Emotionally Healthy Child." Listen to Dr. Berney's podcast, "The Mental Breakdown,” on iTunes and YouTube. You can submit questions or topics to Dr. Berney by email at drberney@pacflorida.com.
This article originally appeared on The Ledger: MENTAL BREAKDOWN
