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E24. ADHD and Friends (Anxiety, Depression, and Bipolar)
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0:00
Welcome to ADHD Crash Course! Today we're going to talk about ADHD and friends. What do I mean by friends? I mean a lot of the diagnoses that often either come with ADHD, or those that are confused with ADHD.
These are the friends that aren't always invited, they dropped by, they're not going home. So, it's a good thing for us to dive in and talk about what they look like, which traits they share with ADHD, and which traits are different.
I want to give you my disclaimer that I am not a psychiatrist or a psychologist, I just think this is very helpful and empowering information. This is not for the purpose of self diagnosing, but for the purpose of providing relevant, helpful information, because someone who is diagnosing you is not necessarily going to have the most intimate view into your life other than what you're able to provide and what they're able to observe.
1:12
The job of a diagnostician is difficult and the more that you know, the better. It's not like diabetes, where you get a number and you know, "Okay, this is where we're concerned". With mental health, it's all about function, and that can be relative. The first friend that I'm going to introduce you to is anxiety.
1:28
Here's the thing about ADHD and anxiety. It is confusing. Why is it confusing? This is because ADHD can cause anxiety. The experience of living with ADHD can be anxiety provoking, and then also ADHD can look like anxiety. We're gonna talk in a second about how those things overlap, and drumroll... they both can occur together.
So, trying to tease out ADHD and anxiety is not a simple task. One of my daughters has been diagnosed with ADHD and anxiety, and she was diagnosed with that in fourth grade. That honestly was the beginning of my road (in learning about the differences).
1:59
Even though I had a sister diagnosed with ADHD when we were children, I just never considered that this was at play for me or my daughters. I didn't know enough about ADHD to know that this was what it looked like. I had the stereotype that a lot of us grew up with; a hyper, much more common-in-boys-presentation. I was not looking for all of the nuanced ways that ADHD shows up, especially in those who have the inattentive form. ADHD was not on my radar.
2:26
(For my daughter) I knew something was amok, because the emotional regulation piece was big. There was some impulsivity that I saw in her, but I really was not expecting ADHD. I was expecting something more exotic, which I know sounds strange to say, but she did things that were really hard to classify.
Like one time she started writing a sentence that was (written) as if you put it up to a mirror backwards. I asked her when she finished (it was several sentences-)and I said, "So is this how you want this to look?" She said, "Oh, yeah, I knew it was backwards when I started. But I didn't want to start over, so I just finished it."
2:57
I never was able to get an answer as to what that was. Was it a party trick or a learning difference? I didn't know, but I thought we should probably go and have somebody help us sort all this out. We did, and I wasn't expecting ADHD. I will tell you she's in high school now, and the way that ADHD and anxiety interplay for her is that the anxiety can absolutely cover up the ADHD traits.
3:19
Oftentimes, her instructors had no idea that she had ADHD. I work with a lot of people who this is also is true for, anxiety helps them manage their ADHD. Whether it's an anxiety diagnosis, or just a part and parcel of how ADHD shows up for them, that hyper vigilance that comes along with anxiety can mask ADHD.
3:41
If we're talking about these two as separate things, how do we differentiate; what are the differences versus what is similar? Now, with both ADHD and anxiety you can see inattentiveness, but the cause may be different.
I did a sensory training (it's still available on my website) and in that training, I talked about how when you have a really elevated nervous system, a.k.a. if you're having an anxious experience, that you are not available for focusing, connecting, paying attention and learning. Now, with ADHD you're also going to struggle with inattention and that's not necessarily related to your nervous system level.
4:10
So it is the same trait, but potentially different causes. Emotional regulation was a topic that we talked about last week and that's going to be impacted with ADHD and anxiety.
Both ADHD and anxiety can impact sleep. So, we're talking about the traits that ADHD and anxiety share, but what is different? Honestly, it's kind of hard to say because ADHD, as you know, shows up so differently for different individuals.
4:36
One of the things that is definitely present for all the people with ADHD is a difficulty with executive functioning skills: organizing, planning, judging time, and breaking things down. That can be much more affected with ADHD.
With the impulsive form of ADHD, it might look quite different. It might even kind of look opposite of anxiety, because if you have somebody who is acting before pausing and evaluating what's going on, it's pretty much the180 from somebody who is over-analyzing risk and danger. In that case, you might have a very clear delineation between ADHD and anxiety.
5:09
As most of you know, I work with women. There's a much higher percentage of the inattentive form amongst women, and for many of the women that I work with, anxiety is somewhere in play. Which leads me to another friend of ADHD; like anxiety, this is classified as a mood or an affective disorder, and it is depression.
5:28
My personal story is that I was not diagnosed with ADHD until I was around age 40. When I was a teenager, I was diagnosed with depression. I was put on depression medication, but it did not go well because that was not the right diagnosis. Many people I speak to have similar experiences. Just like anxiety and ADHD, ADHD and depression share traits. They can exist together, and there is understandable confusion with this.
5:51
So what is similar? ADHD and depression both can affect motivation. When you take ADHD and motivation, it's a really complicated subject. There are tons of layers to that, but at first glance, it can appear a lot like the lack of motivation that is present with depression. Both depression and anxiety can impact sleep, and depression can also impact your ability to focus.
6:12
I'm talking about the traits that ADHD shares with depression. Just like anxiety, ADHD and depression can exist together. You can have ADHD and primary depression, which is what we think of as inherited depression, depression that's not necessarily connected to circumstances.
Oftentimes people with ADHD struggle with secondary depression, depression that has a more of a circumstantial cause. People may experience depression when they have unsupported ADHD. They are striking out, not able to meet expectations and not able to keep their head above water. This can be very discouraging and it can have a mood impact.
6:44
Okay, another friend of ADHD that is also considered an affective disorder or a mood disorder, is bipolar disorder. So, I'm a little slow on the uptake, but after two of my children were diagnosed with ADHD (and one was like my twin), I considered that this might be going on with me, too.
When I went through the process of being screened for ADHD, before I was diagnosed, I was given a questionnaire that was clearly trying to gather information about whether or not I had bipolar disorder. At this point, I was kind of early on in understanding how ADHD shows up and
I was really confused, because I recognized that this was what the questionnaire was getting at.
It wasn't titled "Do you have bipolar disorder?", it was just that the questions were clearly designed to get more information about whether that was the pattern that was showing up for me. It was trying to identify if there was a pattern of significant lows and significant highs. This is the depressive episodes and the manic episodes that are characteristic of bipolar.
6:52
And as somebody with inattentive ADHD, that wasn't how my ADHD was showing up. We're going to talk for a second about the difference between impulsivity when you're talking about ADHD versus the impulsivity that you're more likely to see with bipolar disorder. So, what's similar with bipolar disorder and ADHD is that they both share traits like distractibility, impulsivity, and difficulty with emotional regulation.
ADHD has a childhood onset,. Even if you're not diagnosed in childhood, that's when it's showing up. Differently, bipolar tends to have a later onset for people. With ADHD your traits are constant, they're not cyclical. With bipolar, you have episodes, you have cyclical changes in your mood and your behavior.
8:20
So, there are definitely differences, but you can see how this would be pretty confusing depending on how ADHD shows up for someone. There is a big variation in that, and like all the other things, ADHD can exist with bipolar disorder. It's not mutually exclusive, none of these things are.
8:35
I want to talk about more friends, but I think I'm kind of running out of time. You guys aren't here with me; it's impossible to read the room and see if your eyes are glazing over, but I think it might be a better idea to move the rest of our friends to another episode.
I want to take a look at Autism and ADHD, OCD and ADHD, and trauma and ADHD because just like the mood disorders that we've talked about today, they share some real estate with ADHD. They can exist together and they cause a lot of confusion.
6:52
Just a reminder this episode and next week's episode are just the beginning of the conversation. They're meant to bring awareness. They are by no means complete, each one of the things that I talked about, I scratched the surface on and definitely did not include all there is to know or say about the differences and the similarities in each of these.
However, since I'm guessing that most of you listening to me either have ADHD or love someone who has ADHD, this is good information to have. I'm not implying that you need to be in charge of diagnosis for somebody else, but it helps you bring relevant information to that process when you're working with a health care professional. Okay, that's it for today. Thank you so much for joining me.
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