exploring the Co-occuring Conditions of ADHD and ASD
AKA: The other stuff that tends to pop up when ADHD/ASD is present
What best explains other symptoms?
Clinically, both ADHD and ASD have significant overlap and an increased likelihood of having co-occurring conditions. In fact, having a co-occurring disorder is quite common with ADHD and ASD. Some of the more likely (statistically) options are:
Co-occurring ADHD or ASD
Depressive Diagnoses (Major Depressive Disorder or a number of other forms of depressive symptoms, including self-harm)
Anxiety Diagnoses (Generalized Anxiety, Social Anxiety, or a number of other forms of anxiety symptoms)
Obsessive-compulsive Disorders (Obsessive-Compulsive Disorder and Obsessive-Compulsive Personality Disorders)
Sleep Disorders (Sleep Apnea, Insomnia, Narcolepsy, etc.)
Eating Disorders (Anorexia, Bulimia, Binge Eating, etc.)
Intellectual and/or Language Impairments (Dyslexia, Dyscalculia, Intellectual Development Disorders)
& More!
How A Diagnosis Can Help
In the field of psychology, diagnoses are supposed to offer clarity and direction in treatment planning. Unfortunately, diagnoses in the mental health field have become burdened with a number of unhelpful assumptions. These include fears that medical care (or life insurance, or work opportunities, etc.) will be prevented on the basis of a diagnosis or that a diagnosis will result in tunnel vision in a medical context, resulting in sub-par or insufficient care. Unlike many medical diagnoses, a mental health diagnosis is one person’s interpretation of your presenting symptoms. When additional data is provided, or when a different mental health professional operating from a different interpretive lens looks at your symptoms, they may come to an alternative conclusion, which would likely result in a change of diagnosis.
In the work that I do with ADHD and ASD clients, it is not uncommon that ADHD or ASD are overlooked as a diagnosis. In my experience, this can come as a result of a mental health professional having outdated knowledge/assumptions about these diagnoses, out of fear in providing these diagnoses (again because of their assumptions about what it means to have ADHD or ASD), or sometimes these diagnoses are simply overlooked because of a focus on one or more symptoms which make a compelling case to them that another diagnosis fits.
The most common misdiagnoses I have seen are bipolar disorder diagnoses, narcissistic or other personality disorders, and even ODD (oppositional defiant disorder) in kids. These diagnoses, when they appear to be misdiagnoses, often occur due to a focus on specific traits/symptoms without looking at the clinical presentation more broadly.
The other form of mis-/underdiagnosing that I see is in the form of a number of distinct diagnoses (like depression, anxiety, OCD, eating disorders, etc.) rather than a singular (or at least fewer) diagnosis which explains those disparate symptoms. The principle of Occam’s razor comes to mind, if there is a simpler explanation, it is typically the best possible explanation.
That being said, it is possible that separate diagnoses of ADHD/ASD and a co-occurring condition be meaningfully provided, and that is something that I do with my clients, especially if we want to do targeted work of reducing symptoms related to a particular condition (like OCD or an eating disorder, for example.)
What’s the best way to determine if you have another diagnosis in addition to ADHD and/or ASD?
You could look over the DSM-5-TR diagnostic criteria for any of these diagnoses using your preferred search engine, you could take an assessment/evaluation to get clarity or rule out particular diagnoses, or you can schedule an appointment to talk with an ADHD and ASD specialist who can help determine if another co-occurring diagnosis makes sense for you!