Why Other Disorders Often Coexist with ADHD (Comorbidity)
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- Опубликовано: 30 июл 2024
- Why Do Other Disorders So Often Coexist with ADHD?
00:00 Introduction, Dad Joke and Humorous Bumper Sticker
00:57 Introduction to the question posed in the title - why comorbidity in ADHD?
01:37 Diagram showing disorders most likely to be seen with ADHD
02:53 Diagram from a large study on the shared genetic relationship among mental disorders
07:35 The possible role of shared environmental experiences in further explaining comorbidity
10:00 Summation
This short video discusses several reasons why many other disorders are so often seen as coexisting with ADHD. Over 80% or more of clinic referred children and adults seem to have a second disorder and over 50% may have a third disorder. Why does having ADHD predispose one to a high likelihood of having a second or even third disorder? It's complicated but this video tries to explain the role of shared genetics, shared environments, and the possibility that one disorder (ADHD) predisposes one to experiences that may then lead to developing the second disorder.
You seem to have a whole new level of joie-de-vivre since retiring! Thank you for choosing to continue to bless us with your insight and information 😊
It's because he no longer has to interact with those that have ADHD. 😂
@@lernmor2137 He’s literally spending his retirement voluntarily continuing to interact with people with ADHD lol…
If anything, I’d imagine his newfound energy is due to no longer having to interact with academic + medical bureaucracy, paperwork, and red tape 🤷🏻
@@DannyD-lr5yghe is a god damned valiant crusader for us
Retirement and a new house - he spends as much time as he wants on ADHD for the channel, but isn't in a place of publish or perish and he gets to enjoy golf rather than fly across the country and stay in the most boring part of a city for a conference presentation.
@@publius9350 “publish or perish” - if that doesn’t sum up academia and research, idk what does!! Spot on!
"Gotta stay in shape for you guys!" Awww, thanks Dr. B. We appreciate the many efforts you make our behalfs. We hope that you will stay healthy and fit for decades, not only for your own sake but because we need you to continue to educate us about ADHD (and to tell us Dad/Grandad jokes that make us chuckle and groan).
What did the dad say to ChatGTP? "Hold on, let me get my kids.."
As a social worker, I truly appreciate you sharing your knowledge with us!
Thanks!
Prior to ADHD diagnosis I was diagnosed with Emorionally Unstable Personality Disorder AND Delusional Disorder. Once I received ADHD duagnosis/treatment and follow up appointments my life improved and I could live. I could breathe.
Having some cognitive dissonance again. I was very surprised by the negative correlation between perfectionism and OCD, and ADHD. As a child and young adult, I exhibited those traits very prominently, and those were two of the labels applied to me most often. That's only anecdotal, of course, but I really thought I had heard elsewhere that those sets of behaviors can coincide, at least on a superficial level.
I am curious as to whether these numbers will have changed by now. I personally was surprised to see a negative correlation between adhd and anorexia. But then I realised that the study is from 2018. A lot of women have been diagnosed in the meantime, but there is still a diagnostic bias towards men (so that bias was even more pronounced before the pandemic).
So if (capital IF - I haven't checked anything, just brainstorming) the study has a male bias in its data, this may have skewed some of the numbers and it may be worth rechecking whether the numbers regarding perfectionism-related disorders have changed.
@@cesbi that's a very good point
@@justinwest4923 and more to your point: I have anecdotal data that supports what you said. I've seen several high-masking adhers "resort" to obsessive compulsions as a coping strategy to control the subjective chaos in their minds. So I'm with you on that cognitive dissonance. But again, anecdotal evidence only.
Same. Diagnosed with adhd in kindergarten, OCD in 2nd grade, and autism at 32. And every medical professional I've spoken to has been like, "Oh yeah, these are all connected." Not according to this chart it's not!
It's even weirder because as a kid, my doctor would say when autism was brought up that basically an ADHD/OCD combo mimics autism and since the treatments are the same, there was no point in trying to label it as autism. How can they appear the same, have the same treatment, but not be related?
As to how a perfectionism condition can coexist with an impulsive condition, let me tell ya: not well. Because my impulse is to be perfect. When writing a paper, I cannot decide which source to use, so I get so many I don't finish. I get distracted at work by bumps on my skin and pick myself raw, which is made 10× worse by the stimulant medication I need for the ADHD. I make myself make up any distraction more than a few minutes, since I have a near complete inability to lie. About to go make up the last hour of the 2 hours I need to make up for work today because I had very specific questions about the Mongol Empire, curly hair and height genetics, etymology, ADHD, and probably some other stuff. And I have great difficulty dropping anything until I have complete understanding and feel satisfied.
And when you have a strong desire for perfection but always fall short because you are constantly distracted, it can really mess with you.
@LandCfan thanks for sharing those experiences. I feel like I have a lot of the same struggles and conflicting inclinations, although I may be fortunate to have them with less severity.
I'm curious about the ADHD/Anorexia reasoning - the presentation of ADHD in this context as chaotic and the inverse of perfectionistic misses the role perfectionism plays in an ADHD life, and its link with the fear of failure. In my work with ADHD I often see perfectionism playing out in procrastination and FoF, and intrinsically linked to our executive functioning.
In adults its often the image created of an ambitious goal that is matched to an ideal (perfection) beyond reason and ability because its just an ideal. But unless we unpack the idea into a structured plan the ideal often stops us from starting because we fear never reaching that level of perfection?
To suggest that our chaos is bereft of perfectionism seems to counter every other narrative on ADHD out there?
Yes, I appreciated this comment. I am older and living abroad, so have never been diagnosed with ADHD, but in therapy, my psychologist thinks I have it. So do I. But have always had perfectionism traits, and never anorexia, but restricted eating along with a coffee addiction. But I suffer greatly from procrastination....which tortues my perfectionism. I also have been diagnosed with attachment disorder from early childhood. Any comments on how this affects ADHD?
THE DAD JOKES HAVE RETURNED! 🎉🎉
Don’t encourage me, LOl
I enjoyed it.
My ADHD is so bad it's turned into AD4K, hahaha
We ADHDers may sometimes be scarecrows, but some of us can eventually become outstanding in our fields... OK, I'm going to stop with the dad jokes and get on with re-writing the bloody assignment I failed on inclusion and SEN (oh, the irony!) for my master's in teaching. The one area I'm an actual expert in and I don't pass because I have to do academic writing for it which requires attention to detail and the ability to organise one's thoughts that I don't possess. The worst thing is, it's a "marginal fail" and there isn't one major thing wrong, just lots of shitty little things that my ADHD brain is going to hyperfocus on and obsess about. God, I hope I can get it together to pass... I can't face repeating the whole entire module, what a nightmare!! 😢
Properly diagnose and treat ADHD and you could likely lessen that connection between ADHD and anxiety. Recent Swedish study was showing women were diagnosed on average four years later and develop more comorbid disorders - I'll put money on the late ADHD diagnosis resulting in the comorbidities due to social and educational impacts.
When we think about the connection between stress and depression/anxiety symtoms, Montgomery-Åsberg instrument and how Åsbergs work here at KI investigated the causal relation from stress to these disorders and utmattningssyndrom, earlier called burn-out, but burn-out is too work-related to capture the phenomenon... We'd be surprised if having difficulty with our obligations, even paying rent on time when it's just a question of making yourself log in and punch in the numbers, wouldn't increase the mental load you carry around -- all that anxiety about being almost too late to squeak by with a late submission, getting stress from being late to work, again, and so on and so forth -- why on Earth wouldn't the stress-> depression and anxiety mechanism happen to us, too?
I have ADHD-inattentive type, Dyslexia and OCD. I got diagnosed a couple years into my engineering degree and started learning about myself as I went along, after the diagnoses started coming in.
Starting off in uni my grades were all top or bottom grades. Now I've managed to keep them stable at the higher side of the classes I take.
I am extremely organized, down to crossing off lists for packing my bag to brushing my teeth and when I should go to make it in time to my classes, exc. so others don't see me displaying the typical ADHD disorganisation.
From my point of view, do I think it's important to remember that all these disorders are just symptoms of how brains are connected, and all these diagnoses are not "real things", NOT in the sense that they are not real valid diagnoses of serious disorders, but rather in the sense that they are concepts we have made up to catogorise being over a set cut off value of having sertain problems.
So when I think about my own brain, I think about it as a brain that is connected in such a way that it ends up categorising for these disorders to different degrees.
I also notice the patterns on what parts of each disorder tend to amplify the others in different situations with different catalists, such as lack of sleep, stress, overworking myself, hyperfocusing for too long, rabbit hole of overthinking exc.
This was an interesting study, I do also think it's important to underline that we are all people with different brains, and whatever criteria we meet for different diagnoses, we all just have one brain up there.
Just as a reminder, as I think it's important to remember.
I understand it's easy and often necessary to put us in different boxes to get any data sets that can be used for understanding us better as well as treating us, however, at the end of the day we have to remember it's simplifications.
To not get the wrong idea, thanks for making this video, it was intresting.
*Sorry for any bad grammar or spelling, I am not a native speaker, besides my dyslexia... 😂
Very good point applying social constructivism to the DSM. Even Dr Amen has identified at least 7 maybe types of ADHD brains, what that actually means is beyond my comprehension frankly 😂
Yeah, the hit and miss grades thing also plays havoc with my self esteem because I know I'm capable of doing better, except I'm kind of not (lack of consistency and just bring so damn tired thanks to the ADHD). It feels like I always fark it up. And that it's my fault.
this information you share is so unique and it's generous of you, I appreciate your care for people whose worlds can't be seen and people fail to understand them and blame them for who they are😢
It’s a pleasure
is it possible to show you my brain map?
Researchers in the ADHD field, like the late Joseph Biederman and others say studies show that people with ADHD if they aren't medicated are likely to be killed in accidents or car crashes by the time they are 45 and it is genetic. Well there are clearly exceptions to that rule. Ned Hallowell has ADHD and he's three weeks older than you. John Ratey claims he's got it. He's 76 next month. According to Hallowell he diagnosed an 86 year old with it. Hallowell also claims George Bernard Shaw had ADHD, he lived to 94. Einstein had it, died at 76. Henry Ford had it. Died at 83. Alexander Graham Bell. Died at 85. Richard Branson apparently has it. He's 73. Ty Pennington is 59. Hallowell, Ratey, Branson are still kicking.
And if it is hereditary, who in your family had it before Ron? Did he pass it onto his children? Your Dad lived to 83. Your Mom was 92. Did it come from them?
Also Allen Frances says 3% of kids have it. You say 5-7%. Biederman said 10%. Dodson 10%. The DSM 5%. How can you all be right?
Hallowell and Ratey manage without medication as did the above people. So no. In my opinion it isn't essential everybody with ADHD should be medicated. It is a spectrum, and if the side effects cause problems or you don't feel benefit, don't use them. If they work without the latter, great. If you can manage without it then don't take it. The U.S. consumes 90% of the world’s Ritalin. If it is true that “untreated” ADHD leads to kids committing crimes, then we would see a rash of crimes in other countries that don’t use Adderall or Ritalin or use it sparingly. Japan banned it. The USA has the highest prison population in the western world as well. It is not all black and white.
Ronald Claridge.
@@russellbarkleyphd2023
Hello sir,
Good information.
But, as a psychiatrist, I come across many adult ADHD patients who have strong features of ocd and whose YBOCS is strongly positive.
Please throw some light on it through your vast knowledge and best of all expertise.
🙏
Thanks
Oh yes, the OCD comes out for me when I'm not managing well. I actually use it as an identifier to know that I need to reach out for support!
yeah! exactly😄😄😄😄😄😄sorry for that!!!!
Could OCD tendencies be a sort of coping mechanism? A structure to help get by. Interesting observation.
@@TheFuel89 for me, I think the OCD rears it's ugly head when I'm in a state of complete overwhelm. I think it's because the OCD practices are something I have some warped sense of control over when the rest of my life feels so out of control. The messed up part is that I don't actually have control over the OCD practices because they are essentially compulsive, that I can't help but feel compelled to practice, so they are actually controlling me. I just think I have control over them. Another thing is that I allow the OCD to take over because it serves as a distraction from the things I need to get to task on, so then it becomes a sort of familiar comfort justification for why I'm not doing what I need to do. An uncontrollable excuse. I see this pattern over and over again. It would be great to have Dr.Barkley's thoughts on this co-morbidity.
In my case, I've been diagnosed with ADHD OCD and autism, but I wonder if the OCD (which was diagnosed 2 years after the ADHD) was just a reaction to the stimulant meds (which definitely make my OCD symptoms worse, but I still need them) plus some autism traits.
Dr. Barkley, I find your passion and dedication to ADHD even after retirement so very inspiring! Thank you for helping the world understand us better, and us understand ourselves better! And a big thanks for your dad jokes! 😂
My pleasure. And, yes, more Dad jokes are on the way. Thanks!
What do you have to say about students abusing Adderall to pass exams or crushing and snorting them to get high? @@russellbarkleyphd2023
6:33 I am surprised to hear this from you. From what I learned and experienced, perfectionism is a common trait of ADHD, which leads to procrastination.
Please confirm and clarify this point.
How is it that the line is not more indicative of a connection between ADHD and autism? I'm no expert, but I've read quite a bit about the overlap and co-diagnosis of these and am quite interested in it. Thank you for continuing to educate us!
I think a lot of people diagnosed with adhd and bipolar, or only bipolar are actually comorbid adhd aud but it is not yet to be recognized. I think this presentation mainly effects girls and women thus the lag to notice/acknowledged it.
I wondered about that, and I think there is a strong statistical comorbidity from other material I have read. This study looked at shared GENETICS - suggesting the connection is not genetically based OR that it is, but the genetic methodology used doesn't pick it up. That in itself raises some really interesting questions.
Yes, the overlap is higher than expected. It what this says is that while shared genetics is part of it, I am betting that factors like older paternal age, maternal age and infections, and other things that lead to mutations in genes in the affected child are part of this and these will differ between the disorders yet affect similar neural pathway development that is dependent on multiple genes to progress normally. Also, recent neuroimaging and other studies are suggesting that when the two disorders coexist it is a unique disorder and not just comorbidity. Be well
@@russellbarkleyphd2023 very interesting , thank you for your time
@@russellbarkleyphd2023 Interesting conjecture that may well fit my situation and development from birth, fourth of four boys spread over eleven years, mother was expecting a daughter and was unable to have another child, I bonded with an older brother, running after big brothers at age one before learning to slow down to a walk, polio at age three (yes, I'm that old), she considered me as the independent son (basically had to figure things out myself - significant life questions "you figure it out"), doing errands at age four, neglect, not listened to, SA as a teen by one of her childhood friends. ADHD, ASD, dyslexic (Inc. 2 brothers), ODD but not recognized in DSM as directed toward the sibling I bonded with, C-PTSD, a tendency towards OCD, a major depressive episode, for too long my doctor diagnosed anxiety (yes for a while coming out of depression with random suicidal ideation - stopped (tapered off) both medications once depression cleared). Once she passed another brother related a conversation he had with her when I was about 20 and essentially no contact for over a year, sisters-in-law reaction "how could a mother treat her child like that".
I have ADHD since forever and I have this old injury on the joints from my left side (left shoulder, left wrist and left knee) from ATV off-terrain vehicle accident, and also a bad fall when snowboarding. And when you mentioned the correlation of accidents, injuries and ADHD, suddenly it makes so much sense that before my diagnosis and being medicated I always prone to get into car accidents, freak injuries and generally getting involved with stupidly dangerous stuff. I think way too often, all of these caused by the dopamine-chasing and adrenaline-high my brain craves before I was diagnosed, then medicated and being more mindful of my ADHD tendencies
I am convinced my Adhd went diagnosed until 40 because but the signs are all there. Being tomboy, always conflict at home, feeling off in school like completely zoned out and my teens was a disaster. I put myself through university simply because I had a desire for an education but its all a blur. My parents gave up on me because I could rarely sustain a job due to my issues, I have changed jobs and interest several times. My family life was chaotic and I also had trauma and so that was treated as well as anxiety, depressive dystimia ocd like behabior, bpd traits, which I found to be odd because I never wanted to hurt myself or was suicidal but I was so impulsive and unable to stick to anything. When I started meds in my 40s after being in therapy for over 10 years for all the other issues, I just knew there was something else. I am a very helpful and considerate person, so the issue was not a lack of empathy I just could not motivate myself any longer. I tried and was told I lack motivation, which was heartbreaking because i was trying so hard and several time, that I act like a child and am supposed to know how to be an adult. When I started the meds, things improved, especially my thinking was clearer and I was calmer and I finally felt like the educated person I was supposed to be. I have just started my journey, but just to say that it all makes sense and I hope to get a second chance at life. My parents have these issues as well, but mostly able to get on with life, and basically I was considered a write off. I wish they would have looked into it earlier. My life would have been very different.
Thank you for all the information you provide. I’m 45 and finally was able to talk to my doctor that I have seen for many years and got a prescription for my ADHD. It’s been about 1 month and it has helped me a lot being able to focus enough to start getting things done for myself. I simply stopped caring about my well-being and my ability to function was abysmal. I would love to get extra information or insight as to how one figures out what dosage is correct. My current dosage is 10 mg of Dextroamphetamine, once daily. It’s a-lot to explain, but it took too long for me to advocate for myself but I’m very glad I did. What bothers me the most is that I know there are other people like me who suffer needlessly. Once again thanks for making your content digestible, informative, and accessible. 😊
Advocating for yourself it's very hard for ADHD folks. It's so absurd to be sometimes unable to convince our doctors of our difficulties to get a diagnosis.
Dr. Barkley, please a video on adhd and neuroplasticity: Why isn't it possible to "cure" an executive dysfunction via training? Or is it? Why, despite the daily "good" use of Impuls control, concentration, emotional regulation, etc during medication, our brain does not develop and learn to be able to continue doing this without the medication? I hope you can understand me. English is not my mother tongue, and I am just a late diagnosed adhd woman, daughter of a adhd mother and mother of 2 adhd children. But this question does not leave me in peace...
I would be interested in an answer also.
The brain is not so neuroplastic as some people have advocated. Yes it can reorganize somewhat after injury by neighboring neurons taking over some functions in which they likely participated in that function to some degree anyway. But neurodevelopmental disorders are not due to injury in most cases and even when injury is involved it is often early in development, not in a mature brain. So just as we don’t train out autism in most cases, we don’t train out ADHD either but teach accommodations and compensatory tactics. Be well m
@@russellbarkleyphd2023 - really interesting and helps clarify this recent buzzword. On the Huberman podcast on ADHD he said there is some possibility of improvement in unmedicated executive function that comes from the use of properly prescribed stimulants, which I think he describes as a neuroplastic effect - do you know what he is referring to? Would it be dependent on age of initial use due to the brain development that occurs at different ages? As a neuroscience professor, I would think this is something within his field, and it certainly affects risk/benefit analysis of medication and first usage against learning to work within one's unmedicated state.
I also saw in the Israeli population study on dementia that methylphenidate (Ritalin/Concerta/etc) seems to be neuroprotective against dementia - if there is not a neuroplasticity increase with medication, could it be neuroprotective? There just seems to be a lot of fear of stimulants out there, but it seems like their are unknown benefits to accompany the unknown risks, along with the known benefits and risks.
There are more than 33 studies showing long term stimulant use of two years or more enhances brain growth in regions underdeveloped in ADHD. We don’t know which drugs, doses, ages, etc. are best for this and many cases may not show it. Just use Google scholar to search for ADHD + stimulants + neuroprotection to find them. It really isn’t neuroprotection the way that antidepressant protect against dementia, but neural enhancement. Be well m@@publius9350
Amazing ! its easy to observe that the strongest genetic correlations do make sense psychopathologically, for instance the link between schizophrenia and bipolar disorder, major depression and anxiety disorders, OCD with tourettes and anorexia. i did expect to see a stronger link between ASD and ADHD though
Hmm, I’m not sure about the no perfectionism with ADHD, Dr. Barkley.
I definitely have perfectionist traits. I can’t bear to even try to attempt things if they aren’t going to succeed perfectly ( fear of failure!)
I had a major anorexia episode in my late teens- twenties, and Have always struggled with perfectionist body image etc…
The mental and executive chaos is always battling with with the lofty perfectionist ideals in every area of my life:
Depression and anxiety usually follow…
Have you never seen this?
Dr. B. explains elsewhere in the comment section that perfectionism can indeed co-exist with ADHD but it tends not to do so at a higher rate than in the general population.
That's one of the best dad jokes I've heard in months! Love it!
You came up in my feed and I am so glad I clicked on your video. Very informative and easy to listen to. New sub.
Thanks for paying it forward. I love this channel!!
Thank you for all your work, you have really changed my life. I even made a poster of your 8 rules for ADHD and posted it at my desk to look at daily.
Very helpful. It helps me to understand how the plethora of mental health struggles in this family of mine are so different yet so connected beyond the environmental component
Thank you for this and all your work Russell, watching and listening to anything you have to say about ADHD has been very helpful to me.
Want to add to the chorus of others expressing gratitude for your content. You are blessing my family and the lives of the patients and friends I direct to your channel.
Thank you for your continued education for us lay people. It's so important and appreciated.
Dr Barkley, I’m 68 and was diagnosed with ADHD about 25 years ago. The “assessor” actually said I had CAPD and treatment would be the same as if I had ADHD.
I have learned so much from your talks and believe without a doubt I have ADHD. However one thing I don’t recall if you covered was avolition. I suffer from depression and when I better understood avolition, I believe those symptoms aptly describe my behavior. The upshot, I’d sure like to hear you address this topic within the ADHD context. Thanks so much!
I simply lololove your videos. Thx so much for all the work you have done and now share with us. Much gratitude from Basel, Switzerland
Thank you good sir!! We appreciate your dedication and shared knowledge!!
I am so grateful that you continue to explain ADHD even after retiring! You’ve helped me understand my ADHD so much. I’m forever grateful. Thank you
Please continue your videos. You are a hero!
Thank you for this it's so valuable for us that we are trying to understand
I'm diagnosed ADHD and also think I've got covid/ lockdown PTSD. Think this needs to be discussed further. Doubt I'm alone feeling like this. Thanks doc another great video.
I think I'm traumatised by what I saw of the world during covid. And was harmed by isolation during lockdown.
@@nataliebutler me too 100%. I've attempted suicide twice and lost all my confidence.
Thank you very it was the thing i have been looking for so long now it all makes sense.
The counting to 10 sticker is very relatable having adhd & the help of stimulant meds 😂
This is the most factual scientific, logical explanation & easy to understand as a person diagnosed at nearly 50 with extreme adhd, yet somehow got missed 🤷🏻♀️😂. I’m getting annoyed with some information hitting the headlines through celebrities sharing on the topic that doesn’t resonate at all with how it affects me. I have respect for the people that have dedicated their lives to science always questioning, but not with an obsession to be famous, more a passion on the topic & that’s a well deserved fame 😂🤜🏻🤛🏻
Thank you 🙃
Thankyou Dr Barkly, the information you provide, are sometimes rather usually needed for me to balance issues centred on my ADHD.
Is part of ADHD genetally bei g gullable, excluded very regularly, Im trying very hard to understand as my work is in talking tp people with continence issues with conversations that take alot of care, i have to ring 150 people a week, create p
Repal and yet Im told I do rhis easily but socially, Im a clutz, Im no-ones friend, sibling, daughter just mylittle dog.
Its all so wrong.
So isolation is why Ive written this, and should be up there on the graph.
CauseIve had some years with frinds, but would be 10/50 years, so 40 years, alone.
Yes, being more easily socially influenced is part of the disorder as one function of the executive system is social self defense from the nefarious influences of others via critical thinking.
It's funny to be naturally oppositional, but still easily socially influenced. I can think it through, but still - we resist guidance automatically, but if someone knows how to do it, we will do whatever we are told.
Thank you for this video. I'm in my 40s, female, and I'm in the process of getting an ADHD diagnosis. My GP is trying me out on medication, starting with a low dose of Ritalin (my prescription coverage won't cover Vyvanse unless he tries me on an older drug, first. He wants me on Vyvanse, though). So far, I've experienced a modest yet clear improvement in symptoms. I have another appointment in a week, and I'm excited to try something stronger, after being so dysfunctional for so long.
I already have some CSA trauma, plus GAD diagnosed in my teens with anxiety going back to childhood. I'm also obese, an emotional eater, trying to lose weight to regain my health, and I think my food choices and lack of self-control are, in part, driven by undiagnosed/untreated ADHD.
I'd also be interested in a video on other, more physical conditions co-morbid with ADHD. I've already been diagnosed with Fibromyalgia since my mid-20s, which is a sensitization of the CNS as far as we know these days, and my Google-Fu tells me that several studies have found a prevalence of ADHD ranging 25%-45% in people with FMS. I'm not terribly surprised, it makes sense that CNS sensitization would go hand in hand with neurodivergence and everything else chronically activating my sympathetic nervous system since childhood! IBS is another one that occurs with these.
this is amazing information! Thank You so much for sharing. I'm very surprised to see that ADHD and Autism are not more related. Both can have strong pulls to specific interests and hyperfocuses
Yes, but see my comment above on why the genetic link is not as high as expected. Thanks!
I reached out to you 12 months ago from Australia 🇦🇺. A then 48 year old mother of 3 kids. Since then I finally got to the top of an assessment wait list. ADHD combined types. And AUTISM…
My whole life has been traumatic as someone experiencing life as though I were a flimsy old shirt in a washing machine. Desperately trying to control my environment and please others. I surprisingly was a perfectionist for a very long time. Burnout after having kids saw me never again be perfect at anything…
The impact of inability to focus has resulted in many “starts” but not many runs through the finish line on a multitude of tangents and rabbit holes of interest… Relentless critique from my mother to this day totally obliterated my self esteem. Motherhood really puts ADHD to the test. Since becoming a mother I’ve rarely felt competent at anything. So late to be diagnosed but at least I know and I can be kinder to myself and thus reduce beating myself up without is unnecessary, depressing and energy draining in itself 🙏🏻
Dr Barkley I have learnt a lot from reading your books and doing on line course of yours also watching your podcast. Thank you for contdinuing to share your knowledge and making it easy to understand. A family member of mine has ADHD.
My pleasure. Thanks!
@@russellbarkleyphd2023 Hello and thank you! Just wanted to check with Dr. Barkley the link between ADHD and perfectionism and anorexia. As doctor says, there is no link as per studies (gens), but as behaviours, 'strategies', outcomes of untreated ADHD they do 'co-exists'? Thank you!
Yes they can but not at much higher rates than in the general population. ADHD alone does not seem to predispose to them. The rate of OCD for instance in ADHD is only slightly higher than in the general population.
Be well. @@katarzynaturek4775
Thank you so much for all your videos and books, Dr. Barkley! I have ADHD and severe depression and anxiety, and since reading your Take Charge of Adult ADHD book I have being getting very depressed because ADHD has already ruined most of my life. Is there any hope besides using sticky notes an notepads? I am too afraid to even apply for jobs now due to so many failures...
lovely Docror Barkley, thanks, from Iran
Please talk in the future about struggles with switching tasks
I find this particularly fascinating. When I was diagnosed with ADD back in the day I was also diagnosed with TICs and OCD, and I was told that it’s not uncommon for those to co-exist, and if they do that I am likely to have at least one family member that has at least one of those conditions. Back when I was diagnosed a diagnosis of ADD automatically meant you couldn’t qualify for a diagnosis of what at the time was called Asperger’s, but I strongly suspect I do have ASD as well, and I have noticed a lot of overlap there as well. Since I strongly suspect I have Cognitive Disengagement Syndrome rather than ADHD, I do wonder how that factors into all of this.
For what it’s worth, I also have an additional theory. I’m pretty sure my ADHD/Cognitive Disengagement Syndrome is caused by low dopamine. From what I have seen, OCD can be caused by extreme/regular fluctuations of dopamine. Tourette’s/Tics also is suspected to have a possible Dopamine component. From what I am reading, it is also speculated that Autism Spectrum Disorder is at least correlated with abnormal Folate levels, and Folate is needed to synthesize Dopamine.
It’s definitely incomplete and inconclusive data. After all, ASD is also highly correlated with low Vitamin D levels, and who knows if low Folate/Vitamin D/etc. contribute to ASD or if ASD causes people to have less healthy diets which leads to various Vitamin deficiencies. And the human body certainly is more than just a mere biological machine. But I do find it fascinating to at least consider if these conditions are often co-morbid because if you have highly fluctuating Folate it can contribute to highly fluctuating Dopamine, which can lead to significant periods of specifically low dopamine, etc. In other words, these conditions may be linked because the biological mechanisms are so similar that once one effect starts happening it’s much more likely for the other effects to start happening, too.
ADHD still seems like a bag of symptoms that can be improved with certain drugs, rather than a coherent itiology. I am skeptical about thinking of it as a singular clinical entity in this way. It may help us identify where certain drugs may have an impact, but it also confounds the discernment and treatment of underlying itiologies
There is also a higher rate of ADHD reported in children with autoimmune type 1 diabetes. There is an overlap in symptoms of ADHD and complex PTSD associated with childhood emotional neglect which can occur without a parent/guardian realising they are causing harm.
It changed my life listening to Dr. Barkley a few years ago. Now I'm doing the best I've ever done in life.
Genetically, the link between ADHD and ASD is very weak, if I read the colours correctly. As a clinical psychologist working in this area for 30 years, I have long viewed these two conditions as different, and when they coexist together in one individual, they represent separate areas with similar-looking problems, each needing their own strategies to improve. Russell, would you care to comment? Regards from Perth, Australia, Derek
Yes, but there is a significant linkage between them even if smaller than expected. One reason for this was noted in several earlier weekly research reviews I did this past few months showing that both genetically and neurologically the combination of these together is a unique condition, not merely comorbidity or additive genetic effects. Second is that while ADHD does occur in ASD in at least half of the cases of the latter, this could be misdiagnosis as the more common attention deficit in ASD is CDS, the second attention disorder I discuss in my video. And only about 20% of ADHD cases have ASD and it’s higher functioning usually. A third reason is that maternal and especially later paternal age are risk factors for both disorders explaining why they may coexist in some cases based on risk for de novo mutations that give rise to either or both. Those would not be inherited genetic effects but the result of aging populations where parents are delaying childbirth until their 30s or later. So it’s complicated. Thanks!
@@russellbarkleyphd2023 is it common for people with ADHD have non - disabling traits of autism ( borderline autism ) or is it a minority of people with ADHD ?
It’s about 20-25% have ASD that is usually toward the higher functioning range. @@ALADDIN22091978
Thank you 🙏🙏🙏🙏🙏🙏🤣🤣🤣🤣I love the dad Jokes You are a blessing to all god bless you 💜
Me too!
Thank you for your incredible work on ADHD, Dr. Barkley. Your research has greatly influenced my understanding of ADHD's impact.
I recently came across a study on lead exposure and cognitive ability (Duke / Florida State Univ), which made me think of your discussions on ADHD and executive function. What can I do as someone who is not in the psychology field to add value to the research being done in these areas?
Yes, I appreciated this comment. I am older and living abroad, so have never been diagnosed with ADHD, but in therapy, my psychologist thinks I have it. So do I. But have always had perfectionism traits, and never anorexia, but restricted eating along with a coffee addiction. But I suffer greatly from procrastination....which tortues my perfectionism. I also have been diagnosed with attachment disorder from early childhood. Any comments on how this affects ADHD?
Can you do a video on AuDHD. An indepth one. You're my most trusted adhd source Dr Barkley.
Awesome.
Could you possibly link the papers in the description for ease?
Is there any work you're aware of which compares the states and traits of major conditions?
309.81 (PTSD) was Classified as an Anxiety Disorder in the DSM-4.
Dr. Barkley; thank you for sharing your knowledge, what do you think of supplementing with NMN and resveratrol for adult AdHd?
In my years of researching these conditions since I have been diagnosed with many of these, I've also found physical comorbid conditions that are genetically linked to ADHD and Autism. Some examples being autoimmune disorders, digestive dysfunction, and even hypermobility and POTS (due to connective tissue defect). Genetics are so complicated. But it's always fun when you meet medical practitioners who bla.e you and your lifestyle for bringing onset of these conditions like mine did 😂 like sure, let me just go ahead and eliminate every possible toxin amd stressor from my life and I'll be as good as gold!
49 years old and diagnosed with:
MDD
GAD
(C)PTSD
ASD1
ADHD-C
DID (working diagnosis, in successful trauma therapy and working toward diagnosis)
Mental illness also runs in the family, especially schizophrenia (maternal grandmother, paternal uncle).
Just add me to the "genetic connections" pile, I guess!! 😅
Hero of heroes! Love you Dr. Barkley!
Thank you!!,
I don't know if you have done a video about it yet, or if you have any knowledge, but I would love to hear you explain some of the reasons and places where ADHD might differ from person to person, especially men and women
I have ADHD. I’m an adult over 40 years old and I was only diagnosed with it a few years ago. I was diagnosed with a learning disability at a young age. I don’t believe I was ever told what that learning disability was or is. I also have been diagnosed with binge eating disorder at the time of my adhd diagnosis. I would definitely say I have some level of anxiety (for sure social anxiety and general worry or doom and gloom at times). I also feel some level of depression. I haven’t been officially diagnosed with anxiety of depression, but I can see how my adhd has created an environment over the years to bring them about.
I think it would have been helpful to describe the PTSD component as something that may have happened in childhood, rather than just saying that people with ADHD 'set themselves up for incidents that may cause PTSD'. They way you worded that explanation made it seem like a child is responsible for setting themselves up for trauma. I think that deserved some different, and additional, explanation. But I really did appreciate this genetic analysis. Was very helpful.
I had a similar thought. He said "they put themselves in situations" for certain risks and I was like "I'm pretty sure I did not put myself into my family" Maybe he means as adults we might do that, as a result of ACEs or early trauma?
You a real blessing ❤
Thanks
Please share your thoughts and the research about monotropism and ADHD.
I was diagnosed with schizoaffective disorder at 14. It is a mix of schizophrenia and bipolar disorder. Almost two years ago, I was diagnosed with ADHD. It is a curse. The funny point here is- I don’t get side effects on stimulants, but I do get severe side effects on medication to treat bipolar disorder- like lithium -and schizophrenia - like Risperdal .
I'm surprised assortive mating wasn't mentioned. People with ADHD have been found to be 9.25 times more likely than average to select an autistic mate. I have personally come across a very large number of ASD+ADHD pairings. It's a known thing in the ND community. Of course, their children will likely present with either individual diagnoses or AuDHD, and they will carry some genetic features of both, regardless of neurotype. Similarly, there is a very high likelihood of autists selecting schizophrenic or bipolar mates. There are other studies that have demonstrated how common it is for neurodivergence to cluster within families and friend groups. I wonder how mate selection is factored into this research.
That's fascinating. Do you have a link to the "9.25 more likely" study? I see those partnerships all around me in real life but I'd never seen anything proving how common it is. Also, I see a lot of ADHD + ADHD marriages.
The one I identify is with oppositional defiant disorder or the way I call it " extremely boundaries " .If im honest , saved me from a lot of problems .
But is the hyperfocus that comes with adhd special interests not a form of neuroticism and sometimes or often leading to perfectionist outcomes?
I often dont start .task because i feel overwhelmed by the need to deliver perfection by doing the task.
Other times, i deliver way beyond what was asked and expected when a subject catches my interest.
Also, i didn't see auditory processing disorder mentioned but i imagine youre only covering the major comorbidities in this short excerpt.
There is also a risk to us as one our parents likely had ADHD. It was my father and he admitted to me he dropped me DOZENS of time as a baby..forgot me on the table until i fell..or he heard me fall down the stairs. I think he was feeling guilty about my rage.
A (completely unfounded) theory I have is that when someone has only one disorder, they are more likely to be able to 'pass' in normal society. When you have multiple interacting disorders, you are more likely to end up getting diagnosed for one, and while you are dealing with one disorder the other is more likely to be discovered. Is this a measureable/significant factor?
Is there a chart for the co-occurrence for Tourette’s and ADHD? Because I’m currently being evaluated for TS and I know ADHD and TS both effect the basal ganglia which involves motor, and as you put it “broken switch of private vs public thoughts”
Wow that mental map graph is absolutely a hot mess... as someone who does a lot of data science this visual drives me nuts!
What would be better?
I think it's a really clear depiction of the strength of connections.
Yeah I find it really clear lol
It looks messy but I can't think of a better way to depict this particular data
@@eliad6543 A correlation table that includes both effect size and p-value!
Hi Dr Barkley, I'm not sure if you read the comments on these older videos or not, but I am very curious. I was diagnosed in adulthood with both ADHD and OCD after being misdiagnosed with MDD for most of my life. And the more I learn about these disorders and myself, the more my doctors and I are extremely confident that both labels seem accurate.
But looking at your video, as well as other research on the topic, I was surprised to see that it seems these disorders normally have very little correlation and rarely coexist, what do you make of that? I know for certain I have OCD, my obsessive/compulsive thoughts and behaviors are fairly textbook, and as far as labels are concerned I fall very neatly into the ADHD bubble as well. I also find myself completely relating to the content in your videos in that regard without any dissonance. Should I be worried that my doctors and I might be treating my problems incorrectly? Or is this something that can happen, and I am just a statistical outlier?
I think the issue here is what I view as a one way comorbidity. Having ADHD does not increase the odds of having OcD by much if at all. Rates of OCD in ADHD people is 4% or less. We see a similar situation with the condition of Tourette’s Syndrome. However, if you have OCD or TS, then the odds are considerably higher that you may have ADHD. One reason for such a finding is that OCD and TS involve deeper brain structures such as the basal ganglia and striatum and so networks built on top of and reliant on them may lead to ADHD if they impinge on the EF networks. But disorders of the EF networks are at a higher level in the brain hierarchy and thus don’t interfere as much with the lower brain structures. Hence they don’t lead to OcD or TS but the latter disorders, disrupting lower structures in the brain hierarchy can give rise to disorders perched at higher levels above them. Confusion can also arise due to CDS, the other attention disorder, being more common in OCD but being misdiagnosed as ADHD. It makes it appear as if ADHD is more common in OCD when it’s really CDS that may be so. Just my two cents.
@@russellbarkleyphd2023 Thank you so much! This was an incredibly helpful description, especially your mentioning of CDS. Which, to be honest, is a disorder I have never heard of, and has never been mentioned by any of my psychiatrists. Doing a bit of digging, I honestly think you might be correct that CDS could be a more accurate label for me than ADHD, as it actually does accurately describe some symptoms I have had that didn't fit neatly into the labels of OCD or ADHD. In fact, I feel like my world's been shaken up a bit reading through articles on the disorder haha, the symptom list is eerily familiar to my own life.
In your opinion, would I possibly find benefit in seeking out a professional that has a better understanding of CDS? I have long been seeing psychiatrists and a therapist for my existing disorders, but they have mostly been treating me in the standard ways you would treat ADHD/OCD. I don't believe my current psychiatrist is familiar with the label, as I have told her of many of these symptoms, but she has stuck with the usual ADHD path that one would expect. Treatment has been helpful and I somewhat have my life together, but I certainly still have significant struggles in my day-to-day life that I have to deal with.
I love the bumper sticker, haha!
Does this information include studies done on women and children?
It's really frustrating not being able to do my internship with you.
Very cool graphic esthetics, shame the subject is a downer...
Admin - New mic is clipping, maybe a slightly bigger distance is better, or position lower.
The Fun Russ is great!
Thanks! I will try it. So much to learn for this old dog.
Thanks for great videos dr Barkley. What are your thoughts on TMS treatment for ADHD? I couldn't find any videos about this from you. Is the topic worth exploring or rather it is a scam? :)
I have discussed some of the studies in my weekly research review. A meta analysis found it doesn’t work effectively at this time. But the studies are very small and poorly done so we really don’t know.
@@russellbarkleyphd2023 Thank you for the answer.
what is your opinion around CPTSD at the same time as having ADHD. I have CPTSD, and just got the ADHD diagnose.(finaly at 36) I am new to you after my cousin who is a PsyD (psycologist) and he recommended me to listen to you and you allready give me goosbumps, never have I heard any talk about "me" this accurate.
what about "thought disorders" comorbidity, where there could be considerable overlap with the frontal-striatal circuitry (the 'what', as you mentioned in one of your previous lectures) with ADHD?
I thought that asd and adhd would have a stronger genetic relationship given that up to 60% of asd people have also adhd,somethink is wrong here or i did not fully understood the presentation
Me, too
See my comment above.
How to find best teachers for 6 year old going into kindergarten?
Watching these videos are kind of disheartening since I can not get proper treatment and I'm already old at this point. Good video, anyways.
Thank you so much for what you do 🙏
Is there some study analyzing the long term use of stimulants by a non ADHD person? My doubt is around a possible mistaken diagnosis where would have a use of stimulant in a normal dopamine and noradrenaline level
Not that I know about but you can use Google scholar to search the journals for such studies. Keep in mind that people without ADHD using stimulants are likely abusers using much higher doses as well as nasal sniffing or intravenous delivery and so a detrimental effect of brain status would be expected for them.
I'm curious about the link b/t ADHD and OCD. I was under the assumption that up to 30% of people with OCD also have ADHD, but this chart suggests a much less strong relationship?
Not sure if you've heard this dad joke. "Where do dads store all of their dad jokes? In the Database"
When associated disorders are at such a high comorbidity rate due to behavioural observational diagnostic criterium that they "occur" due to perceptions and diagnostic history. Burnout would have been depression on here
How about narcissism?
A "bulemia demon" jumped on me when I was 16 in 1984. I have aspergers/adhd. The bulemia thing didnt stick though, due to; failure to make myself sick......was a gross idea........didnt make logical sense......bad memory gets in the way of forming some habits
So I have ADHD and have OCD and have been recovered from OSFED. (Other specified feeding or eating disorder)
I developed the OCD though in highschool as well as the OSFED. I also have dyscalculia
and another question if I don't bother: is it possible that people show more signs (or symptoms?)of ADHD after trauma and shock?
COVID and lockdown and lies = trauma
@@truth-hurts3089 For some of us it was actually a very blissful time (albeit for a terrible reason) but for once ppl stopped demanding "do this, do that" cause they spent more time with themselves and less with the constant stress of work. Yet again other ppl developed a way better understanding of sensory issues after "getting back out" into the way too noisy world. Nature had a BLAST, too.
I'm sorry if you developed trauma and struggled to discern lies from "lack of information". Still, it's really no reason to make such off topic comments. What's the purpose anyway other than actually spreading more negativity and making ppl's ability to work together worse and worse??
@@KxNOxUTA because I have ADHD. And I believe as per diagram that I have chronic anxiety then trauma and PTSD since COVID. Since then I've had multiple interventions with local crisis teams. I didn't realise the strong correlation between ADHD and PTSD until I saw Drs graph. That's why. Alone struggling WFH &stressful job while being full time teacher to my 2young kids while struggling with ADHD wasn't exactly "blissfull" for me. It was the most difficult period in my life EVER.
Happy it was blissful for you though.
I have severe adhd. they only other condition impacting me the most is dyscalculalia, which I believe is associated with poor executive function
I thought it as going to be "a creeping vine"
Interesting. It doesn't seem to show a link between ADHD and austism, I thought that they tended to run together in families.
You get a like just for the dad joke … groan! 😂
Comorbidity Man is my superhero name. 😝
yes yes I'm dying faster than my dad with dementia . Thank you