ADD & Secondary Disorders

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ADHD rarely comes by itself.  Studies estimate that upwards of 70% of adults who have ADHD have a secondary issue, sometimes more. The most common are Depression and Anxiety, perhaps the result of having undiagnosed ADHD. But there are numerous other disorders that overlap ADHD. Diagnosing is tricky, and teasing out what is going on can take time. And, yes, I know, we’re impatient. We want things NOW!


What are co-morbidities?

DR. MUGGLI: ADHD commonly occurs with depression, OCD.  It could be a thyroid issue.  You know, if you’ve ‑‑ it could be several different things.  It could be a mood disorder.

Dr Kurtz: If your child has ADHD, if we make a good diagnosis, they have a 40 percent likelihood of also having ODD, a nasty kissing cousin of Oppositional Defiant Disorder.  And that’s separate from the ADHD.  Kids who break rules, they’re defiant, they say no more often than other kids.  And that really complicates or flavours the issues.

Pat McKenna: Do Add’ers have a lot of learning disorders?

Dr Kurtz: They have a reasonable chance, an elevated chance, of having a learning disability.  They have an elevated chance of also having a language disorder.

DR. MUGGLI: It’s very common, you know, if you are constantly feeling like you can’t get it done right or you’re not reaching your potential or if you could just only do it the way everyone else does, then you would feel, you know…  And that affects your self‑esteem and your mood and everything else over the years, so, you know, then you have these people with ADHD and depression or low self‑esteem, you know, so.

DR. ADLER:  When someone comes into my office, you know, the real world things that they often complain about are some of the consequences of ADHD.  It may be some of their educational (inaudible) or some of their difficulties on the job.  Sometimes it’s some of the (inaudible) conditions, the travel with ADHD, that they’re thinking about it.  It may be that they’re presenting for depression that’s been chronic and it’s actually the ADHD that has been present.  It doesn’t mean they don’t have a history of depression, but the ADHD is there.

And sometimes the depression has been treated and hasn’t responded until the ADHD is diagnosed.  Sometimes it’s that they recently obtained a promotion, actually, and they have more to manage and their symptoms come forward.  It’s not that they weren’t there, it’s that the increases (inaudible) increases.  Sometimes it’s a family member has been diagnosed with the condition and they see the symptoms in themselves.  Those are some the common presentations.

DR. MUGGLI: And one of the other things that we would do a lot of times is we do neuropsychological testing here too to really tease out is it really a problem with inattention or if they have some other mood component going on, we would also want them to get psychological testing to make sure that it’s not something else, or, you know, going on with them that’s causing the inability to focus and pay attention.

Dr Kurtz: Every ADHD kid is not like every other ADHD kid.  In fact, one of the greatest things I ever heard is, you’ve seen one kid with ADHD, you’ve seen one kid with ADHD

One Reply to “ADD & Secondary Disorders”

  1. Hi!! I am enjoying this site tremendously. I wanted to add (oopppss….ADHD) one comment about the one kid with ADHD that I know about. My middle son Roque; he was always so incredibly different from my first son (different fathers for both). None of my parenting skills that worked so well with #1 worked at all with #2. At times I felt he couldn’t possibly have come out of my body…….because I didn’t understand him at all.

    It became clear in Kindergarten that Roque would need help in Grade 1; we had him extensively tested over that Summer. Lo and Behold! He had ADHD. He also had a Learning Disorder: they called it an “Auditory Processing Problem”. I was flabbergasted on one hand, and relieved on the other—to find out that he wasn’t really an Alien, and to learn how to talk with him so that he could understand.

    It is odd to me. A few years previously, I had taught Parenting Skills to parents with At Risk children. They all wanted the drugs; I wanted to teach actual parenting skills. I used PET, that teaches how to use Natural Consequences for behaviors, or use Logical ones sometimes. But in the present, I was using every possible parenting skill I could to help Roque, and it still wasn’t enough. I kept him on a strict schedule, always telling him about 5 minutes ahead of time when we were going to change activities. I minimized distractions in the house. I always let him play outside, as appropriate, because he absolutely needed all that activity. I helped him to learn things for school using several different modalities, like tracing letters on mild sand paper, to activate his kinesthetic system. In school, the first word he learned to write was when they let all the kids dip their bare feet into colored paint and then “walk/paint” a rainbow!! Roque learned RED! He was so excited and happy. I also carefully structured his diet; we did not eat foods that were not found in nature.

    Anyway (SEE! I have ADD, too! I tell stories that go all around the barn!!)…….Anyway, we put him on Ritalin, and it helped him immensely. Roque had begun to have problems interacting with other children his own age. He thought if a joke was funny, it should be funny ten times. He couldn’t read social cues, so he played well with children one or two years younger than he was. He even played well with my youngest son, his baby brother, who was 4 years younger. They played so well together….. Somehow, the Ritalin helped him to focus at school, plus he was in a Special Ed class where the teacher let all the kids work standing up at the blackboard—-which I thought was brilliant.

    I wanted to comment at how much Roque fit the profile the doctor talked about above. I wish I could give you more insight into how he grew up, what his interests were, what kind of impact Roque made on the world, but Roque died in 1993. He got a rare illness and died within six weeks. You can read more about his last weeks of life at or you can google his name: Roque Wikstrom Aguilar. Doctors still don’t know what causes KD, and their only treatment is boosting the child’s immune system with IVIG……but it didn’t work. The most devastating symptom of Kawasaki disease is the development of coronary artery aneurysms, and if they continue to grow like Roque’s did, then they are called Giant CAA. He collapsed in my arms, I did CPR on him in the ambulance, I had to tell the doctors when it was time to stop CPR, and I held him in my lap until he grew cold. It is the most horrible thing that ever happened to me in my life.

    Harold, thank you for all the laughs you have given me through the Red Green Show. And thanks to all of you involved with this website. I have my own diagnosis of ADD now, and I take Vyvanse to try to help it, and various anti-depressants ever since my little boy died. My marriage ended, but both my other sons are doing well. And I am a Grandmother now! I am not particularly happy, because even happy things are so bittersweet. But I am surviving.

    Thanks for listening.

    Namaste, Nina Wikstrom Aguilar

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