ADHD

 

Co-occurring Disorders

 
 

Attention-Deficit/Hyperactivity Disorder (ADHD) is characterized in the American Psychiatric Association’s Diagnostic and Statistical Manual Vol.5 (DSM-5) as a pattern of “inattention that interferes with functioning or development.” Children with ADHD tend to exhibit behaviors that include an inability to stay on task, an inability to focus and being disorganized—behaviors that are not due to rebellion or comprehension issues. In adults with ADHD, that tendency for hyperactivity appears as restlessness or wearing others down with activities. Impulsive behaviors and social intrusiveness (e.g. excessively interrupting others) are also symptoms of those with ADHD. 

ADHD is estimated to occur in around 5-percent of children and 2.5-percent of adults. There is some research suggesting that those with Borderline Disorder have a higher incidence of ADHD as a co-occurring disorder. According to the Mayo Clinic, ADHD can co-occur with other mental health disorders that are commonly associated with Borderline Disorder, including anxiety, depression and Bipolar Disorder. This is another illustration of how difficult a diagnosis of Borderline Disorder can be for professionals to determine. 

There are three types of ADHD:

  • Inattentive: Symptoms relating to inattention (e.g., focus, organization, follow through)
  • Hyperactive-Impulsive: Symptoms relating to impulsivity or hyperactivity (e.g.,  constant motion, interrupting, fidgeting). This type is most commonly seen in boys.
  • Combined: A mix of Inattentive and Hyperactive/Impulsive symptoms. This is the most common type of ADHD diagnosed in the United States.

How a health professional chooses to treat ADHD has a huge impact on children who may develop Borderline Disorder. Children displaying traits of ADHD are often treated with stimulant medications. Unfortunately, people with Borderline, regardless of age, typically do not respond well to stimulants. However, there are indications that if Borderline and ADHD do co-occur, mental health professionals who prescribe a low dose neuroleptic or antipsychotic agent to treat the symptoms of Borderline Disorder may enable a stimulant to produce a beneficial effect for the symptoms of ADHD. 

Because of the propensity to misdiagnose children who may have Borderline Disorder, these are important considerations for you to discuss with your child's clinician if believe your child has the symptoms of ADHD or has a diagnosis of ADHD as well as a diagnosis of Borderline Disorder. 

 

Sources Cited: 

  • Mayo Clinic Staff. “Attention-Deficit/Hyperactivity Disorder (ADHD) in Children.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 16 Aug. 2017, www.mayoclinic.org/diseases-conditions/adhd/symptoms-causes/syc-20350889.
  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. American Psychiatric Publishing, 2014.
  • Friedel, Robert O. “Borderline Personality Disorder Demystified.” Borderline Personality Disorder Demystified, 10 Feb. 2018, www.bpddemystified.com.