Conditions That Can Produce ADHD-Like Symptoms

Attention-deficit hyperactivity disorder (ADHD) is most often diagnosed in childhood. It is characterized by hyperactive, impulsive, and inattentive characteristics, but that doesn't always mean that every child or adult who exhibits these symptoms necessarily has ADHD. In fact, there are many conditions that are sometimes mistaken for ADHD.

If your child seems hyperactive—fidgety, impulsive, and inattentive—don't automatically assume that they have attention deficit hyperactivity disorder (ADHD). Anxiety, depression, learning disorders, physical health, and many other conditions can cause symptoms that look like ADHD, but aren't.

Environmental Conditions

Stress or a sudden life change, such as a move, parents' divorce, a death, financial difficulties, or even a new sibling, can sometimes lead to ADHD-like behaviors.

Likewise, neglect, parental/marital conflict, inconsistent discipline, bullying, abuse, and other stressors can negatively affect a child's emotional and mental health. This can lead to distraction, inattention, restlessness, hyperactivity, and "acting out" behaviors that can resemble, but have nothing to do with, ADHD.

Sleep Problems

Sleep disturbances can have a profound effect on the ability to focus. Other issues can include:

• Hyperactivity
• Irritability
• Slowed visual, auditory, sensory, and motor reaction times
• Mental slowness
• Impaired learning of information
• Decreased school performance

Insufficient sleep is also linked to increased risk-taking behaviors in teens. This can include things such as smoking, drinking alcohol, and taking drugs.

Mental Health Issues

Anxiety can manifest as restlessness, an inability to concentrate, impulsive reactions, and hyperactive behaviors. This anxiety can make it extremely difficult to sit still and control fidgeting.

Similarly, depression can cause lack of focus, forgetfulness, low motivation, indecisiveness, trouble getting started on and completing tasks, lethargy and sluggishness, disorganization, and sleep difficulties.

The disruptive behaviors and poor impulse control associated with oppositional defiant disorder and conduct disorder also can look like ADHD.

Bipolar Disorder

Bipolar disorder is a serious mental health condition characterized by extreme changes in mood, energy, thoughts, and behaviors. Symptoms of bipolar disorder can include:

• High energy levels
• Excessive talking
• Racing thoughts that make it difficult to concentrate
• Impulsivity
• Risk-taking
• Intrusive behaviors

Such symptoms typically occur during a manic or hypomanic episode. Because of this, it can also be confused with symptoms of ADHD.

Obsessive-Compulsive Disorder

Attention and concentration problems associated with obsessive-compulsive disorder (OCD) may appear to be ADHD-related, but when delving deeper, a clearer picture emerges. Attention problems may be related to overfocusing, and problems in shifting attention may be due to obsessive thinking.

A person with OCD may be slower to start and finish tasks because of the compulsive behaviors and rituals that they must complete first.

Substance Misuse

ADHD has been associated with a risk for substance misuse. A person who is misusing drugs and/or alcohol can also have behavioral symptoms that mimic ADHD. Such symptoms can include:

• Difficulty concentrating
• Problems with memory
• Restlessness
• Irritability
• Talkativeness
• Sleep problems
• Moodiness
• Academic or work difficulties

Autism

Children and adults on the autism spectrum can have symptoms that resemble ADHD. They may become overexcited, hyperactive, and impulsive in stimulating environments, tend to focus on only those things that interest them, have trouble shifting focus, struggle to understand social cues and boundaries, and experience social impairments.

High motor activity and problems with inhibition are common characteristics of both tic disorders and ADHD. Fidgeting, motor movements, and random noises may hint at ADHD, but tics are defined by rapid, repeated, identical movements of the face or shoulders or vocal sounds or phrases.

Learning Issues and Processing Problems

Similar to a person with ADHD, someone with a learning disability may struggle with issues of attention, processing, organizing, remembering and learning. Learning disabilities in reading, written language, and mathematics interfere with academic functioning, as can speech and language impairments and auditory and visual processing disorders.

A child who is gifted academically but not challenged in the classroom might display ADHD-like behaviors out of boredom, becoming inattentive, impatient, and disruptive. The same issues can also result from a poor educational fit, a classroom with a pervasive negative climate, a non-stimulating curriculum, or ineffective management.

Medical Conditions

Certain medical conditions can cause problems with attention, irritability, impulsivity, or hyperactivity. Examples include:

• Seizures
• Thyroid disease
• Allergies
• Iron-deficiency anemia
• Chronic ear infections
• Hearing/vision impairments

Even certain medications can trigger ADHD-like behavior.

The Importance of Testing and Accurate Diagnosis

ADHD and many conditions like it improve in many people with early intervention. This makes accurate, thorough testing and evaluation using an empirically validated approach so important.

During the evaluation process, the healthcare provider must rule out alternative explanations that might better account for ADHD-like behavior before arriving at an ADHD diagnosis.

To complicate things further, an estimated 77% of children with ADHD have comorbid conditions such as anxiety, depression, behavior issues, learning disabilities, sleep problems, and substance abuse. All of this must be accounted for in your child's treatment plan, which must be tailored to their needs and diagnosis.

Takeaways

Naming a problem is often the first, most important step in attending to it. A host of other conditions can mimic ADHD, each requiring a different treatment protocol. If you think your child might have ADHD, seek out a reputable psychologist who will provide thorough, accurate testing to pin down the issue—and ultimately, help your child achieve their potential.