The Link Between Mental Health and ADHD Is Strong, so Why Aren’t We Paying Attention?

Summary: An ADHD diagnosis is more predictive of poor mental health outcomes than other neurodevelopmental disorders such as autism.

Source: University of Bath

Adults with high levels of attention-deficit hyperactivity disorder (ADHD) symptoms are more likely to experience anxiety and depression than adults with high levels of autistic traits, according to new research led by psychologists at the University of Bath in the UK.

This study is the first to show that ADHD is more predictive of poor mental health outcomes in adults than other neurodevelopmental conditions, like autism.

Until now, there has been a dearth of information on the effects of ADHD on poor mental health, with far more research focusing on the impact of autism on depression, anxiety and quality of life. As a result, people with ADHD have often struggled to access the clinical care they need to cope with their symptoms.

The authors of the study hope their findings will trigger new research into ADHD and ultimately improve the mental health outcomes for people with the condition. ADHD is a neurodevelopmental condition characterised by inattention and/or hyperactivity and impulsivity. The condition is estimated to affect between 3% and 9% of the population.

Blue Monday

Speaking on Blue Monday (January 16) – the third Monday of January, described by some as the gloomiest day of the year – lead researcher, Luca Hargitai, said: “Scientists have long known that autism is linked to anxiety and depression, but ADHD has been somewhat neglected.

“Researchers have also struggled to statistically separate the importance of ADHD and autism for mental health outcomes because of how frequently they occur together.”

Ms Hargitai, a PhD Researcher at Bath, added: “Our aim was to precisely measure how strongly ADHD personality traits were linked to poor mental health while statistically accounting for autistic traits.”

The new research – a collaborative effort between the Universities of Bath, Bristol and Cardiff, and King’s College London – is published this week in the prestigious journal Scientific Reports. It comes in the same month that two British TV personalities – Johnny Vegas and Sue Perkins – have opened up about their recent diagnoses of ADHD.

“The condition affects many people – both children and adults – and the fact that more people are willing to talk about it is to be welcomed,” said Ms Hargitai.

“The hope is that with greater awareness will come more research in this area and better resources to support individuals in better managing their mental health.”

Overly active, as though driven by a motor

The study used a large, nationally representative sample of adults from the UK population. All participants completed gold standard questionnaires – one on autistic traits, the other on ADHD traits – responding to statements such as “I frequently get strongly absorbed in one thing” and “How often do you feel overly active and compelled to do things, like you were driven by a motor?”

The researchers found that ADHD traits were highly predictive of the severity of anxiety and depression symptoms: the higher the levels of ADHD traits, the more likely a person is to experience severe mental health symptoms.

Through innovative analytical techniques, the study authors further confirmed that having more of an ADHD personality was more strongly linked to anxiety and depression than autistic traits.

These results were replicated in computerised simulations with a 100% ‘reproducibility rate’. This showed, with great confidence, that ADHD traits are almost certainly linked to more severe anxiety and depression symptoms in adults than autistic traits.

Shifting the focus of research and clinical practice

Ms Hargitai said: “Our findings suggest that research and clinical practice must shift some of the focus from autism to ADHD. This may help to identify those most at risk of anxiety and depression so that preventative measures – such as supporting children and adults with the management of their ADHD symptoms – can be put in place earlier to have a greater impact on improving people’s wellbeing.”

According to Dr Punit Shah, senior author and associate professor of Psychology at Bath, another important aspect of the new study is that it advances scientific understanding of neurodevelopmental conditions.

“By addressing the shortcomings of previous research, our work provides fresh information about the complex links between neurodiversity and mental health in adults – an area that is often overlooked.

“Further research is now needed to delve deeper into understanding exactly why ADHD is linked to poor mental health, particularly in terms of the mental processes that might drive people with ADHD traits to engage in anxious and depressive thinking.

“At the moment, funding for ADHD research – particularly psychological research – is lacking. This is especially pronounced when you compare it to the relatively high level of funds directed at autism.

“As the evidence becomes clear that ADHD isn’t just a childhood condition but persists throughout life, we must adjust our research agendas to better understand ADHD in adulthood.”

This shows the outline of a brain
The researchers found that ADHD traits were highly predictive of the severity of anxiety and depression symptoms: the higher the levels of ADHD traits, the more likely a person is to experience severe mental health symptoms. Image is in the public domain

Commenting on the new findings, Dr Tony Floyd, CEO of ADHD Foundation, The Neurodiversity Foundation, said: “This research demonstrates clear evidence of the increased risks of mental health comorbidities associated with adult ADHD. This is a step towards recognising the broader impact of unmanaged and untreated ADHD. We hope this research will lead to more research being commissioned in this area. We also hope it will result in changes to the design and delivery of health services.

“The cost implications to the NHS of leaving ADHD untreated, and the need to better train health practitioners in both primary and secondary care, are now more apparent. And of course there are other costs too that need to be considered – to the health of UK citizens with ADHD and to their family life, employability and economic wellbeing. These costs are often hidden but they are considerable.

“This research from Bath University will add to the growing national debate and the business case for a national review of health services for ADHD across a person’s lifespan.”

About this ADHD and mental health research news

Author: Chris Melvin
Source: University of Bath
Contact: Chris Melvin – University of Bath
Image: The image is in the public domain

Original Research: Open access.
Attention-deficit hyperactivity disorder traits are a more important predictor of internalising problems than autistic traits” by Punit Shah et al. Scientific Reports


Abstract

Attention-deficit hyperactivity disorder traits are a more important predictor of internalising problems than autistic traits

Autism Spectrum Disorder (ASD) and Attention-Deficit Hyperactivity Disorder (ADHD) are both linked to internalising problems like anxiety and depression. ASD and ADHD also often co-occur, making their individual statistical contributions to internalising disorders difficult to investigate.

To address this issue, we explored the unique associations of self-reported ASD traits and ADHD traits with internalising problems using a large general population sample of adults from the United Kingdom (N = 504, 49% male).

Classical regression analyses indicated that both ASD traits and ADHD traits were uniquely associated with internalising problems. Dominance and Bayesian analyses confirmed that ADHD traits were a stronger, more important predictor of internalising problems.

However, brief depression and anxiety measures may not provide a comprehensive index of internalising problems.

Additionally, we focused on recruiting a sample that was representative of the UK population according to age and sex, but not ethnicity, a variable that may be linked to internalising disorders.

Nevertheless, our findings indicate that while ASD and ADHD uniquely predict internalising problems, ADHD traits are a more important statistical predictor than ASD traits.

We discuss potential mechanisms underlying this pattern of results and the implications for research and clinical practice concerning neurodevelopmental conditions.

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  1. What i do seem to understand is that there is a difference in behaviors when you are a victim of being misdiagnosed. This can be devastating to someone who is desperately trying to get help, just to move on with their lives. Finding their niche, career, spouse, friends and all that life seems to be about. And not getting a proper diagnosis,that misdiagnosis that may follow someone for a lifetime, has the power to make ones life at the mercy of public assistance, as they can not mentally take on challenges that lead to being self reliant. We need help! We need to get more real solid help out to people suffering with mental illnesses.. and not think this is a way of ‘getting out of our responsibilities

  2. Just a thought. If ADHD is an emotional state are the sufferers over-sensitive and therefore, perhaps, have a lack of confidence in themselves which increases anxiety and leads to depression.
    We cannot think positive if we lack the emotion of confidence.

  3. I ha e had adhd since childhood.
    As an adult ppl who knew me in my teens, when I was in the midst of impulsive, reckless behavior, they now comment, ” we knew you had adhd”. However these clinicians did nothing.

    I was engaged 4 times, failed to finish 2 different graduate programs, which proves I couldn’t complete my goals.

    I also have had PTSD, since childhood. 2014 I was attacked and assaulted, that trauma exacerbated my adhd.

    My adhd annoyed others too. I had no idea how my near constant fidgeting and restlessness affected others. M

    A major intervention, by family, colleagues, and clinicians, was done. It was strongly suggested that I go to a 30 day out patient program for evaluation. I had no medical coverage at the time.
    My Nurse Practioner advocated fir me and I was provided free care by the facility.

    Initially I was put on a very low dose of Adderall it helped for a few hours.

    18 months later, I got to see a psychiatrist who specialized in adhd/adolescents. He tweeked my dosage by adding a Time release

    Once I started taking the proper dose of Adderall, for my condition, if there was a family event my siblings would say ” Did you take your meds”.

    Slowly I started improving.
    This continued until he left and a saw a Nurse Practioner, who thought Mt dose was too high. It was my first visit and despite the fact I was stable and doing good on this dose, he cut my dose.

    The problem I find is FEW CLINICIANS, even know how to evaluate the proper titration for an individuals dosage.

    One dose does not fit everyone!
    It’s the equivalent of everyone having the same prescription for eye glasses !
    The fact that my adhd had not been treated until I was 59, is worth noting.

    Prior to my intervention I
    tried treating my adhd with caffiene, 3 pots a day. Such a level of caffiene, caused me to see a specialist in Boston, where I had to be DETOXED from the caffiene. It was 2 weeks of horrific headaches.

    I have done more research on adhd than most clinicians I have met.

    I was misdiagnosed with depression, I wasn’t depressed I was frustrated because I couldn’t focus, complete various tasks and felt hopeless because of it.

    Presently I am back on the dose that the psychiatrist had prescribed.

    It’s not a panacea, I meditate, pray and exercise and take my medication.

    Recently,my nephew, was having major behavioral issues at school. In the 1st grade he was suspended from school.

    Finally he was thoroughly evaluated for adhd.
    He stated medication and therapy, last week he won a prize at school for being THE BEST ROLE MODEL !
    A far cry from last years suspension !

    I am so happy for him. I admit I wish that could have been my experience.
    I am just grateful that I was finally evaluated properly by Dr. Kazi and presently on the dose that I need.

    The only problem is the shortage of the medication that I need. Each month I am scrambling around looking for a pharmacy that has it in stock.

    This too shall hopefully pass.

  4. “ADHD isn’t just a childhood condition but persists throughout life”
    [It affects] “family life, employability and economic wellbeing. These costs are often hidden but they are considerable.”
    [And] “the higher the levels of ADHD traits, the more likely a person is to experience severe mental health symptoms.“
    Nonetheless, the cure for ADHD symptoms might be a simple as getting oneself into a regular sleep routine — and staying on it come hell or high water.

    1. No it really isn’t that simple. You obviously don’t understand ADHD at all.
      Yes some people with ADHD struggle with sleep patterns but the lack of sleep is a symptom not a cause.

  5. Those of us who exhibited ADHD behaviors in the 40s and 50s before the syndrome was identified suffered from often being told we were lazy and dreamers. Our parents were frequently blamed for the bad parenting that caused our poor behavior. When ADHD was first recognized, we were told that we grew out of it and I remember a psychiatrist in the 1970s telling me, a psych grad student, that I could not have ADHD any more and my problems were anxiety. It’s nice to see the progress that is being made in understanding the behaviors and the co-morbid problems that often partner with ADHD.
    As an old guy of 80,I am confident that the new generations will fare better that my generation did because of studies like this.

    1. Attention is the highest level of function of brain. A disruption to any underlying process will result in an impact in one’s ability to attend.

      Studies like this truly confused me as they appear to have it the wrong way around. It’s like saying death is highly indicative of cancer, so we need to fix the problem of death. No, no you don’t.

      Fix the underlying issues that are resulting in attentional difficulties (depression, anxiety etc) and you go a long way to removing the ADHD.

  6. I am shocked that a basic system cant tell my what is wrong. It just says seek medical help. I dont know any more.

  7. Its nice to be seeing more information about the comorid effects that result from having ADHD. But as a perso who has stuggled with severe ADHD all of my 52 years of life, i think the biggest problem here in the U.S. that needs to be talked about is the lack of access to the type of specialized healthcare that is needed to adress this disorder. I know personally that as a person who is considered disabled under law, it is very difficult to find a psychatrist who specializes in adhd that accepts medicare and publicly provided secondary healthcare services. Almost all of the psychiatrists(at least where i live in phila. Pa) do not accept medicare as payment. So getting proper diagnosis, proper treatment and specialized counciling and proper medication doses becomes the issue for those people who cannot afford to pay their very high out of pocket costs for treatment. Its good to talk about adhd and its high rate of effects on other problematic psychological problems is good, but maybe we should focus and start having conversations about the lack of the proper healthcare services offered to the public and why the specialists in this field dont accept goverment provided insurance payments should be first adressed so people can feel empowered by the info obtained by reearch on this subject. I have not been able to find a medical doctor who specializes in Adhd and accepts medicare, to monitor the large dose of medication i take daily for over 10 years now. It is very difficult to understand why this country does not see the value in providing the much needed healthcare options to those who suffer with adhd and the other problematic psychological disorders that often coexist. Having nore information about adhd is good but knowing that there is very limited access to medical professionals who are properly trained in its treatment, feels very defeating. I could go on and on about this and my personal experience in managing life with adhd,but i just wanted to make a suggestion about what i think needs to be adressed and conversations that need to be had before wetalk about the statistics and research findings regarding adhd and apparant links to other physical and mental healh disorders. I think muvh more education is needed at tbe primary care level since those are the doctors who are actually dealing with it and many lack the information necessary to properly treating and medicating their patients who suffer with adhd. Thanks very much.

      1. 100% Agreed! Thank you for posting. I’m 48 have had ADHD all of my life. It was until 2017 that I had a comprehensive evaluation through rater forms and neuro feedback. It was a relief to know that I had it, but I also feel the label has exacerbated my anxiety and depression. I had low confidence most of my life, but a fighting spirit. I’d want to prove others wrong who believed I “couldn’t do it.” I was told how disorganized, forgetful, and dingy I was. I’ve had over 6 years of psycho therapy, frequently use the CBT method to cope with anxiety. I also meditate, pray, and exercise. But with all of the things I do, I feel my obtrusive thoughts are non stop, I annoy most because I talk so much and I have severe insomnia. I also come from a troubled family so my ADHD is co morbid with severe CPTSD. Thankfully, I have a higher education and make a decent income, but I just have little to no interest with my career and I get bored quite easily. If I’m triggered (which is often) by my past, it takes a lot of mindful breathing to regulate my emotions. I don’t know. I feel so misunderstood. I am a gentle human being and have an immense amount of compassion, but I don’t always get it back. I’m really just surrendering these days. I also take Vyvanse, but it doesn’t always work. There’s so much more clinical training and resources that need to be available for clinicians and their clients. Two of my children have it as well. We are all motor mouths.

  8. What about people like me who have been diagnosed with all of those and more? Anxiety depression OCD gender dysphoria ADHD combined type autism childhood post-traumatic stress disorder adverse child experiences etc or what about people just like this article talks about who have anxiety depression autism and adhd? We really get swept under the rug but there’s a lot of us

    1. They literally said this study highlights the need to consider comorbidities associated with depression other than autism… That implies all comorbidities (with ADHD being the highlight). In other words – many conditions are being overlooked in favor of autism/depression research and this study hopes to begin changing that… Obviously, they can’t research every single condition in one study

    2. Ppl on spectrum only to find out decades later have more then add,
      As stated “spectrum ” know see
      I know dna.
      And experienced, with formal diagnosis, and a fault of; I produced 2 success members of society; so far.ppl that r not on spectrum NEED to recognize ppl on the spectrum and what they produce to society, and ask how “they” did with fault and trauma…..

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