What are the most common co-morbid conditions for people with ADHD?

If your first thoughts were depression, OCD, anxiety, or learning disabilities, you’re on the right track. In fact, about half of people with ADHD also have at least one other condition, and these are just a few of the front-runners.

One co-morbidity you probably didn’t think of immediately is chronic pain – yet, studies estimate that around a quarter of chronic pain patients are also diagnosed with ADHD.

Attention Deficit Hyperactivity Disorder (ADHD) and chronic pain may seem like unrelated conditions at first glance, but a closer look reveals a surprising connection between the two.

Just as individual threads of yarn become intertwined and knotted, making it difficult to separate and untangle them, ADHD and chronic pain can be closely interconnected, each exacerbating symptoms of the other, making it challenging to address them separately.

The Prevalence of ADHD and Chronic Pain

ADHD is a neurodevelopmental disorder that affects approximately 5% of children and 2.5% of adults worldwide. Its symptoms include inattention, impulsivity, and hyperactivity, which can cause significant difficulties in daily life.

Chronic pain, on the other hand, is a persistent pain that lasts for three months or longer, affecting around 20% of the global population. Causes of chronic pain vary widely, ranging from injuries and surgeries to long-term conditions such as arthritis or fibromyalgia.

Interestingly, studies have shown that individuals with ADHD are more likely to experience chronic pain than those without the disorder—and vice versa. In fact, one study found that about 25% of people with Fibromyalgia also had a diagnosis of ADHD.

The Surprising Link: Exploring the Connection

This link has been studied for a long time. One of the most well-known symptoms of ADHD is difficulty with attention and focus. We also know that when someone has chronic pain, their attention span suffers, and that people with ADHD feel more pain than those without ADHD.

Symptom-wise, there’s also a lot of overlap. Both ADHD and chronic pain can cause:

• Distractibility
• Sleep Issues
• Difficulties sustaining or dividing attention
• Difficulty finishing tasks
• Inability to inhibit irrelevant stimuli
• Emotional dysregulation

Unfortunately, what we don’t know yet is why ADHD and chronic pain are connected. At least, not with certainty. One theory is neuroinflammation – that is, inflammation in the brain – because it’s seen in both people with ADHD, and in people with chronic pain. Other possibilities include:

1. Shared neurological pathways: Research has shown that both ADHD and chronic pain are associated with alterations in the brain's dopamine and serotonin systems. These neurotransmitters play crucial roles in regulating pain perception and attention processes.
2. Emotional and psychological factors: Individuals with ADHD often experience anxiety, depression, and emotional dysregulation, which can exacerbate chronic pain. Similarly, chronic pain can lead to increased stress, anxiety, and depression, further complicating ADHD symptoms.
3. Stress: Chronic stress has been linked to both ADHD and chronic pain. High levels of stress can worsen ADHD symptoms and contribute to the development or persistence of chronic pain.

Regardless of the cause, treatment for both ADHD and chronic pain is complex.

Current treatments for ADHD

• Coaching/therapy for associated social, emotional, and other trauma
• ADHD Coaching to support daily functioning and work/school success
• Stimulant medication to support or improve brain function, and enable the success of therapy and/or coaching

Current Treatments for Chronic Pain

Chronic pain, on the other hand, has largely been “treated” by trying (and in many cases, failing) to alleviate the severity of symptoms. Some treatments include:

• Coaching/therapy for associated social, emotional, and other trauma
• Physical therapy
• Chiropractic
• Anti-depressant medication
• Opioids and other pain medication (though, these are becoming more and more difficult for patients to access)
• Alternative medicine such as massage, acupuncture, or marijuana, where legal

Why Does it Matter?

Figuring out how the two are connected could have huge implications for the treatment of both conditions. For example, if neuroinflammation is indeed causing or worsening symptoms, then eliminating or reducing inflammation could become a new treatment for people with ADHD and chronic pain.

Given that both chronic pain and ADHD share some common features, such as impulsivity, restlessness, and problems with focus and attention, it is not surprising that the two disorders often co-occur. When this happens, it creates a unique challenge for clinicians who must treat both conditions simultaneously. A comprehensive approach is needed to manage patients with overlapping symptoms. In order to optimize treatment outcomes, it is essential to understand the relationship between chronic pain and ADHD.

A skilled coach or professional, much like a patient person carefully working to untangle the yarn, can help individuals with ADHD and chronic pain to unravel the complexities of their conditions, addressing the root causes and working towards lasting relief and improved well-being.