ADHD seems to have really gained popularity among consumers. It may be that when individuals have difficulties with attention, labeling it helps makes sense of it. But whatever the reasons, research has found that we as clinicians seem to be overdiagnosing ADHD. And that overdiagnosing may be harmful!
ADHD can certainly contribute to a lot of legitimate difficulties for individuals. But there are controversies surrounding the ADHD diagnosis itself, especially among adults. One contributing aspect may concern attention. Attentional problems are not unique to ADHD; they occur as part of many disorders.
Concentration difficulties are actually one of the 9 symptoms of depression! Attentional problems are also commonly seen in anxiety disorders, PTSD, prolonged grief, borderline personality disorder, and a host of other difficulties.
There are a few key reasons for these impacts. First, disorders like major depression, generalized anxiety, and prolonged grief (among others) typically come along with high levels of rumination. Rumination is highly distracting and makes it difficult to attend to our environment. It also makes it difficult to gather information to inform how we may respond to stressors and other events.
Physical and emotional arousal is another reason multiple disorders impact attention. High arousal when experiencing anxiety or trauma triggers (think fight/flight/freeze response) distracts one from being present in the moment. This constant distraction can constantly steal one’s attention.
Lastly, a number of these difficulties are characterized by increased focus on negative information and difficulty attending to positive information. Attentional bias makes it hard to pay attention when we often fixate on negative content.
All these impacts on attention can have affects on other cognitive and emotional factors. Depression and anxiety often impact memory, for example. PTSD has similar effects on memory. This is because initially encoding information into memory requires paying attention to that information.
Overdiagnosis and harm done from misdiagnosing ADHD suggest that we as clinicians should pay extra attention to (see what we did there…) how a range of issues could be impacting clients’ attention. Are attentional difficulties actually due to depression, anxiety, or trauma? This assessment is key for us to learn how to most effectively help our clients.
