Conditions That Can Produce ADHD-Like Symptoms

Certain conditions can mimic ADHD, which can lead to misdiagnosis

By

Keath Low

Updated on August 03, 2024

Medically reviewed by

Aron Janssen, MD

Mother and son playing with blocks — Comstock Images / Stockbyte / Getty Images

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.

At a Glance

People with ADHD often have characteristics such as high energy, problems focusing, and impulsive behaviors, experiencing these symptoms doesn't always mean you have ADHD. In fact, sometimes these symptoms can be a sign of another condition, such as stressful life events, sleep issues, or mental health conditions. Getting an accurate diagnosis is important to get the kind of treatment that is right for your needs.

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.

If you observe an increase in these behaviors following a stressful event, it's crucial to seek ways to support your child in coping with the upheaval they have faced. But it’s also essential to remain vigilant about these symptoms; your child may also be displaying signs of ADHD. Don’t disregard potential symptoms as being stress-related when they could be linked to 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.

The underlying reasons why kids may struggle with sleep can vary. Poor sleep habits are sometimes the culprit. However, medical conditions that disrupt the sleep cycle, such as sleep apnea, restless legs syndrome, and other sleep disorders, can also play a role.

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.

Adverse mental health also affects sleep, in turn resulting in the sleep issues mentioned above. These are all symptoms that can resemble ADHD but may be unrelated.

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.

Anxiety, depression, and disruptive behavior disorders (as well as the conditions listed here) commonly occur alongside ADHD. Each can be a separate disorder with distinct etiology and treatment needs, or each may be a secondary condition that develops as a result of the problems associated with ADHD.

This is why assessments of ADHD must gather and integrate specific information about emotional functioning, rather than focusing exclusively on the overt disruptive behavioral symptoms.

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.

ADHD and learning disorders often occur together, but they are separate conditions.

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.

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