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Are the Comorbid Conditions of ADHD the Same Impairment?

By Christopher Hayes at 15 years old and later rewritten at 17 years old.

 

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Introduction

Hello, my name is Christopher, you may know me as the cartoonist for hi2u or as the son of Andy Hayes who created the hi2u website. I would like to start this article by telling you a little bit about how it was made. This was originally written when I was 15 years old however it was never published because I lost interest in it and stopped editing the last few mistakes out of it. A few days ago my dad found it on a disk using file recovery software and we both enjoyed reading it. Now I've decided to rewrite it (as it was hard to follow in parts) and update some bits of it which had not been included.

I am diagnosed with ADHD, Aspergers Syndrome, OCD, and ODD. This, I feel, gives me a fair amount of power to describe them from a user's point of view, and even describe other, similar, impairments, to a lesser degree. Either way I have known and learnt about most of these conditions for a fairly long time now - as ever since me and my dad thought I had ADHD I've been very interested in it and other conditions - so only a few required me to do research other than checking that my facts are okay, so I'm not just speaking a load of twaddle. I'd like to point out that I'm not a professional so if you want to act upon anything in this article I'd advise you to consult a professional first.

Myself and many others believe that some of the most common behavioural and recognition impairments are related. Currently these are called the comorbid conditions of ADHD, but I and others, feel strongly that they are all the same impairment merely displaying different symptoms.

One of the two names used in the original article was Neurological Processing Impairment, however, as I stated back then, the name wasn't set in stone. On the other hand, Neurodiverse (which was the main reason why I writ the article Why Not Call Disability, Disability?) seems a much better name for this. To quickly sum up the way I feel about the name "Nuerodiversity", I can give it credit for being a useful name which really sums up many of these conditions, however I feel that it was created because people were ashamed of the current labels used to describe these conditions. The article I've referred to - which was written around the same time the original article of this was written I think incidentally - covers how I feel about people trying to sugar-coat disability.

Now that I've introduced the concept of this family impairment, I would like to give a concise definition of the impairments covered and display them in 3 main categories that I have split them into. Behaviour Eccentricities, Attention Deficits, and Specific Recognition Disorders, however there's a forth group which doesn't really fit in with the others, this is called Involuntary Movement.

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Behaviour Eccentricities

The impairments in this category effect behaviour. The reason why ADD, ADHD and Hyperkinetic disorder are not included in this group is because they are less about how we see the world and more about how we act towards it (or, how the world sees us perhaps).

 

Autism

The symptoms of Autism, without other learning disabilities, mainly include fascination with things that "normal" people mostly overlook. The fascination can be with patterns, shiny things, smells (any smells), textures, theoretically sounds and anything else that is of interest to the senses. Another thing is that people with Autism normally are socially out of tune, not really weird or anything normally remember, but small things that most people do when talking like sharing eye contact, body language, smiling, and those sorts of things which often can't even be properly noticed by your average person, but will probably be noticed but just as something being a bit strange. People with Autism often take things completely literally - similes are not exactly the right way to talk around them - for more information on this trait of Autism see the section on Semantic Pragmatic Disorder which is a little further down.

Often people with fairly strong Autism are unable to see things from someone else's point of view. An example of this would be one of the first - if not the first - accurate way of testing for Autism. In 1985, Baron Cohen et al ("et al" is a posh way of saying "and a bunch of other people") used a test called the Sally-Anne test. Basically the it involves two dolls, Sally and Anne rather unsurprisingly, a marble, a basket and a box. The patient being tested watches as the psychologist puts on a kind of puppet show for the patient. With the help of the psychologist, Sally puts the marble in her basket and then walks out the room. After Sally leaves, Anne takes the marble out of Sally's basket and puts it into her box. Then Sally comes back (dramatic silence!) and the psychologist asks the patient where Sally will look for the marble. People without Autism are supposed to say that Sally will look in her basket, because Sally last saw it in her basket. However people with Autism are supposed to say that Sally will look in Anne's box. This is said to happen because people with Autism lack a "theory of mind" however not everyone with Autism have this problem, I have Aspergers (and as I've made clear in the section about Aspergers, I feel strongly that the name "Aspergers Syndrome" is merely saying Autism without severe learning impairments as well - in other words they are exactly same thing) and I wouldn't be able to get a diagnosis through the Sally-Anne test.

On the one side Autism - theoretically - sounds great, having a mind which can really appreciate and acknowledge the beauty and charm of the world in a way that other people normally can't. Being able to sense this beauty and charm in often the most mundane of objects, smells, sights, noises, just about anything, especially things that are quite interesting like holographic patterns and other things that "normal" people mostly take for granted and see nothing in. However on the other hand there is the social problems that go along with it.

 

Asperger Syndrome or High Functioning Autism

Aspergers is essentially Autism. I far as I can make out the only difference is that it doesn't include the other (often severe) learning disabilities which people often think are part of the Autism. And as I've only written about Autism in the Autism section (rather unsurprisingly) you should read that part, which is above, for information about Aspergers. People with Aspergers Syndrome might not display all the symptoms of Autism and might display them much weaker too.

 

SPD (Semantic Pragmatic Disorder)

This is also in the Autism family, it's essentially one symptom of Autism which is the one about taking things for their exact literary equivalent. What I mean by this is that, when I was little I got very upset when dad used to say that it was "raining cats and dogs" and even when I first wrote this article I would get annoyed when people said silly things like that, especially if they are used really out of context. I would like to add another symptom to this too, I think that wanting to correct mispronunciations and wrong words fits well into this category, this is something I do, but perhaps it needs OCD to add a little power to the feeling, and of course AD/HD or ADD might be needed to interrupt someone to correct them, but it's not like I anyway do correct them.

 

OCD (Obsessive Compulsive Disorder)

OCD is the impairment that involves compulsive behaviours and rituals. These compulsive behaviours can ruin life to a large degree. The stereotypical behaviour that OCD is known by is the infamous "dirt problem". This is something that I used to have and used to make my life horrid, since getting my dog though it's almost disappeared, it probably isn't purely because of the dog though - either way that's a different story. For many years now my psychologist calls it a "contamination problem" which is probably more accurate. But anyway, this problem involves lots of hand washing, a set of clothes for inside the house and another set for outside, etc. The best example of the "contamination problem" and why this describes it better than "dirt problem" was when I agreed to go to school camp, I knew I my home wasn't going to be affected by whatever I do because I'd have my clothes washed and a bath when I got back, and I'd find somewhere to keep my small amount of stuff while I figure out what to do with it. So I was free to much around and get mucky those few days. And yes, as soon as I got home I had that bath and changed my clothes! (not at the same time though!)

But the even more life wrecking side of OCD is the rituals. This classic example is people being stuck to things, and people having to check their door several times - not because they are unsure of whether it's locked or not (or at least not most the time) but instead because they HAVE to. Another one I can think of was a joke on some sitcom about a guy having to turn the light switch on and off (something like 62 times) before leaving a room. Rituals will often ensure their effectiveness by latching onto things, often things which people care a lot about (e family in the sitcom example) for instance when I was little I had a problem. This where I had to say in my head "not die" or "maybe not die" or something like that every time I said "die" because I thought that my cuddly animals might die if I didn't. Yes I believe my cuddly animals are alive, so what?

 

ODD (Oppositional Defiant Disorder)

I believe that only severe ODD is talked about, So to begin I'm going to set out a mild, less talked about ODD. In my opinion mild ODD is an objection to authority and also a high regard to personal morals. Basically I will not normally (if ever) take direct orders. However, only my own laziness might object to being asked to do something if I've been given reasons why I need to. If my doctor ran up to me yesterday and said, "you must drink this within 5 seconds or you'll die!!!" I wouldn't be here right now because I'd be too busy asking. "Why? Are you sure? I'll sue you if you're wrong!?"

Severe ODD is a lot more of a problem though, basically the severe person with ODD will say "no" on principle. In my opinion they will not allow themselves to loose face and that is why they can be quite prepared to argue black is white. Also within many 27 hour arguments it is also possible to get mixed up and wonder off into a completely different debate where although you might not have all the facts, you might not even like arguments (normally you do though) but you still can't loose face, so you still have to keep arguing. However I feel that we a blurring 2 separate conditions with ODD because the other side of it is purposely stepping over the line and basically just doing things wrong on purpose, which really is Conduct Disorder.

When people talk about ODD people showing a lack of emotion when they do something wrong I think firstly, there could be a high chance that the person has some form of Autism as well. Secondly that it might be Conduct Disorder and not ODD And thirdly that - back to the issue of losing face - I feel that during certain points in an argument by showing emotion you can (a) be owning up to full or partial responsibility for the accident, and (b) when I do something wrong I tend to be more worried about what's going to happen to me, in the lines of a punishment, rather than what I have done. At the end of the day it seems that those with ODD are mainly listening to their self, and worrying about their selves would indicate that people with ODD are people who look out for number one.

 

CD (Conduct Disorder)

This is the big one. From what I've read, these are people that don't feel emotion. Also, from what I've read, the sort of behaviour associated with this disorder are things like lying, inflicting pain, breaking things, cruelty, and those sorts of things. Because of the severe nature of this particular impairment, and because of having no first, or second hand experience with this impairment, I feel it wouldn't be right to go into any further detail about this "big one".

 

Depression

Whether I do or don't believe it should even be in this article, I have included it. Depression is something that affects behaviour and people with these sorts of impairments may be much more vulnerable to it due to having a fixation on certain things, and tasks, which may end up falling into pieces. The smallest things, for someone who needs to achieve perfection, may break them depending on how fixated they are. And also people with these sorts of impairments may have had a rotten education, little to often no friends, home life going down the spout, and specific problems associated with their individual impairments, for example; a kid with a "contamination problem" (because of their OCD) probably will sit down on multiple occasions and wonder just what on earth is left of life when you can't even do the things that "normal" children take for granted, like play with other children, or come back from school without going through a session of getting changed and washing hands - or just for one second not having to think about dirt, dirt, dirt, all the time.

 

Bipolar-Manic Depressive Disorder

I do not know much about this so I'll only write a little bit. Apparently children with this can have huge bouts of rage and these can continue for hours, these bouts are followed by some remorse. In adults the mood swings span from days to weeks

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Attention Shortages & Hyperactivity

This is the smallest of the 3 main categories and contains the easiest ones of all to basically describe.

 

ADD (Attention Deficit Disorder)

ADD is affects people by making it hard for them to concentrate. These people are often described as daydreamers, and are nearly always finding things like school or work and repetitive things not stimulating enough to focus on. The person can be extremely smart and be able to concentrate immensely on certain activities. However saying that, sometimes even when they have an extremely stimulating thing right in front of them, something that they really want to complete, they'll often still end up getting distracted from it, or just slouching around not doing anything sometimes.

 

ADHD (Attention Deficit Hyperactivity Disorder)

ADHD is ADD but with added bounce!!!

Sorry, I just really wanted to say that. But that is pretty much what it is. It's just like ADD, except the person with ADHD cannot just "turn off" they can't just sit around doing nothing! If nothing stimulating is happening, it must be up to them now. So while the person with ADD may sit there like a baked potato, the person with ADHD will muck around, start drawing, play a game while at work, and that sort of stuff. Although it should be pointed out that people with ADD may do this too, but they aren't so hyperactive about it. These people may often end up crossing the road without checking first.

Someone with a neurological impairment is often a sitting duck for any unscrupulous person, and this is especially true for those with ADHD. Because of needing so much stimulation they will often go along with things in the haste of the moment, sort of blinded by the idea of something interesting, instead of sitting down and thinking about it for a moment, if they did they might have gone along with it. Currently it is thought that the reason why people with ADHD and ADD will act before they think is because some of the chemicals used to pass messages to the frontal lobe of the brain, which checks that it's okay to do things, aren't at the right levels, so messages don't get through in time.

 

Hyperkinetic Syndrome

Due to this being an impairment I have no real knowledge on I shan't be giving a description until I know more about it.

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Specific Recognition Disorders

This, last out of the 3 main groups, is the one with Dyslexia type impairments in, and as I don't have much experience in this area shall be giving brief descriptions, if any.

 

Dyscalculia

People with Dyscalculia find it hard or impossible to understand the formulas, rules and sequences in mathematics for example, time. Time has two number systems, minutes which are base 60 and hours which are base 24 or 12! They also have problems with things like direction and the "layout" of things and often cannot see the "big picture", these problems may cause the person to lose their way easily and often loose things. Dyscalculia doesn't effect reading, writing and verbal communication skills unless the person also has Dyslexia or Hyperlexia however one of the symptoms is that the person may have poor athletic coordination and being able to keep up with sequences - especially fast changing ones, that seems like a mild type of Dyspraxia to me.

 

Dyslexia

Dyslexia can effect the ability to read, write, spell and manipulate numbers. People with Dyslexia often have poor short-term memory too. The symptoms for Dyslexia can also include those of the other impairments that are in this group, and also some from the other groups too - such as poor short-term memory which is also a symptom of ADD and ADHD. Dyslexia is probably the most common condition in this article with up to 10% of the general population said to have it according to some statistics.

In 1970 Dr McDonald Critchley, Chairman of the World Federation of Neurologists, described Dyslexia as being "a disorder manifested by a difficulty in learning to read, despite conventional instruction, adequate intelligence and socio-cultural opportunity, which is dependent upon fundamental cognitive difficulties which are frequently of constitutional character."

 

Dyspraxia

Not being able to emulate patterns quite often is attributed to Dyspraxia, and more mostly not being able to regulate certain body movements.

 

Hyperlexia

Children who have Hyperlexia are able to read words at a level much higher than their chronological age and are fascinated by letters or numbers. On the other hand, they also have problems with understanding verbal language and exhibit the social problems which are probably the same as those that people with Autism often have. In fact, most of the other symptoms are those of Autism too - one of them is SPD.

 

Involuntary Movement

This group isn't one of the three normal groups because it doesn't have symptoms that would fit into any of the other groups, but is probably in the same family as the others.

 

Tics & Tourette syndrome

Tics cause, mainly minor, involuntary movements, mostly around the face, winking is the classic. Tourette syndrome involves larger things like clearing of the throat without wanting to, and larger involuntary movements. Yes, Tics are probably just a common way that Tourettes often effects people and not a different disorder. You may have seen a documentary a while back about severe Tourettes syndrome (or super severe Tics if you rather) and I remember one person on it couldn't help shouting swear words, and cursing loudly, almost all the time I think. It is worth pointing out that I have thought of ways that this condition can be linked in with OCD and maybe some others. I might not be right however I had an idea that they are similar except Tourettes works on a purely subconscious level whereas OCD consciously forces you to do repetitive things.

 

Ending

While I've been rewriting this article I've started thinking about how these impairments are overlapping into other impairments and often into other categories too. I think I may write another article from scratch which takes the symptoms of impairments and regroups them like how I've done here with the impairments in this article. I truly believe that this is probably the way forward.

I hope this piece of writing has helped people to understand the relationship between all these similar impairments and that those who believed these impairments were linked have gotten something out of this. I also hope that people who don't think that these are all the same sort of thing have perhaps changed their views to a small extent - or perhaps more. I would like to say that I am not trying to force people - especially not at this stage - to believe that all these impairments are the same thing. I know this is a very sketchy piece of writing. The main interest in writing this has purely been into linking the impairments together, but because I've been wanting to do a basic description of these kinds of impairments for a while, and just an idea of grouping and linking wasn't enough to fill much with, I combined the two ideas and this is the result.

I would like to thank you for reading this article without quitting, stopping, or exploding half way through, and I am eager to have your input about this article too So if you have any comments on it at all please click on the link below this article which goes to the discussion page for this article.

Christopher B. Hayes

Started: 2003(?)-??-?? rewrite started: 2005-02-05 last rewrite updated: 2005-02-14

Are the Comorbid Conditions of ADHD the Same Impairment?
On going discussion.

You may also be interested in the following link on this site.

ADHD Pages.
This page has information that will enable you to learn more about attention deficit hyperactivity disorder. There are links to articles regarding ADHD.

 

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