Between 80 and 90 per cent of adults diagnosed with ADHD also have another diagnosis such as difficulties with sleeping or anxiety, a leading general practitioner has said.
The number of people being diagnosed with attention deficit hyperactivity disorder has increased in recent years.
The rise has largely been attributed to underdiagnosis of women, and boys and men who were quieter.
Dr Aoife O’Sullivan, clinical lead for mental health at the Irish College of General Practitioners (ICGP), said ADHD rarely exists alone.
She added that for many people these co-morbidities could be partially a result of going undiagnosed for so many years and not having the treatment or support they needed.
“The most common ones – so common you’d nearly consider them part of the diagnosis – are sleep issues. They have difficulty getting to sleep. Cognition insomnia – you’re exhausted but you’re brain keeps going,” she said.
“Anxiety on some level. It mightn’t be a diagnosed anxiety disorder, but a lot of people talk about being an anxious person. It’s years and years of working really hard to do normal things, and anxiety is just a natural reaction to that.”
O’Sullivan cited figures from ADHD Ireland which found 20 per cent of adults with ADHD have attempted suicide in their lifetime and 50 per cent of adults with ADHD have self-harmed at some stage in the past.
“That’s really stark. It shows the levels of mood disorder whether anxiety or depression and the real impact that has,” she said.
“A lot of our adults with ADHD are late diagnosis; they’ve lived varying amount of years undiagnosed. I think that’s partially why there are so many co-morbidities in a way.”
She added: “The longer this has gone, the more likely it is you have anxiety or low mood because it hasn’t been addressed. And then there are things like rejection sensitivity dysphoria; people having difficulties trusting in relationships or being very sensitive to perceived criticism.”
O’Sullivan was speaking at the annual Irish College of General Practitioners conference in south Dublin on Saturday, which also heard about trends in menopause care and hormone replacement therapy (HRT).
Dr Ciara McCarthy, the GP clinical lead for women’s health, said there has been “a surge” in demand for menopause care in recent years.
“From 2020 to 2022, prescribing exponentially increased. The number of items of HRT medication that was prescribed in 2020 was around 80,000. By 2022, it was over 240,000,” she said.
The data is from the HSE’s reimbursement system, which covers medical cards, but does not include private patients.
McCarthy also noted the data predates the provision of free HRT from June last year, and attributes the jump to greater awareness and women being more comfortable seeking help.
“Menopause symptoms has an impact on quality of life for women and they are becoming more proactive about seeking out help,” she said.
“The other really interesting thing we can see from that data … over that time period there were changes in trends of prescribing. We see a big shift from older, oral oestrogen products to what we call transdermal products so that’s our patches or gels or sprays.”
McCarthy said these products have a “much better safety profile” and the change in prescribing practices reflects the upskilling of GPs in menopause care as well as changing international guidelines.