How is ADHD different from narcissism

Comorbidities in ADHD

ADHD is common - but rarely comes alone

In contrast to earlier ideas that the ADHD problem would "grow" with puberty, it is now assumed that in 60-70% of those affected, relevant restrictions in quality of life and especially in everyday organization persist even in adulthood. We also know today that a change in symptoms with a decrease in the noticeable (because disturbing) hyperactivity and impulsiveness can occur during puberty, whereas problems of self-organization and accompanying affective problems can usually only become symptomatic in adolescents or young adults. It is likely that at most 10-15% of those affected are aware of the diagnosis or possible connections to this problem. Even in cases where treatment was initiated in childhood for hyperactivity or complex developmental and perceptual disorders, targeted treatment has rarely been continued until after puberty. This is especially true for girls or women, whose symptoms are examined much less often in childhood or adolescence with regard to a possible ADHD predisposition.

Lifelong experience of ADHD-related self-regulatory and behavioral disorders and related problems can lead to serious self-esteem problems and tension in family and social relationships. In clinical practice, patients (18 to 40 years of age) are particularly noticeable who do not respond to the usual medicinal and psychotherapeutic treatment options because of, among other things, affective disorders and symptoms of overstrain (e.g. burn-out, symptoms of exhaustion).

In the presence of an ADHD predisposition, an "atypical" colorful symptom pattern with a rapid change in symptoms of depression, anxiety or obsessive-compulsive symptoms, addiction problems and excessive behavioral patterns, including eating disorders or impulse control disorders, can be found. The differentiation from personality disorders, especially from the emotionally unstable personality disorder, from narcissistic, dependent and infantile disorders, is difficult due to overlapping diagnostic criteria. It is not uncommon for a comorbidity to exist, i.e. several mental illnesses coexist.

Atypical somatic complaints (unclear morning dizziness and tiredness or "paradoxical" drug effects) are common. Many ADHD patients (over 50%) also complain of problems falling asleep and staying asleep. They state that they are actually only tired early in the morning and then cannot be sufficiently awake and productive during the day. Particularly in externally determined requirement situations (e.g. additional occupational stress or conflicts), they increasingly react with avoidance behavior or physical complaints and withdraw from stress in an apparently inexplicable manner. These strong fluctuations (often with repeated sick leave) lead to absences from work for many of those affected, including termination and social decline.

ADHD has a lasting effect on the partnership, which among other things contributes to a significantly increased divorce rate. Sexual problems are common and can lead to relationship disorders. On the one hand, there can be increased appetite with hypersexualized behavior and lead to couple problems; on the other hand, sexuality can be negatively influenced by erectile dysfunction or orgasm disorders due to the existing attention problems.

In the inpatient setting, chronic pain syndromes or fibromyalgia and restless leg syndromes are often seen as comorbid disorders in these patients. Atypical migraine-like headaches and tension headaches in relative rest phases (on Sundays or at the start of vacation) are to be found more frequently.