3 Reasons Mental Health Conditions and Neurodivergence Often Co-Occur

Mental health diagnoses such as anxiety or depression commonly co-occur with neurodivergent diagnoses such as ADHD, Autism Spectrum Disorder (ASD), and Learning Disabilities. This month, I am going to talk about why this co-occurrence is common and why it is critical to identify and address co-occurring mental health concerns. In this post, I will focus on three reasons why the co-occurrence between neurodivergence and mental health concerns is so common.

First, an example from one of my clients that illustrates how this co-occurrence impacts kids and teens.

Jessica listened as her teacher explained that they would be learning about the steps involved in DNA replication and then breaking up into groups to make posters for each step. 

As soon as Jessica heard the word poster she couldn’t think of anything else. Jessica has dyslexia and is embarrassed by both her penmanship and spelling ability. She also has social anxiety and struggles to navigate the intersection of her dyslexia and anxiety. 

As Jessica’s teacher described the steps for DNA replication, Jessica knew that she should be taking notes. She wanted to and thought DNA replication sounded interesting. But all she could think about was avoiding writing on the poster. Her mind raced- Who could she partner with who would do the writing? What excuse could she give her classmates to get one of them to write? Every excuse she could think of sounded strange. She was sure they would judge her. If they saw her spelling, they would think she was dumb. She couldn't let that happen. Also, if she had notes, her classmates would be more likely to want her to write on the poster. Maybe she should ask to go to the nurse?

Jessica heard her teacher behind her, “We have talked about this before. You need to pay attention and take notes.” She looked down at her empty paper and sighed. She knew her teacher thought she didn't care. She wished her teacher knew what was really going on.

Despite not being regularly discussed, the co-occurrence of neurodivergence and mental health is extremely common. 

Autism Spectrum Disorder (ASD)

• Over 95% of children with ASD have at least one co-occurring condition or symptom.

• More than half of children with ASD have four or more co-occurring conditions or symptoms.

• People with ASD are four times more likely to experience depression in their lifetime than neurotypical people. ¹

ADHD

• 15% to 35% of people with ADHD experience anxiety symptoms. 

• 12% to 50% of youth with ADHD have major depression. That is more than five times the rate of depression in youth without ADHD. 

• 30%-50% of children with ADHD also fulfill the criteria for Conduct Disorder (CD) or Oppositional Defiant Disorder (ODD). ²

The reasons neurodivergence and mental health concerns co-occur are complex and multifaceted. However, a lot of the reasons fit into three major categories. 

1. The Lived Experience of Nuerodivergent People 

   The everyday experiences of neurodivergent people can contribute to mental health concerns. Our schools and society are designed to cater to neurotypical people. Many neurodivergent people constantly try to decode and fit into systems that do not work well with how neurodivergent brains process information. This often leads to neurodivergent people trying to cover up their neurodivergent traits and behave in a neurotypical way. This is called masking. Masking is stressful and exhausting and can exacerbate feeling alone and misunderstood. 

   Since neurodivergence is often an invisible disability, highly masking neurodivergent people frequently find themselves misunderstood by those they interact with. For example, people often perceive that a high masking neurodivergent person “should” be able to do something and miscategorize their real symptoms and laziness or lack of effort. 

2. Overlapping Genetic Causes Between Neurodivergent and Mental Health Diagnosis

   The causes of neurodivergence are not completely understood, and it is a rapidly developing area of research. However, it is known that neurodivergence often runs in families and that genetic variations make it more likely that a person will be neurodivergent. Some of these genetic variations are linked to multiple types of neurodivergence and are thought to explain some of the co-occurrence of these conditions. For example, studies show that shared genetic factors explain much of the overlap between ADHD and mental health concerns like depression and anxiety. ³

3. The Way Neurodivergent People Think and Experience the World Can Tax Their Mental Health 

The brains of neurodivergent people organize and process information differently than those of neurotypical people. Thought patterns of neurodivergent people are often flexible, creative, and good at seeing multiple perspectives or points of view. This way of processing information can make neurodivergent people highly aware, feeling, and empathetic. This is why neurodivergent people are often described as inclusive, understanding, and kind. While these traits are normally considered positive, processing the world in this way can be exhausting and carry a high emotional and mental burden. Neurodivergent people may feel the distress of others very accurately to the point that it can take a toll on their mental health. 

Resources 

If your neurodivergent child or teen is struggling with mental health concerns, know that you are not alone! This co-occurrence is extremely common, and treatment and support are available. 

In my next post, I will talk about how we can best support the mental health of neurodivergent kids and teens. So keep an eye out for that!

Here are some other resources that you might find helpful:

• My recent blog post, Should I Have My Child Evaluated?

• Register for my upcoming webinar, Finding the RIGHT Therapist for Your Neurodivergent Kid or Teen, on Thursday, June 20, 2024, 9-9:45am MST.

• My course, Understand and Access Evaluation for Your Child, will guide you through the evaluation process from start to finish, including both school and medical model evaluations. 

And, as always, if you are looking for support on a specific topic and can’t find it, let us know here. My team and I are always looking for more ways to support this community :)

I do have some availability for one-on-one consultations, coaching, and therapy. Please email info@reachlearningservices for more information.

[1] Hudson, C. C., Hall, L., & Harkness, K. L. (2019). Prevalence of Depressive Disorders in Individuals with Autism Spectrum Disorder: a Meta-Analysis. Journal of Abnormal Child Psychology, 47(1), 165–175.

[2] Gnanavel, S., Sharma, P., Kaushal, P., & Hussain, S. (2019). Attention deficit hyperactivity disorder and comorbidity: A review of literature. World journal of clinical cases, 7(17), 2420–2426.

[3] Faraone, S. V., & Larsson, H. (2019). Genetics of attention deficit hyperactivity disorder. Molecular psychiatry, 24(4), 562–575.