by Lauren Dykstra
A study by Leirbakk, et. al investigated the comorbidity of Attention-Deficit-Hyperactivity-Disorder and mental illness on children. The American Psychiatric Association also describes ADHD as a persistent pattern of inattention and/or hyperactivity-impulsivity that is more frequently displayed and severe than is typically observed in individuals at a comparable level of development. ADHD is one of the most prevalent neurodevelopmental disorders in children today. Children with ADHD will appear to daydream, fidget in their seats, have trouble controlling impulses, may have difficulty organizing tasks, may have trouble getting along with others, and they are typically lacking in the areas of executive functioning. This can make learning extremely difficult for students and can cause an academic and social lag if not diagnosed and treated properly. As if ADHD is not as trying enough, oftentimes it is coupled by a mental illness such as anxiety and/or depression which can develop through the characteristics that children with ADHD possess.
Students with ADHD tend to have average-above average intelligence, high comorbidity with learning disabilities, and an impaired ability to plan and organize their materials, schedules, and important tasks. This leads to increased frustration and poor self-regulation of emotion, especially for those students with a high IQ who understand that they are unable to complete certain tasks. These children often have difficulty performing in their school setting because of their disruptive classroom behavior. With all of these commonalities that exist in children with ADHD, it is no wonder that mental illness such as depression and/or anxiety can develop. Statistics show that students with ADHD underperform academically, 30% of students with ADHD repeat their grade level, 45% of students experience school suspensions, 10-20% experience school expulsions, and 10-35% of these children fail to graduate high school.
ADHD is like going through life being the ONLY cook in the kitchen at a well-renowned restaurant with an oven that does not work. It is difficult and challenging for these students to carry this burden with them every day and balance even the simplest of tasks. Children will often present with somatic complaints such as headaches, a racing heart, pain in different parts of their body, and stomach aches. Although it is challenging to determine which of these complaints is due to the ADHD medication, if the child is on medication, or if these complaints are due to depression or anxiety, this behavior alone is taxing and trying on the student. Many children with ADHD often get in trouble and have trouble making friends with others due to their aggressive and oftentimes impulsive behavior. This can lead to anxiety and depression because most children will internalize these “mishaps” and start to get down on themselves for acting out and not being able to control it. Teachers will become frustrated with their behavior and they will be coined “the bad kid” during their academic career. They will begin to overanalyze and wonder why they are always in trouble or unable to make friends. In the older grades like middle school and high school, the impact is far greater as students will demonstrate a fear of going to their classes, sitting at lunch with other peers, and other social affairs. Without friends during a time when socializing is most prevalent, it is arduous for students, and this is why you see a greater case of depression and/or anxiety in students with ADHD.
Imagine being in fourth grade knowing that you are a struggling reader, you are aware that you are in the “lower group” for reading, while your peers are reading all types of books, intelligently discussing them, and performing in math contests with such poise and ease. During the pivotal and influential stages of your schooling career, the last feeling you want to have is a feeling of inadequacy. Now I am not saying that all students with ADHD will get some form of anxiety or depression, but there is a connection and a relationship between the two because of the characteristics that follow a child with ADHD.
I am a second-grade teacher in an integrated co-teaching classroom working with students with special needs and I have seen anxiety and/or depression first hand. Students will repeatedly ask why other children are mad at them or do not want to play with them. They will often lose interest in academic tasks because of their inability to attend to the task fully. They become upset and frustrated when they feel you are moving on in the lesson without them and they will often act out because of this. When there are punitive results for their actions, they often shut down due to their inability to regulate their emotions and will begin to form an anxious personality in the classroom perseverating all of the things they have done “wrong.” It is important to treat these students empathetically and with care. They are fragile and often need assignments broken down into smaller tasks, a special, quiet place to work, directions repeated, and a special schedule that they can follow. Many accommodations are made in the classroom for students with ADHD to prevent anxiety and/or depression that is often connected with ADHD.