EP 124: When Concussion and ADHD Collide: Untangling Two Conditions that Look Identical

So what is... why does this come up why does this become a gray area and i you hear me talk a lot about it in kids when i talk about pediatrics and concussion but it definitely comes up in adults too we're going to talk about how but really there's a symptom overlap right so when you think about adhd and concussion or persistent concussion, they don't just affect a structure per se, there's more research that's showing that it affects networks, it affects the communication pathways, right? And in some of the symptom profiles, they can be almost identical.

let's talk about what some of those shared symptoms are.

So when you think about ADHD, and then when you think about some of your persistent symptoms, perhaps, or some of the symptoms that your clients talk about, it's that thing of inattention and distractibility.

Shiny object syndrome, squirrel syndrome, the real thing.

Poor working memory or forgetfulness.

cognitive fatigue and mental exhaustion, emotional dysregulation, things like irritability and frustration, and a decreased kind of tolerance to that frustration, impulsivity or difficulty with inhibition, okay? Sleep disruption, difficulty with complex tasks, planning, and sequencing.

And like we know, just like persistent concussion isn't the same for everyone, nor is ADHD, right? Both of the diagnoses involve disruption to the prefrontal cortical pathways and the networks that those communicate with.

So the difference is in the actual mechanism, not necessarily in the output.

And this is why it can get really confusing because it can look the same.

So there's two ways I think that I see this show up the most.

Number one, you had undiagnosed ADHD when you get your concussion, whether you're a child or whether you're an adult.

So basically this could be somebody that has always struggled with some focus or some memory or some inattention, but they've managed it really well.

They had tools, they compensated and they were able to kind of get through life.

And then the concussion happens and the concussion knocks out or gives challenge to those compensation strategies.

So now you're seeing the impacts of the concussion, but now that you've lost those tools that you always had to manage the undiagnosed ADHD, now you're seeing ADHD symptoms as well.

But in this scenario, because you didn't have the diagnosis first, it solely gets written off as the concussion.

That's scenario number one.

Scenario number two is you have an ADHD diagnosis prior to the concussion.

And so then when you start to have these symptoms after the concussion, they just get written off, oh, it's just your ADHD.

When in fact, yes, there's the ADHD, but the concussion could be exacerbating because it has a compounding interest of effect on these networks.

So these are the two scenarios I see a lot of time.

And I'm going to share a study that makes this even more confusing.