When symptoms have multiple causes, mistakes are made
By Linda Spiro
When you have a headache, you know there are many possible causes, ranging from the mild to the very serious. When you see your doctor, she will likely ask you detailed questions about how long the headaches have been taking place, what type of pain you are feeling, when they occur, and what other symptoms you’re experiencing. Without a thorough assessment and examination, it would be absurd for your doctor to diagnose you with a brain tumor or the flu, both of which can give you a headache. And, of course, the treatment for a brain tumor versus a virus would look very different.
The same thing is true of mental illness: many common symptoms occur for a variety of reasons, and can reflect several different diagnoses. That’s why a good mental health professional will give your child a thorough evaluation based on a broad range of information before coming up with a diagnosis. It’s crucial to understand what’s really behind a given behavior because, just as in medicine, the diagnosis your child receives can drastically change the appropriate treatment. ADHD medications, for example, won’t work if a child’s inattention or disruptive behavior is caused by anxiety, not ADHD. And, just like a medical doctor, when a treatment doesn’t work, whether it’s therapeutic or pharmaceutical, one of the things a good clinician will do is reexamine the diagnosis.
Here we take a look at some of the common psychiatric symptoms that are easily misinterpreted in children and teenagers, leading to misdiagnosis. For each symptom, we explain the diagnosis it is commonly linked to, and what some of the alternate causes for what that behavior might be. (This list is only meant to be used as a guide, and it is important to always consult with a trained diagnostician before beginning treatment or assigning a label to your child.)
The common diagnosis: ADHD
The symptom of inattention is often first observed by teachers, who may notice a student who is unusually easily distracted, is prone to daydreaming, and has difficulty completing homework assignments and following directions. While all children, especially those who are very young, tend to have shorter attention spans than adults, some children have much more trouble focusing than others.
Inattention that is outside the typical range is one of the three key symptoms of ADHD, along with impulsivity, and hyperactivity. So when a child seems unusually distracted ADHD tends to be the first thing parents and clinicians suspect. However, there are many other possibilities that can be contributing to inattention.
“The kid who is inattentive could be inattentive because he has ADHD,” notes Dr. Steven Kurtz, the senior director of the ADHD and Disruptive Behavior Disorders Center at the Child Mind Institute. “Or he could be inattentive because he is worried about his grandmother who’s sick in the hospital, or because he’s being bullied on the playground and the next period is recess.”