Are you or your child struggling with additional mental health challenges even after being diagnosed with and treated for attention deficit hyperactivity disorder (ADHD), also called attention deficit disorder (ADD)? Are you noticing signs of other mental disorders, such as anxiety, depression, oppositional behavior, trouble with learning, or problematic substance use?
Complex ADHD refers to cases where ADHD is present alongside co-occurring disorders. This can be found in both children and adults, and these scenarios are more common than many people think. They also complicate both diagnosis and recovery for those affected.
Let’s look at some of the most common conditions that occur alongside ADHD, including their symptoms and possible treatment strategies.
Complex ADHD refers to cases where ADHD is present alongside co-occurring disorders, such as anxiety, depression, learning disabilities, or substance abuse.
WHAT IS COMPLEX ADHD?
ADHD is a neurodevelopmental disorder that involves problems with attention and focus, impulsivity, disorganization, and in some cases hyperactive behavior. Complex ADHD is defined as the presence of both ADHD and another mental health condition, learning disability, neurodevelopmental disorder, or substance abuse problem.
Press Play to Learn ADHD is the Wrong Term for This Common Condition
In this video, Dr. Daniel Amen explains why the term ADHD basically discounts half the people who have the condition.
Click below to tune in:
Symptoms of other mental disorders, such as oppositional defiant disorder, anxiety, autism spectrum disorder, and bipolar disorder, can overlap with those of ADHD. This can complicate the diagnosis process and make it more challenging to find an effective treatment plan.
Having complex ADHD can disrupt a person’s daily functioning and performance. In addition to ADHD’s hallmark symptoms, further difficulties may be triggered from the condition itself.
For example, a student with ADHD may experience anxiety when their performance at school suffers. But when the ADHD is properly treated, these symptoms can reduce or disappear altogether.
However, those with complex ADHD have full-fledged secondary disorders that require their own treatment. Such comorbid conditions are common.
Research shows that up to 80% of adults with ADHD have at least one co-existing condition. And anywhere from 60% to 100% of children with ADHD are affected by another issue, according to a review published in World Journal of Clinical Cases.
The most common co-existing conditions noted in the review, followed by the percentage of children thought to be affected, are:
Related: Oppositional Defiant Disorder: Symptoms and Management
There is also a significant overlap between ADHD and substance use disorders (SUD). According to research published in 2021 in Alcohol and Alcoholism, half of adults from ages 20-39 with ADHD have had a SUD in their lifetime. This is more than twice the number of non-ADHD young adults (23.6%) who have had a SUD.
In other words, as some researchers have suggested, complex ADHD—the presence of one or more additional conditions alongside ADHD—may be the rule rather than the exception.
Let’s look at some symptoms for each of the above disorders that commonly co-occur with ADHD.
Researchers defined these as “significant difficulties in learning one or more academic domains, such as reading, writing, listening, speaking, reasoning, and performing mathematical calculations and problem solving.”
In both conditions, affected functions may include movement, language, memory, social skills, decision making, impulse control, time management, focus, and organization skills.
Tic disorders are typically grouped into three categories: Tourette’s syndrome, persistent/chronic motor or vocal tic disorder, and provisional tic disorder.
Individuals may lose interest in activities they previously enjoyed, feel fatigued or lethargic, or engage in suicidal thoughts or behavior.
Related: How Untreated ADHD Can Cause or Worsen Depression
Depressive episodes involve the symptoms noted above, under #5. Manic episodes manifest as an influx of energy, less need for sleep, fast speech, grandiose ideas, and/or racing thoughts. Both of these states occur at more intense levels than a person’s normal ups and downs.
Symptoms include extreme worry and nervousness, even leading to panic attacks. Physical symptoms, such as a racing heart, trembling hands, dizziness, and muscle tension, can also accompany anxiety disorders.
People with addictions typically lack self-control around the substances they’re using. So, even though they experience negative consequences and they want to stop using, they continue to use.
Getting the right complex ADHD diagnosis is a critical step in the treatment process. According to one study on the condition, a wide range of assessments are required to diagnose both ADHD and co-existing disorders.
A helpful tool in complex ADHD diagnosis and treatment is brain SPECT imaging. Single photon emission computed tomography evaluates blood flow and activity in the brain. Based on over 250,000 SPECT brain scans on tens of thousands of patients, Amen Clinics has identified seven types of ADHD, each associated with its own brain pattern.
Related: Treating the Brain for 7 Types of ADHD
SPECT can also help pinpoint signs of other co-occurring disorders. For example:
These brain scans can also help identify or rule out other potential causes for brain and mood changes, such as head trauma, infection, or toxin exposure.
Because more than one issue is at play in complex ADHD, treatment needs to be personalized and comprehensive. Treatment for complex ADHD may include:
Additional treatments for complex ADHD will depend on the co-occurring disorder that is diagnosed.
Because ADHD so often co-exists with other mental health conditions, it’s important to remain on the lookout for additional issues, even after receiving an ADHD diagnosis and treatment plan. When treating ADHD has not helped reduce or eliminate other mental health symptoms, it might be time to seek evaluation for a comorbid condition.
Complex ADHD refers to attention-deficit hyperactivity disorder (ADHD) that occurs alongside one or more co-occurring conditions—such as anxiety, depression, learning disabilities, autism spectrum disorder, or substance use disorder. This combination can make diagnosis and treatment more challenging, which is why a comprehensive, brain-centered evaluation is so important.
Diagnosing Complex ADHD requires more than just a checklist of symptoms. At Amen Clinics, we use brain SPECT imaging, neuropsychological testing, and a full evaluation of biological, psychological, social, and spiritual factors to identify both ADHD and any co-existing conditions. This helps ensure a personalized treatment plan that addresses the whole person, not just the label.
Yes. While Complex ADHD may take more time and nuance to treat, healing is absolutely possible. The key is to identify and address all contributing factors—not just ADHD. At Amen Clinics, we offer integrated treatment options that may include medication, psychotherapy, nutritional support, lifestyle strategies, and cutting-edge tools like neurofeedback, all guided by your brain’s unique needs.
ADHD, learning disabilities, and other mental health conditions can’t wait. At Amen Clinics, we provide personalized, science-backed treatment plans designed to target the root causes of your symptoms. Our 360-approach includes brain SPECT imaging, clinical evaluations, innovative therapeutic techniques, medications (when necessary), and holistic lifestyle recommendations to promote the health of your brain, body, and mind. Speak to a specialist today at 888-288-9834 or visit our contact page here.
Gnanavel S, Sharma P, Kaushal P, Hussain S. Attention deficit hyperactivity disorder and comorbidity: A review of literature. World J Clin Cases 2019; 7(17): 2420-2426. https://www.wjgnet.com/2307-8960/full/v7/i17/2420.htm DOI: https://dx.doi.org/10.12998/wjcc.v7.i17.2420
Katzman, Martin A et al. “Adult ADHD and comorbid disorders: clinical implications of a dimensional approach.” BMC psychiatry vol. 17,1 302. 22 Aug. 2017, doi:10.1186/s12888-017-1463-3
News Release, 25 Aug 2021, Half of adults with ADHD have had a substance use disorder, University of Toronto, https://www.eurekalert.org/news-releases/924775
ADHD and Autism Spectrum Disorder, CHADD, https://chadd.org/about-adhd/adhd-and-autism-spectrum-disorder/
Specific Learning Disorders and ADHD: Current Issues in Diagnosis Across Clinical and Educational Settings. Andy V. Pham & Alexandra Riviere. Curr Psychiatry Rep (2015) 17:38 DOI 10.1007/s11920-015-0584-y. https://www.researchgate.net/profile/Andy-Pham-5/publication/275216473_Specific_Learning_Disorders_and_ADHD_Current_Issues_in_Diagnosis_Across_Clinical_and_Educational_Settings/links/55366b990cf218056e94f8e6/Specific-Learning-Disorders-and-ADHD-Current-Issues-in-Diagnosis-Across-Clinical-and-Educational-Settings.pdf
Koolwijk I, Stein DS, Chan E, Powell C, Driscoll K, Barbaresi WJ. “Complex” attention-deficit hyperactivity disorder, more norm than exception? Diagnoses and comorbidities in a developmental clinic. J Dev Behav Pediatr. 2014 Nov-Dec;35(9):591-7. doi: 10.1097/DBP.0000000000000109. PMID: 25343695.
Before becoming a parent, you may have sworn you’d never be the one losing it in the grocery store aisle. But if you’re raising a child with attention deficit hyperactivity disorder (ADHD), also known as attention deficit disorder (ADD), you’ve probably found yourself yelling more times than you’d like to admit.
You’re not alone. Raising an ADHD child can be challenging—and it can stretch even the most patient parent to the brink. But here’s the tough truth: yelling doesn’t help. In fact, it usually makes things worse.
In this blog, you’ll discover why yelling doesn’t work with children with ADHD, and you’ll find nine calm parenting strategies that do work.
Yelling at an ADHD child may give their brain a dopamine hit—and reinforce bad behavior. Here’s what to do instead.
The brain-imaging work at Amen Clinics shows that children and teens with ADHD often have low activity in the prefrontal cortex, the part of the brain responsible for impulse control and emotional regulation.
SPECT scans on tens of thousands of children and adults with ADD show that when they try to concentrate, activity in this critical brain region drops.
That’s the opposite of what happens in the brains of those without the condition. When kids who don’t have ADHD attempt to focus, the prefrontal cortex activates to help them.
Children with ADHD also tend to have low levels of dopamine and adrenaline, which can make them feel under-stimulated.
That’s where the conflict comes in. They look for ways to activate their brain.
Related: The Prefrontal Cortex and ADD
Yelling, screaming, or engaging in power struggles actually stimulates their brain. Your angry reaction becomes their emotional fuel. They don’t consciously seek it out, but when they have a meltdown and you explode, they get a hit of adrenaline and dopamine—and it feels good to their brain.
Over time, this can lead to an unconscious addiction to chaos. Your anger becomes their medicine. Research published in the Journal of Child and Family Studies explored conflicts between parents and adolescents with ADHD and found the most common arguments centered around:
This pattern is sometimes referred to as children addicted to conflict—a destructive cycle in which emotional outbursts reinforce the child’s need for stimulation and attention, while leaving parents feeling drained and defeated.
Press Play to Learn More About Parenting ADHD Kids
In this video, Dr. Daniel Amen explains why yelling only makes things worse—and what strategies help children with ADHD thrive.
In our clinical work at Amen Clinics, we often see an unhealthy cycle of behavior. Basically, a child with ADHD becomes addicted to provoking intense reactions from others—especially their parents.
They know how to push your buttons. They know what words, actions, or tone will make you lose it. And when you finally do, they feel better. It’s a neurological rush.
That’s why your anger may be feeding the very ADHD behaviors you’re trying to stop. This cycle is a classic example of ADHD and conflict seeking—a behavioral loop driven by underactive brain regions and a subconscious craving for stimulation.
Related: 10 Things Parents Should Never Do
Here’s something important to know: when you stop reacting with anger, your child’s behavior may escalate at first. They’re going through a kind of withdrawal from the emotional intensity they’re used to getting from you.
They may become more outrageous, louder, or more defiant—because they believe you’ll eventually give them the adrenaline rush they crave.
But don’t fall for it.
If you practice calm parenting strategies, their conflict-driven behavior and emotional dysregulation will usually diminish over time. This is where calm discipline for ADHD becomes essential.
As psychiatrist and Amen Clinics founder Dr. Daniel Amen writes in his book Raising Mentally Strong Kids, “Remember the words firm and kind.” He calls these two words the essence of great parents who raise great people.
So what should you do instead of yelling? These behavior strategies for ADHD will help you respond more effectively—without feeding the conflict.
Your child’s behavior is not an excuse to lose control. Take a few seconds to pause and center yourself before reacting. Remember, your calmness can help regulate your child’s nervous system.
Make a rule for yourself: No talking until you can speak at a normal volume and respectful tone. If your tone is out of control, your message will be lost.
Teach yourself and your child simple breathing techniques to calm a tense situation. A few slow inhales and exhales can change everything. Even just 10 deep breaths can shift you out of fight-or-flight mode.
When things start to escalate, everyone goes to a quiet space for 10–15 minutes to cool down. This gives both you and your child a break to reset and prevent further escalation.
Don’t ignore broken rules, but avoid emotional punishment. State the consequence in a neutral tone and follow through. Consistency builds trust and teaches accountability without fear.
Try humming a tune or silently counting to 30. It helps you stay grounded. Small distractions can interrupt the flood of emotions before they take over.
Help your child shift focus—offer a new activity or ask a surprising question to interrupt the cycle. A well-timed redirection can break the loop of defiance or dysregulation.
Not every annoying behavior needs a response. Focus on what really matters. Letting go of minor infractions can reduce unnecessary power struggles.
It sounds counterintuitive, but speaking softly can snap your child to attention more effectively than shouting. A whisper forces them to tune in, and it models emotional control.
If you’re wondering how to stop yelling at your child with ADHD, these strategies provide a powerful place to start.
Yelling shows your child that you’ve lost control. And guess what? Kids do more of what you do—not what you say.
Emotional regulation for parents is just as important as it is for kids. Modeling calm, regulated behavior teaches them to manage their emotions more effectively, too. When you respond with patience, even in difficult moments, you’re showing your child what emotional self-regulation looks like in real time.
Over time, your steady presence becomes a powerful anchor for their nervous system. Children with ADHD often struggle with impulse control and emotional outbursts, but when they’re consistently exposed to a calm role model, their brain begins to internalize those strategies.
It’s not about being perfect—it’s about being predictable, present, and peaceful. That’s the essence of parenting without yelling—less chaos, more connection.
At first, they may push harder. That’s a normal part of change. Stick with it. If behavior continues to escalate, a brain-based evaluation can help uncover root causes.
Because behavioral symptoms often overlap, SPECT scans can reveal distinct brain activity patterns helping identify the correct diagnosis and avoid trial-and-error treatment.
If yelling, meltdowns, or defiance are a daily issue, it’s time to get support. At Amen Clinics, we use a functional brain-imaging technique called SPECT (single photon emission computed tomography) to understand what’s really going on and how to help.
SPECT scans have helped us identify seven types of ADD, and knowing your child’s type is critical to getting the most effective treatment. Brain scans also help physicians ask better questions and help target treatment plans to an individual’s brain patterns and specific needs.
ADHD and other mental health conditions can’t wait. At Amen Clinics, we provide personalized, science-backed treatment plans designed to target the root causes of your symptoms. Our 360-approach includes brain SPECT imaging, clinical evaluations, innovative therapeutic techniques, medications (when necessary), and holistic lifestyle recommendations to promote the health of your brain, body, and mind. Speak to a specialist today at 888-288-9834 or visit our contact page here.
Garcia, A.M., Medina, D. & Sibley, M.H. Conflict between Parents and Adolescents with ADHD: Situational Triggers and the Role of Comorbidity. J Child Fam Stud 28, 3338–3345 (2019). https://doi.org/10.1007/s10826-019-01512-7
Ginapp, Callie M et al. “The experiences of adults with ADHD in interpersonal relationships and online communities: A qualitative study.” SSM. Qualitative research in health vol. 3 (2023): 100223. doi:10.1016/j.ssmqr.2023.100223
Amen DG and Fay C. Raising Mentally Strong Kids: How to Combine the Power of Neuroscience with Love and Logic to Grow Confident, Kind, Responsible, and Resilient Children and Young Adults. Tyndale Refresh, 2024.
Are you dating as a neurodivergent adult—or dating someone who is neurodivergent? Are you navigating intimacy with ADHD or autism? Or are you wondering about the links between neurodiversity and emotional connection?
Like neurodivergence itself, relationships are never simple or straightforward. But with some helpful hints on improving your neurodivergent partnerships, you’ll be better equipped to establish and maintain healthy interpersonal connections that thrive over the long term.
All partners—not just neurodivergent individuals—will benefit from taking steps toward creating a healthier brain. And so will their relationships.
Thanks to emerging research, we know that neurodivergent brains are simply wired differently. The American Psychiatric Association notes that neurodivergence can describe multiple conditions, including:
In addition, these can be complex disorders. For example, brain-imaging research at Amen Clinics shows there are seven types of ADHD, also known as attention deficit disorder (ADD), as well as eight to 10 suspected factors influencing ASD (which can be categorized into high and low activity patterns).
Related: Getting Treatment for 7 Types of ADHD eBook
Each type and each individual has their own brain patterns and symptoms. However, neurodivergence in general can affect relationships in multiple ways.
ADHD can create problems with attention, focus, impulsivity and hyperactivity. Resulting behavior issues can disrupt social development and peer interactions.
Procrastination, disorganization, and lack of follow-through can also frustrate friends, workmates, and partners. Here are some additional ways ADHD can negatively impact relationships:
Because of these issues, the ADHD experts at Amen Clinics say that ADHD and relationship conflict often go together.
Related: How Can ADHD Affect Your Love Life and Relationships?
Autism is associated with deficiencies in social and communication skills, as well as limited and repetitive behaviors and interests. In many cases, ASD is accompanied by developmental disabilities, including intellectual and language impairments.
Some of these symptoms can make relationships more challenging. This includes difficulties with nonverbal communication, like understanding social cues and reading facial expressions. It may also be difficult for those with autism to engage in or initiate communication with others.
However, a study published in Autism established that, when communicating with other autistic people, they possessed “the skills to share information well with one another and experience good rapport.”
But in mixed groups (which included non-autistic people), there was less information shared, as well as less rapport. This may suggest an ability to communicate better in situations where they are (or feel) more understood.
Another study, published in a 2025 issue of Neuroscience & Biobehavioral Reviews, evaluated social cognition in both autism and ADHD. Its author explained that those with autism tend to have different performance on social cognition tests versus neurotypical subjects.
The study notes that this difference in social cognition relates to implicit processing (automatic cognitive processes) in those with autism. But those with ADHD—who tend to achieve “intermediate” performance on social cognition tests—are more affected by difficulties with their executive functioning.
Fortunately, interventions like appropriate medication for ADHD and social skills building for those with autism have been shown to improve social performance. It also seems to improve with age.
In recent years, neurodiversity advocates have pointed out that rather than seeing these traits as “wrong,” they can simply be considered different. Therefore, both partners in a neurodivergent relationship should hone their interpersonal skills with their different needs in mind.
Here are some relationship strategies for neurodiverse individuals. Further below, you’ll learn how to help support a neurodivergent partner.
All partners—not just neurodivergent individuals—will benefit from taking steps toward creating a healthier brain. And so will their relationships. Some easy tips to maximize brain health include:
Those with conditions like ADHD and autism benefit from establishing routines. Setting aside specific times to spend with your partner can reduce anxiety, help with schedule management, and create needed structure.
One of the best communication tips for neurodiverse individuals is to share your story. Only you can decide what and when to disclose with partners when it comes to your health, including any mental health challenges you face.
But, when you feel safe doing so, sharing your story with a friend or romantic partner allows them to better support you.
Exercise is imperative for everyone, but it can be especially helpful for neurodivergent individuals. Schedule time with your partner to go for a walk, run, or bike ride. You’ll both benefit from a shared, health-boosting activity—and become closer in the process.
A 2023 systematic review found that those with ADHD and autism are prone to “poorer psychosexual functioning…including a lack of satisfaction in their sexual relationships, sexual dysfunction, risky sexual behaviors, and victimization.” These issues appear to be more prominent among females.
Researchers advise dialogue between clinicians and their neurodivergent patients about these potential pitfalls. Therefore, you may want to discuss with your doctor topics such as sexuality, risky behaviors, and adopting safe sexual health practices to prevent negative outcomes.
Learning more about your partner’s type of neurodiversity is a great start in understanding them better. And, because each individual is unique, opening a nonjudgmental dialogue is also crucial. Taking turns sharing and listening will help establish empathy on both sides.
There are also general steps you can take according to your partner’s condition. For example, the brain health experts and mental health professionals at Amen Clinics have found that the following tactics may help an autistic partner feel safer in a relationship:
Meanwhile, the experts at Amen Clinics recommend the following ways to support those with ADHD:
Finally, remember that different types of neurodivergence can overlap. For example, one 2019 review found that autism and ADHD co-occurred in 21% of subjects. And these conditions can also coincide with mental health issues, like depression and anxiety.
Regardless of the symptoms or condition(s) present, neurodivergent relationships can be optimized by employing many of the same tactics that promote health in all relationships.
When both partners cultivate care, open communication, and empathy, they will enjoy plentiful rewards—and minimize misunderstandings—as they deepen their bond.
ADHD, autism, and other mental health conditions can’t wait. At Amen Clinics, we provide personalized, science-backed treatment plans designed to target the root causes of your symptoms. Our 360-approach includes brain SPECT imaging, clinical evaluations, innovative therapeutic techniques, medications (when necessary), and holistic lifestyle recommendations to promote the health of your brain, body, and mind. Speak to a specialist today at 888-288-9834 or visit our contact page here.
American Psychiatric Association. Exploring a Strengths-Based Approach to Neurodiversity. April 11, 2022. https://www.psychiatry.org/news-room/apa-blogs/exploring-a-strengths-based-approach-to-neurodiver
Crompton CJ, Ropar D, Evans-Williams CV, Flynn EG, Fletcher-Watson S. Autistic peer-to-peer information transfer is highly effective. Autism. 2020 Oct;24(7):1704-1712. doi: 10.1177/1362361320919286. Epub 2020 May 20. PMID: 32431157; PMCID: PMC7545656.
Sven Bölte, Social cognition in autism and ADHD, Neuroscience & Biobehavioral Reviews, Volume 169, 2025, 106022, ISSN 0149-7634, https://doi.org/10.1016/j.neubiorev.2025.106022. https://www.sciencedirect.com/science/article/pii/S0149763425000223
Young S, Cocallis K. A Systematic Review of the Relationship Between Neurodiversity and Psychosexual Functioning in Individuals with Autism Spectrum Disorder (ASD) or Attention-Deficit/Hyperactivity Disorder (ADHD). Neuropsychiatr Dis Treat. 2023 Jun 2;19:1379-1395. doi: 10.2147/NDT.S319980. PMID: 37287894; PMCID: PMC10243356.
National Autistic Society. Autism and Communication. https://www.autism.org.uk/advice-and-guidance/topics/about-autism/autism-and-communication
Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD): Attention Magazine, June 2018. Don’t Give Up, Don’t Give In: Survival Skills for the Non-ADHD Partner by Susan Tschudi LMFT. https://chadd.org/attention-article/dont-give-up-dont-give-in-survival-skills-for-the-non-adhd-partner/
Hollingdale J, Woodhouse E, Young S, Fridman A, Mandy W. Autistic spectrum disorder symptoms in children and adolescents with attention-deficit/hyperactivity disorder: a meta-analytical review. Psychological Medicine. 2020;50(13):2240-2253. doi:10.1017/S0033291719002368
What’s worse than getting diagnosed a mental health condition? Being misdiagnosed with the wrong one. Some mental health conditions look and feel so much alike, it’s difficult even for professional clinicians to tell them apart.
That’s certainly the case for bipolar disorder (BD) and major depressive disorder (MDD). As many as 60% of people with bipolar disorder who visit psychiatry clinics are mistakenly diagnosed with depression, research has found.
Unfortunately, bipolar disorder misdiagnosis too often leads to inappropriate treatments, increased risk of worsening of symptoms, and delay in getting the right care. Early and accurate diagnosis of BD is critical for initiating successful treatment and attaining better outcomes.
Here, you’ll learn about the key differences in symptoms between the two disorders, as well as an innovative tool called brain SPECT imaging, which greatly increases the likelihood of getting an accurate diagnosis, the right treatment, and a better outcome.
The good news is that with the correct diagnosis and treatment, people with bipolar disorder or depressive disorder do get better.
Up to 60% of patients with bipolar disorder who visit psychiatry clinics are mistakenly diagnosed with depression.
Let’s take a look at a real-world example. Jenna is a college athlete whose depression diagnosis masked bipolar disorder.
As a college freshman, Jenna was a competitive track and field athlete who loved spending her days in her running shoes. By the time she reached her sophomore year, however, things had changed. She was filled with sadness, felt like she had no energy, and had lost interest in training.
When she mentioned it to her primary care doctor, she was diagnosed with depression and given a prescription for antidepressants.
The medication boosted her mood—a lot! She felt like she was on top of the world. It filled her with so much energy, she felt invincible and began training all day and staying up all night doing her homework.
She also became sexually aggressive, hitting on the other track athletes even though she had a steady boyfriend. She even came on to her coach multiple times, which didn’t go over well and ended up with her almost getting kicked off the team.
What went wrong?
Related: The Hidden Signs of Bipolar Disorder Even Doctors Can Miss
Jenna had been misdiagnosed with depression. In reality, she had a form of bipolar disorder, formerly known as manic-depressive disorder. People with bipolar disorder display dramatic swings in mood, energy, and activity levels, going from depressive episodes to manic episodes in a cyclical pattern.
The antidepressants Jenna took not only failed to work, but they were also making her worse by triggering a manic episode.
Jenna’s misdiagnosis and experience is not unique. In a study analysis on bipolar disorder misdiagnosis, researchers noted that BD gets mistaken as depression because it typically starts with a depressive episode, and a patient is diagnosed before a manic or hypomanic episode occurs.
Additionally, research has found that bipolar disorder in women tends to manifest with more depressive episodes, which may increase their risk of being misdiagnosed with depression.
Another reason why bipolar disorder misdiagnosis occurs has to do with how mania appears in the patient.
Bipolar disorder’s manic episodes are characterized by:
When mania symptoms are mild and less severe, it’s called hypomania. An individual who has hypomanic episodes may feel like they have better energy than usual and a brighter mood but not so much that they engage in risky behavior.
When asked about mania in a clinical setting, they may not perceive these periods of improved mood and energy as manic.
Press Play to Learn the Early Signs of Bipolar Disorder
In this video, Amen Clinics psychiatrist Dr. Jay Faber discusses mood swings, sleep changes, and energy levels that might indicate bipolar disorder.
Click below to tune in.
While they are distinct disorders, depression and bipolar disorder are both mood disorders and have depressive symptoms in common.
Let’s look at depression vs bipolar disorder.
Depression is characterized by persistent feelings of sadness, hopelessness, and loss of interest or pleasure in activities. It can significantly impact a person’s daily life, affecting their feelings, thoughts, behaviors, and physical well-being.
It’s more common than BD. An estimated 21 million adults in the US had at least one major depressive episode—about 8.3% of all adults, according to recent data. It is more common in females.
On the other hand, bipolar disorder (also called manic depression) is characterized by pronounced shifts in mood, energy, and activity levels—just what Jenna experienced.
An individual with BD cycles through these moods, which vary from periods of intense highs (mania or hypomania) to dark lows (depression).
These highs and lows are much more intense than the typical ups and downs of life that we all experience. An estimated 2.8% of U.S. adults had bipolar disorder in the past year, data indicates. About 82% of people with BD are seriously impaired, and 17.1% are moderately impaired.
A depressed person and an individual with bipolar disorder in a depressive episode will exhibit depressed symptoms, which may include any number of the following:
Thus, if you have bipolar disorder and are experiencing a depressive episode, it may look just like depression.
As we saw with Jenna, when a person with bipolar disorder gets misdiagnosed with depression, they will typically be treated with antidepressants. However, antidepressants and bipolar disorder are not good together. Without mood stabilizers, they are linked to poor outcomes for BD patients, in most cases.
A misdiagnosis of depression and antidepressant treatment will increase the risk of manic episodes in approximately 30% to 40% of people with bipolar disorder, studies have found. This was proven to be true in Jenna’s case.
Because manic and hypomanic symptoms are not characteristic of major depressive disorder, they offer one of the best ways to discern BD from depression. The problem is, as mentioned, hypomania can be challenging to identify.
Hypomania and mania both involve episodes of increased energy and elevated mood, but they are very different in severity and the impact they make on one’s daily life.
Let’s take a closer look at hypomania vs mania.
Hypomania may involve many of the manic symptoms listed above, with a couple of exceptions. Typically, the symptoms appear in a milder form than mania.
It does not involve psychosis and only minimal disruption to one’s daily functioning, if there’s any disruption at all. It typically does not require hospitalization. Experts say that a good measure is a noticeably different mood than usual.
Mania is a highly disruptive, intense experience that often requires hospitalization and may involve psychosis. The elevated mood can also come with irritability and its increased energy is often coupled with lots of activity.
Mania typically lasts at least one week but can continue for several months, and even up to a year, if left untreated.
Although mania and hypomania symptoms offer valid biomarkers to distinguish BD from depression, research reports that there’s not enough information available to clinicians about the harder-to-detect hypomania symptoms.
Studies have also found that bipolar disorder patients typically lack insight about their own mania or hypomania symptoms. This adds to the issue of misdiagnosis, delayed diagnosis, and poor outcomes.
When a person with bipolar disorder is misdiagnosed with depression, it can be downright dangerous. Antidepressants may work well for depression, but antidepressants and bipolar disorder can be a bad combination.
For example, they can trigger manic episodes, worsen instability, and delay effective treatment. Research indicates that people with BD who take antidepressants are believed to have an increased risk of rapid cycling.
Rapid cycling is when an individual with BD has at least four episodes of affective illness in one year, with two months of full or partial remission in between, or a switch to the opposite pole. In some cases, rapid cycling is associated with greater resistance to treatment and worse outcomes.
Currently, treatment guidelines recommend bipolar disorder patients take antidepressants together with a mood stabilizer. However, when the wrong treatment delays successful bipolar disorder management with mood stabilizers, it may increase the risk of lithium resistance. This is known to occur as a person has more episodes.
Appropriate treatment is critical for those with bipolar disorder as it can reduce suicide risk. And when it is caught early in children and adolescents, it can reduce the risk of substance abuse as they grow older.
Accurate and early diagnosis can make a marked difference in outcomes for those struggling with this mental health disorder.
Related: The Surprising Differences Between Bipolar 1 and Bipolar 2
Like so many mental health conditions, bipolar disorder is not a simple or single condition. It manifests in different ways.
Mental health experts have identified at least four types of bipolar disorder.
The types are distinguished by the severity of the symptoms (yet all four types are equally serious):
The good news is that bipolar disorder responds well to proper treatment, but knowing an individual’s type is essential for developing the right medication and therapeutic approach.
The turning point for Jenna was when she decided to visit Amen Clinics to get a brain scan to find out what was really happening in her brain.
Amen Clinic’s brain SPECT imaging, which measures blood flow and activity in the brain, can reveal differences in brain activity patterns between individuals with bipolar disorder and those with clinical depression.
Jenna’s SPECT scan for bipolar disorder, along with a complete personal history and other assessments, pointed to bipolar 2 disorder. Knowing her condition type helped develop a treatment plan personalized for her needs.
With the proper treatment and good compliance, Jenna’s moods stabilized, and she eventually became a successful and well-liked track and field coach at her alma mater.
For many patients, visualizing their brain scan helps them accept their diagnosis, stay compliant with treatment, and feel empowered to heal.
In Jenna’s case, seeing her brain scan helped her understand that her condition was real, so it encouraged her to take her medication regularly. Compliance is a problem for many people with bipolar disorder because when they start to feel better, they don’t believe they have a problem at all and often stop taking their medication.
For Jenna, as with many people, seeing was believing.
At Amen Clinics, we see this often especially in young adults and women. If your depression treatment has made you feel wired, impulsive, or emotionally unstable, it may be time to take a deeper look.
Yes. In many cases, antidepressants can trigger manic or hypomanic episodes in people with undiagnosed bipolar disorder. That’s why proper diagnosis is so critical before beginning treatment for bipolar disorder.
We combine brain SPECT imaging with an in-depth evaluation of your biological, psychological, social, and spiritual history. This approach helps us identify the right diagnosis and tailor treatment to your brain type.
Mood disorders, such as depression or bipolar disorder, and other mental health conditions can’t wait. At Amen Clinics, we provide personalized, science-backed treatment plans designed to target the root causes of your symptoms. Our 360-approach includes brain SPECT imaging, clinical evaluations, innovative therapeutic techniques, medications (when necessary), and holistic lifestyle recommendations to promote the health of your brain, body, and mind. Speak to a specialist today at 888-288-9834 or visit our contact page here.
Wu, Z., Wang, J., Zhang, C. et al. Clinical distinctions in symptomatology and psychiatric comorbidities between misdiagnosed bipolar I and bipolar II disorder versus major depressive disorder. BMC Psychiatry 24, 352 (2024).
Hui Shen, Li Zhang, Chuchen Xu, Jinling Zhu, Meijuan Chen, Yiru Fang – Analysis of Misdiagnosis of Bipolar Disorder in An Outpatient Setting: Shanghai Archives of Psychiatry 2018;30(2):93-101.
Parial S. Bipolar disorder in women. Indian J Psychiatry. 2015 Jul;57(Suppl 2):S252-63.
National Institute of Mental Health, https://www.nimh.nih.gov/health/statistics/major-depression, Accessed June 20, 2025
National Institute of Mental Health, https://www.nimh.nih.gov/health/statistics/bipolar-disorder, Accessed June 20, 2025
Glick ID. Undiagnosed Bipolar Disorder: New Syndromes and New Treatments. Prim Care Companion J Clin Psychiatry. 2004;6(1):27-33.
Vöhringer PA, Perlis RH. Discriminating Between Bipolar Disorder and Major Depressive Disorder. Psychiatr Clin North Am. 2016 Mar;39(1):1-10.
Hui Shen, Li Zhang, Chuchen Xu, Jinling Zhu, Meijuan Chen, Yiru Fang – Analysis of Misdiagnosis of Bipolar Disorder in An Outpatient Setting: Shanghai Archives of Psychiatry 2018;30(2):93-101.
Glick ID. Undiagnosed Bipolar Disorder: New Syndromes and New Treatments. Prim Care Companion J Clin Psychiatry. 2004;6(1):27-33.
Suppes, T., Swartz, H. A., & Schley, S. (2023). Special Report: Bipolar Disorder II—Frequently Neglected, Misdiagnosed. Psychiatric News, 58(03).
Feeling angry these days? Join the club. Nearly 90%of Americans say a recent political issue or news story has triggered their anger, according to the latest Mood of the Nation Poll. And 46% of them said it made them “extremely angry.”
There’s a lot to be upset about—divisive politics, economic stress, social unrest, ongoing global conflict, rising mental health struggles, and even the relentless negativity in the news cycle. These are just some of the causes of increased anger.
Social media fans the flames, feeding us a constant stream of outrage-inducing content. It’s no wonder so many people feel like they’re at a breaking point.
But here’s the problem: chronic anger doesn’t just make life more stressful—it actually harms your brain. When anger simmers or explodes regularly, it can lead to serious consequences for your mental health, physical well-being, and relationships.
In this blog, you’ll discover what anger does to your brain, why anger management is essential for your emotional and cognitive health, and practical strategies to help you cool down and regain control.
Chronic anger doesn’t just make life more stressful—it actually harms your brain and can lead to serious consequences for your mental health, physical well-being, and relationships.
Uncontrolled anger is detrimental in so many ways, negatively affecting relationships, physical health, and mental well-being.
Related: Intermittent Explosive Disorder: Symptoms and Treatment
Anger is a complex emotion that involves various regions of the brain, each contributing to how we experience and express this powerful feeling. Understanding the neurobiological underpinnings of anger can provide valuable insights into managing and mitigating its effects.
The interplay between these brain regions and chemicals forms a network that governs our experience of anger:
Having explored the neurobiological foundations of anger, it’s essential to recognize how these internal mechanisms interact with external factors, such as environmental stressors and personal experiences, in shaping our emotional responses.
Anger issues can be a sign of trouble in the brain. In a study in the Annals of Clinical Psychiatry, the research team at Amen Clinics performed brain SPECT imaging studies on 40 individuals who had physically attacked another person or destroyed property as well as on 40 non-aggressive people as controls.
The SPECT scans of the people with aggressive behavior showed significant differences from the control group in several brain regions. These included:
Dysfunction here is associated with irritability, anger, and violent thoughts. Common causes of temporal lobe problems include genetics, head injuries, and exposure to toxins or infections.
Related: 7 Lessons from Murderers’ Brain Scans
The good news is you can control temper flare-ups even in the worst situations. The following six steps have proven to be helpful for many Amen Clinics patients.
Press Play to Learn More About How to Calm Anger
In this video, Dr. Daniel Amen reveals why some people have what he call the Angry Dragon, one of the mental “dragons” that are constantly breathing fire on the emotional centers of the brain. Find out if you have this dragon, what causes it, what triggers it, and how to tame it.
Click below to tune in:
Video: 8 Ways to Soothe Anger
Anger may feel justified in the moment, but when it lingers or erupts uncontrollably, it can damage your brain, your body, and your life. Understanding the neurobiology of anger—and seeing how it shows up on brain scans—proves that this emotion is more than just a fleeting feeling. It’s a brain health issue that deserves your attention.
The good news is, you don’t have to stay stuck in a cycle of rage or regret. With the right tools and support, you can learn to manage your anger, protect your brain, and build healthier relationships. Your brain can change—and when it does, your life can, too.
Anger, depression, ADHD, and other mental health issues can’t wait. At Amen Clinics, we provide personalized, science-backed treatment plans designed to target the root causes of your symptoms. Our 360-approach includes brain SPECT imaging, clinical evaluations, innovative therapeutic techniques, medications (when necessary), and holistic lifestyle recommendations to promote the health of your brain, body, and mind. Speak to a specialist today at 888-288-9834 or visit our contact page here.
Helmstetter C, et al. Mood of the Nation: Angry. APM Research Lab, April 23, 2024. https://www.apmresearchlab.org/motn/what-makes-americans-angry-proud
Williams JE, et al. Anger Proneness Predicts Coronary Heart Disease Risk : Prospective Analysis From the Atherosclerosis Risk In Communities (ARIC) Study. Circulation. Volume 101, Number 17. https://doi.org/10.1161/01.CIR.101.17.2034
Mostofsky, Elizabeth et al. “Outbursts of anger as a trigger of acute cardiovascular events: a systematic review and meta-analysis.” European heart journal vol. 35,21 (2014): 1404-10. doi:10.1093/eurheartj/ehu033
Romero-Martínez, A et al. “High Immunoglobulin A Levels Mediate the Association Between High Anger Expression and Low Somatic Symptoms in Intimate Partner Violence Perpetrators.” Journal of interpersonal violence vol. 31,4 (2016): 732-42. doi:10.1177/0886260514556107
Kubzansky, L D et al. “Angry breathing: A prospective study of hostility and lung function in the Normative Aging Study.” Thorax vol. 61,10 (2006): 863-8. doi:10.1136/thx.2005.050971
Deschenes SS, et al. The Role of Anger in Generalized Anxiety Disorder. Cognitive Behaviour Therapy. March 2012Cognitive Behaviour Therapy 41(3):261-71
DOI:10.1080/16506073.2012.666564
Amen, D. G., Stubblefield, M., Carmichael, B., & Thisted, R. (1996). Brain SPECT Findings and Aggressiveness. Annals of Clinical Psychiatry, 8(3), 129–137. https://doi.org/10.3109/10401239609147750
Have you ever had a “gut feeling” about something or felt butterflies in your stomach when you were nervous? It turns out those aren’t just concepts or figures of speech.
Your gut and brain are in constant conversation, which plays a huge role in how you feel—from your mood to your mental clarity to your emotional stability. The reality is your gut health and mental stability depend on each other to help you survive.
A growing body of research shows that imbalances in the gut microbiome may contribute to anxiety, depression, brain fog, and more. On the flip side, taking care of your gut may produce noticeable improvements in your mental health.
In this blog, we’ll explore the science behind the gut-brain connection and uncover practical ways to support both your digestive and emotional well-being.
Imbalances in the gut microbiome may contribute to anxiety, depression, brain fog, and more. On the flip side, taking care of your gut may produce noticeable improvements in your mental health.
Your gut and brain are linked through a complex communication network called the gut-brain connection. This includes:
Roughly 90% of serotonin—a key brain chemical that influences mood and anxiety—is produced in the gut. When the gut is out of balance, it directly impacts your brain chemistry and leads to emotional and cognitive challenges.
One of the most powerful aspects of the gut-brain connection relationship is your microbiome—essentially, the ecosystem of trillions of bacteria, fungi, and other microorganisms living in your digestive tract.
Why is this important for mental health?
When your microbiome is thrown off by poor diet, stress, antibiotics, or illness, it affects your mood, sleep, and focus. In other words, there is a clear link between your microbiome and mood so take it seriously.
Another critical factor in your gut health and brain function is inflammation. When the lining of your gut becomes compromised (often referred to as “leaky gut”), harmful substances can pass into the bloodstream and trigger immune responses.
Related: How Do I Know If Inflammation is Killing My Brain?
This chronic inflammation is increasingly being linked to mental health issues. In fact, studies show a strong relationship between inflammation and mental illness, particularly in cases of:
It’s important to know that inflammation in your gut doesn’t just stay there. It often causes neuroinflammation, which affects how your brain functions and how stable your mood feels day to day.
You might not immediately connect that your gut is a big reason why you’re feeling disconnected emotionally. Here are some signs that poor gut health could be at the root of your mental instability:
If these symptoms sound familiar, it’s worth exploring the link between your gut health and mental stability with an integrative mental health professional. Amen Clinics takes a “whole person” approach to mental health that includes investigating potential gut-brain imbalances.
If you want to improve your gut-brain connection, it starts with what’s on your plate. Certain foods can nourish your microbiome and reduce inflammation, which benefits your mood and mental clarity. Here are some gut healthy foods the specialists at Amen Clinics recommend:
Eating a whole-foods, anti-inflammatory diet is one of the most accessible and effective gut health strategies you can adopt to improve your mental well-being.
Press Play to Discover Foods That Fuel Gut Health
In this video, Tana Amen reveals her favorite gut-healing foods.
Click below to tune in:
You may have heard of probiotics for mental health, but not all probiotic strains are created equal. Research highlights specific strains—sometimes called “psychobiotics”—that support emotional regulation and reduce stress.
Some of the most promising strains include:
Ask a mental health professional how to incorporate targeted probiotics in a personalized care plans.
The field of nutritional psychiatry is helping to bridge that gap between your mental health and digestion, so they work together. More practitioners are using food as a first-line approach to mood disorders, focusing on how dietary changes impact brain function. This includes:
If you’re struggling with anxiety, depression, or brain fog, your fork might be one of your most powerful tools for change.
Related: What Is Nutritional Psychiatry?
To be clear, your diet is only one piece of the puzzle. Here are some additional gut health strategies you can make into habits that benefit your mental stability:
Creating a gut-friendly lifestyle doesn’t mean you have to be perfect. The goal is to make small, consistent steps toward a better lifestyle to feel better from the inside out.
Never underestimate the power of a conversation with your healthcare provider. Seek help if you’re experiencing:
To determine if gut issues are contributing to mental health conditions, it’s a good idea to get help from a functional mental health physician. Integrative or functional psychiatry specialists use comprehensive brain-body evaluations to uncover root causes and tailor treatment plans to address your emotional and physical symptoms.
Unlike conventional approaches that treat symptoms in isolation, functional medicine addresses the body as an interconnected system. A functional medicine approach to gut health and mental stability might include:
By identifying and treating the underlying issues, functional medicine can help mental stability.
If you’ve been struggling with emotional ups and downs and can’t figure out why, don’t overlook your digestive health. Through simple gut health strategies, targeted probiotics, and a personalized treatment plan, you can begin to heal from the inside out.
At Amen Clinics, we recognize that the gut and brain are in constant communication through the vagus nerve and chemical messengers like serotonin. When your gut microbiome is imbalanced or inflamed, it can disrupt mood, focus, and overall mental clarity. Addressing gut health is often a key part of restoring emotional balance and cognitive function.
If you’re experiencing symptoms like brain fog, chronic fatigue, mood swings, anxiety, or unexplained depression especially alongside digestive issues like bloating or food sensitivities, it may be a sign that gut-brain imbalance at play. Our comprehensive evaluations help identify whether your symptoms may stem from the inside out.
Research has shown that certain probiotic strains known as “psychobiotics” can influence mood, lower anxiety, and support emotional regulation. At Amen Clinics, we often incorporate targeted probiotic and nutritional protocols as part of a personalized care plan.
Anxiety, depression, and other mental health conditions can’t wait. At Amen Clinics, we provide personalized, science-backed treatment plans designed to target the root causes of your symptoms. Our 360-approach includes brain SPECT imaging, clinical evaluations, innovative therapeutic techniques, medications (when necessary), and holistic lifestyle recommendations to promote the health of your brain, body, and mind. Speak to a specialist today at 888-288-9834 or visit our contact page here.
Xiong RG, Li J, Cheng J, Zhou DD, Wu SX, Huang SY, Saimaiti A, Yang ZJ, Gan RY, Li HB. The Role of Gut Microbiota in Anxiety, Depression, and Other Mental Disorders as Well as the Protective Effects of Dietary Components. Nutrients. 2023 Jul 23;15(14):3258. doi: 10.3390/nu15143258. PMID: 37513676; PMCID: PMC10384867.
Clapp M, Aurora N, Herrera L, Bhatia M, Wilen E, Wakefield S. Gut microbiota’s effect on mental health: The gut-brain axis. Clin Pract. 2017 Sep 15;7(4):987. doi: 10.4081/cp.2017.987. PMID: 29071061; PMCID: PMC5641835.
Breit, S., Kupferberg, A., Rogler, G., & Hasler, G. (2018). Vagus nerve as modulator of the brain–gut axis in psychiatric and inflammatory disorders. Frontiers in Psychiatry, 9, Article 44. https://doi.org/10.3389/fpsyt.2018.00044
Fleming MA 2nd, Ehsan L, Moore SR, Levin DE. The Enteric Nervous System and Its Emerging Role as a Therapeutic Target. Gastroenterol Res Pract. 2020 Sep 8;2020:8024171. doi: 10.1155/2020/8024171. PMID: 32963521; PMCID: PMC7495222.
Barandouzi, Z.A., Lee, J., del Carmen Rosas, M. et al. Associations of neurotransmitters and the gut microbiome with emotional distress in mixed type of irritable bowel syndrome. Sci Rep 12, 1648 (2022). https://doi.org/10.1038/s41598-022-05756-0
Braga, J.D., Thongngam, M. & Kumrungsee, T. Gamma-aminobutyric acid as a potential postbiotic mediator in the gut–brain axis. npj Sci Food 8, 16 (2024). https://doi.org/10.1038/s41538-024-00253-2
Ouabbou S, He Y, Butler K, Tsuang M. Inflammation in Mental Disorders: Is the Microbiota the Missing Link? Neurosci Bull. 2020 Sep;36(9):1071-1084. doi: 10.1007/s12264-020-00535-1. Epub 2020 Jun 27. PMID: 32592144; PMCID: PMC7475155.
Tsamakis K, Galinaki S, Alevyzakis E, Hortis I, Tsiptsios D, Kollintza E, Kympouropoulos S, Triantafyllou K, Smyrnis N, Rizos E. Gut Microbiome: A Brief Review on Its Role in Schizophrenia and First Episode of Psychosis. Microorganisms. 2022 May 29;10(6):1121. doi: 10.3390/microorganisms10061121. PMID: 35744639; PMCID: PMC9227193.
The American Brain Foundation. (2025, January 13). Neuroinflammation: What many brain diseases have in common. https://www.americanbrainfoundation.org/what-is-neuroinflammation/
Garone, S., & Chavoustie, C. T. (2023, February 16). What is IBS brain fog and what can you do about it? Healthline. https://www.healthline.com/health/ibs-and-brain-fog
Nagy-Szakal, D., Williams, B.L., Mishra, N. et al. Fecal metagenomic profiles in subgroups of patients with myalgic encephalomyelitis/chronic fatigue syndrome. Microbiome 5, 44 (2017). https://doi.org/10.1186/s40168-017-0261-y
Fu Y, Wang Y, Gao H, Li D, Jiang R, Ge L, Tong C, Xu K. Associations among Dietary Omega-3 Polyunsaturated Fatty Acids, the Gut Microbiota, and Intestinal Immunity. Mediators Inflamm. 2021 Jan 2;2021:8879227. doi: 10.1155/2021/8879227. PMID: 33488295; PMCID: PMC7801035.
Sarkar A, Lehto SM, Harty S, Dinan TG, Cryan JF, Burnet PWJ. Psychobiotics and the Manipulation of Bacteria-Gut-Brain Signals. Trends Neurosci. 2016 Nov;39(11):763-781. doi: 10.1016/j.tins.2016.09.002. Epub 2016 Oct 25. PMID: 27793434; PMCID: PMC5102282.
Spahn, I., & Wilson, D. R. (2019, March 8). 16 benefits of Lactobacillus helveticus. Healthline. https://www.healthline.com/health/lactobacillus-helveticus
Sun J, Fang D, Wang Z, Liu Y. Sleep Deprivation and Gut Microbiota Dysbiosis: Current Understandings and Implications. Int J Mol Sci. 2023 May 31;24(11):9603. doi: 10.3390/ijms24119603. PMID: 37298553; PMCID: PMC10253795.
Casale TB, Warren C, Gupta S, Schuldt R, Wang R, Iqbal A, Seetasith A, Gupta R. The mental health burden of food allergies: Insights from patients and their caregivers from the Food Allergy Research & Education (FARE) Patient Registry. World Allergy Organ J. 2024 Mar 23;17(4):100891. doi: 10.1016/j.waojou.2024.100891. PMID: 38559493; PMCID: PMC10973659.
Did you know that attention deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD) can sometimes look alike?
It’s true. Although ADHD and OCD are two distinct neurodevelopmental disorders, they share a surprising number of overlapping of symptoms that can blur the lines between them. In fact, even mental health professionals can sometimes mistake one disorder for the other.
Too often, this can lead to misdiagnosis, ineffective treatment, and ongoing struggles that leave individuals feeling frustrated and misunderstood.
Those who struggle with ADHD can overcompensate for their inclination to be disorganized, distracted, and inattentive by adopting OCD-like coping skills.
The good news? There are ways to avoid this scenario from happening to you or a loved one.
In this blog, we’ll break down the key distinctions between each mental health condition, as well as a powerful diagnostic tool that helps ensure greater accuracy. With the right diagnosis, you (or a loved one) can get the right treatment and move toward lasting relief and a better quality of life.
Experts have noted that ADHD and OCD symptoms associated with attention and concentration can appear remarkably similar despite each disorder having different brain activity dysfunction. This overlap in symptoms is particularly common among children and adolescents.
Related: 11 Things Not to Do If You Have ADHD
Unless a clinician is highly trained to spot nuanced differences between the two disorders and/or uses imaging to examine activity patterns in the brain, misdiagnosis can and does occur. Indeed, in one study, evidence suggested that OCD may be misdiagnosed as ADHD. This is because OCD-related attentional impairment looks like ADHD symptoms.
OCD is well-known to be misdiagnosed in general, particularly with family physicians. For certain types of OCD, misdiagnosis is shown to be as high as 52%, according to research. Childhood ADHD misdiagnosis also happens as documented in research.
ADHD is a neurological disorder rooted in prefrontal cortex dysfunction and linked to lower levels of dopamine and norepinephrine. It is characterized by significant problems with attention and disorganization, and frequently with impulsivity and hyperactivity as well.
Often these issues lead to behavioral problems, which may create challenges in school or at work. They may also interfere with social development and interactions.
ADHD is the most common neurodevelopmental disorder in childhood—and it can continue into adulthood. Roughly 7 million (11.4%) U.S. children aged 3–17 years have ever been diagnosed with ADHD, based on a 2022 national survey. Survey data from 2023 from the Centers for Disease Control and Prevention (CDC) estimates 15.5 million adults have had an ADHD diagnosis.
The core symptoms of ADHD include:
Symptoms can range from mild to severe. Note that hyperactivity is not one of the hallmark ADHD symptoms.
The brain SPECT imaging work at Amen Clinics has revealed seven types of ADHD, which share the core symptoms plus the following:
ADHD symptoms are known to overlap with a number of other mental health conditions, including:
Obsessive-compulsive disorder is a serious and often debilitating mental health condition rooted in brain overactivity, primarily in the frontal lobes. It is associated with:
Left untreated, persistent obsessions and compulsive rituals can take over an OCD individual’s life and lead to significant problems with personal, interpersonal, professional, academic, and social functioning.
The lifetime prevalence of OCD among U.S. adults is estimated to be about 2.3%, reports the CDC. That is 1 in 40 adults. In children and teens, it is estimated to be 1 in 100, according to the International OCD Foundation.
Related: What You Need to Know About OCD According to a Psychiatrist
Obsessive thoughts typically involve unwelcome, repetitive ideas, urges, or mental images that may feel disturbing, irrational, or even offensive. These thoughts often spark intense feelings of anxiety, fear, or revulsion.
Individuals with OCD will often try to suppress or resist their obsessions, but the more they attempt to control them, the stronger they can become.
Obsessive thoughts are often focused on one of these areas:
Compulsions are behaviors that are performed repeatedly, even though they do not bring any reward or pleasure. The disorder’s compulsions serve to neutralize the distress caused by the obsessions.
Inside, a person with compulsions feels compelled, almost like they have to perform the compulsive behavior according to certain rules and often in a specific, rigid manner. They can be complicated, time-consuming rituals.
Some of the most frequent compulsive behaviors seen in OCD include:
Interestingly, most people with OCD either know or have a feeling that their obsessional thoughts are not true or realistic, but they still have trouble disengaging from the obsessive thoughts or stopping the compulsive behaviors.
While distinct disorders, there’s an ADHD-OCD overlap of symptoms, which leads to confusion and misdiagnosis.
The most common symptoms they share are the following:
Here’s how these five symptoms can cause both ADHD and OCD diagnosis confusion:
Perfectionism is the most common cognitive distortion adults with ADHD report. It typically manifests as procrastination and/or a negative self-image.
Having ADHD often makes a child the recipient of criticism and punishment because memory and attention issues make completing schoolwork and chores very difficult and hyperactive behavior can cause disruption.
Additionally, the disorganization that goes with impaired executive function may also cause ADHD people to be perfectionistic. They’re basically trying to overcome their shortcomings, as if a little more discipline or trying harder would solve their challenges.
But OCD individuals struggle with perfectionism too. With OCD, perfectionism manifests in fixing and checking behaviors to ensure things look, feel, and sound correct, symmetrical, organized, and balanced.
For example, OCD children or adults might compulsively check a written communication to ensure it is perfect or repeatedly rearrange objects on their desk or in their closet.
In addition to having poor impulse control because of executive dysfunction, ADHD individuals may additionally display impulsivity as a result of perfectionism. They set very high standards typically and when they are not met, they can make impulsive decisions out of frustration. It creates a negative feedback loop.
Imaging research on OCD individuals shows that they have dysfunctional reward processes thought to be important in addictive disorders and impulse control. Impulsivity is linked to more severe OCD.
The low dopamine and epinephrine in the frontal lobes of an ADHD brain translates to difficulty paying attention for longer periods of time and being easily distracted. Those who struggle with ADHD can overcompensate for their inclination to be disorganized, distracted and inattentive by adopting OCD-like coping skills. Such compulsive tendencies indicate OCD traits in ADHD patients, which can be misleading.
Conversely, when OCD mimics ADHD in school and social settings, a clear diagnosis is difficult. Like ADHD, OCD can cause inattention but for a different reason. Preoccupied by an obsession or a compulsion, an OCD person may not be able to keep their focus on what’s going on around themself.
For example, a student who seems inattentive and antsy during class may actually have OCD and not ADHD since distraction from repetitive thoughts and fidgeting from compulsive behaviors can both appear to be ADHD symptoms. Because teachers usually equate attention problems and hyperactivity with ADHD, many OCD patients are being misdiagnosed.
ADHD with compulsive behaviors and sensory seeking, like fidgeting or touching objects for stimulation, can look superficially similar to OCD compulsions.
ADHD individuals may experience heightened stress and anxiety from the inherent challenges of the disorder, such as disorganization and impulsivity.
For example, a person with ADHD may regularly struggle with managing their time, which may lead to anxiety about keeping up with deadlines and maintaining job performance. Of course, anxiety is a hallmark symptom of OCD, stemming from distressing obsessions.
Additionally, both conditions may trigger irritability and depression and are associated with sleep and gastrointestinal health issues.
Press Play to Learn If Having ADHD and OCD Is Possible
In this video, Dr. Daniel Amen shares whether or not people can have both ADHD and OCD at the same time while offering advice on what medicine or supplements will help balance the brain.
Click below to tune in:
When treatments for ADHD and OCD have opposing goals, a misdiagnosis of one for the other can have disastrous results. For example, a clinician will typically prescribe stimulant medication (such as methylphenidate, sold as Ritalin or Concerta) for an ADHD child or adult to increase dopamine and epinephrine levels and promote greater focus.
Yet, research warns that if an OCD individual is misdiagnosed with ADHD, a stimulant medication will exacerbate their symptoms making their OCD worse.
Conversely, the main medicines prescribed for OCD are a type of antidepressant called selective serotonin reuptake inhibitors (SSRIs), aimed to help OCD symptoms by increasing serotonin levels in the brain.
However, if an ADHD individual is misdiagnosed with OCD and undergoes antidepressant treatment with an SSRI medication, research shows inconsistent changes, often worsened ADHD symptoms, and sometimes apathy and disinhibition.
When this happens, in either case, misdiagnosis delays critical and effective treatment for both conditions.
Despite the overlapping symptoms seen in these mental disorders, the following three differences can help you answer the question, is it ADHD or OCD?
ADHD is considered an “externalizing disorder,” meaning that it impacts the way an ADHD individual responds and engages with their external environment.
OCD is considered an “internalizing disorder,” meaning that it impacts how a person relates to themself. They have obsessive thoughts and react with compulsions to help them feel a sense of control over them.
Experts suggest looking closely for the presence or absence of risk-taking or impulsive behavior. OCD people are rarely impulsive and seldom exhibit risk-taking behavior. One study found that OCD individuals exhibiting doubt and checking behaviors appeared to be risk adverse. OCD individuals tend to be overly conscientious about causing harm.
On the other hand, risky behavior is a common symptom of ADHD, according to research. Novelty seeking and high-risk behavior can increase dopamine levels, something ADHD brains crave.
With OCD, compulsions are typically carried out consistently, and according to precise rules. However, a strict and detailed routine, which would require paying close attention might be challenging for a person with ADHD.
Simply evaluating the complexity of rituals an individual performs offers a great way to differentiate between ADHD and OCD.
The best way to obtain a definitive diagnosis is to get a brain scan for ADHD and OCD. Brain SPECT imaging at Amen Clinics is one of the most reliable tools to examine brain activity and guide diagnosis.
It measures blood flow patterns in the brain showing where there is too little activity, too much activity, or balanced activity. SPECT imaging can be especially helpful when behavioral symptoms overlap as they can do with ADHD and OCD.
At Amen Clinics, our integrative evaluation process combines brain SPECT imaging with a biological, psychological, social, and spiritual history, plus neuropsychological assessments. This aids our specialists in understanding the root causes of symptoms and developing a personalized treatment plan.
If you or a loved one is suffering from any of the symptoms associated with ADHD or OCD, it’s a good idea to seek this type of integrative mental health support. Using our innovative and personalized care, outcomes consistently demonstrate improvement for patients—including many who have tried and failed prior treatment.
ADHD involves poor focus due to distraction and impulsivity, while OCD involves obsessive thoughts and compulsive actions often aimed at reducing anxiety. Both can look similar on the surface but differ at their root.
Because behavioral symptoms often overlap, SPECT scans can reveal distinct brain activity patterns helping identify the correct diagnosis and avoid trial-and-error treatment.
Yes, there are seven types of ADHD, and each requires different strategies. A brain scan can uncover the specific type and lead to more effective solutions for both behavior and relationship success.
ADHD and other mental health conditions can’t wait. At Amen Clinics, we provide personalized, science-backed treatment plans designed to target the root causes of your symptoms. Our 360-approach includes brain SPECT imaging, clinical evaluations, innovative therapeutic techniques, medications (when necessary), and holistic lifestyle recommendations to promote the health of your brain, body, and mind. Speak to a specialist today at 888-288-9834 or visit our contact page here.
International OCD Foundation website
Accessed June 14, 2025
Perez M, et al. Obsessive-Compulsive Disorder Misdiagnosis among Mental Healthcare Providers in Latin America. J Obsessive Compuls Relat Disord. 2021 Nov 1;32:100693.
Ford-Jones PC. Misdiagnosis of attention deficit hyperactivity disorder: ‘Normal behaviour’ and relative maturity. Paediatr Child Health. 2015 May;20(4):200–202.
Danielson, Melissa L et al. “ADHD Prevalence Among U.S. Children and Adolescents in 2022: Diagnosis, Severity, Co-Occurring Disorders, and Treatment.” Journal of Clinical Child and Adolescent Psychology : The Official Journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53 vol. 53,3 (2024): 343-360. doi:10.1080/15374416.2024.2335625
Centers for Disease Control and Prevention website
https://www.cdc.gov/mmwr/volumes/73/wr/mm7340a1.htm
Accessed June 14, 2025
National Institute of Mental Health
https://www.nimh.nih.gov/health/statistics/obsessive-compulsive-disorder-ocd
Accessed June 14, 2025
Frydman I, et al. Self-reported and neurocognitive impulsivity in obsessive-compulsive disorder. Compr Psychiatry. 2020 Feb:97:152155.
Abramovitch, A., Dar, R., Mittelman, A., & Schweiger, A. (2013). Don’t judge a book by its cover: ADHD-like symptoms in obsessive compulsive disorder. Journal of Obsessive-Compulsive and Related Disorders, 2(1), 53–61. https://doi.org/10.1016/j.jocrd.2012.09.001
Popper, CW. Antidepressants in the treatment of attention-deficit/hyperactivity disorder. J Clin Psychiatry. 1997:58 Suppl 14:14-29; discussion 30-1.
Luigies J et al. Doubt in the Insula: Risk Processing in Obsessive-Compulsive Disorder. Front Hum Neurosci. 2016 Jun 14;10:283.
Shoham R et al. ADHD-associated risk taking is linked to exaggerated views of the benefits of positive outcomes. Sci Rep. 2016 Oct 11;6:34833.
Facebook-f X-twitter Youtube Falling in love with someone with ADHD can be easy. People with this common mental health condition are often intelligent, passionate, and
Falling in love with someone with ADHD can be easy. People with this common mental health condition are often intelligent, passionate, and spontaneous, which can make a relationship exciting. Living with these people, however, can pose some unique emotional and behavioral challenges that may lead to relationship problems and marital conflict.
At Amen Clinics, the global leader in brain health, our neuropsychiatrists have worked with thousands of people with attention deficit hyperactivity disorder (ADHD)—also known as attention deficit disorder (ADD)—and their partners. Based on this experience, here are the 12 most common issues that arise in these relationships and some simple strategies to help partners of people with ADD cope more effectively.
Falling in love with someone with ADHD can be easy. Living with them, however, can pose some unique emotional and behavioral challenges that may lead to relationship problems and marital conflict.
People with ADHD can be incredibly creative and high energy. Decades of clinical practice at Amen Clinics working with individuals who have ADHD have shown that they can be:
Thanks to these traits, life with someone who has the condition can be spontaneous, exciting, and unpredictable. But that same impulsivity and intensity can lead to conflict and misunderstanding.
The brain-imaging work at Amen Clinics using single photon emission computed tomography (SPECT) shows that people with this common condition often have abnormal activity in certain areas of the brain. single photon emission computed tomography (SPECT) is an advanced imaging technique that measures blood flow and activity in the brain.
SPECT scans reveal that ADHD is often associated with low blood flow and activity in the brain’s prefrontal cortex. The PFC is responsible for high-level brain functions such as decision-making, judgment, impulse control, and learning from one’s mistakes. Low blood flow here is linked to problems in these areas, which can have a negative impact on relationships.
For instance, research on marital relationships involving adults with ADHD indicated that they frequently held more negative perceptions of the relationship compared to their spouses, who reported higher levels of satisfaction.
Let’s explore the most frequent issues couples face when one partner—or both—has ADHD and take a look at some of the consequences that can develop.
Although a person has a thought, it doesn’t mean that it is accurate or that they even necessarily believe it. Statements like “that’s a stupid idea” can be damaging to hear in a relationship and result in hurting the person on the receiving end. Yet, many people with ADHD tend to blurt out whatever comes to mind without thinking about how it will affect their partner.
Misperceptions often cause serious problems in relationships. Often the spouse of an ADHD person must spend an inordinate amount of time correcting misperceptions that lead to disagreements.
One Amen Clinics patient said that before he was leaving on a business trip, he told his wife that he was going to miss her. She heard his words as “I’m not going to miss you” and was angry at him for the rest of the night, no matter what he said.
Science backs this up. One study in the Journal of Attention Disorders found that people with ADHD have higher levels of interpersonal problems and troubles with family relationships.
Due to distractibility, conversations are often cut short or left uncompleted, leaving the other person feeling unimportant. People with ADHD need to have what they want right away, which often causes problems in situations where they need to take turns, such as in conversations.
Spouses often complain that they are cut off or interrupted, which makes them feel disrespected.
People with ADHD person often wait until the very last minute or are too disorganized to get things done such as paying the bills, buying holiday gifts, or making dinner reservations for anniversaries.
A study performed on people with ADHD showed that poor time management, low self-esteem, and worries may be associated with reduced interpersonal skills and difficulty maintaining relationships.
In addition, they may not complete chores even though they fully intended to do so. This may irritate spouses who feel the need to pick up the loose pieces or who feel unloved or unimportant.
Some adults with ADHD are sensitive to touch, which can make them shy away from affection. This can harm a relationship, especially if the person’s partner wants or needs affection.
Sometimes people with ADHD talk for self-stimulation. There is an internal drive to go on and on. This may irritate significant others, who feel like a prisoner of the conversation—or monologue—because they can’t get a word in edgewise.
In other cases, people who love someone with ADHD may complain that there is little talking or emotional expression in the relationship. “They seem turned off when they come home” is a common complaint, and many spouses report getting short responses, such as, “fine” or “OK.”
This type of behavior worries the partners of the ADHD person. In some cases, spouses feel pressured to go along with dangerous or reckless behavior, causing a rift in the relationship.
Many spouses say that they never know what to expect from their ADHD partner. “One minute they’re happy, the next minute they’re screaming,” is a common complaint. Small amounts of stress may trigger huge explosions.
Problems with emotional regulation and ADD are common. Some studies have reported that approximately 70% of adults with ADHD struggle with emotional dysregulation. Rooted in an inability to manage emotional responses, emotional dysregulation can look like bursts of rage, crying, and temper.
After this occurs several times in a relationship, the partner can become “gun shy” and may begin to withdraw from the person. In some cases, untreated ADHD may be often involved in abusive relationships.
This is a common complaint among people living with someone who has ADHD. People with this condition often look for trouble as a way to self-stimulate. Rather than ignoring a minor incident, they focus on it and have difficulty letting it go.
Romantically, partners who have ADHD struggle in navigating conflict resolution and maintaining the relationship long term. Things in an ADHD house do not remain peaceful for long periods of time.
Having ADHD can make a person feel restless or anxious, causing them to seek out ways to relax. They may use excessive sex, food, or alcohol to try to calm themselves.
One patient at Amen Clinics had sex with his girlfriend over 500 times in the last year of their relationship. She left him because she felt that their relationship was only based upon sex.
Many people with ADHD have trouble getting outside of themselves to see the emotional needs of others. Studies have shown that adults with ADD tend to have lower levels of empathy.
This is theorized to stem from the difficulties tied to socializing skills, executive functioning, and emotional dysregulation. Spouses often label them as spoiled, immature, or self-centered.
People with ADHD often engage in repetitive, negative arguments with their partner. They don’t learn from the interpersonal mistakes from their past and repeat them again and again.
Supporting a partner with ADHD is critical for your relationship, as well as for your loved ones’ physical and mental health. Research on people with ADHD over the age of 50 found that a lack of a support system negatively impacted quality of life. On the flip side, having a supportive spouse enhanced daily functioning and overall sense of well-being.
If you’re wondering how to support an ADHD partner, try the following expert tips. These ADHD survival strategies can help reduce conflict and improve emotional connection in relationships.
Avoid vague requests. Clarity helps reduce misunderstandings. For example, when you ask your significant other to do something, make it clear. Instead of asking, “Can you rake the leaves?” try “Can you rake the leaves before lunchtime?”
Set up alerts, lists, and visual cues to help your partner stay on track. Perhaps you leave sticky notes around the house for them, download a shared calendar app, or set up check-in reminders to show your investment.
Related: 8 Brain-Based Habits That Elevate Your Relationships
Accept your partner’s strengths and limits with compassion, not frustration. This may involve building in extra time when making plans, asking them to sit down and connect if you’re feeling ignored, or even offering support if they are not meeting your expectations.
Boundaries build safety. Remind often and reinforce without shaming. If your partner is raising their voice at you during a heated discussion, instead of adding fuel to the fire, you could say “I want to keep talking, but I need us to lower our voices. I won’t continue the conversation if we’re yelling.”
Exercise, nutrition, and supplements like omega-3 fatty acids and green tea can improve brain function. Suggesting healthy meal ideas, making plans with them that involve exercise, and having nutritious snacks available in the house can all help.
Based on the brain-imaging work at Amen Clinics, there are seven types of ADHD:
Knowing more about your partner’s ADHD type can increase understanding and help you come up with targeted solutions to reduce symptoms and improve relationships.
When natural solutions or traditional treatments aren’t working, a brain scan may be beneficial to identify their type and to see signs of other problems, such as traumatic brain injuries that can mimic or worsen ADHD symptoms.
Related: 7 Types of ADHD eBook
If your partner has ADHD and marriage problems persist despite trying natural interventions and standard treatments, it may be time to seek help from a mental health professional. In some cases, a SPECT scan can offer insights into the underlying neurological patterns contributing to relationship conflict.
In marital partnerships, there are promises and investments made. While these deepen the relationship, they also invite larger expectations, greater responsibilities, and a constant collision of lifestyles.
To make sure that you are there for each other “in sickness and in health”, there are resources you can seek to support both you and your partner.
ADHD can be challenging not only for the person diagnosed, but also for their romantic partner. Each person in the relationship experiences unique obstacles and overcoming the relational complexities requires effort and vulnerability.
While these types of dynamics require more work, it’s this very investment in which healthy habits are more frequently practiced, and a deeper, more resilient union is formed.
Communication issues, emotional dysregulation, impulsivity, and forgetfulness are common relationship strains that often stem from untreated or mismanaged ADHD.
Support looks like structure, clear communication, and healthy boundaries, not rescuing or doing everything for them. Encourage brain-healthy routines and consistency.
Yes, there are seven types of ADHD, and each requires different strategies. A brain scan can uncover the specific type and lead to more effective solutions for both behavior and relationship success.
ADHD and other mental health conditions can’t wait. At Amen Clinics, we provide personalized, science-backed treatment plans designed to target the root causes of your symptoms. Our 360-approach includes brain SPECT imaging, clinical evaluations, innovative therapeutic techniques, medications (when necessary), and holistic lifestyle recommendations to promote the health of your brain, body, and mind. Speak to a specialist today at 888-288-9834 or visit our contact page here.
Beheshti, A., Chavanon, ML. & Christiansen, H. Emotion dysregulation in adults with attention deficit hyperactivity disorder: a meta-analysis. BMC Psychiatry 20, 120 (2020). https://doi.org/10.1186/s12888-020-2442-7
https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-020-2442-7
Groen, Y et al. “Reduced emotional empathy in adults with subclinical ADHD: evidence from the empathy and systemizing quotient.” Attention deficit and hyperactivity disorders vol. 10,2 (2018): 141-150. doi:10.1007/s12402-017-0236-7. https://pmc.ncbi.nlm.nih.gov/articles/PMC5973978/
Sodano, S. M., Tamulonis, J. P., Fabiano, G. A., Caserta, A. M., Hulme, K. F., Hulme, K. L., Stephan, G. R., & Tronci, F. (2019). Interpersonal Problems of Young Adults With and Without Attention-Deficit/Hyperactivity Disorder. Journal of Attention Disorders, 25(4), 562-571. https://doi.org/10.1177/1087054718821728 (Original work published 2021). https://journals.sagepub.com/doi/10.1177/1087054718821728
Ginapp, Callie M et al. “The experiences of adults with ADHD in interpersonal relationships and online communities: A qualitative study.” SSM. Qualitative research in health vol. 3 (2023): 100223. doi:10.1016/j.ssmqr.2023.100223
https://pubmed.ncbi.nlm.nih.gov/37539360/
Wymbs, Brian T et al. “Adult ADHD and romantic relationships: What we know and what we can do to help.” Journal of Marital and Family Therapy vol. 47,3 (2021): 664-681. doi:10.1111/jmft.12475
Sodano, S. M., Tamulonis, J. P., Fabiano, G. A., Caserta, A. M., Hulme, K. F., Hulme, K. L., Stephan, G. R., & Tronci, F. (2019). Interpersonal Problems of Young Adults With and Without Attention-Deficit/Hyperactivity Disorder. Journal of Attention Disorders, 25(4), 562-571. https://doi.org/10.1177/1087054718821728 (Original work published 2021)
Nyström, A., Petersson, K., & Janlöv, A. C. (2020). Being Different but Striving to Seem Normal: The Lived Experiences of People Aged 50+ with ADHD. Issues in Mental Health Nursing, 41(6), 476–485. https://doi.org/10.1080/01612840.2019.1695029
Kwon, Soo Jin et al. “Difficulties faced by university students with self-reported symptoms of attention-deficit hyperactivity disorder: a qualitative study.” Child and adolescent psychiatry and mental health vol. 12 12. 1 Feb. 2018, doi:10.1186/s13034-018-0218-3
When someone asks how you are, is “fine” your default answer—even when you’re not? Do you tend to hide your true feelings from others, including close friends and family?
Do you often feel disconnected and numb? Or are you prone to excessive or explosive emotional outbursts or reactions, even after seemingly minor setbacks?
Any of these symptoms may occur when you bottle up your emotions, a habit also called emotional suppression. This means that rather than facing, feeling, and working through emotions—whether positive or negative—you tend to bury or deny them.
While it can seem preferable in the moment to avoid feeling difficult emotions, this practice can lead to all kinds of issues, psychological as well as physical. This blog will explore some of its many dangers, symptoms to watch out for, and how to instead process your emotions in healthy ways.
Over decades, researchers have discovered significant evidence that bottling up emotions is associated with a long list of negative effects, from poorer health outcomes to less satisfying relationships.
Over decades, researchers have discovered significant evidence that bottling up emotions is associated with a long list of negative effects, from poorer health outcomes to less satisfying relationships.
Related: 8 Negatives of Positive Thinking
Here are just some of the ways that suppressing emotions can impact well-being:
Social consequences. A study of students published in the Journal of Personality and Social Psychology examined the links between suppressing emotional expression and the adaptation and social skills required for transitioning to college.
Researchers found that “suppression predicted lower social support, less closeness to others, and lower social satisfaction.” Indeed, an inability to trust others and to express emotions are often intertwined.
Mortality risk. A 12-year study surveyed the association between suppressed emotions and mortality. It considered death from all causes, as well as cardiovascular and cancer mortality.
Those with emotional suppression scores in the higher range (75th percentile) had a 35 percent greater risk for all-cause mortality than those in the 25th percentile. That number jumped to a 70 percent greater risk when examining cancer and cardiovascular disease mortality in particular.
Mental health issues. A study of men with prostate cancer, almost half of whom demonstrated signs of major depression, found that suppressing emotions was linked to anger and depression symptoms. Bottling up emotions was associated with low moods, sleep problems, and feelings of guilt among the cancer patients studied.
Different research uncovered an association between bottling up emotions and increased aggression. In this case, subjects who suppressed their reactions to disturbing film scenes displayed more aggression afterward, versus those who were allowed to show their emotions while viewing.
Finally, a study that examined adolescents between 14-19 years old found links between emotional suppression and how they responded to challenging life events. Those who bottled up their emotions were more likely to experience both suicidal thoughts and suicide attempts.
Compromised health and decision making. A 2019 study that examined repressed emotions symptoms noted many dangerous ripple effects of this habit, including:
Clearly, emotional suppression consequences can be hazardous to health and relationships in numerous ways. Repressed emotions, in addition to the many effects outlined above, may also lead to angry outbursts, isolation, and feelings of numbness.
Keep in mind that bottling up your emotions doesn’t always look negative. For example, some people bottle up their emotions by restricting themselves to only positive thinking. This habit, also called “toxic positivity,” can be just as harmful, since negative emotions must be allowed expression for optimal mental health.
Human beings evolved to have a negativity bias, because staying alert and aware of potential dangers literally keeps us alive. So, while it’s harmful to remain stuck in an overly critical outlook, it’s important to acknowledge and even embrace negative emotions when they arise.
Press Play to Learn More About Negativity Bias
In this episode of the Change Your Brain Every Day podcast, Dr. Daniel Amen and Tana Amen discuss why we tend to have fear-based thoughts.
Click below to tune in:
Video: Negativity vs. Positivity Bias: Why Are We Hardwired to Be Negative?
If you’re guilty of bottling up your emotions, it’s possible to change this habit. You can learn how to be more expressive and cope with your feelings rather than stuffing them down or pretending they don’t exist.
Here are some tactics to start processing your emotions in a healthier way:
The first step toward processing negative emotions is being aware that they exist. Fortunately, your physical state will often alert you to these issues.
Meanwhile, stress-relieving practices like meditation, prayer, and deep breathing also help relieve anxiety and can reduce the intensity of your strongest emotions.
This practice encourages you to review your life, revisiting both positive and painful experiences along the way. It helps bring repressed emotions like fear, shame, or anger into conscious awareness.
This practice helps you get out of a harmful cycle of distress and gently moves you toward peace, clarity, and true emotional freedom.
For example, approaches like cognitive behavioral therapy (CBT) can help rewire negative thought patterns while introducing healthier ways to handle challenges and stressors. You can also deconstruct and reframe any automatic negative thoughts (ANTs) using Amen Clinics’ How to Kill the ANTs practice.
Related: Automatic Negative Thoughts (ANTs) How to Stop Toxic Thinking and Rewire Your Brain
Over time, you will learn that you don’t need to avoid or be afraid of negative emotions. They are actually instrumental in making us stronger, wiser, and more resilient human beings. They only need to be processed in a healthy way and in safe settings.
While it’s more acceptable now to display emotions than in decades past, they can still be a source of shame, guilt, and fear for many Americans. This can be especially true for men, who are often taught to be stoic or “strong” in the face of threats.
But we now know that showing our emotions is a sign of strength. And “sucking it up” can destroy our health—physical, psychological, and emotional.
Rather than bottling up your emotions, learn to let them out in productive ways. With practice and patience, you’ll notice that your well-being, relationships, and quality of life steadily improve.
Srivastava S, Tamir M, McGonigal KM, John OP, Gross JJ. The social costs of emotional suppression: a prospective study of the transition to college. J Pers Soc Psychol. 2009 Apr;96(4):883-97. doi: 10.1037/a0014755. PMID: 19309209; PMCID: PMC4141473.
Chapman BP, Fiscella K, Kawachi I, Duberstein P, Muennig P. Emotion suppression and mortality risk over a 12-year follow-up. J Psychosom Res. 2013 Oct;75(4):381-5. doi: 10.1016/j.jpsychores.2013.07.014. Epub 2013 Aug 6. PMID: 24119947; PMCID: PMC3939772.
Rice SM, Kealy D, Ogrodniczuk JS, Seidler ZE, Denehy L, Oliffe JL. The Cost of Bottling It Up: Emotion Suppression as a Mediator in the Relationship Between Anger and Depression Among Men with Prostate Cancer. Cancer Manag Res. 2020 Feb 11;12:1039-1046. doi: 10.2147/CMAR.S237770. PMID: 32104085; PMCID: PMC7023872.
University of Texas at Austin. “Psychologists find the meaning of aggression: ‘Monty Python’ scene helps research.” ScienceDaily. ScienceDaily, 24 March 2011. <www.sciencedaily.com/releases/2011/03/110323105202.htm>.
Kaplow, J.B., Gipson, P.Y., Horwitz, A.G. et al. Emotional Suppression Mediates the Relation Between Adverse Life Events and Adolescent Suicide: Implications for Prevention. Prev Sci 15, 177–185 (2014). https://doi.org/10.1007/s11121-013-0367-9
Patel, J. (2019). Consequences of repression of emotion: Physical health, mental health and general well being. International Journal of Psychotherapy Practice and Research, 1(3), 16–21. https://doi.org/10.14302/issn.2574-612X.ijpr-18-2564. https://oap-journals.org/ijpr/article/999
Parenting is never an easy task. But parenting a neurodivergent child can offer up additional challenges—as well as unique rewards.
From autism spectrum disorder (ASD) and dyslexia to attention deficit hyperactivity disorder (ADHD)—also known as attention deficit disorder (ADD)—and Tourette syndrome, neurodivergence takes many forms. At the same time, conditions like ADHD and autism are never singular or simple. Each presents a distinct mix of symptoms in each person, shaped by a variety of factors.
Fortunately, some helpful hints and habits can assist parents with raising all types of neurodivergent children, helping them grow and thrive. And parents themselves will benefit by taking advantage of various strategies that can ease their challenges and concerns.
Neurodivergence isn’t something to be fixed, but to be optimized. Despite their challenges, neurodivergent children will also display unique strengths.
Neurodivergent children can have a range of conditions diagnosed. But, in general, this term refers to children whose brains are simply wired differently. These developmental differences evolve early in life—before birth or in the first stages of childhood.
Neurodivergence may present itself as a learning disorder, such as dyslexia and dyscalculia. Or it may mean your child falls on the spectrum of autism or ADHD. Other types of neurodivergence include Tourette syndrome, synesthesia, and dyspraxia.
Symptoms will differ according to the condition, and many can affect mental health—or overlap with mental health symptoms. Here are some signs to watch for in the most common types of neurodivergence.
Through decades of performing brain SPECT scans, Amen Clinics has determined there are seven types of ADHD. However, general core symptoms seen in all types of this mental health disorder include:
Related: 7 Types of ADHD eBook
Autism is not a simple or single condition. But symptoms can include the following:
Related: The Many Faces of Autism
Learning disabilities can appear in various forms and make schoolwork more difficult.
According to the American Psychiatric Association (APA), 5-15% of school-age children have a learning disability.
Tourette syndrome is characterized by sudden and involuntary tics, either vocalized or through movements. Synesthesia creates a conflation between two senses at once, such as seeing colors when hearing sounds.
Dyspraxia, also called developmental coordination disorder, affects motor abilities. A child with this condition may be perceived as clumsy, accident-prone, or uncoordinated.
Brain-based parenting strategies for neurodiverse children will encourage emotional regulation, structure, and connection. While each child (and parent) is unique, here are some approaches to try:
For example, kids with ADHD can incorporate a 500-mg supplement of L-tyrosine twice daily, which assists in attention and focus, as well as a high-protein, low-carbohydrate diet. (An exception is those with the over-focused type of ADD, for whom higher complex carbohydrate intake is recommended.)
Many neurodivergent children will benefit from an elimination diet. Try removing sugar, gluten, dairy, corn, soy, and artificial dyes and sweeteners, which can worsen conditions like autism.
Related: 5 Foods That Can Make Autism Worse
Finally, studies have suggested that boosting omega-3 levels in children can help reduce a variety of issues, including symptoms of ADD and autism. Add omega-3s through high-quality supplements and/or dietary choices like salmon, avocados, flax and chia seeds, walnuts, and dark leafy green vegetables.
Press Play to Discover the Best Foods for ADHD
In this video, Amen Clinics psychiatrist Dr. Steven Storage reveals the top five foods to eat to help ADHD.
Click below to tune in:
Considering the complexity of neurodivergence and the myriad ways a brain may be affected, a SPECT scan is instrumental in forming an accurate diagnosis, and therefore a sound treatment plan. Fortunately, symptoms of ADHD can improve significantly with all-natural solutions—not just pharmaceutical medications.
Supporting children with autism or ADHD may involve a variety of innovative therapy techniques. Neurofeedback, for example, helps children learn how to self-regulate their brain function. Psychotherapeutic modalities like cognitive behavioral therapy (CBT) can retrain the brain to reduce negative thinking and behaviors.
Also seek support in the environments your child frequents, such as at school, extracurricular activities, or church. Speaking to teachers, faculty, or counselors can help you all work together to make spaces outside the home more accommodating for your child.
Parenting inevitably contains countless ups and downs—both excruciating challenges and indescribable joys. And when responding to the unique needs of a neurodivergent child, those experiences can feel even more intense.
The good news is that we now have more information than ever about neurodivergence, including how we can best support those whose brains have developed differently—as well as their caretakers. Maintaining patience, a sense of humor, and an open mind will help you and your child thrive through their adolescence and beyond.
ADHD, autism, and other mental health conditions can’t wait. At Amen Clinics, we provide personalized, science-backed treatment plans designed to target the root causes of your symptoms. Our 360-approach includes brain SPECT imaging, clinical evaluations, innovative therapeutic techniques, medications (when necessary), and holistic lifestyle recommendations to promote the health of your brain, body, and mind. Speak to a specialist today at 888-288-9834 or visit our contact page here.
American Psychiatric Association. What Is Specific Learning Disorder? https://www.psychiatry.org/patients-families/specific-learning-disorder/what-is-specific-learning-disorder
Autism Speaks. Autism and exercise: Special benefits, By Dr. Sean Healy. https://www.autismspeaks.org/expert-opinion/autism-exercise-benefits
Sarfraz S, Shlaghya G, Narayana SH, Mushtaq U, Shaman Ameen B, Nie C, Nechi D, Mazhar IJ, Yasir M, Arcia Franchini AP. Early Screen-Time Exposure and Its Association With Risk of Developing Autism Spectrum Disorder: A Systematic Review. Cureus. 2023 Jul 22;15(7):e42292. doi: 10.7759/cureus.42292. PMID: 37614255; PMCID: PMC10442849.
Iao LS. Editorial: Wellbeing in parents of neurodivergent children. Front Psychiatry. 2024 Oct 9;15:1480313. doi: 10.3389/fpsyt.2024.1480313. PMID: 39444626; PMCID: PMC11496123.
