Introduction: ADHD, Moodiness, Meteorology, and Elephants

Abstract

ADHD often occurs along with symptoms of moodiness or mood disorders, which add greatly to patients’ impairment. Students of mental health are taught that patients’ “affect” is to their “mood” like a city’s “weather” is to its “climate.” However, in patients with ADHD such a distinction seems less clear. For example, their emotional problems may represent a true mood disorder, psychiatric disorders, an undiagnosed medical problem, a medication side effect, or even a symptom of the ADHD itself. It is not surprising that even experienced clinicians and clinical researchers often disagree about such patients’ diagnoses, bringing to mind another analogy of us being like “blind men” who identify an elephant differently based on the body part we feel. Such diagnostic discordance and the potential for adverse events from improperly selected treatments underscore the need for thorough assessments to inform the best strategy of pharmacological and psychosocial treatments. Chapters that follow are written by clinical and research experts in their respective topics, and focus on different causes of mood, moodiness and ADHD symptoms, and how to differentiate them from other causes. The goal is to provide clinicians a broad, evidence-based framework, along with specific clinical tools to enhance their skill caring for their patients with symptoms of ADHD and other disorders of mood or affect.