Hypermobility And ADHD: What You Need To Know
Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder and form of neurodiversity that may be diagnosed in individuals as a child and continue into adulthood. In some cases, other disorders may occur comorbidly with ADHD. One of these disorders is joint hypermobility syndrome, also called hypermobility disorder. Joint hypermobility-related disorders may impact an individual's connective tissues and cause joints to move beyond the typical range of motion.
While the link between hypermobility and ADHD is not entirely understood, if you have ADHD and are experiencing chronic physical symptoms or musculoskeletal symptoms, it may be beneficial to let an expert know. A mental health professional, along with an orthopedic doctor, may work together to help you manage both physical chronic pain and cognitive symptoms related to the two disorders.
What is joint hypermobility and Ehlers Danlos syndrome?
Individuals with hypermobility have joints that move beyond the typical range of motion and may cause pain as a result. Hypermobility spectrum disorders are connective tissue disorders that may include conditions like hypermobile Ehlers-Danlos syndrome (EDS) and benign joint hypermobility syndrome, as well as general orthostatic intolerance symptoms.
Generalized joint hypermobility (GJH) may be relatively rare, with around 12.5% of adults living with hypermobility in the United States. Although GJH can be painful and not curable, a doctor or physical therapist may manage co-occurring physical symptoms by guiding clients to build strength and muscle to ensure joint protection.
What is ADHD and how is it linked to hypermobility?
ADHD is a neurodevelopmental disorder that impacts how sensory information is processed within the brain. Symptoms of ADHD may include inattention, hyperactivity, and impulsivity. Individuals with ADHD may have a hard time focusing during work or school, and they may make decisions without thinking about consequences or impact. It is estimated that around 11% of children and 4.4% of adults are living with ADHD.
Studies have shown that neurodivergent conditions like ADHD and autism spectrum disorder may be linked to hypermobility. Individuals with ADHD have significantly more symptoms related to hypermobility than those without an ADHD diagnosis. A University of Sussex Medical School study also showed that individuals with hypermobility may also be at risk for other psychiatric disorders, including anxiety and depression.
It is believed that a genetic component plays a role in how connective tissue is formed. Individuals with ADHD and other types of neurodivergence may also have a higher pain sensitivity, which may cause the symptoms of hypermobility to be more pronounced.
Common overlapping symptoms between hypermobility and ADHD
There may be a genetic link between ADHD and hypermobility in that an impacted region of DNA may cause both ADHD symptoms and hypermobility symptoms. While both ADHD and hypermobility are distinct conditions, they may share common symptoms. Overlapping symptoms of hypermobility and ADHD may include:
- Motor skills:Both hypermobility and ADHD can affect motor skills. Individuals may exhibit clumsiness, poor coordination, and difficulties with tasks that require fine motor skills, such as writing.
- Impulsivity: Impulsivity is a hallmark symptom of ADHD but can also be present in individuals with hypermobility. This symptom can manifest as acting without thinking, interrupting others, or difficulty waiting their turn.
- Attention difficulties: ADHD is characterized by inattention, but individuals with hypermobility may also have trouble maintaining focus, particularly during tasks that require sustained attention.
- Hyperactivity: While hyperactivity is a primary symptom of ADHD, it can also be seen in individuals with hypermobility, especially in children with difficulty sitting still or engaging in quiet activities.
- Sensory processing issues: Both hypermobility and ADHD can be associated with sensory processing issues, such as hypersensitivity or hyposensitivity to sensory stimuli (e.g., touch, sound, light).
- Anxiety: Anxiety disorders are common in ADHD and hypermobility. Individuals may experience heightened levels of anxiety, which may be due to increased chronic pain.
- Difficulty with transitions: Both conditions can make it challenging for individuals to transition between tasks or activities, leading to resistance or difficulty adapting to changes in routine.
- Sleep disturbances: Sleep problems, including difficulties falling or staying asleep, are common in ADHD and hypermobility-related conditions.
- Executive functioning challenges: Executive functioning refers to mental skills that help individuals plan, organize, and complete tasks. ADHD and hypermobility may impact executive functioning, leading to difficulties with time management, organization, and prioritization.
- Emotional dysregulation: Individuals with both conditions may have difficulty regulating their emotions, leading to mood swings, irritability, or emotional outbursts.
Diagnosis and treatment for hypermobility and ADHD syndrome
Similar to diagnosing hypermobility, it may be difficult to diagnose ADHD. ADHD is often highly variable, and symptoms do not always present in the same way for all people. Being diagnosed with ADHD involves working with a doctor or mental health professional to see if your symptoms meet those characterized by the Diagnostic and Statistical Manual (DSM). If you meet the criteria laid out in the DSM, your provider might diagnose you with ADHD.
Treating attention deficit hyperactivity disorder or ADHD
Treating individuals with comorbid ADHD and hypermobility may involve a multidisciplinary approach that consists of meeting with doctors, mental health professionals, and physical therapists. ADHD may be managed by making lifestyle changes, taking medication, and practicing various coping strategies such as deep breathing and meditation.
Treating hypermobile symptoms
Hypermobility may benefit from a routine designed to build muscle around the joints to stabilize and strengthen them. It also may be beneficial for individuals with both ADHD and hypermobility to work with a therapist to manage mental health symptoms that accompany both disorders, including anxiety and depression.
Strategies for managing hypermobility and ADHD
While hypermobility and ADHD are not curable, both can be managed by implementing an interdisciplinary approach that includes working with professionals in health-related fields. These professionals could include psychotherapists, psychiatrists, physical therapists, and orthopedists, who can work as a team to help you manage symptoms.
Strategies your professional team of healthcare providers may recommend could involve treating both the mental and physical aspects of both ADHD and hypermobility. Strategies for managing symptoms of both disorders include the following.
Attend physical therapy
Physical therapy may strengthen muscles and improve joint stability for individuals with hypermobility, reducing their risk of injury. A physical therapist may provide clients with specific exercises and help them track progress. Working with a physical therapist can also improve accountability and consistency in physical activity.
Although not typically prescribed for ADHD, physical activity has been shown to be beneficial for individuals with ADHD, as it can reduce hyperactivity and improve focus. For some individuals with ADHD, studies have also concluded that there may be an increased risk for musculoskeletal conditions, further demonstrating the potential benefit of physical activity.
Work with an occupational therapist
An occupational therapist may help an individual develop coordination and fine motor skills. For individuals with hypermobility, both coordination and fine motor skills can be impacted by musculoskeletal symptoms related to connective tissue. People with ADHD may also benefit from working with an occupational therapist to build organizational skills and manage sensory processing challenges.
Like other mental and physical health professionals, an occupational therapist may begin by inventorying symptoms and evaluating your needs. They may then develop a strategic plan to manage symptoms and improve outcomes. ADHD and hypermobility are treated using various techniques, and occupational therapy may be one part of the overall treatment plan.
Make environmental changes
The environment where a person works and lives can impact symptoms of hypermobility and ADHD. Using ergonomic or dynamic furniture may reduce pain in individuals with hypermobility and could positively impact focus. In addition to furniture that reduces distraction, it may be beneficial to think about creating a work or study environment free from sensory distractions. For example, you might try positioning your desk to avoid loud noises or busy areas at work.
Make lifestyle changes
For both hypermobility and ADHD, specific lifestyle changes may be beneficial. Adding exercise and physical activity can help a person with hypermobility gain muscle mass and protect joints. People with ADHD may also benefit from routine exercise as it can improve focus and may reduce ADHD symptoms. Exercise may also enhance the quality of sleep, which could positively impact ADHD symptoms.
Another lifestyle change that may improve ADHD and hypermobility is eating nutritious and filling foods. Individuals can work with a nutritionist to develop a menu of meals to manage ADHD symptoms and potentially improve overall physical functioning with hypermobility.
Online therapy for hypermobility ADHD
Individuals with hypermobility and ADHD may be diagnosed with co-occurring mental illnesses like depression and anxiety. Online cognitive-behavioral therapy is effective at treating depression and anxiety, as well as reducing overall ADHD symptoms. A therapist can guide you in identifying significant symptoms and work with you to manage those symptoms in daily life.
For individuals with hypermobility and ADHD, it can be challenging to drive to an office and sit with a therapist for an hour in a new environment. Online therapy through a platform like BetterHelp offers the benefit of working with a therapist from anywhere with an internet connection. You can receive therapy sessions from the comfort of your own home and choose between phone, video, or live chat sessions.
Takeaway
What is Ehlers-Danlos and joint hypermobility syndrome?
Ehlers-Danlos syndrome (EDS) is a condition that affects connective tissue. Specifically, it affects the body’s ability to produce collagen, which makes the connective tissue weaker than it should be. There are multiple types of EDS; the most common types cause loose and hypermobile joints and fragile skin. Other symptoms of EDS include bruising easily, fatigue, muscle and joint pain, unusual scarring, and difficulty concentrating.
Are people with ADHD or attention deficit hyperactivity disorder hypermobile?
Some research has found that ADHD and other neurodevelopmental condition diagnoses can be linked to hypermobility. One paper, Joint Hypermobility Links Neurodivergence to Dysautonomia and Pain, found that joint hypermobility mediates the link between neurodivergence and symptoms of dysautonomia and pain in neurodivergent adults. This study included autism spectrum disorder, tic disorder (like Tourette syndrome), and ADHD patients together instead of separate diagnostic groups or diagnostic categories.
Other studies have found that about 32% of participants with ADHD have generalized joint hypermobility compared to only 14% of the comparison group. Another study determined that people with EDS were more than five times likely to have ADHD than the general population.
What’s the difference between Ehlers-Danlos and joint hypermobility ADHD?
While EDS is a condition that affects connective tissue, joint hypermobility ADHD is not an official diagnosis. While neurodivergent participants reported significantly more symptoms of joint hypermobility in multiple studies, these are seen as two different conditions with unique diagnostic criteria.
Is hypermobility syndrome affecting the physical body?
Hypermobility syndrome can have a variety of physical health issues. Some common symptoms include frequent sprains and dislocations, joint and muscle stiffness, fatigue, bladder and bowel issues, and thin, stretchy skin. Some people with EDS can experience postural orthostatic tachycardia syndrome, which causes an excessively elevated heart rate when standing from a lying or sitting position. This can lead to autonomic dysfunction and orthostatic symptoms, including dizziness and lightheadedness.
Is there a link between autism and hypermobility?
Yes, research has found that there may be a link between ASD and general joint hypermobility. One study found differences between the neurodivergent and comparison groups that included gender differences. For women, 44.7% of those with ASD demonstrated elevated levels of hypermobility compared to 24% of those without ASD; for men, 21.6% of those with ASD had generalized joint laxity compared to only 7.6% of those without.
Other research has found that hypermobility can be associated with several mental health conditions. For example, according to MQ Mental Health Research, hypermobility may be associated with depression and anxiety in adolescence.
What disorder is associated with hypermobility?
Multiple conditions can be associated with hypermobility, including heritable disorders like EDS, pseudoxanthoma elasticum, Marfan syndrome, and Stickler syndrome.
Do hypermobile people have more anxiety?
Yes, research has found that people with joint hypermobility are more likely to experience anxiety, likely due to changes in brain structure or genetic factors..
What to avoid with hypermobility?
People with symptomatic hypermobility should avoid intentionally overextending their joints and engaging in repeated exercises or activities. Not doing any exercises can make symptoms worse, so people with this condition may be encouraged to engage in low-impact strengthening exercises, maintain a healthy weight, and wear supportive footwear. For assistance with managing joint instability, limiting musculoskeletal pain, and overall pain management, contact the healthcare professionals managing your care.
What can be mistaken for hypermobility?
Hypermobility can also be mistaken for inflammatory arthritis. The difference between hypermobility versus arthritis is that hypermobility typically has to do with the ligaments and tendons, while arthritis is an inflammation in the joints. While they share some symptoms, including impacting physical coordination, health providers may be able to distinguish between the two on physical examination.
Does hypermobility get worse with age?
It can depend on the cause of the hypermobility. For example, while EDS is not a progressive disease, some people may experience worsening symptoms as they age. On the other hand, people with generalized hypermobility may experience improvement with age as the joints naturally stiffen and some people experience a loss of mobility. Talk to experienced health providers to learn more about your specific diagnosis and clinical implications.
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