When my mother and grandmother took a drawing class together, they were taught to draw the voids between objects, rather than the objects themselves. They achieved startlingly better results with this method than anything they’d attempted before. It’s something humanity isn’t typically adept at seeing, what’s not there.

The rate of comorbidity, or disorders accompanying, ADHD is 80%. In other words, if you’ve been diagnosed with ADHD, there’s an 80% chance you also have something else at play.

Often these conditions are exacerbated by the ADHD. In the beginning of my mental health awareness journey, I was diagnosed with depression and prescribed antidepressants. These were totally ineffective in alleviating my symptoms because the source of my depression wasn’t chemical but due to the constant frustration of being someone with untreated ADHD. Once my ADHD began to get the treatment it needed (in my case mostly behavioral and lifestyle changes) I began to feel much better.

But what happens when ADHD is at play, but it isn’t alone, and its friends are much stronger? The complexities of treating multiple comorbidities at once isn’t in my skill-set. However, that doesn’t mean my gut doesn’t occasionally send me messages.

It’s the void between the ADHD symptoms that send up red flags for me. If several tried and true ADHD strategies consistently fail to bring about the desired improvement, I begin to suspect something. If lack of motivation is an even bigger problem than with most people with ADHD, it will twig something. If emotional regulation is a constant and seemingly insurmountable issue, I will begin to sense limitations to my assistance.

I am not qualified to diagnose medical or mental health challenges, and I never seek to, but I can sense the void where my skills as an ADHD coach aren’t enough to support my client. At these times, it becomes my duty to suggest my client seek out different or additional support to assess the possibility.

It will always be an incredibly complex subject, even for those educated and trained in this area. So many issues can mask each other or mimic each other. How do you tell the difference between Bipolar and ‘Ring of Fire’ type ADHD? I haven’t a clue. I am confident, however, that finding someone who does know is essential when it comes to effective mental health management when things stop adding up.

What’s something unexplained about your mental health?