The most common mimics of attention disorders in adults are anxiety disorders and mood disorders, and these must be carefully ruled out to make the diagnosis. The list of other mimics includes nutritional deficiencies, kryptopyroluria, eczema, mental retardation, schizophrenia, learning disabilities, developmental disorders, lead poisoning, thyroid hormone dysregulation, seizure disorders, sleep apnea, Lyme disease, multiple sclerosis, and head trauma. Thorough evaluation is necessary to assess the possibility that one of these disorders is primarily responsible for an attention disturbance. Common comorbid disorders, such as conduct disorder, antisocial personality disorder, bipolar disorder, substance abuse disorder, must be ruled out as well.
It is worth noting that anxiety (whether caused by family conflict, or inflammation or infection in the body, or other reasons), acts to ‘shut down’ the pre-frontal cortex in the brain. This is where our executive functions reside (planning, organizing, short-term memory, attention, and focus). This means that if a child has activation of the emotional brain (e.g., fear, anxiety, learning disability, depression), or any other problem that shuts down the prefrontal cortex, they will appear to have ADD or ADHD, and receive Ritalin or some stimulant medication, even though the underlying cause lies elsewhere.