ADHD and Anxiety are Closely Connected.
It’s estimated that 60% of people with ADHD have a comorbid, or coexisting, condition. About 50% of adults and up to 30% of children with ADHD also have an Anxiety Disorder, because the ADHD experience makes for a life characterized by stress and worry. As a result, adults with ADHD often lead anxious lives. Basically, the nature of ADHD often makes day-to-day life stressful, creating situations and environments fraught with uncertainty, which is anxiety’s primary fuel.
That is why ADHD cannot be discussed without bringing up anxiety, whether that means pesky, troublesome bouts of worry that present only in specific contexts (like meeting work deadlines or making difficult back-to-school decisions), or full-fledged anxiety disorder. Either way, the link between the two is direct, so much so that anxiety is the most common comorbid diagnosis with adult ADHD.
In effect, if you have ADHD, it may be difficult to recognize the symptoms of anxiety. However, ADHD is an ongoing condition that often starts in childhood and can continue into adulthood. It can affect your ability to concentrate. At ATTN Center our therapists recognize the complex connection between ADHD and anxiety and understand that both must be addressed together.
ADHD May Result in Behavioral Problems, such as:
● hyperactivity
● lack of attention
● lack of impulse control
● fidgeting and trouble sitting still
● difficulty organizing and completing tasks
An Anxiety Disorder is More Than Just Feeling Occasionally Anxious.
It’s a mental illness that is serious and long-lasting. It can make you feel distressed, uneasy, and excessively frightened in benign, or regular, situations. If you have an anxiety disorder, your symptoms may be so severe that they affect your ability to work, study, enjoy relationships, or otherwise go about your daily activities. The symptoms of ADHD are slightly different from those of anxiety. ADHD symptoms primarily involve issues with focus and concentration. Anxiety symptoms, on the other hand, involve issues with nervousness and fear.
Is Anxiety a Symptom of ADHD?
Although anxiety alone is not included in the diagnostic criterion for ADHD, the link between the two conditions is strong. Anxiety refers to our mental and physiological response to a perceived risk or threat. Additionally, anxiety disorders, which range from social anxiety disorder to panic attacks to post-traumatic stress disorder (PTSD) and more, are characterized by constant feelings of worry and fear that interfere with daily life. Some symptoms, like fidgeting and trouble concentrating, are hallmarks of both ADHD and anxiety. As a result, clinicians must rule out anxiety and other mental disorders when diagnosing ADHD, and vice versa.
Does ADHD Make Anxiety Worse?
Individuals diagnosed with ADHD and anxiety disorders tend to have more severe anxiety symptoms than those without ADHD. But even adults with ADHD who do not meet the diagnostic criteria for anxiety may experience occasional/situational anxiety in their daily lives, due to things like time blindness, poor working memory, and exaggerated emotions, among other anxiety-producing symptoms. In one study on adults with ADHD, researchers noted that problems stemming from ADHD, such as tardiness, procrastination, and the prospect of social stigma, all led participants to experience anxiety at many points in their lives, and once they were anxious, their ADHD symptoms worsened.
Individuals with ADHD know what they need to do, but they have problems with implementation. This is a big part of what makes ADHD so frustrating, particularly in adulthood.
Here are some of the common roadblocks to implementation:
● Front-end perfectionism: “I have to be in the mood/have enough energy to do something.” These unlikely standards are by far the most common distorted automatic thought among adults with ADHD.
● Self-regulatory efficacy: “I know I can do this, but I’m not sure if I can resist distraction or focus.”
● Incautious optimism: Otherwise known as distorted positive thoughts. “I work best at the last minute”, “It’s better if I go to a party and have fun first before I get my work done.”
● Emotional dysregulation: Part of managing anxiety is being able to change and control our emotional states so that we can readily engage in a task. However, failing to manage discomfort effectively can lead to avoidance and procrastination, which exacerbates anxiety.
How to Regulate Anxiety and ADHD Behaviors
To effectively manage your anxiety through ADHD-Focused Therapy for Anxiety, firstly, we begin by using your feelings and behaviors as information. Anxiety and troubling feelings can be conditioned to signal the following questions to reflect on:
● Which feeling am I feeling?
● What is this feeling trying to tell me?
● What is the problem?
● What was the trigger?
● Is the problem really a problem? If so, how can it be managed?
● What’s the best, worst, and most likely outcome of the issue?
ADHD-Focused Therapy for Anxiety uses Cognitive Behavioral Tools to Help Patients Solve Their Anxiety.
One example is: Suppose you find yourself self-medicating through alcohol or binge eating during quarantine. How can you manage these urges?
● Ask: “What am I feeling? What is the benefit of this behavior? What am I getting out of it?” These behaviors are typically associated with reducing anxiety, numbing oneself to stress, or feeling in control. Labeling the feeling (anxiousness, overwhelmed, out of control) is also a form of acknowledging the situation, in turn, an action that calms us.
● Identify the triggers or problems that gave rise to the binging or self-medicating behavior. This varies according to the individual, but common ones include boredom, loneliness, worries about meeting obligations, unrest or tension at home, work-related stress, and even the news cycle.
● Think hard about these triggers and problems. Dispute them. Are the listed problems truly problems? Maybe you gave yourself an unrealistic deadline to meet the obligation you’re stressing over. What are the best- and worst-case scenarios, and what’s most likely to happen? Thinking through these can help us dwell on the probabilities rather than the possibilities, recognizing that the perceived problem might not be a problem after all.
● That said, self-medicating on alcohol and binging are problems that need addressing. One way to handle both is through stimulus control, including removing temptations in the household and looking for replacement behaviors, like swapping in healthy foods or replacing alcohol with another liquid or stimulus, like tea or listening to calming music. Of course, if these or any other issues feel completely out of control, it may be best to get in touch with a licensed mental health clinician.
Other Coping Mechanisms for ADHD and Anxiety
1. Structure unstructured time.
There’s no way around it: Creating a routine is a must, especially one that’s highly visible. For Example, that could be an appointment planner, a calendar on the wall, or a digital planner kept open on a tablet. Additionally, think of planners as time machines that allow us to look at hours, days, and weeks into the future, priming us for what we plan to do. Breaks must be worked into any schedule as well, including making room for…
2. Exercise and movement.
We underestimate the loss of “stealth” movement during the course of the traditional workday (walking down hallways, to the parking lot or train station, etc.). As basic as it sounds, movement helps. This is especially true when cooped up and working from home. In addition, movement can be its own form of meditation, allowing us to remove ourselves from work or home and reset.
3. Maintain healthy habits.
Many individuals, ADHD or not, are experiencing chronic stress and general feelings of overwhelm with no one particular stressor. As a result, better exercise, sleep, and diet — like limiting physical anxiety triggers like caffeine and alcohol — are effective at reducing overall stress.
4. Organize physical spaces.
Firstly, define where work, leisure, sleep, study, and other activities will be done around the home to help with behavioral priming and habit formation. Secondly, combat “sight pollution” by resetting and preparing your spaces for the next day, which also helps with transitions.
What Are the Similarities Between ADHD and Anxiety
Similarities between anxiety and ADHD can be named under behavioral disorders that adults or children with these conditions will encounter. These can be listed below:
● Inattention
● Distraction
● Fidgeting
● Disorganization
● Poor time management
● Difficulty concentrating
● Difficulty remembering
● Procrastination
● Getting stuck
What Are the Differences Between ADHD and Anxiety
The difference between anxiety and ADHD is based on the source of the individual’s focus problem. In addition, some individuals cannot focus due to fearful, anxious thoughts. Or even if their mind is calm, they cannot focus because they are easily distracted. In short, people with anxiety disorders will also have a poor capacity to focus because their mind is busy with anxious, worrying thoughts, but don’t necessarily have ADHD too.
Symptoms ADHD and Anxiety Share
Difficulty concentrating or paying attention
Hard to relax, feeling restless
Forgetfulness
Irrational fears
Symptoms Specific to ADHD
Trouble completing tasks
Difficulty listening to and following instructions
Inability to focus for long periods of time
Difficulty listening to and following instructions
Symptoms Specific to Anxiety
Chronic feelings of worry or nervousness
Trouble sleeping or insomnia
Headaches & Stomachaches
Fear of trying new things
Start ADHD-Focused Therapy for Anxiety in NYC and Find Peace
ADHD-Focused Therapy for anxiety at the ATTN Center is unique because it offers traditional therapy practices to address the psychological and emotional impacts of having ADHD and anxiety in the real world. We also offer practical support for organization and structure (scheduling, calendaring, to-do lists, not losing keys, etc). All through the lens of Neurodivergence.
In addition to understanding the unique challenges of having ADHD that other therapies do not, our expert ADHD-Focused therapists look forward to speaking with you. We offer a free 20-minute phone consultation to discuss your case and how we can help. Contact us today.
- Learn more about our team and the services offered here!
- Reach out to us through our convenient online therapy contact page here!
- Begin the journey to understanding your diagnosis and living your best life!
Other ADHD Services Offered by The ATTN Center in NYC
We not only offer ADHD-Focused therapy for anxiety, but also other services related to the treatment of ADHD and its side effects. This includes neurofeedback, group therapy, and ADHD testing options. At ATTN Center of NYC, we do everything in our power to treat ADHD without the use of medication, but we understand in some severe cases additional measures may be needed. As a result, we also maintain close relationships with many of NYC’s best psychiatrists.
Resources:
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Sciberras E, Mulraney M, Anderson V, Rapee RM, Nicholson JM, Efron D, Lee K, Markopoulos Z, Hiscock H. Managing Anxiety in Children With ADHD Using Cognitive-Behavioral Therapy: A Pilot Randomized Controlled Trial. J Atten Disord. 2018 Mar;22(5):515-520. doi: 10.1177/1087054715584054. Epub 2015 May 4. PMID: 25939582.
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Shephard E, Bedford R, Milosavljevic B, Gliga T, Jones EJH, Pickles A, Johnson MH, Charman T; BASIS Team. Early developmental pathways to childhood symptoms of attention-deficit hyperactivity disorder, anxiety and autism spectrum disorder. J Child Psychol Psychiatry. 2019 Sep;60(9):963-974. doi: 10.1111/jcpp.12947. Epub 2018 Jul 2. PMID: 29963709; PMCID: PMC6694009.