ADHD and anxiety disorders are two conditions that often go hand-in-hand. ADHD is a neurological condition characterized by symptoms of inattentiveness, impulsivity, and hyperactivity. Anxiety is a disorder that causes feelings of fear or worry often disproportionate to the situation. ADHD can worsen anxiety symptoms because of its impact on brain chemistry.
This blog post will discuss how ADHD affects anxiety, and what it means to have both conditions. You’ll learn about treatment options for anxiety and ADHD available through integrative medicine practitioners, and functional medicine solutions like diet changes, supplements, behavioral therapy, or medications.
The Relationship Between ADHD and Anxiety
The connection between ADHD and anxiety is significant. According to two national surveys, nearly 40% of adults and about 30% of children have at least one other co-occurring condition in addition to ADHD (1).
Half of all adults with ADHD also had an anxiety disorder of some type, including generalized anxiety disorder (GAD) (1). Anxiety often mimics ADHD, and vice versa. It can be difficult to tell these two conditions apart because they share several specific symptoms.
For example, in anxiety disorders as well as ADHD, people often have difficulties with focusing and self-regulation. Feelings of anxiety can also make ADHD symptoms worse.
It’s also not uncommon to see symptoms of one improve while treating the other. But learning about the difference between the two disorders is important for the management and treatment of both.
Related: Holistic Modification for Depression and Anxiety
Anxiety Is Often a Symptom of ADHD
Adult ADHD can worsen an anxiety disorder because of its impact on brain chemistry. In ADHD, the brain has trouble making dopamine and serotonin in a consistent way. This means that levels are sometimes too high or low which causes mood problems such as depression, irritability, anger issues, impulsivity, or mania.
These same neurotransmitters are also affected by ADHD medications, such as Ritalin or Adderall. These drugs manipulate dopamine and serotonin levels in the brain which helps improve things like focus, attention, and impulsivity issues.
However, these same chemicals can worsen some issues like loss of appetite, sleeplessness, irritability, or other problems regulating mood because of their effect on mood and brain chemistry. Though stimulant medications almost always improve feelings of anxiety associated with ADHD, in limited cases stimulant medications can also worsen anxious feelings (2).
Read more: Signs + Symptoms of Anxiety in Children
Anxiety is more common in those with ADHD than in people who do not have ADHD
Almost half of people with ADHD also experience coexisting anxiety, according to a national survey, compared to about 20% of people who do not have ADHD (1). Anxiety disorders span from social anxiety disorder to panic attacks and post-traumatic stress disorder (PTSD). In most cases, an anxiety disorder is defined as a disproportionate worry or fear which interferes with daily activities and quality of life.
If ADHD is making your anxiety worse, it’s important to work with a qualified integrative medicine doctor to properly evaluate and treat coexisting anxiety.
How Anxiety Symptoms Mimic ADHD
Anxiety looks similar to ADHD in many adults and children. People who suffer from anxiety and those who have ADHD both experience trouble with self-regulation.
It’s this difficulty to regulate that causes many of the overlapping signs and symptoms of ADHD and anxiety. Both ADHD and anxiety may result in difficulty focusing or staying on task. ADHD also makes it difficult for people to shut out distracting thoughts so they can relax, which is similar to anxiety.
Keep in mind that anxiety often appears as a symptom of ADHD, but someone can experience anxiety without having ADHD.
What ADHD or anxiety looks like at home or school
In both conditions, a nervous or anxious person may tune out teachers in class or coworkers in meetings that involve in-depth attention. Children with both ADHD or anxiety often fidget in class, and may also have trouble sitting still for extended periods. Fidgeting can also be a way to dispel anxious energy by stimulating the body as a way to distract the mind.
An anxious mind often struggles with perfectionism and/or self-doubt. This makes it challenging to complete homework or other tasks. In ADHD, one may also experience self-doubt and have trouble balancing their workload because of a restricted attention span or motivation. This perceived procrastination for tasks often exacerbates anxiety, resulting in a spiral where the ADHD person becomes overwhelmed.
Common ADHD Thought Patterns That contribute to anxiety
The narratives a person with ADHD tell themselves, often contribute to and are exacerbated by feelings of anxiety themselves:
Perceived self-regulatory efficacy: “When a task gets boring, I won’t know how to make it interesting enough to complete it.” (3)
Distorted positive thinking: Or overly positive “automatic” thoughts. “I perform better when I wait until the last minute.” (4)
Front-end perfectionism: “If the circumstances are right, then I can begin this task.” This conception that rigid standards must be in place before engaging in a task are one of the more common cognitive hurdles in ADHD (5).
Trouble with self-regulation: New and ongoing research suggests that at its core, ADHD may be more about the difficulty in emotional regulation than the traditional two-dimensional hyperactive/attention-deficit criteria (6).
How do I tell ADHD and anxiety apart?
While ADHD often both contributes to and is exacerbated by anxiety, there are a few ways you can distinguish between anxiety and ADHD.
If your anxiety comes and goes based upon environmental triggers such as stress at work, an argument with a friend or family member, or financial worries, and you tend to return to a baseline in the absence of a significant stressor, it’s likely you’re dealing with anxiety and not ADHD.
Symptoms of Anxiety in Adults and Children with ADHD
Anxiety symptoms in children, teens, and adults with ADHD include:
- Restlessness or irritability
- Difficulty concentrating on tasks, homework, chores
- Fidgeting and squirming in your seat when seated for long periods of time at school or work.
- Procrastination (often as a result of overwhelm or distorted positive thinking)
Adults with ADHD may also suffer from chronic stress, worry, or:
- A sense of dread about the day ahead, including anticipating failure or embarrassment
- Difficulty getting out of bed in the morning; difficulty falling asleep at night
- Other Ways to Spot Anxiety in Your ADHD Child
ADHD children may also struggle with physical symptoms, such as:
- Frequent stomach aches and headaches
- Sensitivity to loud noises or bright lights, which can be associated with sensory processing issues.
- Muscle tension
- Outbursts of anger or frustration
ADHD kids are often not aware of the impact their behavior has on others, which leads to misunderstandings about the support they need from family members and peers.
Related: Causes of ADHD in Children: Diet, Chemistry, and Environment
Why is ADHD misdiagnosed as anxiety?
It is not uncommon for those who have anxiety to have an incorrect diagnosis in regards to ADHD. Both conditions are related to brain differences but they are not the same. More research is always ongoing to better understand the connection between ADHD and anxiety, and individualized treatment options.
ADHD and anxiety both involve brain chemistry and neurotransmitter function. Serotonin, dopamine, and acetylcholine are a few of the neurotransmitters involved.
When these neurotransmitters become imbalanced or dysregulated, the resulting behaviors can look similar in several different cognitive disorders, including ADHD and anxiety.
Learn how easy it is to get started with CentreSpringMD’s comprehensive cognitive and behavioral health program, Brain Boost. Proper evaluation and treatment can help any child or adult thrive mentally, physically, and emotionally.
Treating both anxiety and ADHD
Ongoing research suggests that a holistic and integrative medicine approach is the most effective at addressing both conditions. This involves:
Medication – stimulants or non-stimulants.
Behavior therapy – This includes children, parents, and individuals.
Lifestyle and diet changes – Functional therapies to treat ADHD naturally, or to maximize the effectiveness of medication.
While it’s tempting to label one approach as the best way to treat ADHD, remember that each individual’s behaviors and diagnosis are unique, and the goal is to find the most effective approach–or combination of approaches–that works best to support them.
Related: 10 Strategies to Address ADHD Without Medication
Tips to Address ADHD and Anxiety
Create a schedule
Schedule specific tasks and include unstructured “downtime” as well. Explore process vs. outcome-oriented scheduling (i.e. “spend 30 minutes on this project” vs. “complete this project before lunch”). You can also follow daily routines consistently, as this has been shown to benefit both conditions simultaneously.
Learn your triggers
In some people, anxiety can result from particular events such as a big event at work or school, or unfamiliar situations. Preparing for situations that trigger anxiety may help alleviate some anxious feelings and behaviors.
Related: Holistic Tips to Handle Stress
Eat well
The right nutrients are important for cognitive function. Quality proteins, healthy fats rich in omega 3s, nutrient-dense fruits and vegetables, and minimally processed grains provide optimal fuel sources for both adults and children for healthy brain and neurotransmitters.
Read: 14 Best Brain Foods for Kids
Decrease excitatory triggers like energy drinks and coffee
Even if you’re taking medication, it’s helpful to avoid substances that can trigger excitatory neurotransmitters in the brain such as high-sugar foods, energy drinks, or caffeine. An adequate supply of the amino acid, GABA, can help.
Exercise regularly
A 30-minute daily exercise break has been shown to reduce anxiety and be an effective complementary treatment for ADHD, improving impulsivity and attention (7).
Medication (stimulant and non-stimulant)
Medication is a necessary part of treatment for many people. While it’s not the only solution available, your integrative doctor can help you figure out if a stimulant or non-stimulant medication can help you better manage your ADHD symptoms.
Work with a qualified integrative medicine provider
Working with a qualified integrative medicine provider gives you the advantage of addressing these two conditions with a holistic approach and solutions that suit you as an individual. ADHD symptoms both contribute to and are worsened by feelings of anxiety, so it’s not uncommon for people diagnosed with one condition to also be experiencing some level of the other.
It’s important to find someone who can treat your body as a whole in order to get better results than with symptom management. We know how difficult this can seem when dealing with more complicated medical issues like anxiety or other cognitive issues; however, we’re here for you every step of the way at CentreSpringMD! Contact us today for help finding holistic relief from your mental or physical ailments.
Resources
- https://chadd.org/about-adhd/co-occuring-conditions/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4617411/
- https://www.frontiersin.org/articles/10.3389/feduc.2020.00019/full
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4403795/
- https://www.psychologytoday.com/us/blog/rethinking-adult-adhd/202012/adult-adhd-perfectionism-and-procrastination
- https://psycnet.apa.org/record/2014-57877-003
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5281644/
