Anxiety and ADHD: Connections and Causes

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Anxiety is a horrible feeling. The churning stomach, racing thoughts, sweaty palms… it can be debilitating. It’s why I started my career in hypnotherapy in the first place. I know the feeling of being lost in anxious thoughts, and I wanted to help people find their way out.

As I’ve started to specialise in patients with ADHD, I have found an increasingly strong connection between the two issues. In fact, ADHD is commonly misdiagnosed in adults as Generalised Anxiety Disorder.

While ADHD and anxiety have a certain amount in common, treating them as one and the same is generally unhelpful. It’s important to pinpoint which symptoms of anxiety were caused by ADHD-related difficulties, and which were pre-existing, to work out an effective treatment plan.

Stories from the real world

Although I value the contents of scientific journals, I find that my work is vastly improved if I ask for anecdotal feedback from people who are currently living the issues I want to help with.  

In that vein, I recently asked for real-life input from 25 people with both ADHD and anxiety. Some of the questions and responses (occasionally tweaked for anonymity) are featured throughout this article.

How does anxiety affect you?

“It is my normality, my baseline; so it affects everything. Racing thoughts, insomnia, heartburn… I can’t get anything done as I spend too much time stressing about everything.”

 

“Variable. Often hyperfocus on the possibility of my partner cheating on me or leaving me.”

 

“I try to control everything in my environment in an attempt to prevent emotional overwhelm.”

Anxiety and ADHD: Correlation or Causation?

ADHD and anxiety disorders are often “comorbid”, which means that they occur together.

The exact figure depends on the source, but it’s estimated that 25-50% of adults with ADHD also have an anxiety disorder.

The two problems have some overlap in symptoms (especially reduced focus and increased stress) but sometimes stem from completely different root causes.

More commonly, though, there is some tie that links anxiety and ADHD within a person – or at least exacerbates one or the other.

What is your “take” on how ADHD affects/influences the anxiety you experience?

“Poor self control due to impulsivity issues. Anxiety comes form anticipating that this will happen and worry that I am about mess up without getting a grip of the situation.”

 

“I think they are intertwined. You mess up a lot or struggle with ‘easy’ tasks with ADHD so it increases the anxiety.”

 

“My low processing speed and working memory are easily overwhelmed. Overwhelm feeds the amygdala which responds by preparing for danger and battle.”

The obstacles that ADHD cause often bring on feelings of anxiety.

       Poor time management/not being able to “feel” time passing leads to missed deadlines and appointments. This can make even the idea of time commitments seem scary

       Impulsiveness from childhood onward often means difficulty with socialising, which can evolve into social anxiety

       An inability to “let things go” is common in people with ADHD, and the obsessive thoughts this causes mirrors symptoms of anxiety

       Self-medication through methods such as substance abuse and thrill seeking often has knock-on effects on health, finances and so on. These issues can also cause anxiety

When these anxious feelings become an anxiety disorder is a bit of a grey area. In a nutshell, “normal” anxiety is when you can pinpoint the cause of what’s making you anxious. Disordered anxiety is more likely to have a vague or unknowable source. One can lead to the other, in some cases.

Do ADHD meds make anxiety worse?

This has the same annoying answer as so many questions about ADHD: it depends.

Some people report that their anxiety symptoms are lessened when they take their ADHD medication. Others say it makes little difference. Still others say it makes the anxiety worse.

Plus, if one medication has a certain effect on a person’s anxiety, another might have a completely different impact.

What would life be like if you could rid yourself of your anxiety,and how would it feel?

“I’d like to think my functionality would be a lot better. In particular my executive functioning skills.”

 

“I think I would do more for myself. I would follow more things that make me happy rather than just doing what I’m “supposed” to do. I would be more willing to go against the grain.”

 

“I think my anxiety is a less healthy presentation of a really useful trait I have that 90% of other people don’t. So, instead of thinking how I could get rid of it, I look for great ways to manage my brain so I feel less anxious.”

What else is there?

Happily, there are lots of routes for people who’ve found that ADHD medication has more downsides than upsides. Hypnotherapy is one of them. Changes to diet and lifestyle can also help.

In fact, those options are also useful things for people who are medicated to consider – a multi-pronged approach to treatment is often very effective.

Please feel free to contact me if you would like to know more.