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Anxiety and ADHD

Emily is a 36-year-old mother of two – Avery, 4, and Lance, 7. She’s a business owner, the founder of her neighborhood watch, an avid baker, and a foster mom to dogs from the local humane society. She does yoga every morning, unfailingly schedules playdates for her little ones, and is meticulous about her home, which she designed with her architect husband, Rory. On the outside, Emily is, as she describes, “Instagram-ready.”

 

Emily also has adult ADHD. Six months ago, she was diagnosed with generalized anxiety disorder. This is her story.

 

“I am a frantic human being,” she says. Although she’s being interviewed on the phone, the sounds in the background are of a person rummaging through drawers and things, and her voice fades in and out when the phone, cradled against her chin carelessly, slips time and again.

 

“Every morning I’m up before the alarm clock, and I’m almost angry at the alarm clock for being late. Before the sun is even up, before anyone in my house is up, I’m running. Not literally – not all the time, anyway – but I’m already thinking of the 19,000 things I have to do before anyone gets up.

 

“It’s like I’m running a race. I’m my own stopwatch, except there’s no stop. It’s just go, go, go. I’m making breakfast, I’m making a list of things to do for the day, I’m going on to the next thing before I’ve even begun to think about the last thing, if that makes sense. Have you ever had a panic attack? You know that feeling when it’s like everything is about to blow up? I feel like that most days. It’s insane.

 

“I justify it by telling myself all moms are like this. All working moms, all stay-at-home moms. All moms. All women. There’s a lot of stuff to do. Not enough time to do it. I’ve been in therapy a long time, so I know the skills and the tools and the things to watch out for and the things to do and I do them all. My issue is that I try to do them all at the same time and if I feel unsuccessful – which is like, all the time – I feel like I’ve failed, or I’m failing, and then my anxiety gets the better of me.

 

“But I don’t stop. I just keep going. I keep going to the point that I frustrate everyone in the house – my husband, my kids. I bet I bug the dogs, too – don’t they have a sense of how humans feel? They must think I’m spun too.

 

“Nothing changes in any environment. I’m like this at home; I’m like this at work. I’m like this from the minute I get up to the moment I sleep. I talk really fast, I move really fast, I think really fast. I overwhelm myself. I can calm down when I do breathing exercises, but that’s the one thing I need a rubber band or an app to remind me to do, and it’s seriously the last thing I want to do. I get anxious when I’m breathing consciously because I’m like, ‘What am I forgetting to do while I’m doing this again?’

 

If you're an adult who suffers from anxiety at home and at work, learn more about how you can cope with it for a brighter future.

 

“When I used to tell people I have ADHD, I’d get a response along the lines of, ‘Oh yeah, me too!’ It’s a joke. A punchline. A woman who’s busy, a woman who’s juggling kids and a marriage and a career – yeah, must be ADHD. Never mind it’s a real, legit disorder, and I have a hard time shutting off my brain. You know what’s so awful about this is that I’m constantly aware of people judging me, and I used to worry that people were judging me about actually having ADHD. Actually, to be truthful, I’m worried that people are judging me because they think I’m faking having ADHD. Who would fake this?

 

“I’m functional. I’m fully aware of how successful I look on the outside, but you’d be shocked at my internal dialogue. Until I started seeing a therapist, I thought this was perfectly normal. These catastrophic thoughts I have – doesn’t everyone have those? Turns out they don’t, which is such a relief to me. It feels like I can overcome it, somehow. Sometimes, anyway. I have to be really aware, really conscious of my thought patterns, even a year into (cognitive behavioral therapy).

 

“It’s affected a lot of my life. I’m a pretty cutthroat business person. I have a hard time trusting anyone. I have very few friends because I’m convinced I’m not easy to like. God bless my husband for his sweetness and patience. I’m a lot to handle. I know that. My ADHD and social anxiety isn’t debilitating in a sense that I’m not able to get out there and talk to people. Oh, I talk to people. I think I go overboard overcompensating for what I believe in my heart is a terrible personality, so I’m excessively loud and really try to win over everyone I talk to, to the point that I’m sure it’s so transparent I’m being inauthentic. In my head, after any encounter, I’m like, ‘Oh God. They hated me. Did they hate me? I’d hate me. Eww. What did I just say to who?’

 

“Yes, it’s isolating. Wow. That’s the word I’m describe both of these disorders (ADHD and generalized anxiety). It’s hard enough having one, let alone both. I’m not having a particularly fantastic day today, but I know better that this isn’t who I am – it’s something I live with and function with, every day. I’m lucky – I have a compassionate therapist who gets me and who understands that ADHD literally looks different on everybody and every face, and I’m empowered to find what works for me. Anxiety and ADHD isn’t a rare combination.”

 

The link between ADHD and anxiety

 

Anxiety is often a standalone diagnosis. So is ADHD. But for approximately half of people living with ADHD, anxiety is present as well. ADHD and stress very typically go hand in hand.

 

If you’ve been diagnosed with ADHD, and you have the following symptoms, you may also have anxiety:

 

  • Restlessness
  • Trouble focusing
  • High levels of stress
  • Constant worrying about anything, from trivial matters to more serious ones
  • Feeling on edge, like something bad is about to happen
  • Sleeplessness
  • Constant fatigue

 

While everybody can experience anxious, stressed feelings from time to time, anxiety is a real and legitimate mental illness and disorder that requires evaluation and treatment. You may have anxiety over your ADHD symptoms, but you may also have anxiety over matters outside of your ADHD. Either way, help is available.

 

ADHD and anxiety in children

 

Nine-year-old Matthew has been suspended from school three times this year – and it’s only February. His persistent unpleasant behaviors in the classroom have drawn the attention of irate parents, and his own parents, Sid and Lynn, are tired and frustrated.

 

But in recent weeks, the family has been under the care of a therapist who specializes in anxiety in children, particularly those who also have ADHD.

 

“Matthew is not a bad kid – that’s the first thing our therapist reassured us,” shares Lynn. “We knew that. But after careful examination and a lot of conversation, he drew out that the violent behavior is a result of his anxiety more so than his ADHD.”

 

“He’s struggling,” says Sid. “He gets a lot of negative feedback from his peers, who don’t fully understand him. How can you blame them? They’re eight, nine years old, and Matthew can be a big personality to handle. The tension and stress of going to school and facing those kids every day has become somewhat of a traumatizing thing for him.

 

“It’s really no surprise that his stress levels have skyrocketed. Even before anything happens, he’s already anticipating a reprimand or chatter from his classmates.”

 

The Centers of Disease Control and Prevention report that approximately 30% of kids with ADHD will also be diagnosed with an anxiety disorder. Like Matthew, many of these children with fidget, act out, frequently interrupt others, and will be intrusive in class or in social situations. Because these behaviors are generally looked down upon in classroom settings, these kids will often be scolded by teachers or criticized by other students, leading the child with ADHD into an uncomfortable state of stress and anxiety. Chronic stress, therefore, is not uncommon.

 

And because children with ADHD have difficulty regulating emotions, the negative wave of feelings are particularly difficult to manage. It’s not unusual for kids to get trapped in the negative and anxious thoughts circling in their minds.  

 

Dealing with the emotions, especially aggression, can be hard for kids with ADHD, but we have methods to help your children cope and work through their feelings

 

While adults may come to the conclusion that they need assistance with anxiety, rarely will a child approach you and say, “I think I have anxiety.” Instead, they may exhibit the following symptoms:

 

  • They may be unable to fall or stay asleep
  • They may constantly complain of a “stomach ache” or a “headache” which seems to go away when they’re told they don’t need to go to school
  • They may be easily irritated or frustrated
  • They may argue more than usual
  • They may act up or act out in school
  • They may avoid seeing or hanging out with friends
  • They may pick at their skin, twirl or tug on their hair, or repeat other anxious behaviors

 

ADHD and anxiety treatment

 

The following treatments can be tailored for adults or children with ADHD and anxiety.

 

Be aware of triggers. With some investigation and tracking, you may easily uncover and understand what triggers or stressors cause anxiety for you or your child. You can keep a journal, a notebook, or an app on your phone where you can jot down any time or circumstance you are feeling anxious and overwhelmed. Armed with this knowledge of what triggers the anxiety, you or your child can learn to predict the situations and how you can manage your symptoms and behaviors when (or if) the situation arrives.

 

Adult example: If you are an adult with ADHD and anxiety, and a big presentation is overwhelming you, you can perhaps speak to your boss and see if you can pre-record your presentation so you don’t have to speak in front of a live audience. If public speaking is a trigger, a pre-recorded presentation may alleviate some of your stress.

 

Child example: If tests trigger anxiety for your child, speak to his or her teacher to see if accommodations can be made. Your child may be permitted to write the test in a quiet room with a proctor, or given extra time to complete it.

 

Read more of our tips on how to manage your anxiety.

 

STOP. Some experts recommended visualizing a large red stop sign when you’re feeling overwhelmed and stressed. Kids and adults alike can be bombarded with terrible, negative thoughts – training yourself to say, “STOP!” to the bad thoughts can be empowering and successful. Most people with ADHD are visual, so imagining a large red stop sign may be the perfect way to bring those negative thoughts to a grinding halt.

 

Breathe. Breathing is a fantastic way to alleviate stress for both adults and children. We so often forget to breathe properly – deeply, through our bellies, instead of in a shallow manner – that when we do breathe the correct way, it very effectively and noticeably slows down our hearts and relieves tension.

 

An exercise your child (or you) can do is hold a book to your stomach. Breathe in for four counts, feeling the book moving inward with your belly. As you exhale, count to four again, and feel your stomach pushing the book out. Do this for a few minutes each day, or any time you’re feeling anxious, and feel yourself begin to experience calm.

 

If you or your child has ADHD and anxiety, and you need further guidance, visit www.hopetherapyandwellness.com.

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