Living with co-occurring anxiety and attention-deficit/hyperactivity disorder (ADHD) can feel like a never-ending uphill climb. Having both conditions contributes to what some describe as an “extra loud” mind, characterized by racing thoughts, worries, and distractions. The intersection of ADHD and anxiety can present in various ways, from struggling with organization and time management to increased stress and social difficulties. Finding balance and managing impulsivity, inattention, and relentless worries can be a constant struggle.
Despite these challenges, many people find the help they need to support their resilience and strengthen their coping abilities. In this article, we’ll explore the complexities of living with ADHD and anxiety, including shared symptoms and differences, as well as treatment options and support strategies to help you thrive.
Understanding Anxiety and ADHD
Attention-deficit/hyperactivity disorder is a neurodevelopmental condition that typically starts in childhood. It involves persistent patterns of inattention, impulsivity, and hyperactivity that interfere with functioning or development.
Anxiety disorders include a wide range of conditions characterized by excessive worry, stress, fear, or nervousness. These disorders include generalized anxiety disorder (GAD), social anxiety disorder, panic disorder, and specific phobias.
Think of it this way: ADHD is like having a brain that’s always on the move, making it hard to focus or sit still. Anxiety feels like being stuck in a loop of worry and fear. It may be general anxiety or fear about something specific.
Co-occurring Anxiety and ADHD
If you’re dealing with both conditions, know you aren’t alone. A recent study of 353 participants with ADHD found that around half of them also had an anxiety disorder. This is consistent with a national study conducted nearly 20 years ago that found that 47% of individuals with ADHD had a co-occurring anxiety disorder.
Symptoms of ADHD, such as time management issues, poor working memory, difficulty focusing, and emotional dysregulation, can exacerbate anxiety. Missed deadlines and procrastination may lead to stress about meeting expectations. Poor working memory interferes with planning, problem-solving, and completing tasks, causing feelings of inadequacy and anxiety. Emotional dysregulation can heighten your rejection sensitivity, increasing insecurity and frustration. These symptoms create a cycle of stress and self-doubt, worsening anxiety.
The two conditions can develop independently, or difficulties with ADHD may lead to anxiety. If your anxiety is directly related to your ADHD, you may experience fears surrounding the impacts of your ADHD symptoms. For example, worrying about tasks, forgetting things, or not meeting expectations. If the conditions develop separately, anxiety will likely include concerns outside of your ADHD.
Shared Symptoms
When these two disorders co-occur, symptoms may overlap, complicating diagnosis and treatment. Some shared symptoms include:
- Difficulty Concentrating: Both conditions can impair attention and focus, leading to distractibility and decreased performance.
- Restlessness: Individuals with anxiety may experience restlessness due to nervousness or agitation, while those with ADHD may exhibit hyperactivity or an inability to sit still.
- Racing Thoughts: Anxiety often involves constant thoughts and worries, while those with ADHD may experience a stream of unrelated thoughts or ideas.
- Impulsivity: While this is a common symptom of ADHD, it can also occur in cases of anxiety. Individuals in distress may become more impulsive in an effort to soothe themselves.
- Impact on Daily Functioning: Having both disorders can significantly impact aspects of functioning, including:
- Academic or Work Performance: Difficulties with concentration, organization, and time management can harm your school or work success.
- Relationships: Impulsivity, mood swings, and social anxiety can strain your relationships.
- Emotional Well-being: Constant worry, stress, and feelings of overwhelm can take a toll on your emotional health, leading to depression, low self-esteem, or burnout.
Treatment for Anxiety and ADHD
It can feel like a constant challenge to find relief when you’re dealing with co-occurring anxiety and ADHD. Effective treatment involves a multifaceted approach that addresses both conditions and helps you strengthen your ability to cope and manage symptoms. Treatment options may include a combination of therapy, medication, and lifestyle changes.
Therapy
Cognitive-behavioral therapy (CBT) has been used to treat both anxiety and ADHD, helping individuals develop coping skills and address negative thoughts and behavior patterns. Additional therapies used to treat anxiety may include acceptance and commitment therapy (ACT), exposure therapy, or mindfulness-based exercises. Dialectical behavior therapy (DBT) and insight-oriented therapy are also employed in anxiety and ADHD treatment. These therapies help address negative thought patterns, emotional regulation, and self-perception.
Overall, effective treatment will involve education about both conditions and skill-building to mitigate your stress and symptoms.
Medication
Your provider may prescribe medication to treat your anxiety, ADHD, or both. Common medications used for anxiety include Serotonin and norepinephrine reuptake inhibitors (SNRIs), selective serotonin reuptake inhibitors (SSRIs), or beta blockers. For attention-deficit/hyperactivity disorder, there are stimulant and non-stimulant medication options. The Drug Enforcement Administration (DEA) categorizes stimulants as Schedule II controlled substances, placing them in the highest legal risk category. This classification is due to their high risk for dependence and abuse. Talk to your doctor about which type of medications would work best for you, considering your history, potential side effects, and risks.
Lifestyle Changes
Your provider may discuss ways to support treatment at home. Getting enough sleep, practicing stress management strategies outside of sessions, moving your body, and eating a nutrient-rich diet can promote your overall health and help alleviate symptoms of both conditions.
How to Cope with Anxiety and ADHD
Finding ways to cope with these co-occurring conditions may require some trial and error. Try different strategies until you figure out what works best for you. Common techniques include:
- Establish a Routine: Creating a structured daily routine can help you manage your time more effectively and reduce overwhelming feelings. Set specific times for tasks and activities, including work, meals, exercise, and downtime.
- Break Tasks into Manageable Steps: Break down large tasks into smaller, more manageable steps. Set realistic goals and prioritize tasks based on importance and urgency.
- Use Visual Aids and Organizational Tools: Color-coded schedules and visual timers can help you stay organized and on track. Explore task management or reminder apps on your phone to help with time management and task prioritization.
- Practice Mindfulness: Engage in mindfulness practices such as meditation, breathing exercises, or yoga to help reduce anxiety and improve focus and attention. These techniques can also help you manage impulsivity and hyperactivity.
- Ask for Help: Consider seeking support from a licensed mental health professional who specializes in both anxiety and ADHD.
- Move Your Body: Regular exercise can help reduce symptoms by releasing endorphins, improving mood, and promoting better sleep. Aim for at least 30 minutes of exercise most days of the week.
- Practice Self-Compassion: Allow yourself to make mistakes and learn from them without self-judgment.
- Connect with Supportive Communities: Seek out support from others who understand what you’re going through (e.g., online support groups, peer support networks, or local community organizations). Sharing experiences and learning from others can be incredibly helpful.
- Educate Yourself: Take the time to learn more about anxiety and ADHD. Understanding these conditions can empower you to make informed decisions about your health and well-being.
Co-occurring anxiety and ADHD can feel overwhelming and isolating, but with holistic treatment and support, you can learn to manage your symptoms effectively and lead a fulfilling life.
If you or someone you know experiences mental health issues, it is important to seek help from a qualified professional. Our Resource Specialists can help you find expert mental health resources and support in your community. Contact us now for more information on this free service.
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About the Medical Reviewer: David G. Zacharias, MD, is a faculty member in the Department of Psychiatry and Behavioral Sciences at the University of Washington Medical Center and owner of Existential Psychiatry, a Seattle-based private practice specializing in existential psychotherapy, medication management, and personal development. Having trained and worked at various institutions, including Mayo Clinic, Harvard, Vanderbilt, and NASA, he has over 20 years of experience in healthcare and an extensive background in basic science and clinical research, public health, ethics, speaking, and publishing.
Sources
Kessler, R.C., et. al. “The Prevalence and Correlates of Adult ADHD in the United States: Results From the National Comorbidity Survey Replication.” The American Journal of Psychiatry, 2006. Accessed February 12, 2024.
Quenneville, A. F., et al “Anxiety Disorders in Adult ADHD: A Frequent Comorbidity and a Risk Factor for Externalizing Problems.” Psychiatry Research, 2022. Accessed February 12, 2024.
Photo by Andrea Piacquadio: https://www.pexels.com/photo/woman-in-red-and-black-checked-shirt-smiling-3853463/
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