Got anxiety and ADHD? What a combination!
Rachel C. Sykes
I Work with Stressed Out Professional Women
Licensed in Massachusetts & New Hampshire
Rachel C. Sykes, LMHC, LLC
Rachel@rachelcsykes.com
I recently realized that a large number of my clients cope with both anxiety and ADHD (Attention Deficit-Hyperactivity disorder). While I do intentionally work with clients who deal with a broad range of anxiety symptoms, I had never pitched myself as someone who concentrates specifically on ADHD. Yet it seems as if that is what I spend a lot of my time doing. I really enjoy these folks, so I am not complaining. Upon reflection, it really isn’t so surprising that many of my clients deal with both.
According to WebMD, about half of adults with ADHD also have anxiety. Technically, these conditions are two separate disorders but it is certainly possible that the difficulties associated with ADHD might create or worsen existing anxiety. Why? Well, one reason is that some of the symptoms of ADHD are often mistaken for character flaws. For example, folks who primarily experience inattention (this refers to the ‘AD’ in ADHD) are often labeled as lazy, slow, uncaring, rude, lacking in respect... you get the picture. When you repeatedly hear these messages as a child, one tends to internalize them, and that does a number on self-esteem and can manifest in all sorts of unhelpful ways, like anxious and depressive symptoms.
Can clients have both ADHD and anxiety and they are truly distinct and unrelated? Apparently so. While I have come to believe that few things are perfectly black and white, a person could experience ADHD with no resulting or related anxiety. Then, for other reasons altogether, anxiety starts to creep in and becomes a full-blown problem. Yup. However, I believe that folks are less likely to develop anxiety, etc. as a result of ADHD if they are diagnosed early, treated successfully, and have learned how to manage their symptoms.
Three categories of ADHD
Some background might be helpful here. According to the DSM, the accepted diagnostic manual for mental health disorders, there are three basic presentations:
Predominately hyperactive/impulsive
Predominately inattentive
Types 1 & 2 combined
Boys are more likely to have ADHD- OR ARE THEY???
The DSM says that males are more likely to be diagnosed with ADHD than females at a ratio of 2:1. For my former finance colleagues, you will know that means twice as many males are found to have ADHD than females. However, there is anecdotal evidence that this might be changing, as the condition slowly becomes better understood as it relates to females.
While I can’t say I know why, it seems that boys with ADHD are more likely to manifest with symptoms of hyperactivity. Hyperactivity is something we can see because these folks can be fidgety and have a hard time sitting still. There are a few kids from elementary school that pop into my mind as I write this and I can remember them pretty clearly, even after all these years. And guess what? They were all boys.
Interestingly, now mental health practitioners are seeing a large uptick in ADHD diagnoses for adult women, and their symptoms are different. A lot of these women are not hyperactive and restless but rather easily distracted and have great difficulty with organizational tasks. Notice that these symptoms are more about one’s internal experience, where the primary symptoms of the traditional male version of ADHD are external??? In fairness, it makes sense that hyperactivity is more easily diagnosable because you don’t need to be an expert to make an informed guess that someone might be hyperactive when they are jumping out of their seats and running around the classroom. Now, I cannot say whether this gender difference is biological, environmental/societal, or some combination of both but that would be really interesting to know.
Some characteristics associated with ADHD, inattentive type
Daydreaming
Distracted much?
Unsplash+ In collaboration with Getty Images
Have you seen the old movie classic The Secret Life of Walter Mitty? I am talking about the original 1947 movie starring Danny Kaye, although I understand that Ben Stiller did a remake, too. This movie is based on a short story by James Thurber where the main character is constantly daydreaming that he is a noble, fearless hero who is fighting villains to save the innocent where, in reality, he is a frightened, nervous office worker who is constantly brow-beaten by everyone around him. Anyway, Walter is an extreme example of a daydreamer but there are some folks who are more prone to distraction and daydreaming to the extent that it worsens their functioning in the real world. While Walter gets both the girl and the big new job, that is not necessarily a probably outcome for most people.
Losing things: I lost my: homework, keys, wallet, eyeglasses, phone…
Can you think of anyone in your life you would not trust to hold the plane tickets? Now, there are a lot of reasons that someone might misplace airline tickets when preparing for a trip but if you’re that person every time regardless of the circumstances, it’s possible there is a bigger issue in play. So, I have always been pretty organized – in fact, I would typically be the person in charge of airline tickets, passports, car rental confirmations, etc. However, if I am really stressed getting out the door, I am definitely more apt to forget stuff. While annoying, this is normal and likely not diagnosable. However, if forgetfulness as a function of distractibility is a pervasive problem, you may consider getting tested for ADHD.
-
ADHD is highly hereditable – this study published by the NIH estimates that 77–88% of ADHD cases are explained by heredity
Treatment options
While I am not a prescriber, medication is considered to be very effective with ADHD. There are many medication treatments available including stimulants, non-stimulants, and even anti-depressants, so be sure to discuss with your presriber. As always, there are risks with all medications, as well as risks associated with not taking medications, so be an informed consumer. Psychotherapy and skills training can also be effective, especially for strengthening organizational skills/executive function and overcoming the potential negative feelings associated with ADHD (embarrassment, low self-esteem and self-confidence, etc.).
References
“There’s No Way I Could Have ADHD, Right?!?”, February 6, 2024. Jane Harding, ADDitude. https://www.additudemag.com/adult-adhd-late-diagnosis-women-emotions/
Grimm O, Kranz TM, Reif A. Genetics of ADHD: What Should the Clinician Know? Curr Psychiatry Rep. 2020 Feb 27;22(4):18. doi: 10.1007/s11920-020-1141-x. PMID: 32108282; PMCID: PMC7046577. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7046577/
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
Questions?
Check out my website, request an appointment, or call/email to ask for a free 15-minute consultation.
email: Rachel@rachelcsykes.com
phone: 617.804.6471