Understanding the Link Between ADHD and Anxiety
When I ponder which came first, my anxiety or my Attention Deficit Hyperactivity Disorder (ADHD), the question is akin to asking which came first, the chicken or the egg or hearing the question of is ADHD real or not.
While the two things are distinctly different, they are also intricately wound together. They are as much a part of me as my eye color. (Which is green, if you are wondering. Despite the woman at the DMV who insists they are brown.)
ADHD and Anxiety Often Exist Together
It is estimated that between 30 and 50 percent of those with ADHD also have some form of anxiety. With numbers like that it is hard to deny a correlation.
The four most common anxiety disorders associated with ADHD are:
- Generalized anxiety disorder (GAD)
- Separation anxiety disorder
- Social anxiety disorder or social phobia
- Post-traumatic stress disorder (PTSD)
What Are the Statistics for ADHD and Anxiety?
- Generalized anxiety disorder (GAD) is more likely to occur in children with ADHD. Twenty-five percent of children with ADHD will experience GAD, as opposed to 2.9-4.6 percent of the general population. Fifty-two percent of adults with ADHD will experience GAD, as opposed to 5 percent of the general population.
- Eighteen percent of people with ADHD have a lifetime occurrence of social phobia, as opposed to half that for the general population.
- Separation anxiety will affect 2.4 percent of the general population, but ten times as many children with ADHD will experience this form of anxiety.
- There may not be a lot of information on ADHD and PTSD specifically, but there is evidence that people with ADHD are more vulnerable to developing post-traumatic stress disorder.
I can understand how having ADHD can heighten anxiety. The worry over screwing things up, behaving appropriately in public, and forgetting everything can certainly cause tension.
At any given moment we are worrying. We have anxiety about letting people down, performing well at school or in our jobs, the social cues we miss, the conversations we zone out of, wondering if we locked the front door, and feeling overwhelmed trying to figure out how to get from point A to point B on any given project.
Still, I wonder if my anxiety arose from my ADHD, or if it existed solely on its own. Before I knew the word anxiety, I knew the tight, nervous feeling in my stomach; the jittery ball of worry that whispered to me constantly. Was I just an anxious child or did those feelings occur because I was ADHD?
Social Anxiety and Me
I am the most social phobic person I have ever known. As a child, my mother said I was painfully shy. As an adult, I know the truth: I am an introvert, and I have social anxiety disorder.
Social anxiety ruled my world for years. I couldn’t say, “Good afternoon" to the clerk at the store. If someone spoke to me, I’d turn red. For example, if someone complimented me I would cry. When I talked to someone I would stay awake for days picking apart the conversation, telling myself I sounded like a fool.
I hyperventilated every day of my high school career, I ate lunch alone, I would throw up after being called on in class or if I had to give an oral report.
On the flip side, I was in the choir, and I loved it. Singing made me happy as nothing else did. I just didn’t want a solo — okay, my heart did, but I was too scared to try.
What Does Anxiety Feel Like?
Anxiety is a prison. It is a dark place in your soul that grips you tightly and won’t let go. At least that’s what it felt like to me as I went years with untreated ADHD and anxiety.
The fears, no matter how far-fetched, controlled every aspect of my life. I was scared of everything, and I always worried about insignificant things. I worried about things I couldn’t name and things that would probably never happen.
So what does anxiety look like? While it’s true that GAD can often be missed, here are some of the symptoms. Along with excessive worry and anxiety, a person will exhibit at least three of the following:
- Restlessness
- Fatigue
- Difficulty concentrating
- Irritability
- Muscle tension
- Trouble sleeping
It is often easier to see the symptoms of social phobia, separation anxiety, or PTSD. However, some other symptoms of anxiety to look for can be:
- Irrational fears
- Chronic indigestion
- Extreme self-consciousness
- Panic
- Flashbacks
- Perfectionism
- Excessive self-doubt
- Compulsive behaviors
Living With ADHD and Anxiety
Having ADHD can be rough. You spend so much time trying to concentrate that you are concentrating on concentrating and missing what’s going on around you.
It’s easy to get bogged down in your worry and stress. You may find yourself angry at everything and nothing, short-tempered, and on edge.
When my anxiety is raging, I often find I have a much lower tolerance for people in general. It seems everything gets on my nerves no matter how small. I just want to curl up and ignore all my responsibilities.
It Is Exhausting and Stressful
It’s only natural that ADHD and anxiety would go hand in hand. There’s so much to keep up with, and so much we can mess up. There are only so many mistakes we can make in a day without feeling like we are failing everyone.
Sometimes the anxiety seems to come from a separate source. I can see that my social phobia could stem from my ADHD. After all, social situations are prime opportunity to be embarrassed by traits I may not be able to control. I can’t help but wonder if I would be that way even without my ADHD.
Honestly, I will never know. I will always have ADHD, and I will always have anxiety. Maybe the two travel hand in hand and maybe they are separate entities.
Coping With ADHD and Anxiety
No matter which came first, it took years for me to accept these two traits not as shortcomings or afflictions, but as part of who I am. For years I just wanted them to go away so I could be “normal."
That kind of thinking was wrong. There is no cure. There doesn’t need to be. Treatment and managing symptoms are important, but so is learning to accept yourself as you are. I found this to be the most difficult undertaking, but worth the time and effort.
Only through time, soul-searching, studying, and connecting with others like me have I learned that I could treat my ADHD and anxiety as an extension of myself. They are character traits.
I had to learn to be kind to myself and remember that my dentist was not up all night dwelling on our conversation making sure he hadn’t said anything wrong. He was home sleeping, not even remembering our mundane talk.
What Are Some Things You Can Do to Ease Anxiety?
- Stop and meditate. It can be as easy as concentrating on your breathing. Be mindful of each breath and spend a few moments mindfully inhaling and exhaling.
- Talk to someone who understands. Call a friend or family member that you trust and can talk to. Share your feelings with them, or ask them to distract you.
- Our brains seem hardwired to accept the negative, but we often have a hard time believing the positive things about ourselves. Use affirmations to rewire your brain for empowering messages.
- Turn up the music and let it help lift your mood. My daughter often says music is what helps her through the toughest times.
- Aerobic activity. Get moving even when you don’t feel like it. The endorphins released from exercise have incredible mental benefits.
- Get your hands busy. Art, crafts, gardening – whatever makes you happy can help. It may be hard to get your mind on something else completely, but doing something you enjoy that keeps your hands busy can contribute to redirect your attention. I find knitting soothing when I am overly anxious. My daughter turns to her artwork.
Spending some time learning to recognize your anxiety triggers and finding alternate solutions will be substantial. A therapist can help you to not only identify your triggers but assist you with coping strategies and lifestyle changes.
Don’t Beat Yourself Up
I still turn red for no reason when someone talks to me, I will never feel comfortable walking into a room full of people, and I replay conversations and feel like an idiot on a regular basis.
These things are never going to go away, but I have to accept them as part of myself and work with them as best I can.
I’m sure the other moms at my daughter’s school think of me as that weird, quiet woman. I often cry before I have to go into a social situation or somewhere where I know I will have to talk to a stranger. The important thing is that I do it anyway. Because I am human and I have to live in this world, and I have to do unpleasant tasks.
I can use my ADHD and even my anxiety to my advantage. Instead of hiding because I’m afraid of what I might say or do, I can live my life knowing I will make mistakes and do dumb things, but at the end of the day, those things aren’t going to matter. In a year’s time, no one is going to remember them.
It’s easy to see the gifts of ADHD. Creativity, passion, heart, and intelligence are just a few. It’s harder to see any good in anxiety. It can rob us and steal our lives if we let it. But it’s a part of us.
Anxiety can cause us to be careful, conscientious, driven and focused. This may sound outrageous, but it can be true. I can treat my anxiety, but I will never be free of it, so I had to start looking at the flip side; the side that isn’t all bad– even if the good is hard to find, difficult to remember, and maybe even very small.
Resources
U.S. Department of Health and Human Services (What are the Five Major Types of Anxiety Disorders)