Navigating the Intersection: ADHD and Anxiety in Children and Teens

Introduction: For children and teens, living with ADHD and anxiety can feel like a rollercoaster ride through a maze. These two conditions often coexist, influencing each other in complex ways. In this blog post, let’s explore their connection, coping strategies, and the importance of seeking professional healthcare.

1. Understanding the Overlap:

• ADHD (Attention-Deficit/Hyperactivity Disorder): A neurodevelopmental condition characterized by inattention, impulsivity, and hyperactivity.
• Anxiety: A persistent feeling of worry, fear, or apprehension.
• Shared Features:
  • Executive Function: Both ADHD and anxiety impact executive functions, such as focus, organization, and decision-making.
  • Emotional Dysregulation: Intense emotions and difficulty managing them are common in both conditions.

2. The Chicken-and-Egg Dilemma:

• Which Came First?: Sometimes it’s unclear whether ADHD predisposes individuals to anxiety or vice versa.  Accurate diagnosis is important.  In my practice, it is not uncommon for me to evaluate and treat children with both ADHD and obsessive anxiety (without compulsions).  It is hypothesized that this may be due to a child’s fear of “forgetting something” concurrent with the child’s predisposition to intense emotions.
• Biological Factors: Shared genetic and neurobiological factors contribute to their co-occurrence. Some current research suggests that about 28% of children and teens who have been diagnosed with ADHD also meet the criteria for a concurrent diagnosis of an anxiety disorder.

3. Coping Strategies:

• Routine: This one is simple: consistent schedules reduce anxiety triggers.
• Break Tasks Down: Chunk tasks into smaller steps to ease your child from feeling overwhelmed.
• Evidence Based Therapy: Cognitive-Behavioral Therapy (CBT) and Behavior Therapy (BT) modified for the age of your child or teen by a licensed child psychologist which includes the parent(s) in its implementation across therapy sessions and home is most effective.
• ADHD “coaching techniques” to improve preparation and organization across home and school life can also provide valuable tools. Often this can be implemented with your child’s school through an accommodation plan that might include a “check in/ check out program” and frequent opportunities for short breaks and lots of positive reinforcement across home and school.  This is NOT special education but is a “civil right” protected under Section 504 of the Rehabilitation Act of 1973. The parent/school relationship is the best predictor of success in helping your child. Involving your child’s licensed psychologist in this process can be helpful in “touchy” or “complex” situations.
• Mindfulness: Grounding techniques and meditation help manage racing thoughts in teens, but this technique must be modified for children by a healthcare provider such as a licensed child psychologist.

4. Seeking Professional Help:

• Diagnosis Matters: Accurate diagnosis ensures targeted treatment.
• Medication: Stimulants for ADHD, and sometimes SSRIs for anxiety have been shown to provide improvement when combined with Cognitive Behavioral Therapy and Behavioral Therapy.
• A Combined Treatment Approach: Combining evidenced based therapy with your child which also includes the parent(s), medical consultation by your licensed psychologist and medical primary care provider, lifestyle changes including regulation of sleep, activity level and screen time, and parental guidance has the best outcomes.

Conclusion: Remember, you and your child are not alone on this journey.  Connect with legitimate support groups such as CHADD.org and consult with your child’s primary care provider.  Seek a licensed child psychologist who uses “evidence-based practices”.  With consistency and working as a team with your child or teen, management and improvement are likely!

As always, reach out if I can be of assistance.  Dr. M