ADHD News & Research

Nine Months in, the Spread of Anxiety Remains Unchecked

In ADDitude’s 11th pandemic survey since March, nearly three-quarters of readers report feeling overwhelmed, exhausted, anxious, and/or worried. This number has remained alarmingly high for well over half a year, though the reasons are now more varied – and plentiful. From science denial to political uncertainty to school closings to infection spikes to worries for the holiday season, here are the top concerns among ADDitude readers today.

Coronavirus Update from ADDitude

November 3, 2020

Winter is coming.

Game of Thrones fans know this as a grim warning and a call for vigilance. It also feels like an apropos motto for this moment in time — nine months into a global pandemic, the second wave of which is crashing down predictably upon many nations as the days grow shorter, the air colder, and the political landscape no less acrimonious.

Grim. Frustrating. Suffocating. This is how 2,589 ADDitude readers described their world in our eleventh pandemic survey, fielded from October 19 to November 1, 2020. The emotions reported were as follows:

  • Overwhelm or exhaustion: 74% of respondents
  • Worry or anxiety: 70%
  • Sadness or depression: 54%
  • Loneliness: 45%
  • Grief: 36%
  • Anger: 33%

Notably, 41% of ADDitude readers said they are more concerned about the coronavirus now than they were one month ago; only 14% said they were less concerned. The reasons cited were numerous, and sometimes heart-breaking, as dozens of the 230,000 Americans lost to COVID belong to ADDitude readers’ families and circles of friends:

  • Outbreaks are increasing, hot spots are growing larger, the general public is tired of taking simple precautions and letting their guard down way too much. It’s getting colder, gatherings are moving indoors. This is only going to get worse,” said one woman with ADHD and anxiety in New York.
  • “I work in health care. We got hit with a COVID outbreak and lost around 30 patients in 2 months. The lack of concern for others is baffling,” said one woman in Tennessee.
  • “With the holidays coming up, I am nervous about college students returning home and infecting their families throughout the country,” said one reader in Virginia
  • “More and more people I know are experiencing serious long-term health consequences and/or death as a result of complications after COVID,” said the parent of two children with ADHD in Missouri.
  • “I’ve never been terrified about an election like this before. I’m afraid and not sleeping well ,” said one reader with ADHD and comorbid conditions in California.
  • “I am currently operating at 20% of my normal workload — just enough to keep the bills paid with the newly created Unemployment Insurance assistance,” said one woman with ADHD in Washington.
  • “The number of anti-mask conspiracies and people just outright refusing to accept that the virus is real seems to be growing daily. It’s beginning to make me think that this will never end as people will just keep spreading the virus out of ignorance,” said one man with ADHD.

[Read the First 10 Pandemic Survey Results]

The Impact on ADHD Treatment Plans

Indeed, despite mounting scientific evidence that wearing a mask does help to reduce the spread of COVID-19, and calls from the Centers for Disease Control and Prevention (CDC) to wear face coverings in public, others’ refusal to comply with medical guidance is a persistent worry for ADDitude readers. Among the 1,649 survey respondents who said their own treatment plan has been impacted by the pandemic, many said that concerns about visiting their doctor’s office and/or pharmacist kept them from accessing their ADHD medication.

“I wasn’t comfortable going to my doctor during quarantine, so I had to go without my Adderall for several months,” said one reader with ADHD, anxiety, and depression. “I’m only recently back on it.”

Overall, 85% of adults said their treatment plan has changed since March. Many cited a disruption in medication, but even more said the quarantine — plus new WFH and learn-from-home realities — threw off their previous exercise, nutrition, and therapy routines.

“The uncertainty and disruptions to routine have completely undermined my abilities to manage my ADD,” said one man in Kansas. “It has been an exceedingly difficult time.”

“As a part-time worker with no insurance, I’ve been unable to afford to seek therapy during the pandemic to treat my anxiety and ADHD,” said one woman who is an essential worker.

[ADHD in a Pandemic: A Survival Guide]

Caregivers reported fewer treatment disruptions for their children. Of the 676 caregivers who responded to this question, the majority reported no medication changes. That said, many have also resumed, added, or increased the frequency of therapy sessions — both individual and family sessions — with teletherapy now the norm.

Quite a few adults with and without children said the time at home allowed them to fully recognize and confront their own symptoms for the first time, prompting them to seek a diagnosis and treatment.

“Lockdown gave my significant other the opportunity to see my symptoms and bring his concerns to my attention,” said one middle-age woman in Michigan. “I was subsequently diagnosed with ADHD.”

The Impact on Productivity and Motivation

Disruptions to productivity and motivation were even more common among adults with ADHD. More than 95% of the survey respondents reported some lost productivity or motivation due to the pandemic.

“I started the COVID-19 lockdown period with an odd but refreshing sense of motivation that stemmed from the reduced social pressure to always be doing something. This allowed me to do things around the house I’ve been wanting to do for ages,” said one parent who is working from home. “As time went on, this motivation faded and I’ve begun feeling incredibly listless, with nothing to plan and no apparent end in sight.”

“I have exactly zero motivation to do anything, and any productivity I manage is focused on non-urgent tasks,” said one woman in Texas.

Among caregivers, waning motivation may be the most common and persistent problem associated with the pandemic. Survey respondents reported plummeting grade-point averages, school avoidance and refusal, a need for constant supervision while learning from home, and more family fights. Others say that, without sports teams to motivate them to maintain their grades, some student athletes are struggling both physically and academically.

“He is so sick of online school,” said one mother of an 8th grader in California. “The Zooms are exhausting and there is no motivation to work on projects. The absence of the fun things of school has made him hate school, which has never happened before.”

The Impact on Health

The pandemic’s impact on physical and mental health is significant as well — nearly 93% and 95% of adult respondents, respectively, reported a change in these areas. Most of the change was not good. A quarter of respondents reported suffering from new or resurgent feelings of depression and anxiety; only 3% said they feel mentally better now.

“My mental health is almost completely gone,” wrote one mother of a 1st grade student with ADHD. “I feel like most days I don’t even know who I am anymore.”

Among children, the mental toll is similar. More than 11% of caregivers reported increased depression, and another 11% reported increased anxiety in their children. Sadness and loneliness were other commonly cited emotions.

“My child has much more anxiety toward other students (and adults) who refuse to follow COVID safety precautions or admit that there even is a pandemic,” wrote one mother of a 7th grade student in Texas. “She has difficulty understanding the selfishness and lack of compassion and empathy in others.”

Roughly 15% of adult survey respondents mentioned gaining weight this year, and about 5% reported feeling fatigue or exhaustion. Others have reported that the time at home has allowed them to focus more on diet and exercise than they did before the pandemic, leading to healthy habits and some weight loss. Still others have ridden a roller coaster of highs and lows.

“When COVID started, I began Weight watchers and lost 25 pounds,” said one mother in Illinois. “Being home helped me to stay on track. Now, as always, I’ve lost interest and find myself eating to cope with stress and overwhelming emotions.”

Children with ADHD benefit hugely from physical exercise, so the cancelation of organized sports and even normal P.E. and recess time at school has had a large negative impact. Many survey respondents reported a stark decline in physical activity over the last seven months. For almost everyone, too much screen time is a concern.

“It is a struggle to get kids outside when they want to connect with friends through gaming,” said one mother of an 8th grade student with autism in Missouri.

School Uncertainty Taking a Toll

About 45% of survey respondents said their children are learning remotely now. In addition, 31% of students have experienced a major change of some kind — schools moving from remote to in-person instruction, and vice versa — just since this school year began. The A/B schedules of those students doing hybrid learning is also causing disruption and confusion, especially among kids with ADHD who thrive on reliable routine.

“Our school started all online, but then we were forced to choose between all in person or all online, so a lot of things changed between the first and second quarter,” wrote one parent of a 5th grade student with ADHD. “It’s a little stressful because now she has a new teacher and has to stay motivated all the time. Not ideal.”

Whereas the primary challenge last Spring was orienting students to virtual learning, the biggest hurdle now is navigating unpredictability and inconsistency, two features that do not play well with the ADHD mind.

“Monday through Thursday, my kids are in school and Fridays are remote learning. BUT, if there is a confirmed COVID-19 case, the school shuts down to disinfect,” said one parent of an 11th grade student in Alaska. “We’ve had four different confirmed cases this year so far, and every time we remote learn, it is a different process. There is absolutely no consistency.”

Even those families with relative consistency at school have faced changes with services and accommodations that have proven disruptive.

“We chose remote learning, but the plan was not very well-developed,” said one parent of an 8th grade student with ADHD in Michigan. “It has been difficult to get IEP services in place since the teacher for this year has never met my son in person or worked with him 1:1. And resource room services are not very helpful in a remote environment.”

In a year marked by massive change, it seems the only constant is anxiety — if not sparked by the pandemic itself, then elevated certainly by the upending of routines, the uncertainty about the future, and a culture of divisive political rhetoric. It bears pointing out that one of those factors is entirely within our collective power to change — today.

More Coronavirus Updates from ADDitude

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