ADHD News & Research

Pandemic Anxiety and the ADHD Brain: Where Worry Takes Root

Last week, we polled ADDitude readers regarding their mental, emotional, and physical health amid this global pandemic that has shuttered schools, offices, and whole cities. The results were pronounced: Life is upside down for 95% of you, and the change and uncertainty that pervade everyday are causing anxiety for more than two-thirds of respondents. At the same time, more than a third of you feel a sense of calm acceptance and relief over lower levels of daily stress. Here is an in-depth view of how you’re really, truly doing these days.

April 13, 2020

Is it disappointment? Fear? Gratitude? No, the strongest and most pervasive emotion among ADDitude readers living through the coronavirus pandemic today is anxiety.

You are worried. You are also overwhelmed and exhausted. More than two-thirds of the 3,561 individuals who answered ADDitude’s recent reader survey said as much. And with good reason.

More than 95% of you tell us that you have experienced significant life upheaval since coronavirus shut down offices, schools, and whole cities last month. Roughly 13% of ADDitude readers have lost their jobs; 38% have started working from home for the first time; and nearly 13% continue to work as essential employees — in both medical and non-medical positions. Almost all of your children are now learning (or trying to learn) from home. For most of us, nothing is as it was before — and that is stressful.

Unwelcome change is a common source of stress for adults and children alike. On top of the broiling turmoil of life closing down very suddenly and very drastically, now, is also a hearty dose of uncertainty. No one knows when the stay-at-home orders will end. When a vaccination might be available. When the curve will flatten. And that bed of uncertainty is where anxiety takes root.

“You cannot discuss ADHD without including anxiety, as it is the #1 comorbid diagnosis, at least among adults,” says J. Russell Ramsay, Ph.D., co-founder and co-director of the University of Pennsylvania’s Adult ADHD Treatment and Research Program. “The thing that has emerged from research is that anxiety is the perception of risk/threat, but the driving force underlying all of that is inherent uncertainty.”

[Self-Test: Signs of Generalized Anxiety Disorder in Adults]

Indeed, 88% of survey respondents said they are concerned or very concerned with their mental, emotional, and physical health right now. Fifty-nine percent of the readers who completed our survey reported comorbid anxiety; fifty-four percent reported comorbid depression. Battling the symptoms of these very real and menacing conditions is quickly becoming a daily preoccupation for many.

Coronavirus Survey: Adults with ADHD

For some, working from home — with all of the distractions, technologies, and problems associated with doing so — is a primary source of anxiety. “My inability to focus and be productive (in work, my household, my hobbies and keeping in touch with friends and family) in this unstructured time is very stressful to me, and a source of guilt, anxiety and depression,” wrote one respondent. “It is perhaps exacerbated by the need to find out information in this uncertain time – another distraction. I spend too much time on social media or surfing websites. And when I’m working, I feel I’m not working fast enough or producing enough output. I feel incredibly guilty that my manager will think I’m being lazy, unproductive, and unfocused, and might be comparing me to others who are doing more.”

For most of you, though, it’s the dissolution of all boundaries — the melding of work and family, office and home, responsibilities and medical conditions — that is causing anxiety to spike.

“My primary emotion is anxiety about how to balance the combined demands of supporting my two sons with online learning as our school term begins next week, working from home, and trying to manage the household,” wrote one reader. “I normally rely on the structures and boundaries that are naturally provided by sending my kids to school, going to my workplace to work, and doing household and family responsibilities when at home. Now it’s all jumbled together. My kids will need my support with school, but I have a full-time job that involves supporting other parents, families, children and schools. I know that I’m better qualified than most to do it (as a psychologist and former teacher) but I’m feeling anxious and overwhelmed.”

“I have ADHD and anxiety,” wrote another mother. “Managing this unstructured time and working from home is killing me! I am a high school teacher taking Masters classes and there are not enough hours or medication in the day for the levels of distractions I face. Not to mention a husband and son who also have ADHD, and my sweet daughter that struggles with anxiety and has reverted back to wanting ALL of my attention even though she knows that I’m trying to do a million other things as well.”

[Self-Test: Signs of Generalized Anxiety Disorder in Children]

This challenge of “managing unstructured time” was the second more prevalent worry among survey respondents, 46% of whom called it a serious concern and 35% of whom called it a concern. The problem is not boredom; in fact, it’s quite the opposite. Trapped in a home with to-do lists that stretch seven or eight years long, you don’t know where or how to begin. Suddenly unshackled from the confines of a morning bell or conference call, you now feel listless and directionless. The routines and schedules that sometimes felt confining before are now sorely missed for the guidance they provided. And then there is also the loneliness associated with a calendar devoid of all social engagements.

“The unstructured time is misery,” wrote one reader. “I am used to an automatic structure being in place — kids’ activities, school, my own activities, appointments, errands, etc. Now that it is ‘all up to me’ to structure the day, it is overwhelming. I tend to freeze or sink into the TV.”

“It is extremely difficult for me to manage the unstructured time and consider how to teach my kids (11 and 5) in addition to working from home and maintaining my household right now. I have tried to structure our days to help with this usual time, but it is not proving successful for myself or my son who also has ADHD. Trying to balance and manage all of my responsibilities causes me a lot of stress and anxiety.”

Balancing it all — and specifically managing the household at a time when germs are mortal enemies, grocery stores have barren shelves, and everyone is around dirtying the house all the time — is the third most common concern among ADDitude readers, 69% of whom cited the balancing act as a stress. Unhealthy expectations about what you can and should accomplish during a global health pandemic is part of this equation for sure.

“I feel such guilt about not having a clean house, now that I have time; about not being able to occupy and amuse my three children while I am working,” wrote one reader. “I feel guilt that I am struggling and unable to help them all with schoolwork at the same time.”

“Less structure each day means the days can run together easily,” wrote another respondent. “Activities seem to collapse – spreading out like tentacles – tasks getting increasingly bigger, making incrementally slower progress and struggling more with time blindness. Also, being home all the time (and with very limited time to myself to try and work myself up to starting and actually tackling my ‘household mess and chaos’ projects) makes this period of time in the house feel like I’m living in some kind of twisted ‘ADHD theme park’ – a fully immersive experience that showcases many overlapping issues…where at times I can feel powerless to achieve positive changes I am struggling to make, and can’t ‘unsee’ the reality of the day to day life I am juggling and my responsibility for creating it, and shame of failing to change for the better…”

At the same time, we are seeing evidence of ADDitude readers looking at stay-at-home orders through a positive lens. Thirty-four percent reported a sense of calm resulting from less daily stress, and 42% said the extra time to complete projects or pursue hobbies is a surprising upside to being stuck at home. Forty percent are taking advantage of the opportunity to stop, breathe, and reflect. Sleep is improving, symptoms of Rejection Sensitive Dysphoria are fading, and families are eating dinner together every night.

“I am being more intentional about small acts of self-care,” wrote one respondent.

“I am learning and practicing new skills (counterpoint in music),” wrote another reader. “I’m actually reading a book I’ve wanted to read for years. I enjoy watching the educational shows being broadcast for high schoolers (even though I’m 57!).”

“I feel like this is an opportunity to rethink my lifestyle — how I work, what I want to do for work, how to improve the quality of my life overall,” said one ADDitude reader. “I hope others are able to make that shift, too.”

Coronavirus Survey: Parents of Children with ADHD

Among parents with children now learning at home, the top concerns centered around remote learning, screen time, and schedules. Managing e-learning was cited by 82% of caregivers as a top concern. The specifics of that range from motivating students to take their new course load seriously and supporting students with learning challenges who need more resources to mastering new technologies and encouraging independence without allowing a child to fail. Parents who had no desire to homeschool their children are left with little choice but to do so, while also holding down a full-time job and trying to salvage some sense of family harmony, and it’s proving just as impossible as it sounds.

“E-learning on a screen has been incredibly debilitating for our highly distracted son who also struggles with processing,” wrote one reader. “Not having a teacher who is constantly redirecting him and engaging him is failing him. He’s independent to the degree that he won’t take help from parents – rarely has – and now that the mode of learning requires more support from us, he still refuses to accept it. When he gets frustrated, he jumps right onto YouTube or an online game. We have tried blocking sites and apps, but the reality is we would have to block the Internet. And his teachers are providing links for instruction on sites like YouTube. He feels incapable of learning this way and it’s diminishing his capacity to complete expected work.”

Screens are the ultimate double-edged sword for ADHD families right now. Your children rely on screens now to learn, but on the other side of every Google Classroom tab is a video game or Insta post or YouTube video beckoning their ADHD brains. Digital distractibility is an escalating concern among parents, who also rely on game consoles more and more to occupy their kids and facilitate connections with friends who can no longer play together in person. All of this results in absurdly high screen time counts, and extremely worried parents.

“My 6th grader’s work is entirely on his Chromebook, which is like giving an alcoholic a bottle of whiskey and asking them to spend the whole day reading the label without taking a sip,” wrote one reader. “Distracting video games are one tab away, and many of his lessons are simply a YouTube video featuring flashing pictures and words and music that is too overwhelming.”

“My son’s anxiety, rage, melt-downs are becoming more intense as the days go on,” wrote one respondent. “He’s extremely addicted to his iPad to the point he needs to know where it is at all times, has extreme meltdowns and rage issues if I say he needs a break from screen time. He doesn’t wish to participate in anything other than iPad time. I find it extremely challenging to keep him focused on any school work.”

The antidote to screen time run wild seems to be a regular schedule with daily time slots for digital rewards once work is completed. But putting these routines into place two-thirds of the way through the school year, when everyone is stuck sharing the same physical space, is more than a little challenging.

“A schedule is needed for sanity but I am working full-time remotely and cannot manage the schedule,” wrote one mother. “Plus we relaxed our rules around screen time significantly, which has resulted in aggression towards wanting even more screen time – screens seem to be addictive. The school remote learning demands are extraordinary and unorganized. I cannot keep up with school demands for 2 children plus manage full time work and the extra step of securing food.”

For caregivers, the Number One benefit to stay-at-home orders is a less stressful morning and evening routine. With some flexibility to sleep in longer, kids are less argumentative in the morning and less likely to miss something really critical like that 7:30 am bus. Parents also appreciate the fact that a homeschool schedule allows their children with ADHD to get up and move their bodies more often. This energy release is a positive thing, and often encourages siblings to find ways to play together cooperatively. The lightened academic load — less nightly homework squeezed in before and after activities — and break from school reprimands and social struggles has improved daily life for many families touched by ADHD.

“School is one of my biggest stresses,” wrote one reader. “My son not going means I don’t have the worry and anxiety of getting a call every day to pick him up”

“I appreciate the time to focus on educational activities like puzzles, cooking, baking, and board games that teach both social and academic skills in a non-structured, non-academic setting, almost like passive learning,” wrote one parent. “My children don’t know their learning about fractions while baking cookies or counting while playing mancala!”

“We got a new puppy and my daughter’s life has transformed,” wrote another respondent. “There is so much joy in our house and the puppy is loving everyone at home.”

“It’s been wonderful… Our kids are outdoors a ton right now, rain or shine, and that helps a lot. They are relaxed and happy!”

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