When ADHD and Anxiety Collide: How to Stop Paralyzing Worry
“The genetic underpinnings of ADHD and anxiety overlap. They have a lot in common.” Here, Dr. Ned Hallowell explains why you’re so worried, and what to do about it.
ADHD and Anxiety Disorders
Approximately 25 to 40 percent of adults with ADHD also have an anxiety disorder, perhaps because ADHD can give a person a lot to worry about. ADHD often causes a person to lose track of time, cause offense without meaning to, or hyperfocus on a minor worry.
Can Untreated ADHD Cause Anxiety?
First, let’s distinguish between worry and anxiety. Worry has a target; one worries about something. Anxiety is usually free-floating, with no clear source or direction. Both are unpleasant, but anxiety may be more so, because the sufferer can’t identify a cause.
Attention deficit gives a person a lot to worry about. ADHD often leads a person astray, down blind alleys, or on wild goose chases. It causes a person to lose track of time and, suddenly, in a panic, get things done in an hour that might have taken a week. ADHD often induces a person to misspeak or to make an offensive or misleading remark without meaning to. In short, ADHD can turn a good day into chaos, a good week into mayhem, a good month into disaster, and a good life into one of missed chances and shattered hopes. A person with ADHD has a lot of trouble finding peace, harmony, or equanimity during the course of his life.
The genetic underpinnings of ADHD and anxiety overlap. I have treated people who suffer from worry and anxiety, as well as ADHD, for more than 30 years. They have a lot in common. Most worriers are creative and smart. It takes a lot of creativity and smarts to dream up all those things to worry about. I should know. I have ADHD and I am a worrier.
People with ADHD live in a realm I call in my book, Worry: Hope and Help for a Common Condition (#CommissionsEarned), “the infinite web of ‘what-if.'” We also tend to be creative, original, and come up with new ideas out of nowhere. I have come to believe we were born this way. Our genetic endowment gives us the reward of original thinking and the pain that comes when that thinking goes awry, as it sometimes does.
Worry and anxiety have an upside for the person who has ADHD. We are always searching for mental focus. The most riveting stimulus is physical pain. Put your finger near a flame, and you will pay attention to the flame. Worry and anxiety are the mental equivalent of physical pain. The person with ADHD may wake up and find that life is good. However, contentment is not riveting. So he scans the horizon looking for something to worry about. Once he finds an object of worry, it pierces his mind like a dagger. It becomes a source of focus throughout the day.
There are other sources of worry and anxiety, and both can bring on anxiety disorders, including phobias, generalized anxiety disorder (GAD), panic attacks, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and more.
A little worry is healthy. We all need it. But when worry careens out of control, it is paralyzing. When worry paralyzes a person, it leads to loss of perspective, irrational thinking, and poor judgment. For full-blown anxiety disorders, one should consult a psychiatrist or other professional. But in the case of paralyzing worry, try the following three-step solution, which even children can be taught to use:
1. Never worry alone. Worrying alone leads a person to brood, globalize, awful-ize, and sink into a dark place. Talk with someone you like or love.
2. Get the facts. Paralyzing worry is usually rooted in wrong information, lack of information, or both. Don’t take to heart everything you hear or read.
3. Make a plan. When you have a plan, you feel more in control and less vulnerable, which diminishes worry. If the plan doesn’t work, revise it. That’s what life is all about.
Edward Hallowell, M.D., is a member of ADDitude’s ADHD Medical Review Panel.
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Updated on October 9, 2020