Stress & Anxiety

Recognizing the Stressors That Paralyze ADHD Brains

Many people with ADHD have a lifetime of making impulsive errors, forgetting things, losing jobs, failing tests, or feeling like they were under-performing. Such negative emotional experiences build up over time, and can “hard-wire” the brain to be always on the lookout for danger.

Black-and-white man is clasping his head with hands, suffering from unbearable headache caused by stress and overwork, head is broken down to fragments, over depressive red background
Black-and-white man is clasping his head with hands, suffering from unbearable headache caused by stress and overwork, head is broken down to fragments, over depressive red background

The ADHD Brain During A Pandemic

In recent months, we have been living in uncertain, dangerous times. Most of us are experiencing an increase in stress. The anxiety we feel is created by many factors, including political unrest and the COVID crisis. We worry about keeping or losing a job, parenting, and our children’s return to school in some form or another.

With so many unknowns, and the endless flow of confusing and conflicting information, we have diminished control — the perfect environment for stress to thrive and do its damage.

You are reading this because you or someone you care about has ADHD. You wonder whether you, your child, or your spouse find these fearful times more challenging than those in the general population.

The simple answer is: maybe… and maybe not.

Two facts: All people do not worry about the same things in the same way. What one person thinks of as a small problem may be perceived by another person as an intense stressor. We face life’s stressors in different ways, depending on our health, our age, our temperament, and our previous experiences. In terms of our ability to face danger and manage stress, we range in character from “Navy Seals” to “Nervous Nellies.”

The second fact is that people who have ADHD are not all alike. Many exhibit the typical symptoms that are associated with the condition, but not everyone has all of these symptoms. The severity of the symptoms ranges from mild (with little negative impact) to severe (with significant impact). Let’s examine the interplay between behavioral characteristics and the neurobiological differences associated with ADHD, and the stress caused by the intense events that affect our lives today.

[ADHD in a Pandemic: ADDitude Surveys Its Readers About WFH, Distance Learning, Stress & More]

Stressors and Emotional Regulation

People with ADHD often find it hard to regulate emotions, because their brain is different from other people’s. New stressors trigger negative emotions associated with past events. A person with ADHD who has been laid low by the “typical” flu may mix those memories with the threat of COVID, increasing her worry. Those without ADHD might think, “Well, that was the flu, and this is something different,” and not let emotional memories fuel the fear.

Many people with ADHD have a lifetime of making impulsive errors, forgetting things, losing jobs, failing tests, or feeling like they were under-performing. Such negative emotional experiences build up over time, and can “hard-wire” the brain to be always on the lookout for danger. New threats appear much more serious than they really are.

How Stressors Impact ADHD Brains

If people with ADHD are generally under more stress, it follows that they will face the world with an increased level of stress. Here’s why: Stress activates the hypothalamic-pituitary-adrenal (HPA) axis. This creates a cascade of hormones, including catecholamines, corticotropin-releasing hormones, and cortisol (a biochemical indicator of stress). This elegant biological response is designed to keep the body safe in dangerous situations. During such reactions, the body diverts blood away from the stomach (Who needs to digest food when you’re running from a rhino?), and to the leg muscles (All the better to outrun it with!).

Blood is also re-routed from the pre-frontal cortex, the part of the brain behind our forehead that helps us weigh the facts and problem-solve using the executive functions. (Don’t think about this! Just run!) When we’re facing a pandemic, the brain structure that we need to help us plan for survival becomes inactive, all in the service of running away from or fighting with the enemy.

[Pandemic Anxiety: 10 Expert Coping Strategies]

Researchers have found that, in stressful situations, adults with ADHD have higher levels of cortisol than people without the diagnosis. Merely thinking about stressful situations raises the level of cortisol in their body. Too much cortisol is not a good thing. It’s supposed to be manufactured and used in the moment to get us out of harm’s way. But the stressors in our contemporary lives do not attack in a quick strike like a wild animal. The negative event doesn’t hit and run, it keeps threatening us. It comes at us over and over again in the news, or on TV, or in our social media feeds. It is a chronic condition.

Stress-impaired executive function diminishes working memory and impulse control, as well as mental flexibility and coping skills. Stress also makes it hard for people with ADHD to focus and sustain their attention. When we consider the overwhelming amount of information that is streamed into our home (and our heads), we realize the importance of focus. Chronic stress prolongs the protective flow of hormones and causes the brain to recalibrate its biochemistry. It can’t handle all this bad news! (This is the “hard-wiring” that I mentioned earlier.) Looked at in this way, unless individuals with ADHD understand what’s going on in their brains, and learn to monitor and control their stress reaction, having ADHD can impair the way they cope with crises.

How To Cope With Stressors with ADHD

The best predictor of how you deal with these challenging times is how you have handled stressful situations in the past. If you’ve always done something a certain way, you’re likely to do it that way now. And if those approaches have worked well for you, you will likely handle the challenges presented by COVID and work stresses  as well as anyone. If you have not been successful in the past, coping with these events may be your greatest challenge yet.

When you search the Internet, you’ll have no trouble finding advice about reducing stress. There are literally thousands of articles suggesting warm baths, yoga, meditation, prayer, exercise, eating healthy and staying hydrated, staying connected to friends through technology. If any of these have worked for you in the past, or if you think they’ll help you now, use them now. But if you have ADHD, and they have not worked, it’s not likely that you’ll try them now. Some of them ask you to tap into skills that you may not have.

ADHD Tips For Coping With Stressors

Think (yes, right now!) about what you, a person with ADHD, do naturally, without anyone bugging you or guilt-tripping you, to have fun and find pleasure and relief from stress. Maybe you thought of things that were exciting enough to capture and hold your attention, that were thrilling, risky, or — if you’re honest — even a little dangerous. To gain a sense of control over things, get your hormones flowing, stimulate your brain in healthy ways, take your mind off the news, and stay healthy, the following tips might help:

  1. Keep moving! Run or walk (in your living room, on a treadmill, up and down stairs, on the street).
  2. Play video games! Especially exciting ones that challenge you. I recommend race car driving or space exploration over “shooter” games, but that’s your choice.
  3. Follow medical advice. If you’re taking medication for ADHD, follow your doctor’s orders, and make sure you have enough on hand. These meds maintain a healthy balance of chemicals in your brain.
  4. Get unreal! Get yourself a virtual reality headset (you can get the functional fold-out one for under $5), pop your mobile phone into it, and “go” where you want. Your brain will love it. Set a 30-minute timer and give your eyes and brain a rest. The chemicals you’re generating can be addictive for a brain that doesn’t produce enough on its own.
  5. Listen to music that “rocks” you, whatever your musical tastes. Dance if the spirit moves you. The parts of your ADHD brain that register stress and put you in fight-or-flight mode don’t operate when you’re listening to music. Singing with the music or humming along will add to your pleasure.
  6. Mega-clean your room, apartment, or entire house. If you’re the kind of person who gets in a “zone” while cleaning, this will be a win-win for you. It will activate the health-oriented parts of your brain, disinfect your surroundings, and give you a sense of accomplishment. You’ll be in control, a state that wards off anxiety.
  7. Make stuff, write stuff, cook stuff. Find some short-term projects for which you have the materials and skills to successfully complete—painting, song or poetry writing, crafting, baking—things that produce a tangible product you will be proud to show to or share with others. The human brain craves success. It is wired to remember failure, because it doesn’t want us to repeat it. Science tells us that it takes three successful experiences to make up for one failure.
  8. Binge-watch TV! The more exciting the show, the more your brain is activated. But watch only what you like; otherwise the boredom buzzer will go off. Choose shows with short episodes. Surf to keep it interesting.
  9. Read some good news! Or at least alternate some good news with the bad. You should skip the obituary page.
  10. Tickle your funny bone. Watch comedy shows or listen to comedy podcasts. A joke is a good neuro-fix. It’s biochemically impossible for a laughing brain to worry.
  11. Ommm. Your brain shouldn’t be kept on high alert all the time, no matter how much it craves novel experiences. If you give it a break with yoga (or a nap), it has a chance to reset before turning on the steam again.

Stressors and the ADHD Brain: Next Steps

Jerome J. Schultz, Ph.D., a clinical neuropsychologist for more than 30 years, is on the faculty of Harvard Medical School, in the Department of Psychiatry. He is the author of Nowhere to Hide: Why Kids with ADHD & LD Hate School and What We Can Do About It.

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Updated on November 23, 2020

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  1. This is a very valuable and a little out of the box article about stress and ADHD. These days, all we hear about is mindfulness and taking a quiet pause which may be very healthy but not very popular with pre-teens and teenagers (certainly not mine!)

    This also almost directly explains why ADHD and Diabetes Type 2 are so closely connected. High cortisol level on a long period of time leads to diabetes (and adrenal fatigue … and can also impact changes of getting Alzheimer’s disease.) Love to connect these dots!
    Thanks!

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