“Anxiety’s like a rocking chair. It gives you something to do, but it doesn’t get you very far.” —Jodi Picoult
Are you interested in learning how therapy can help with ADHD and anxiety? Do you or someone you love suffer from these conditions? You may be wondering what is the link between the two and how the symptoms can best be treated. In this article I share how evidence based talk therapies can help improve the symptoms of both ADHD and anxiety.
ADHD, Anxiety and the Brain
ADHD is a brain based problem characterized by poor executive functioning skills which include: planning and organization, time management, emotion regulation, impulse control, managing social interactions and motivation to stay on task. These are skills that we need to function in daily life so not being able to manage EF skills gives a person reason to feel anxious and anticipate failure.
Anxiety is also wired into our nervous system and characterized by heightened activity in amygdala and hippocampus, the fear centers of our brain. Anxiety also shuts down the frontal lobes, or thinking part of the brain so that the executive functioning skills discussed above are not accessible.
There is a great deal of overlap between the symptoms of ADHD and generalized anxiety disorder. People who struggle with both conditions may wonder whether they need to treat the ADHD or anxiety, or both. The good news is that therapies for both ADHD and anxiety are effective for both problems. Medications can be helpful but many people seek out non-medical approaches that work on the basis of neuroplasticity, the brain’s ability to rewire through learning and experience.
Getting a formal diagnosis of ADHD can be helpful as a first step but often can be difficult to access due to cost, waitlists and shortage of diagnosing professionals like psychiatrists and psychologists. If you are struggling with executive functioning skills and anxiety, you don’t need to wait for a diagnosis to improve these symptoms with talk therapy.
General Anxiety Disorder and ADHD
General anxiety disorder or GAD is a condition characterized by “what if” thinking. People with ADHD often feel the need to scan their environment for something to worry about and then ruminate on these problems. They are often restless, easily bored and have difficulty being still.
GAD gets worse when there are multiple previous experiences of failure and things going wrong. People with ADHD often experience the following:
- missed deadlines
- letting people down through forgetfulness
- social blunders because of impulsivity
- difficulty with decision making
- rumination to the point of inactivity
When previous negative experiences pile up we anticipate that it will likely happen again. This leads to constant worry about what could go wrong and avoidance behaviours.
GAD can build up over time especially for those who have undiagnosed ADHD. If left untreated, anxiety can disrupt people’s lives to the point where they are unable to work or function in daily life. Therapy for ADHD and anxiety is best started as early as possible, before life gets too difficult.
How Therapy Can Help with Managing Overlapping Symptoms of ADHD and Anxiety
Fortunately there are a number of evidence based therapies that can help people with ADHD to manage anxiety and improve executive functioning skills.
Mindfulness and Cognitive Behavioural Therapy are the most effective evidence based therapies for people struggling with ADHD and anxiety. Both can also be enhanced with brain training or neurofeedback.
Cognitive Behavioural Therapy is a particular therapeutic approach that examines the connection between thoughts, feelings, and behaviours that contribute to the experience of anxiety. “What if” thinking and anticipation of negative outcomes dominate the minds of many people with ADHD. CBT helps people to become familiar with the landscape of their negative automatic thoughts and challenges them to adopt more balanced and adaptive thoughts.
Mindfulness therapy is also effective for ADHD because it helps people to develop the ability to focus and shift attention. It teaches people to regulate emotions by learning to stay present with feelings as they arise. Meditation practices train the nervous system to feel calm by paying attention to the breath in the body.
Neurofeedback or brain training is another evidence based therapy that trains the frontal lobes, the site where executive functioning thought takes place. Training the neural networks of the frontal lobes can lead to improved focus, planning, decision making, emotion regulation, and impulse control.
Integrative Therapy is Most Effective Approach for Treating ADHD and Anxiety
Before seeking out therapy for managing ADHD and anxiety, many doctors recommend starting with medications. Medications are not the only answer to managing ADHD and anxiety and never provide a solution on its own. An integrative approach to treating ADHD is the best practice for addressing the complexity of the disorder. Integrative therapy combines talk therapy, lifestyle coaching, exercise, diet, sleep hygiene, healthy relationships, managing screen time and maintaining accessible goals.
Recommended Resources for Self Management
In addition to professional support, there is an abundance of self management tools for ADD/ADHD.
To understand the complexity of ADD/ADHD as a brain based disorder, the book Scattered Minds by Gabor Mate is an excellent read.
Another great workbook that I use in conjunction with therapy is “Understand Your Brain, Get More Done”. Start by trying the exercises in this book in a self guided way. Most people benefit most with the support of a therapist or coach who can help with motivation to stick with it.
It’s Okay to Reach Out for Help
Sometimes people struggling with ADHD and anxiety have a hard time asking for help. Today, the general population is more aware and accommodating to the unique challenges of people with neurodiverse brains, such as ADHD. The good news is that ADHD and anxiety are treatable conditions. If you are struggling, don’t hesitate to reach out for professional support to understand ADHD and get relief for your anxiety.
1 Plizka, S. R., Carlson, C., & Swanson, J. M. (1999). ADHD with comorbid disorders: Clinical assessment and management. New York, NY: Guilford
2 Kessler, R. C., Adler, L., Barkley, R., Biederman, J., Conners, C. K., Demler, O., … Zaslavsky, A. M. (2006). The prevalence and correlates of adult ADHD in the United States: Results from the national comorbidity survey replication. American Journal of Psychiatry, 163, 716–723. doi:10.1176/ajp.2006.163.4.716