When ADHD and Anxiety Go Hand in Hand | SoundVision.com

When ADHD and Anxiety Go Hand in Hand

Approximately six million children in the United States have been diagnosed with ADHD, according to the Centers for Disease Control and Prevention.1 Attention deficit hyperactivity disorder usually begins during childhood and can continue to adulthood in some people. This developmental disorder is typically associated with symptoms such as:

  • a short attention span
  • fidgeting
  • hyperactivity
  • impulsivity
  • restlessness2

Among the six million diagnosed children, boys are disproportionately represented. “According to the CDC, boys are three times more likely to receive an ADHD diagnosis than girls. This disparity isn’t necessarily because girls are less susceptible to the disorder. Rather, it’s likely because ADHD symptoms present differently in girls. The symptoms are often more subtle and, as a result, harder to identify.”3

Many times, children with ADHD struggle in school and with structured activities. They are often labeled “lazy,” “rambunctious,” “featherbrained,” “uncooperative,” or “defiant,” when in reality they are usually bright, capable children who are simply grappling with tasks that are too difficult for them to handle without support. Most of the time, kids with ADHD sincerely wish to accomplish all the things expected of them, but their disability sabotages their efforts. Their disability makes it difficult for them to start and finish tasks, recall and follow multi-step directions, stay on track, self-monitor, and balance priorities. While people with ADHD can certainly learn strategies to improve their focus and organizational skills, they cannot alter the way their brain is wired, nor should they be blamed or punished for their disability.

Why Anxiety?

ADHD can make day-to-day life extremely challenging while simultaneously causing children to be treated and labeled negatively by teachers and peers. As a result, anxiety commonly goes hand-in-hand with this disability. According to the Anxiety and Depression Association of America, approximately 50 percent of American adults with ADHD also have an anxiety disorder. The National Resource Centre on ADHD estimates that up to 30 percent of children with the condition experience anxiety.4

According to Medical News Today, “It can be difficult to differentiate between anxiety and ADHD as the two conditions can appear similar. Some signs and symptoms that are common to both conditions include:

  • difficulty socializing
  • fidgeting
  • inattentiveness
  • working slowly or failing to complete work on time
  • being irritable or argumentative
  • causing trouble in class
  • playing video games or watching TV most of the time
  • telling lies about schoolwork or other responsibilities that haven’t been completed
  • withdrawing from people5

“Although there are many things in common,” continues the article, “there are some differences between the two conditions. Anxiety is primarily a disorder of nervousness, worry, and fear, while ADHD is characterized by a lack of attention and focus. People with anxiety can also display compulsive or perfectionist behaviors, which aren’t typically seen in those with ADHD.”6

How to Support your Child

If your child has ADHD and/or anxiety, one of your first and most important goals should be correcting your mindset about your child’s behavior and the root cause of it. We parents tend to expect immediate responses to our requests and to interpret a child’s inaction as misbehavior or disrespect. “In many cases, [Sal Severe, Ph.D.] says, a child with ADHD fails to comply not because he is defiant, but simply because he becomes distracted from the task at hand . . . Distractibility is a common symptom of ADHD — something that he may be unable to control. And when you repeatedly punish a child for behavior he can’t control, you set him up to fail. Eventually, their desire to please you evaporates. He thinks, ‘Why bother?’ The parent-child relationship suffers as a result.”7

1. Be patient.

While patience is undoubtedly difficult to come by for many of today’s frazzled, over-extended parents, it is exactly what a child with ADHD and anxiety needs the most. If a child does not live in fear of his parents’ negative reaction every time he makes a mistake or fails to comply with their orders, his anxiety will be alleviated. However, if his parents are constantly critical, impatient, and dissatisfied, their mindset will only exacerbate his problem. If you struggle to be patient, try to remember that ADHD is an actual disability; it is not an imaginary condition, a result of laziness, a form of manipulation, or a diagnosis that your child has invented or chosen for himself/herself. 

Perhaps you can reframe how you see ADHD by comparing it to other disabilities. For instance, if your child’s legs did not work properly, would you get angry at him for not walking quickly enough? If her vision was impaired, would you blame her for not seeing what was in front of her? Most of us would manage to be compassionate, patient, and helpful if our child had a physical disability. Shouldn’t we apply this same compassion to neurodivergent children? 

2. Help them make the most of their strengths.

A child with ADHD will likely hear countless critical comments throughout her life – “You aren’t paying attention.” “Why can’t you sit still?!” “Your behavior is unacceptable!” – but you can be her advocate who frequently reminds her of her talents, potential, and positive qualities. People with ADHD tend to be creative, energetic, good communicators, resilient, and empathetic. These skills can be nurtured through various activities like debate, sports, art, science, and whatever subject or interest sparks joy in your child. People with ADHD often have hyperfocus, an ability to focus completely for a long period of time on a topic or project they enjoy. During periods of hyperfocus, people with ADHD can accomplish a great deal. Support your child in her interests, encourage her, and provide her with opportunities to shine. 

3. Ask for accommodations.

ADHD is considered a disability under the Americans with Disabilities Act (ADA). If your child has a diagnosis of ADHD, he probably qualifies for certain accommodations at school. If you are not sure which accommodations your child needs, you can request an evaluation at his public school. Submit a letter called a “request for evaluation” to the school’s special education teacher or principal. If, after testing, your child is deemed eligible, the school will work with you to write a 504 Plan or an IEP (individualized education plan). The plan will describe the accommodations, services, and supports your child needs and will be provided. Many times, when a child has the accommodations s/he needs, it will greatly reduce his overall anxiety, and his performance at school will improve.

4. Weigh the pros and cons of medication.

Only you and your child’s doctor can determine whether medication would be beneficial or necessary for your child’s ADHD symptoms. Before jumping to such a big decision, though, it is worthwhile seeing if the accommodations your child receives at school can alleviate some of his symptoms. For instance, if a child struggles to sit still, frequent movement breaks might solve the problem. All kinds of accommodations can be built into an IEP, and these adjustments can make a child’s school day much more bearable for him and his teachers. Be sure to ask your child’s opinion on what he struggles with most and what he thinks might help him get through the day. Would having access to a quiet room during tests help him? What about extra time to finish assignments? Would having a fidget toy at his desk allow him to focus better?  Keep in mind, also, that if a teacher knows a child has an ADHD diagnosis and an IEP, she will probably be more understanding of his behavior and more willing to work with him and you to find compromises. Children are often medicated because they are seen as problematic at school, but sometimes it’s the school that needs to make reasonable adjustments. For further reading, see this article Can You Make It Without ADHD Medication?.

ADHD and anxiety can be difficult to cope with, but the good news is that today, the conditions are being understood and treated more effectively by physicians, educators, and mental health experts. In the old days, a restless or inattentive child would have been punished or beaten, which would have solved nothing and actually might have caused great physical or psychological harm. Today we know kids with ADHD need extra support, understanding, strategies, and accommodations to help them thrive. If your child is one of the six million diagnosed with ADHD, or one of the 30 percent who also have anxiety, know that there are many supports available for you and your child. Do not hesitate to have her evaluated or given academic accommodations; it is much better to know your child has a disability, understand her challenges, and accept accommodations than to live in denial and watch her struggle.

End Notes:

1 Data and Statistics About ADHD | CDC

2 What is the link between anxiety and ADHD?

3 ADHD Symptoms Differ in Boys and Girls

4 What is the link between anxiety and ADHD?

5 What is the link between anxiety and ADHD?

6 What is the link between anxiety and ADHD?

7 Never Punish a Child for Bad Behavior Outside Their Control

Laura El Alam is a first-generation American Muslim and the author of over 100 published articles. She has written a children’s book, Made From the Same Dough, due to be released in 2023. You can visit her online at  www.seaglasswritingandediting.com

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