Why determine if it’s anxiety, ADHD or both: ScienceAlert

“Cassie” is an anxious adult. She stresses out and postpones tasks that should be simple. Seeing others succeed makes her feel inadequate. It is easier to avoid challenges than to risk failing again. She took medication for anxiety, but it didn’t help much.

This hypothetical example illustrates a situation that many people have encountered. Social media is full of stories of people who have unsuccessfully taken anxiety medication and are now wondering about possible undiagnosed ADHD.

So how do you know if it’s anxiety or ADHD, or both? And why is it important?

ADHD and Anxiety Can Go Together

Anxiety and depression can mimic ADHD. Either can be associated with a lack of motivation and difficulty focusing attention.

On the other hand, a tendency to be late, miss deadlines and forget appointments due to ADHD can carry out anxiety and feelings of failure.

Both anxiety and depression are commonly associated with ADHD, especially in women. Anxiety tends to be more severe and persistent and to appear earlier in people with ADHD.

Generalized anxiety has symptoms such as frequent and excessive worrying about different aspects of life (such as work, school, and family). Worry can be difficult to control. Restlessness, fatigue, irritability and sleep disturbances are common.

For some, anxiety can be controlled with therapy, mindfulness techniques, a change in life or work, and/or medication.

For others, no treatment for anxiety seems to help. The problems persist. For these people, it might be helpful to determine if undiagnosed ADHD is a factor.

Successful treatment of coexisting ADHD may, for some, be the best way to get relief from chronic anxiety.

Could ADHD be a factor?

ADHD is often subtle in girls and women, who are less likely to show the disruptive hyperactive behavior that draws attention to ADHD in men and boys.

This matters because women with ADHD have higher rates of depression, anxiety, eating and sleeping disorders.

Old school reports can give telltale clues, such as:

Cassie spends more time socializing than working. She is capable, but is often distracted and falls short of her potential.

“Cassie’s” parents may remember hearing such comments from teachers. She may remember being bored in class and looking out the window instead of listening and concentrating.

However, not all adults with ADHD showed signs of it as children.

ADHD in adulthood

ADHD is usually diagnosed according to the criteria of the American Psychiatric Association.

Problematically, these criteria require that to be diagnosed with ADHD, an adult has experienced difficulties before the age of 12.

Studies have identified ADHD in adults who showed no evidence of it on a previous childhood assessment.

And ADHD is usually assessed in adults as if it were a continuation of the childhood condition. Diagnostic criteria – such as interrupting, fidgeting, not completing tasks, losing things, forgetting things – are derived from observations of children.

Applied to adults, these criteria always relate to behavior seen from the outside by an observer. They lack the depth and insight an adult can provide into their inner world and spirit.

A woman with no history of ADHD-related problems in childhood and no overt signs of agitation or hyperactivity may have missed her ADHD, particularly if she developed coping skills to seemingly stay on track.

She may feel stigmatized by those who believe ADHD is self-diagnosed in treatment-seeking adults who are overly influenced by social media.

If I suspect ADHD, what should I do now?

If you suspect ADHD but are managing to get by in life, you probably don’t need a diagnosis. You should only consider an ADHD diagnosis if you are having significant difficulty.

It can mean disorganization, inefficiency, difficulty in work or family relationships, or depression or anxiety so severe that it affects your ability to function.

To be assessed for ADHD you will need a referral from your GP to a psychiatrist. However, many people who appear to be doing well may find it difficult to convince a GP that an assessment is necessary.

You can bring copies of school report cards if they suggest ADHD. Checklists with ADHD criteria can help, but cannot reliably diagnose or rule out ADHD.

Clear descriptions of the difficulties you encounter when attempting mentally demanding tasks can help.

These may include repeated lapses in attention or having to multi-task to provide sufficient stimulation to continue working.

You can detail, for example, the average number of minutes per hour of your workday that you actually work productively or how long you can concentrate on a difficult task before losing focus. How often are you distracted? How long does it take to resume the task? What strategies have you tried?

A diagnosis of ADHD can be a relief for some, who may find that treatment helps alleviate issues they previously attributed to anxiety. It can also provide an explanation for past difficulties attributed to personal inadequacy.

ADHD treatments can include medication, learning more about it, developing new strategies, counseling, and having an ADHD coach.The conversation

Alison Poulton, Senior Lecturer, Brain Mind Center Nepean, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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