It’s not always easy to distinguish between attention deficit/hyperactivity disorder (ADHD) and anxiety disorders. They often co-exist and can exacerbate each other. Symptoms such as trouble concentrating, feeling overwhelmed, irritability, and restlessness may overlap. One of the tricky things about the different conditions is that stimulants used to treat ADHD can exacerbate anxiety. D’Agati, Curatolo, and Mazzone reported a 25 percent comorbidity rate in 2019.
According to the National Alliance on Mental Illness (NAMI), “Anxiety disorders are the most common mental health concern in the United States. Over 40 million adults in the US (19.1 percent) have an anxiety disorder.”
“We live, as has been said many times since the dawn of the atomic era, in an age of anxiety,” wrote Scott Stossel in his 2014 book My Age of Anxiety. “And yet, as recently as thirty years ago, anxiety per se did not exist as a clinical category.”
Anxiety disorders are a group of related conditions, each having unique symptoms. However, all anxiety disorders have one thing in common: persistent, excessive fear or worry in situations that are not actually threatening. According to NAMI, people with anxiety typically experience one or more of the following symptoms:
Emotional symptoms:
- Feelings of apprehension or dread
- Feeling tense or jumpy
- Restlessness or irritability
- Anticipating the worst and being watchful for signs of danger
Physical symptoms:
- Pounding or racing heart and shortness of breath
- Sweating, tremors, and twitches
- Headaches, fatigue, and insomnia
- Upset stomach, frequent urination or diarrhea
ADHD is a neurodevelopmental disorder characterized by inattention, or excessive activity and impulsivity, which are otherwise not appropriate for a person’s age. One of the main distinguishing factors between ADHD and anxiety is that “ADHD symptoms typically begin, and are worse, in childhood, whereas anxiety typically crops up when you’re a teenager or adult,” Sonia Gaur, a psychiatrist with Stanford Health Care, told Insider.com.
Another way to differentiate between the two conditions is that anxiety caused by generalized anxiety disorder (GAD) can arise for no apparent reason, explained Dr. Gaur on Insider. “For example, someone with GAD may wake up from a peaceful sleep and feel paralyzed by anxiety with no detectable cause. On the other hand, someone with ADHD might only feel anxiety once they start to feel overwhelmed by certain tasks they have to do.”
While 19 percent of American adults have an anxiety disorder, “millions of US children have been diagnosed with ADHD,” reports the Centers for Disease Control and Prevention (CDC). “The estimated number of children ever diagnosed with ADHD, according to a national 2016 parent survey, is 6.1 million (9.4 percent).” Boys are more likely to be diagnosed with ADHD than girls (12.9 percent compared to 5.6 percent).
The symptoms of ADHD include:
- Trouble concentrating and finishing tasks
- Impulsivity
- Lack of time management skills
- Restlessness
- Mood swings
It can be difficult for physicians to correctly diagnose anxiety and ADHD. But a careful diagnosis is crucial because both conditions need to be treated separately, with different medications. Unfortunately, stimulants used to treat ADHD, such as Adderall or Ritalin, can make anxiety symptoms worse. Anxiety is listed as a potential common side effect of Adderall. Dr. Gaur said that stimulants can also cause symptoms like jitteriness, agitation, and a racing heartbeat, which may be mistaken for anxiety.
Some observers have criticized an alleged “widespread misdiagnosis of attention deficit hyperactivity disorder” in the United States. In his 2016 book ADHD Nation, journalist Alan Schwarz concluded that “ADHD has become, by far, the most misdiagnosed condition in American medicine.” Unfortunately, careless over-prescribing has led to frequent misuse and diversion of ADHD medications.
According to a 2016 study published in The Journal of Clinical Psychiatry, Adderall use among young adults who didn’t have ADHD jumped 67 percent in recent years. Emergency room visits related to Adderall and similar drugs has increased dramatically. The federal government classifies Adderall as a Schedule II drug, the same as cocaine. This means the potential for developing a substance use disorder (SUD) is significant.
Anxiety is a major driver behind SUDs. According to the Anxiety and Depression Association of America, “About 20 percent of Americans with an anxiety or mood disorder such as depression have an alcohol or other substance use disorder, and about 20 percent of those with an alcohol or substance use disorder also have an anxiety or mood disorder.”
Severe mood disorders and efforts to self-medicate them are best treated in a comprehensive clinical program to avoid serious negative consequences. If you, a family member, or a friend are struggling with addiction and/or mental health issues, Recovery Ways wants to help. We have a specialized mental health program for those struggling with depression, anxiety, posttraumatic stress disorder (PTSD), and other mood disorders.
Our Mental Health Primary program offers profound and comprehensive long-term support. Our trauma-informed, clinically integrated treatment program has made us a trusted partner with patients, referents, and payers for more than a decade. A substance use disorder (SUD) is not required for admission to this program. For more information, please call us at (888) 988-5217.
