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#38: ADHD and anxiety

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It is not uncommon for an ADHD and anxiety diagnosis to go hand-in-hand. Multiple diagnoses are called comorbidity. According to the Depression and Anxiety Association of America, 50% of all people with ADHD are also diagnosed with anxiety.

Understanding the likelihood of ADHD and comorbidity allows parents to understand the suggested treatment options better. Especially, when they may focus on treating something other than ADHD first. Your child’s doctor will create a treatment plan based on what they feel is the most pressing issue. It is always important to be honest with your child’s doctors about all the behaviors you are seeing.

Dealing with ADHD and anxiety can be tricky as often the ADHD or anxiety treatment can increase their feelings of nervousness and worry. We tell parents that it may get worse before it gets better as your child is learning to cope with the changes. Don’t give up if it’s hard. It also may take some time as adjustments may need to be implemented slowly to keep your child from being too overwhelmed. Your child’s doctor will be able to help you work through these challenges. 

Having both ADHD and anxiety can increase the feelings of frustration and anger for a child as they often feel like they can’t manage either one. Their inability to pay attention often leads to anxiety over not getting tasks done, fear of getting in trouble, or fear of being called to answer a question but what questions was asked.

The behavior skill of Observe and Describe teaches strategies for dealing with anxiety as it allows a child to learn how to identify and process what they are thinking in an impartial and detached way. The basic principle of Observe and Describe is that you observe what is happening, and then you describe what you see. It’s taking a mental picture and then describing what is happening in the picture. This process is especially helpful for children with ADHD and Anxiety as it allows them to filter out all the distractions and better focus on what is important.

We want to help your family! We know that dealing with ADHD and anxiety can be overwhelming. We offer ADHD Parenting Coaching that allows focussing on your and your child’s specific needs and finding tailored solutions. We are giving away free 15-minute coaching mini-sessions with our ADHD behavioral expert, Siope Kinikini. You’ll be amazed at how much insight you’ll gain from having an ADHD behavior specialist working with your family.

Episode Transcript

Today we are talking about ADHD and anxiety.

This is episode 38. Let’s get started.

Smarter Parenting welcomes you to our podcast series, The parenting coach for ADHD. Here to heal and elevate lives is your parenting coach, Siope Kinikini.

Well, hello my friends. Hopefully, everybody’s doing really well. I am doing fantastic. The topic today is one that I’m super excited to share and talk about. There are just so many things that I want to cover today, but we’re going to just take it slow and work through it and provide some suggestions, meaningful things that you can do as a parent if your child suffers from ADHD and anxiety.

I wanted to start off actually by sharing something that happened to me last week. I am one of those people that I like to do things around the house on my own. I don’t like to hire other people to come do it. I just prefer to learn. Unfortunately, I’m not a great handyman. When something comes up that I need to figure out, I usually do what most people do. That is jump on YouTube, right, for a tutorial. Jump on YouTube, I can find what I need. Usually, the tutorials are very clear. They’re pretty easy to do.

Well, I had this task that I wanted to do inside the house. It was installing these these shelves, right? Now installing shelves is fairly easy, but I wanted to figure out if there was an easier way to do it. It’s one of those floating shelves where you stick it. It came with instructions of course. The way I wanted to hang it and where I wanted to hang it, and I just wanted to see a visual, okay?

I’m one of those people that like, I can receive the instructions, but I prefer a visual where I can actually watch somebody else do it. I jumped online. I looked up a video on YouTube on how to do this. How to hang these shelves in the way that I wanted to hang them. I watched the video once, went all the way through it and did not remember a thing about it. The video was like five minutes long.

So I was like, “Okay, I guess I should rewatch it.” I was watching it. I was physically watching it. I was like, the computer was right in front of my face. And I was looking at the screen and I was observing everything that was happening. I was listening to the words. At the end of the video I still did not, it’s like I didn’t even watch it. All right, so my mind was doing this wandering thing, right? I was aware of it, but I’m like, “Okay, I’m just get to watch it one more time.” I ended up doing this over and over and over again.

Actually, after about the fifth time watching this video, I would get bits and pieces each time, but it didn’t make sense. It did not make sense. And so I started to feel this, this anger. Anger’s a good word, right? I started to feel really frustrated. Really angry and anxious about this, because I’m like, “Oh my gosh, this is exactly what was happening when I was in school.” A teacher would say something. I would be like, “Okay, I was here and I was paying attention but I’m sorry I could not focus on what we’re doing.” It drove me crazy. It absolutely drove me crazy until I learned some skills to use while I was at school to better pay attention.

The same thing was happening. I hadn’t experienced this in a while, because it comes and goes, but it was never to this level of frustration that I was feeling. I started to remember. All of these memories started to come back about what it was like for me growing up and these feelings of not only ADHD but escalating into this anxiety into, “Oh, I can do this,” and it just kind of elevated, right?

Now the reason I share this is because children who’ve been diagnosed with ADHD, sometimes they’re diagnosed with additional things. Like a depression, sometimes with anxiety, sometimes as OCD or whatever it may be, right? With anxiety specifically, there’s such a link between the two that a lot of people are diagnosed with both. 

Now there is a society called, it’s called the Anxiety and Depression Association of America. They actually reported that 50% of the people diagnosed with ADHD are also diagnosed with anxiety, with the two. Now how they feed into each other is actually pretty common. I mean, based on what I had shared with you about my experience and trying to put up these shelves in the house and watching this video over and over but not being able to pay attention, it elevated that feeling of anxiety and frustration and anger to the point that I could not watch the video again. I really couldn’t.

And right now those shelves are still sitting somewhere in the house. I still haven’t hung them up, but I will once I can. It was kind of traumatic, really. Anyways, so with anxiety and with ADHD, they’re linked. They’re really closely linked. However, they are not the same thing, okay? I want to be very specific that they’re not.

So with anxiety, it’s more of a nervousness or fear or worry about things to the point where it affects your normal functioning throughout the day. That’s what anxiety is. Anxiety is that overwhelming feeling of fear and trepidation about what is happening or what is about to happen, okay?

With ADHD, it’s the inability to focus or to pay attention. Now if I’m unable to focus and I’m trying my best and I continually do that, then obviously other things are going to be happening too. They start to pile on top of each other, right? So learning to understand the difference between the two now.

What do you do? What does a parent do? What does a child do if they’re struggling with both of those things? When you take your child in to be diagnosed or to receive treatment, usually what happens is the therapist will focus on which issue is the most pressing or the biggest one. That’s usually what they focus on. Sometimes they’ll focus on a smaller issue in hopes that it will affect the larger issue, but they usually will focus. So if your child has been diagnosed with ADHD, they’re going to focus on ADHD to help alleviate some of the symptoms of anxiety, because they feed into each other. That’s what they usually do. Professionals will usually focus on the most pressing issue that needs to be addressed. That, in turn, will affect everything else.

There’s this saying, one of my professors in school, while I was becoming a therapist stated this. “It’s like we live in these systems and if you change even one part of the system, it actually will affect the whole system, right? That is the approach. If your child is dealing with more focus issues, then treatment is going to be focused on that. If you’re dealing with more of the anxiety issues and treatment will be focused on anxiety. Whenever somebody goes in to talk to their professional, their therapist or their doctor, their recommendation is to be as open as possible, to talk about everything that’s happening. Put everything on the table so you can make a good judgment on what needs to be done.

One of the most difficult things for a professional or for a therapist is when somebody comes in and they’ve already diagnosed themselves and have already come up with a treatment plan for it. They’ve convinced themselves that this is the direction that they need to go. That’s really kind of tricky because sometimes you’re too close to the issue and so you need somebody a little bit farther away to help you decipher where you should place the focus. Be open-minded. Be open to those things.

Treatment’s going to be difficult for somebody who is also dealing with anxiety because asking them to do something new or something different will cause some fear to be there. And it will cause some of these feelings of nervousness and worry. So it may escalate the anxiety. I always ask parents to be patient and to be willing to work with their child on the level that they are at in order to implement the changes that need to happen. If you’re dealing with somebody who has ADHD and anxiety, you’re going to find that it’s a struggle. Because you’re going to introduce something to deal with the ADHD and the anxiety may kick in and say, “Oh, I’m too scared. I don’t know. I’m worried. What if it doesn’t work?” Right? Be very cautious. Again, working with a professional would be super helpful for you in order to make that work.

Now, one of the things to be aware of is if you’re being treated for the ADHD and your child is on medication, sometimes the stimulant that you’re providing your child through the medication will actually cause symptoms of anxiety. In that case you do want to communicate with your medical professional so you can choose a non-stimulant to address the ADHD, okay? Just be aware that those are some of the things to really think about.

Now, what are the types of treatments that you’re going to receive? You, through the professional I get and receive usually CBT, which is cognitive behavioral therapy. You’ll learn some relaxation techniques for the anxiety, but also for the ADHD and mindfulness for the ADHD and for the anxiety. These things help calm the mind down. Help keep things calm and okay. You’re also going to be given some recommendations to make some lifestyle changes. This may include getting some exercise. It may include doing everything according to a schedule, changing up some nutrition and being sure that your child gets enough sleep. We’ve talked about this in a previous podcast, but sometimes the ADHD and the symptoms and issues that arise from that are escalated or are compounded because the child doesn’t have enough sleep. Being able to measure those things are going to be super, super important.

Another recommendation for parents when you’re working with treatment in order to help your child who’s struggling with anxiety and with ADHD is that the parents, please, please control your own responses to how things are going and to your child. Sometimes you can be the instigator to their anxiety based on your expectations, your feelings of worry.

Ask yourself, “Am I an anxious parent? Am I over anxious? Am I displaying this? And it compounds for my child.” I’ve seen this so many times. You can always tell when a child is feeding off the anxiety of their parent, usually because when the child does something wrong or they’re unsure, if the child looks to the parent and waits for the response, then you know they’re feeding off of the response to the parent in order to know how to respond, right? If a parent is neutral and allows the child to figure it out, it gives them a lot more autonomy to work through the issue. Just be aware of those things, you know, as you are working towards resolving the issues of ADHD and anxiety.

Now, these things, they sound super simple, but it takes a lot of time and it takes a lot of consistency and a lot of practice. Throughout the whole process, you’ll want to implements some behavioral skills. And those skills are things that will help them so they can manage, self-manage themselves, in addition to what they’re learning with their professional. You can find some parenting skills like how to communicate, how to set good boundaries, et cetera, on the Smarter Parenting website. So, you can jump over there and you can check it out. All the materials are there for free. We wanted to be able to provide that for parents in need. You can use those skills as a way to work through.

Now, one of the skills on the Smarter Parenting website that I wanted to go over with you as parents is a simple one. It’s called Observe and Described. Now Observe and Describe is exactly what it is. There’s a video on the website that explains how it works, but the reason that it’s super helpful is because it helps children take a step back. I used an example at the beginning of me trying to hang up those bookshelves, those shelves and the frustration I was feeling. What I noticed is as I continually watch videos and I started to delve deeper and deeper into this frustration and anxiousness and this worry and this freaking out state, I actually found myself Observing and Describing what was happening to me.

Now Observe and Describe is you observe what is happening at the moment and you describe it, but you do so in a neutral way and without judgment. The example that we give in the video is pretend like you’re taking a picture of something. And then you’re just describing the picture. So in my mind, I took a picture of myself and then I started to describe it, right? So instead of saying I’m feeling frustrated, I’m feeling anger, I was like, “Okay, I’m observing myself watching this video. I am continuing to watching this video.” And so I described the frustration. And the feeling is frustration, because it’s not sinking in. The information is not staying in my brain.

By being able to detach that way, I was able to work through the feelings of frustration better, right? I didn’t let the frustration actually consume my thoughts. I stepped away and removed that part of it, so I can say, “Okay, I observed that your face is making this anger face. You’re starting to feel hot. Your heart is pounding super hard. You’re watching with clench teeth.” When I knew what those symptoms were, then I could start to address them. “Okay, since your heart is beating super fast, take a deep breath, hold it and then let it go slowly.” So I could calm the heart down, right? Unclench your teeth.

It gave me a point where I could work through the issues. It’s one of those things that I think will be super helpful for parents. It’s a simple thing that you can do. If you can teach your child to Observe and Describe. You’ll get a better explanation of it on the Smarter Parenting website. It’s useful tool because it will take you out of all the judgment that is involved with the way that we respond to the world, and it gives us an outlet to address things on a different level. So yeah, check out that video. It’s super short. It doesn’t take very long to watch. There are some activities that are involved with it that will help you integrate it and teach your child how to do that. Once they know what the symptoms are of the feelings that they’re feeling and how their body is responding to it, they can start to address those things one by one, right?

Anyways, I just wanted to provide that information for parents. I mean we’ve talked a little bit about what it is, the difference between anxiety and ADHD. We’ve also talked about how stimulants can actually cause some symptoms to ADHD. We talked about what types of treatments are going to be out there, CBT, relaxation, mindfulness, the lifestyle changes that you can make.

I mean, we’ve covered a lot. I talk fast, because it’s just kind of the way I am. Anyways, my goal now is to actually hang up the shelf, but I still need to watch that video probably for the hundredth time. I should have read the instructions, but I threw the instructions away, because I thought the video would be better. Anyways, my goal is to hang up the shelves and to work through that. I have coping skills that I can use in order to work through the difficult emotions if I’m unable to focus anymore. Right? So that’s it for me from this week.

We at Smarter Parenting are excited to introduce coaching for parents. The coaching aspect is to make it more individual for the parent and for the child based on your specific situation. If you need coaching, you need help and your child needs help sign-up. Let’s do this. Let’s work together to make a huge change in your life. We have all the tools here. We’re ready to share them with you. In fact, I want to share them with you. I am sharing them with you. If you need individual coaching, I am absolutely excited to do that. So you can find more information on that actually on the Smarter Parenting website as well.

So that’s it for me this week. Stay tuned until next week I hope you have a good one. We’ll see you later. Bye.

Anxiety help on Smarter Parenting

Episode 28: ADHD and depression

Episode 34: ADHD and other issues

Free 15-minute ADHD coaching mini-session

Podcast Transcript

The transcript text is below. You can also download the PDF file of the transcript here.