ADHD & Anxiety
Kids with ADHD are 3x more likely to have an anxiety disorder than kids who don’t have ADHD. Some studies put the rate of anxiety amongst children with ADHD at 18% or even higher.
Anxiety manifests as excessive worry, tension or uneasiness even when there is nothing to fear. Feelings are more frequent and excessive in comparison to normal fears and so can affect thinking and behaviour. Generalised anxiety typically emerges when children reach school age.
Anxiety can affect children differently, so some kids may draw attention to themselves whereas others might sit quietly and try not to be noticed. Some children may work very hard to cover up their anxiety but they may often ask frequent questions in new situations such as:
“What’s going to happen?” or
“What if … ?”
Here are some behaviours that may be signs of anxiety in children with ADHD:
- Clowns around too much in class
- Lies about schoolwork or other responsibilities he hasn’t met
- Scared of asking or answering questions in class
- Feels the need to be a perfectionist
- Finds it hard to perform in tests
- Inattention/impaired concentration
- Day dreaming
- Withdraws from people, perhaps by retreating to the bedroom
- Plays video games or watches TV non-stop
- General Worries e.g. health, school, money, safety, world events
- Excessive worry/sense of impending doom
- Afraid of new or unfamiliar situations
- Seeks constant reassurance
- Seems irritable or argumentative
- Refusal to participate in certain activities
- Unexplained tantrums
- Panic attacks
- Feelings of unreality
Some physical signs of anxiety to watch out for could include:
- Stomach aches/digestive upsets
- Muscle tension
- Palpitations/fast heart beat
- Dizziness/feeling faint
- Shortness of breath
Of course these symptoms may not be purely anxiety-related and should be checked out with your doctor too.
Children might find falling asleep at night difficult due to excessive worrying about the events of the next day or may be anxious about being alone in their room or the dark.
Of course it is common for there to be times when children worry a lot, but you know your child best and, if you feel their worrying is affecting their enjoyment of life, or if the worrying continues for longer than six months, it is worth seeking professional help.
Take a look at the ADHD Directory to find a professional suited to your needs.
Anxiety can sometimes be misdiagnosed as ADHD – see Conditions that Mimic ADHD.
What can cause symptoms of anxiety?
There are many reasons why someone may suffer with anxiety.
Many of the challenges that kids with ADHD typically face can make them feel anxious.
In a typical day an ADHD child may struggle with time-keeping, organisation, focusing in class, impulsive behaviour, learning difficulties, how to study for a test or problems with friends.
Their issues with working memory, organisation and time management may make it hard to follow daily routines, leading to chronic stress.
Kids with ADHD often have more trouble managing stress than other kids due to their emotional regulation difficulties, so it’s no wonder anxiety can become a problem for children with ADHD.
However, the causes of anxiety could be many and varied so it’s wise to look for any root causes that can be corrected.
Some root causes for anxiety could be:
- Traumatic life experiences
- Current life situations
- Stress & other psychiatric conditions
- Genetic susceptibility
- Digestive disorders
- Nutritional factors
- Environmental exposures
- Insomnia/Sleep problems
As you can see above, the causes of anxiety can be psychological or physical.
The anxiety could be stemming from an ongoing traumatic situation such as bullying or a past experience or trauma situation such as abuse.
A common example of a physical trigger for mild anxious feelings could be drinking too much coffee (or food/drinks high in caffeine) – particularly if you are a slow caffeine metaboliser. You can suddenly feel a vague sense of anxiety along with physical symptoms, such as rapid heart rate.
All children metabolise caffeine much slower than adults and certain adults also experience slow caffeine metabolism. It can not only increase anxiety but also, affect sleep quality many hours after consumption.
If you suffer anxiety, you should check your diet and remove any caffeinated foods or drinks.
Other chemical compounds entering your body can also have an anxiety-provoking effect.
This could be through foods you’re sensitive to, such as foods with high histamine, phenolic or salicylate contents or food additives, flavourings and colourings.
This category could also include chemicals in personal care or cleaning products, Wi-Fi exposure or side effects from prescribed medications or recreational drugs.
Often people don’t consider these factors when looking for a cause for anxiety, but they are definitely worth investigating, as they are so simple to avoid.
Blood Sugar Balance
When blood sugar drops too low this can cause feelings of anxiety as well as feeling weak, sweaty, irritable and strongly craving high carbohydrate foods. To combat episodes like this, avoid foods high on the Glycaemic Index (GI) such as sugar, white bread, rice and potatoes and choose low GI foods such as unprocessed grains or sweet potato which raise the blood sugar levels slowly, keeping it even and allowing for a calmer mood and sustained attention.
The appropriate levels of certain micronutrients are required for good mental health. These nutrients influence neurotransmitter activity and allow methylation processes to be optimised for effective nerve cell functioning.
The most essential micronutrients for optimal brain health include zinc, vitamin B6, calcium and magnesium.
If methyl concentrations are either elevated or depleted, mood disorders, anxiety & depression can occur.
For example, magnesium is required to produce serotonin and a deficiency, which is extremely common in the general population, has been linked with anxiety and depression and high copper levels are associated with aggression, anger and other mood disorders.
Omega 3 fatty acids (DHA/EPA) are both also needed for optimal brain function, including a relaxed mood.
Vitamin D activates genes that regulate the immune system and release neurotransmitters that affect brain function and development. Vitamin D deficiency is linked with depression and mood disorders. More people than you would imagine are Vitamin D deficient, particularly in winter.
The Gut-Brain Connection
Much evidence and research now suggests anxiety can be caused by issues originating from the micro biome (gut). This is an in-depth topic and an emerging area of science, but when you understand that approximately 90% of serotonin and 50% of dopamine (the ‘feel good’ chemicals that help to regulate and boost your mood) are produced by the bacteria in your gut, it makes perfect sense that if this system is disrupted in some way, then neurotransmitter production, and therefore brain function, mood and behaviour, will be impacted as a result.
A healthy gut micro biome is full of beneficial bacteria that break down, absorb and assimilate nutrients from the foods you eat, which fuel every process in your body.
While a healthy micro biome contributes to good mood, an unhealthy one full of ‘bad’ bacteria or yeast, and all the toxins associated with it, may contribute to mood disorders. The presence of yeast, for example, alters the ability to absorb nutrients and the toxic by-products cause reactions, which cause inflammation in the body, which in turn greatly contributes to anxiety, depression and poor mental function.
Genetic susceptibility means you may have certain genetic mutations that pre-dispose you to certain health issues such as mood problems. For example studies have shown an association between the MTHFR C677T mutation and depression, schizophrenia and bipolar disorder.
Whilst you can’t change your genes, you can support your body with lifestyle, diet and specific nutrients to allow the methylation cycle to function more efficiently.
When the methylation cycle is not working efficiently, it can also affect the body’s ability to detoxify heavy metals and chemicals, to control inflammation, the immune system, energy, histamine levels and be responsible for imbalances in the liver, thyroid, adrenal and digestive system.
PANDAS is an acronym for a condition called Paediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus.
PANDAS is a little-known illness in children resulting in the sudden onset of a range of mental health and behavioural disorders such as severe anxiety, OCD, Oppositional Defiant Disorder, Tourette’s Syndrome, ADHD and even psychosis. Children may also develop new learning difficulties that did not exist before.
PANDAS is a reaction to an infection – often strep throat – which affects up to 1 in 200 children where the child’s immune system reacts to the strep infection by producing antibodies, which then attack brain cells and cause these problems.
While full-blown PANDAS affects 1 in 200 children, many more children are affected to a somewhat lesser extent, caused by infection or an overgrowth of bad gut bacteria, but still have mood, learning and behaviour issues as a result.
You can find more information on PANDAS at www.pandasnetwork.org
How You Can Help?
Because mental health issues are seen so often in association with ADHD, children with ADHD should be checked for anxiety and depression and getting a thorough evaluation is key in understanding whether your child has ADHD, an anxiety disorder or both.
As explained above, there are numerous causes of anxiety, so you might find it useful to seek help from any of the following:
- Integrative GP
- School Counsellor
- GP or Paediatrician for a referral to a child psychologist
Use the ADHD Directory to help you find a practitioner to suit your needs.
Tips for talking with your child:
- Ask your child if something is worrying him or making him feel uneasy and see if you can find a pattern to their behaviour.
- Always acknowledge and validate your child’s feelings. Rather than telling them not to be silly or to calm down – work with them to figure out the next steps to take.
- Help your child to brainstorm what they could do next time in a given situation.
- If you struggle with anxiety yourself it’s important for your child to see you responding positively to stressful situations so they can learn from you.
- Understand your child will probably have had a stressful day at school and will likely let off steam when they come home, so help them to find ways to do this effectively.
If the anxiety is severe, and preventing your child from enjoying life then you should consider seeking professional psychological counselling to help with self-esteem issues and gaining greater resilience.
- Check your gut health
- Identify food sensitivities/allergies
- Correct nutritional deficiencies
- Check for environmental toxins
- Balance hormones
- Ensure optimal thyroid function
- Avoid coffee, cola and other caffeinated drinks or foods
- Reduce sugar/carbohydrates
- Balance blood sugar by eating small, regular, low GI meals
- Try a gluten/dairy-free and/or grain-free diet
- Eat adequate protein
- Consume high magnesium foods e.g. green vegetables, nuts & seeds
- Avoid excessive alcohol consumption
- Eat wild oily fish 2-3 x week and supplement with high quality Omega 3
- Consume flax and linseeds
- Avoid known food allergens
- Epsom Salt baths
- Essential Oils
- Optimise your sleep
- Regular Exercise
- Yoga, Tai Chi or other relaxing activities
- Practice deep breathing techniques
- Spend time in nature – preferably barefoot
- Get adequate sunlight
- Avoid recreational drugs
Where can I find professional help?
Check out the ADHD Directory to find a suitable practitioner for your circumstances.
If you live in and around Sydney’s Northern Beaches please come along to one of our monthly ADHD speaker evenings to increase your knowledge on the co-morbidities of ADHD such as Anxiety.
You can find more information or book one of our events here.
- The Anti-Anxiety Food Solution
- A Mind of Your Own
- Nutrient Power
- Additive Alert
- Dirty Genes
- Gut & Psychology Syndrome
Picture books for children
For more book recommendations see our Resources section.
- Magnesium & Adolescents
- Essential Elements in Anxiety/Depression
- Magnesium & Borderline Disorders
- Junk Food & Adolescents
- Omega 3 & ADHD in Adolescents
- Sugar Consumption & Emotions
- Zinc & Copper in Aggressive Males