Anxiety and ADHD: Which is it?
It is very common for children with ADHD to have other coexisting conditions such as anxiety. In fact anxiety and ADHD look very similar in symptoms at times, but the cause for the symptoms is completely different. I bring up anxiety and ADHD because statistics show children with ADHD are over three times more likely to have anxiety than children without ADHD. In my previous blog post, I mentioned the importance of evaluation in all areas related to ADHD, including anxiety. Without specifically evaluating for each related condition, you can't determine if the symptoms are truly from ADHD or something else that may need attention and treatment.
HOW DO ANXIETY AND ADHD LOOK ALIKE?
Anxiety has several different symptoms. Some children act out, while others withdraw. There is a larger overlap in symptoms between anxiety and ADHD which easily confuse a diagnosis. For example, a child may be fidgety, joke in class or be argumentative. These are all symptoms of both disorders. A child with anxiety may behave this way because he or she is extremely nervous and worried about schoolwork or a situation in school. The anxiety causes the child to avoid the situation with these behaviors. For a child with ADHD, the fidgeting could be hyperactivity and the inability to sit still. The joking could be impulsivity and the argumentative behavior could be avoiding the schoolwork because he or she is completely overwhelmed at how to complete the work assigned. So in this example there are similar looking behaviors, but the causes of the behaviors are completely different.
When a child has ADHD, the executive function skills are greatly impacted. These are the skills that help a person organize, plan, manage time, follow daily routines and complete tasks. Inability to perform these skills increases the stress level. Increased stress can lead to anxiety. When children with ADHD are faced with these challenges in emotional regulation, their mind gets overwhelmed. They don't have the ability to sort through these emotions and manage them. Then the undesired behaviors occur. Children with ADHD experience being overwhelmed all day long with trying to complete simple things such as morning routines, remembering to turn in school assignments, starting a school project or picking up on social cues in social situations with friends. Their whole world can feel out of control in almost every situation.
Anxiety alone usually seems to be present in certain situations, not across all tasks and situations all day. Children with anxiety can be extremely distracted by their worries about things. Anxiety actually causes physical responses in the body. Nervous energy can look like hyperactivity or fidgeting, but it is really the body's physical response to the worries they are feeling. When a child doesn't do a class assignment, it can appear as though they cannot maintain focus and complete the task. Often the child is so preoccupied by worry and not making mistakes they just don't move forward to do the work. So things are not always how they appear.
WHAT DOES THIS MEAN?
The bottom line is that ADHD is real and anxiety is real. Children with ADHD are at a high risk of having or developing anxiety. This is why it is so it important to screen for any time ADHD is involved. Both conditions can greatly impact academic situations, work completion, behavior in class and social situations. All of these activities are life functions that these children need help and supports for to grow, make progress and be successful.
Because the driving forces for anxiety behaviors and ADHD behaviors come from different causes, different methods are used to treat each. For anxiety treatment can include cognitive behavior therapy, relaxation, meditation and anxiety medication. When ADHD is present, some of the treatments include training in executive functioning skills, behavior therapy and ADHD specific medications. For either condition, 504 accommodations and IEP plans should be inclusive of goals and strategies to help the child improve these areas of deficits. Without properly identifying the cause of the behaviors or the condition causing it, specific needs can not be determined and appropriate goals cannot be established with supporting teaching methodologies. Development of the IEP or 504 needs to be complete and fully inclusive of these considerations to be effective.
WRAPPING IT UP
So now that you are seeing how these two conditions are similar and how often children experience both conditions, does that change your perspective on your child and his/her situation? Has your child been evaluated for both conditions? If so, are they both present? Once you know the answer to these questions, you can effectively address them with the 504 or IEP team members to include proper strategies to help your child improve in these areas.
Stay tuned for more blog posts on other AHD related conditions you should be taking a look at!