ADHD and Anxiety

Many of our children have a paired or comorbid disorder along with their ADHD. One of the most prevalent is anxiety. Anxiety can show up as an uncertainty in going downstairs when everyone is upstairs, a reluctance to talk to adults or to children, a tendency not to ask the teacher questions, staying on the periphery of groups who are conversing, as well as a myriad of other indications. When you look back on your childhood or adolescence, you might remember experiencing similar feelings.


If you do remember feeling anxious as well, then that would be a good starting point to talk to your child about how you felt during those anxious moments. Additionally, if your child hears that he is not alone in feeling that way, he will feel much better in the knowledge that he is not alone in his feelings. How did you manage your anxiety? Do you still have anxiety? If so, how do you manage it now?

Certain techniques work with certain people and do not work so well in others. One technique to have your child try is self-talk. When a child is experiencing anxiety, he often is overwhelmed with pure emotion. By the time that the anxiety occurs, it is too late to manage and diminish it. If he uses self-talk, when the first sign of anxiety “rears its head,” he can diffuse the anxiety in a major way. Of course, self-talk has to be taught. Here it is in a nutshell:

What do I mean by self-talk? We have discussed it before, but for those who are new to my blog, I will gladly explain it again. Have you ever talked to yourself when you are getting ready to go on a trip? Have you asked yourself, “Have I packed that sweater?” or “Where did I put my keys?” either nonverbally or verbally? Children may use that type of self-talk to help themselves to feel less anxiety. First, the child talks aloud to practice telling himself not to be anxious. Second, he says the same phrase nonverbally, so that only he is hearing it. Each time that he becomes anxious, he tells himself a phrase to diminish his anxiety.

Let me give you an example. The child with ADHD whom I observed in New England had a great deal of anxiety. He especially became anxious when he did not feel that he was familiar with the people who were interacting in close proximity to him. When I first met him, his Mom was talking to me and had not introduced him to me as of yet. By the time she got around to introductions, he was so anxious that he stood at his Mom’s side and kept incessantly talking in a very agitated way. How do I know that he was experiencing anxiety? First, he did not know who I was which, as he told me later, was not a comfortable feeling for him. Second, his mother told me that he was anxious around strangers.

As he stood next to his Mom, perhaps he could have said to himself, “I will stand here quietly until my Mom introduces me to that lady. I will think of something pleasant so that I will be relaxed. I will think about petting my cat, which always gives me a calm, warm feeling.” By the time that his Mom had introduced us, he would have been somewhat relaxed instead of behaving in the anxious way that I observed on that day.