ADHD and Anxiety

Do you have a child/adolescent with ADHD and anxiety? Do you teach a child with ADHD who experiences anxiety as well?

Many children with ADHD have accompanying anxiety. You probably are asking, “Which comes first? Does one cause the other? If your child has ADHD and anxiety, or if you teach a child who has ADHD and anxiety, which do you treat first?”

It is difficult to say as to whether or not a child’s symptoms of ADHD caused him to become anxious. Children with ADHD typically do not have an accurate worldview. Therefore, they oftentimes do not realize that the symptoms of ADHD that they exhibit annoy other children. For those children with ADHD who do notice that other children rebuff them due to their symptoms such as excessive talking, for example, they may become anxious every time they need to speak.

In all reality, it does not matter whether ADHD precedes anxiety or if anxiety precedes ADHD. What does matter is which disorder to treat first. I always treat the most acute disorder first, which in most cases, is anxiety.

As a parent or as a teacher, how do you know what brings about anxiety in a child or adolescent with ADHD? The only way to successfully find out what triggers anxiety in a child with ADHD is to observe the child’s behavior and then to anecdote their reactions to events.

The largest yield for success, however, is for the parent and the teacher to observe and anecdote the child’s behavior and then to compare and contrast their observations. In that way, the most salient of the triggers that causes these children with ADHD to become anxious will not only be revealed, but additionally, will be validated.

After the triggers of the child’s anxiety are confirmed, what helps to diminish it? What are some steps to helping the child/adolescent to diminish his anxiety?

1.      Help him to become aware of the symptoms of his anxiety, i.e., perspiring, shortness of breath, a desire to run out of a room, trembling, a stomach ache, among many others.

2.      Help him to become aware of when he is experiencing the symptoms of his anxiety.

3.      If he is unaware of when he is exhibiting the symptoms of anxiety, secure permission from his parents to videotape him interacting with others in his home, or in another setting where he has previously experienced anxiety, so that he will be able to observe his own behavior as he watches the videotape.

4.      View the videotape with the child and go over it as many times as needed so that he will ascertain the triggers of his anxiety.

5.      Write down a list of the triggers to his anxiety and the responses that he will learn to make as a way of diminishing the triggers that cause his anxiety.

6.      Design task cards with the child that will cue him to respond in a way that diminishes his anxious responses to specific events.

7.       Teach the child to self-talk his way through the steps that are written on the task cards as a way to diminish his symptoms.

8.      Teach him to self-monitor his own symptoms of anxiety and his responses to those symptoms on a chart each time he experiences them. (or as close to every time as possible)

9.      Encourage an ongoing conversation concerning the level of anxiety that he feels and most importantly, how successful he is at diminishing his symptoms.