ADHD and Anxiety in Children

Attention Deficit Hyperactivity Disorder is a neurodevelopmental disorder that affects one’s ability to hold attention, control impulses, and organise and finish tasks to the point that it interferes with a person’s daily life.

According to Health Direct, one in 20 Australians has ADHD. This condition is also more prevalent in boys. Moreover, around three in four children diagnosed with ADHD continue to experience symptoms into adulthood. 

People with ADHD have differences in their brain structure and activity. Brain scans indicate that some parts of their brain tend to be smaller, and a part of their brain seems to mature later compared with other children. In addition, people with ADHD have lower levels of brain chemicals that are needed to function properly. 

The exact cause or causes of ADHD is not yet understood. However, researchers are looking into several factors such as genetics and the environment. 

Anxiety in Children with ADHD

Those who are diagnosed with ADHD often have other mental health conditions like anxiety and depression. Studies in the US and Australia have shown that around three out of 10 children with ADHD also have an anxiety disorder.

It is not clear why ADHD and anxiety seem to occur together. Genetics could play a role in the development of both conditions. 

But it is also possible that being in a constantly stressful situation because of ADHD leads a person to develop anxiety. 

Kids with ADHD, especially if undiagnosed or diagnosed late could be misunderstood by the people around them. They could be labelled as lazy, unruly, lacking discipline, hardheaded and other negative things because they are having a hard time paying attention or controlling their impulses.

The constant negative attention they get can lead to a feeling of frustration and negativity which can increase the likelihood of developing other mental health conditions such as anxiety disorder. 

It is also possible that both factors--genetic predisposition and the stressful situations brought about by having ADHD can lead to the development of anxiety in children. 

What is anxiety disorder?

Everyone may experience occasional anxiety and that is just a normal reaction to some stressful events in their lives. But when a person feels anxious most of the time even about things that other people may consider trivial, and to the point that it hinders their daily lives, it can be a sign of an anxiety disorder. 

Anxiety disorder can be challenging to detect because its symptoms sometimes overlap with ADHD like difficulty in concentrating and restlessness. Here are the emotional signs you need to look out for in children. 

• Difficulty in falling or staying asleep
• Increased irritability
• Withdrawing from peers
• Refusal to go to school 
• Showing disruptive behaviours in school
• Skin picking, hair twirling, and other displays of anxious behaviour
• Chronic feelings of worry or nervousness
• Worries too much about things before they happen
• Fear of trying new things

Anxiety disorders can also cause physical symptoms such as the following.

• Rapid heart rate
• Quick breathing or difficulty catching one’s breath
• Stomachaches and headaches
• Shaking, dizziness, tingling
• Sweating
• Fatigue

Consult a qualified health professional if you think your child is experiencing the symptoms mentioned above. 

Different anxiety disorders can affect children and teenagers such as the following.

Generalised anxiety disorder (GAD)

Kids with generalised anxiety disorder worry about what most kids worry about (like tests, homework, etc), and also about other things that kids don’t usually don’t worry much about (constantly thinking they could get hurt or sick, etc). They also worry more often and to a greater degree compared to other children. 

Social Anxiety Disorder 

In this type of anxiety disorder, kids worry about being in social situations like being in a classroom, talking in front of many people, and making friends.

Phobia

A phobia is a strong irrational fear of something that poses no real dangers. The fear could be related to anything such as animals (spiders), natural environments (thunder, darkness), specific situations (flying, going to the hospital), and others.

Separation Anxiety Disorder

Separation anxiety is a normal phase in babies and toddlers. They get upset and clingy when their parent goes away. But when older children do not outgrow this stage, they may have Separation Anxiety Disorder.  

Managing ADHD and Anxiety Disorder

Having anxiety disorder on top of ADHD can be tough for children. They need all the support they can get from their family, teachers, and friends. But it is equally important that they be treated for both their conditions.

Medications

Sometimes, ADHD medications may worsen the symptoms of anxiety. If your child is diagnosed with anxiety disorder apart from ADHD, your doctor will assess your child’s current medications and adjust the dosage or change it if deemed necessary. 

Therapies

Children with anxiety disorder can benefit from Cognitive Behavioural Therapy. This aims to help people change their thinking patterns to positively influence behaviour.  

Other strategies

Encourage your child to do the following strategies to help them manage their anxiety.

For some people, specific situations may trigger anxiety. Your child needs to be aware of the things that can trigger their anxiety. Let the doctors know about your child’s triggers so they can create a plan to manage anxiety in these situations. 

Practice deep breathing exercises and other relaxation techniques

Relaxation techniques such as breathing exercises and meditation can help lower heart rate, reduce muscle tension, and improve one’s mood. 

Exercise regularly

Regular exercise can help release brain chemicals that can improve one’s mood. 

Get enough sleep

Inadequate sleep can worsen the symptoms of anxiety. If your child has trouble falling and staying asleep, teach them relaxing techniques and encourage them to try to stick to a sleep routine as much as possible. Sleep aids may help, but ask your doctor’s advice first as even the “natural” sleep aids may interfere with other medications that your child is taking. 

Eat healthy foods

Eating a well-balanced diet can help provide the nutrients needed for proper brain function and overall well-being. 

Some nutrients are also being studied for their mood-boosting effects. Getting enough of these nutrients from food may help reduce some symptoms of anxiety. 

• Vitamin B Complex 

Some studies suggest people with lower levels of vitamin B12 in the blood are more likely to have depression or anxiety. People can get enough vitamin B from eating a variety of foods except when they have absorption problems. Meat, poultry, eggs, dairy, and legumes are good sources of Vitamin B.    

• Vitamin D

Some research suggests that Vitamin D deficiency may be linked to anxiety disorders. While the results are not yet conclusive, it is still a good idea to get enough of this vitamin for general well being. Our bodies can produce Vitamin D if we spend time in the sun (with proper sunscreen). Some foods like salmon, egg yolks and liver are good sources of Vitamin D.  

• Selenium 

Selenium may improve mood by reducing inflammation. Beans and legumes, lean meat, nuts and seeds are good sources of selenium. Bear in mind however that too much of this mineral is bad for the body so it is not advisable to take supplements as it could lead to selenium toxicity. 

• Omega 3 Fatty Acids

Omega 3 fatty acids include DHA (docosahexaenoic acid), ALA( alpha-linolenic acid) and EPA (eicosapentaenoic acid). They are abundant in the cell membranes of brain cells and play an important role in brain health and function. Fatty fish, dark green leafy vegetables, walnuts, and flax seeds are good sources of omega-3 fatty acids. 

• Magnesium

Based on some studies, this mineral may play a role in anxiety. Magnesium is necessary for the proper functioning of every system of the body including nerve function. Magnesium can be found in whole grains, nuts, seeds, legumes, dark chocolates, and green leafy vegetables such as spinach. 

Here are some of the things you can do as a parent or a caregiver of children with ADHD and anxiety.

Consider parenting skills training

This training can help parents and caregivers better understand and respond to their children.

Consider family therapy

Parents and other siblings may find it difficult to manage or deal with the challenges of living with someone with ADHD and other mental health conditions. Family therapy may help them in understanding and developing strategies in coping with their situation.

Bottomline

• It is estimated that three out of 10 children with ADHD also have an anxiety disorder.

• Anxiety may be brought about by stressful situations being experienced by kids with ADHD. Genetic factors may also play a role in the development of both conditions. 

• Anxiety disorder symptoms may overlap with ADHD and other mental health conditions. Thus, it is necessary to look out for symptoms and report any changes in your child’s behaviour to their doctor.

• Both ADHD and anxiety disorders can be treated with medications and therapy. However, some ADHD medications may worsen anxiety symptoms. Parents should monitor their children’s behaviour and well-being and report to the doctor anything that can be a cause for concern for proper assessment.

• Aside from medications and therapies, children with ADHD and anxiety disorders can benefit from other ways to manage their condition such as relaxation techniques, engaging in regular exercise, eating a balanced diet, and getting enough sleep. 

• Children with ADHD and anxiety can better manage their condition if they receive support from family, friends, and teachers.