Helping Your Child Navigate ADHD & Anxiety Expert

Tips from Dr. John Flett

Hi Parents,

We understand that these are indeed worrying times for everyone. From the moment we wake up, we find ourselves anxious about various things, from health concerns to job security and even our vehicle’s reliability. However, sometimes, our anxieties take on a life of their own, not tied to actual events but becoming a constant companion, interfering with our everyday lives. This is when it becomes a problem and needs to be addressed.

One such problem is Anxiety Disorder (AD), which, believe it or not, is often found alongside ADHD in kids. Did you know that AD is the second most common condition that co-exists with ADHD? Nearly half of the adults with ADHD also had some form of anxiety, as reported by the National Comorbidity Survey Replication.

Here’s where it gets tricky, though. Just as we hope our kids will grow out of their fear of the dark or monsters under the bed, we might be tempted to think that they’ll grow out of their anxiety as well. However, studies have shown that these feelings can increase and become even more disruptive as they grow older, making early intervention crucial.

ADHD and anxiety share common symptoms, making them hard to distinguish sometimes. Both might cause a child to feel restless, distracted, or have trouble settling down to sleep. This makes a comprehensive evaluation essential to figure out what’s really going on. This could involve questionnaires or scales for you to share your observations and insights.

Sadly, many kids don’t get the help they need because their anxiety symptoms don’t meet the specific criteria for diagnosis. This can lead to what’s informally known as Multiple Anxiety Disorders (MAD), where kids suffer from severe anxiety but don’t fit neatly into one particular category, leaving them undiagnosed and untreated.

There’s also the question of whether their symptoms are truly anxiety or actually just the heightened alertness that comes with ADHD. After all, it’s known that kids with ADHD have trouble putting a name to their feelings, which can lead to confusion and misdiagnosis.

What’s important is getting the correct diagnosis, because that paves the way to the right treatment. Sometimes, the anxious feelings that kids with ADHD have are tied to their real-life experiences and fears, like not being able to keep up at school or with their friends. These are legitimate concerns, and addressing them is as important as treating the ADHD and anxiety.

Even though anxiety and ADHD are usually considered separate conditions, they often need to be tackled together, and doing so can be quite the challenge. One key hurdle is that if you as a parent also struggle with anxiety, it might be hard for you to steer the course of your child’s treatment.

Another challenge is the concern that the first-line stimulant medications used for ADHD could make the anxiety worse. But rest assured, research shows that for most kids, anxiety actually decreased when these medications were introduced. The advice is generally to treat the ADHD first, followed by tackling any remaining anxiety.

Remember, every child is unique, and there isn’t a one-size-fits-all approach to treating ADHD and anxiety together. So, it’s vital to work with a healthcare professional to find the best way forward for your child. The journey might be tough, but with the right guidance and support, you and your child can manage these challenges together.

We’ll explore how to approach these challenges with the help of expert advice from Dr. John Flett, a paediatrician specializing in ADHD and related issues. This includes anxiety, school-related problems, learning disabilities, and behaviour problems. 

Starting with ADHD, most health professionals tend to address this condition first. Doing so makes subsequent anxiety treatment, specifically cognitive behavioral therapy (CBT), more effective. You see, kids with ADHD can often be so distracted and energetic that they struggle to benefit from CBT. Just like they might find it hard to stay focused in a classroom, they might find it difficult to learn new ways of thinking through this therapy.

A critical step in managing ADHD is determining which medication is best suited for your child, be it amphetamine or methylphenidate, and finding the delivery system that best fits your family’s needs. Equally important is establishing the lowest dose that will provide optimal symptom relief. And it’s essential to know that this dosage will be the same whether or not your child also has anxiety symptoms.

Carefully adjusting the dose is crucial, as kids with anxiety disorders can often be extra sensitive to side effects or any perceived changes in their body. The approach of “start low and go slow” is particularly relevant for kids grappling with both ADHD and anxiety.

Once the ADHD is under control, tackling the anxiety is the next step. This doesn’t need to be modified just because your child also has ADHD. Research over the last two decades has demonstrated that the best treatment for anxiety disorders is a mix of medication and CBT. This combination results in significantly better outcomes than either treatment on its own.

There are some straightforward strategies every family can start implementing to help alleviate anxiety. Establishing routines that are clear, stable, and predictable can provide a sense of security, as kids will know what to expect at any time of the day. Celebrating and praising a child for facing previously avoided situations can also boost their confidence. Breaking schoolwork into manageable “chunks” with rewards for each completed section can help keep them from feeling overwhelmed.

In some cases, especially for those over 12 years of age, a drug screen might be necessary due to the high rate of drug experimentation found in people with untreated ADHD and untreated anxiety. It’s not uncommon for individuals with these conditions to attempt to self-medicate with substances like alcohol and marijuana.

A significant part of the distress caused by anxiety disorders comes from distorted thinking patterns that occur with chronic anxiety. CBT is designed to correct these warped ways of thinking, which can often persist even after the biochemical issues have been addressed with medication.

It’s crucial that the cognitive techniques introduced through CBT are practised every day, both at home and at school, to replace old thinking patterns. Parents themselves can often struggle with untreated ADHD and anxiety, which can hinder the structure and role modelling required for successful CBT. In such cases, it might be necessary for the whole family to participate in CBT.

Remember, managing ADHD and anxiety in children is a journey, but with the right guidance, support and strategies, your child can thrive. Please consider seeking professional help if you believe your child is facing these challenges. As a specialist in the field, Dr. John Flett is always available to assist you and your family.