Managing Stress When You Have ADHD

 ADHD Weekly, October 17, 2019

Halloween is less than two weeks away, and already people are starting to feel stressed about the upcoming holiday season. In some families, progress reports have come home from school and the prospect of helping a struggling student can feel overwhelming.

Many families who contend with ADHD symptoms experience generalized ongoing stress, whether it’s a child who has ADHD or an adult member.

“Stress always makes my ADHD symptoms worse and to top it off, when my ADHD isn’t under control, that creates more stress,” said a member in a recent post to the online community Adult ADHD Support.

Could it be that the daily disarray caused by ADHD symptoms just makes you feel stressed? Or does feeling stressed out really make your ADHD symptoms worse?

Desiree Weems Murray, PhD, is a senior research scientist and the associate director of research for the Frank Porter Graham Child Development Institute at the University of North Carolina. She’s also a member of CHADD’s professional advisory board. Dr. Murray says we need to think about the question in terms of the relationship between ADHD and stress.

“That relationship is complex,” she says. “There is most likely a bidirectional, multidirectional, relationship between ADHD and stress.”

In other words, difficulties caused by ADHD symptoms can cause you to feel stressed, and stress can make those symptoms worse. Our forum members’ experiences are supported by research.

“When someone says that ‘stress is making my symptoms worse,’ I think there is a fairly strong body of literature with examples of that happening,” says Dr. Murray. “I have also heard lots of stories about how the symptoms of ADHD can create stress, and I think that is true, too.”

Research into stress and ADHD symptoms

Researchers are interested in the links between ADHD and stress. A majority of adults report feeling stressed over various situations in their lives, with 73 percent of people experiencing psychological symptoms and 77 percent of people reporting physical symptoms, according to the American Institute of Stress.

Writing in the Journal of Attention Disorders, researchers note that ADHD symptoms are associated with stress, especially for those adults who primarily have the inattentive presentation. Chronic stress makes symptoms worse, and even causes chemical and architectural changes to the brain, affecting its ability to function. In Nature Neuroscience, researchers note that stress affects the prefrontal cortex, the same location of the brain affected by ADHD. There, stress reduces neuronal firing and impairs cognitive abilities.

Dr. Murray says research has shown repeatedly that stress cause changes to the brain. There is a decrease in the executive functioning abilities of the brain, often seen in the person’s ability to organize information and activities, and to manage emotions.

“What we can see over time, especially when stress is at the level we could consider toxic or chronic–or traumatic–you can see some effects on the brain,” she says. “It’s both brain structure, and size of some specific sections, along with brain function, as related to some of the brain chemicals. There is a reduced cognitive capacity for making decisions, goal-setting and problem-solving—the things we think of as related to cognitive self-regulation.”

In addition to these challenges, Dr. Murray says combined stress and ADHD symptoms can harm personal relationships, causing friendships to sour and marriages or partnerships to enter turbulent waters. Too often, the person finds herself with a shorter fuse and blurts out things that are better left unsaid.

“Those relationships get impaired by those things, and then it’s stressful,” she says. “The person then experiences negative feedback and rejection. That’s kind of a vicious cycle.”

Finding a middle point between stressed and able

So, what can you do to manage stress better and lessen its impact on your ADHD symptoms?

Dr. Murray says it’s important to address both the cognitive challenges and the emotional challenges. Techniques such as mindfulness and deep breathing can help to quell stress when it arises. Creating and maintaining routines and systems can also help to minimize stress in your environment by limiting decisions that need to be made and helping to automate daily life.

Once in a calmer state, looking at the situation with a critical eye can help you find ways of improving or changing it. Dr. Murray suggests asking yourself if there are ways to change the situation, or if the cause of the problem is a poor match between what is required and your skills, especially in employment.

“For adults with ADHD, one of the things, I think, is about the matching of one’s strength and skills to their work and job situation,” she says.

Other techniques including incorporating more exercise into your routine and developing personal hobbies. For many parents, working with your spouse or co-parent to allow yourself more time on your own to unwind can also help reduce stress levels.

If stress continues or if you find it affects your ADHD symptoms even further, it may also be helpful to discuss the situation with your doctor. Changes in your treatment plan, lifestyle, or consulting additional health professionals can help you manage stress.

Looking for more ways to help reduce stress?

CHADD has partnered with HealthUnlocked to create the Adult ADHD Support forum. You can join the discussion: How has stress affected your daily life?