Attention Magazine June 2018

IN TODAY’S WORLD, where bad news travels the globe in seconds online, people seem more anxious than ever. For adults and children with ADHD, when worries interfere with daily living, they increase your distractedness or impulsivity and make things seem worse than they are. By changing your relationship to worry and avoiding the pitfalls of negative thinking, you can successfully manage your anxiety.

Anxiety can be helpful: It prepares our bodies for “fight or flight” reactions to genuine threats, like avoiding tigers in the jungle. But whether there’s a real or imagined concern (you’re nervous about the new job you applied for or your son thinks he’ll die in a thunderstorm), anxiety means that someone’s reaction is bigger than the situation actually calls for. In those anxious moments, the feeling part of your brain (the limbic system, specifically the amygdala)–fueled by adrenaline–takes over the thinking part of your brain (the frontal lobe and executive functioning capacities). “What ifs” become worst-case scenarios.

If you think about all of the negative feedback related to ADHD that you’ve heard over the years and how often you wonder about missing the mark or falling short again, it makes sense that many adults with ADHD already carry around a constant low level of worry which primes them for more intense bouts of anxiety. In fact, research has found that 47 percent of adults with ADHD have also been diagnosed with anxiety. When your frontal lobes are already working hard to manage typical ADHD challenges with executive functioning skills, beating back anxiety can be extra tough.

There’s an important difference between worry and anxiety. Worry is how you think about something. Anxiety is a physical response to a trigger that involves your body (rapid heart rate, shortness of breath), your thinking (racing, distorted thoughts), and your emotions (fear, negativity). It’s common for all of us to experience some worry or dread at times. Maybe you’re nervous about meeting new people or perhaps you hate doing presentations at work. Believe it or not, avoiding things only makes the anxiety stronger. Instead, learning to talk back to your worry by recalling times when you relied on your inner resources and problem-solving skills to overcome it helps you turn down its noise. Don’t expect you’ll be able to completely rid yourself of these feelings. But by changing how you respond to them, you’ll regain a sense of control.

When people suffer from anxiety, they usually want comfort and certainty. Kids, especially, push for reassurance and eliminating the cause of their worry. But these responses don’t work. They don’t teach much needed skills for tolerating being uncomfortable, unsure, or disappointed, thereby allowing someone to bounce back. Avoiding something in the moment may feel good, but it’s not a lasting solution. Instead, the goal is to access your inner resources to feel confident enough to go toward your fear and manage any possible setbacks. You’re nervous, but you want something enough to do it anyway.

Let’s say that you’re terrified of flying, but your sister is getting married in Bermuda. You want to be at her wedding but anxiety keeps you imagining a plane crash in the ocean. You also really don’t want to disappoint her or yourself for that matter. Instead of listening to the internal noise about the dangers of flying and why staying home is safer, you say to yourself: “I’m willing to feel unsure. I’m going to grab onto my courage and get on that airplane. I want to be there for my sister. I can do this. I flew to Grandma’s funeral three years ago even though it was super scary.” You talk back to your worry and link past successes to the present challenge.

HERE ARE FIVE STEPS YOU CAN TAKE to change your relationship to anxiety and reduce negative thinking.

1 In a quiet moment, write down something that causes you anxiety. Name your worry and be specific. It’s easier to talk back to “fear of flying” than “dislike traveling.”

2 What are the negative thoughts associated with these worries? How have these interfered with your life? Jot these down too.

3 Identify what you really want (for example, “feeling confident about giving my presentation next month”). Think of a time when you did something similar to your goal that required you to overcome hesitation or avoidance. What exactly did you do and say to yourself? What motivated you? Did anyone help you, and if so, what did they do?

4 See if you can apply any of these techniques and behaviors to your current goal. Write down these tips so you can refer to them later. Anxiety creates amnesia. It’s especially hard to remember your past accomplishments and how you got there when you’re in a worry spiral.

5 Take your negative thinking as far as you can. Keep asking yourself “And then what?” when discouraging, fearful thoughts emerge until you arrive at an endpoint. I bet that you can manage whatever this is or find someone who can.

LET YOURSELF TAKE SMALL STEPS to reduce your anxiety. Maybe you need to fly to the wedding with a cousin. Perhaps you can practice your presentation for a friend. Encourage yourself along the way and stay patient. Anxiety is a tough adversary that takes your natural worry and distorts it out of proportion. You can put things back in perspective.

Sharon Saline, PsyD, a licensed clinical psychologist in private practice, is an expert in how ADHD, learning disabilities, and mental health issues affect children, teens, and families. She has worked extensively with schools on mental health issues in the classroom, interpreting psychological evaluations and improving teacher/parent communication. Her unique perspective, namely growing up in a household with a sibling who wrestled with untreated ADHD, combined with decades of clinical experience, assists her in guiding families as they navigate the confusing maze of information, emotions, stress, and conflict related to ADHD. She funnels this expertise into her forthcoming book, What Your ADHD Child Wishes You Knew: Working Together to Empower Kids for Success in School and Life (TarcherPerigee, August 2018). A part-time lecturer at the Smith School for Social Work, Dr. Saline has conducted trainings around the country and abroad for educators, psychologists, parents, and students.