Anxiety Disorders in Children with ADHD
Being anxious is part of a healthy childhood and can keep children safe. But when anxiety happens a lot and gets in the way of everyday life, it could mean a child has an anxiety disorder. These quick facts will help you:
- Learn how to spot the symptoms of an anxiety disorder in your child with ADHD
- Know what to do if you think your child with ADHD may have an anxiety disorder
- Learn how your child’s doctor will diagnose and treat ADHD with anxiety disorder
What are the signs and symptoms?
Children with an anxiety disorder often worry a lot about many things (school, friendships, etc.) and may feel stressed, tired, tense, and have trouble getting to sleep or staying asleep. They may feel tired at school and have a hard time paying attention or finishing assignments. They may have physical symptoms such as headaches and stomach aches. They may also have these symptoms:
- Panic attacks which may include shaking, sweating, feeling like their heart is fluttering, shortness of breath, and feeling dizzy
- Increased troublesome or defiant behavior
- Worsening attention problems
- Excessive worries about the future, past mistakes, and school performance
- Suddenly having no interest in school activities or spending time with friends
- Avoiding or refusing to go to school
- Refusing to eat at school
- Refusing to use the bathroom at school
- Fear of being away from family members
How common are anxiety disorders in children with ADHD?
About 1 in 3 children with ADHD have an anxiety disorder which can make ADHD symptoms worse. A careful evaluation is needed to address symptoms and develop a comprehensive treatment plan.
What causes anxiety disorders?
Researchers have not found a single cause of anxiety disorders but believe that genetics, environment, stress, trauma, poor sleep, lack of nutrition, and whether a parent has an anxiety disorder can all play a role. Untreated anxiety disorders can get worse as a child grows older and can significantly get in the way of their daily life. For some children, having an anxiety disorder can worsen ADHD symptoms. For other children, struggling with ADHD symptoms can lead to feelings of frustration and helplessness. Over time, this can lead to the development of an anxiety disorder.
Strategies for helping your child with ADHD and anxiety disorders
You can take the following steps if you think your child with ADHD may have an anxiety disorder.
- Talk with your child about their feelings and help them see the difference between what makes them feel afraid and what is dangerous.
- Keep your face, voice, and body calm. Be reassuring and hopeful. Show your child how you cope with anxiety. Children learn by watching the behaviors of those around them.
- Show your child how to deep belly breathe to help them stay calm and relaxed. [https://chadd.org/stroud-umdadhdtools/#]
- Help your child practice mindfulness, a strategy that helps them learn how to stay present in the moment and sit with their thoughts without feeling bad or reacting.
- Teach your child to catch thoughts that are not helpful, check the thought, and then change them.
- Encourage them to do things they enjoy doing, especially if it includes physical activity, and make sure they get enough sleep and good nutrition
- Seek school support if needed.
- If your child’s anxiety is severe, or keeps them from school or play, ask your health care provider about diagnosis and treatment.
Diagnosis
Your child’s doctor will do a thorough evaluation that includes:
- Looking at your child’s developmental, educational, social, medical and mental health history
- Considering ongoing or past ADHD treatment
- Looking at your family’s developmental, neurological and mental health history
All this information will be collected from interviews with parents and the child, teacher behavior ratings, observations, and clinic-based psychological testing.
Treatment
If a child has an anxiety disorder, treatments may include:
- Cognitive Behavioral Therapy (CBT) that helps the child or teen change their thinking patterns and address ADHD symptoms such as poor organizational skills or difficulty completing schoolwork
- Changing CBT treatment as needed
- Parent training to help decrease anxiety
- Medication as needed
The treatment plan must be watched closely so changes can be made for the best results.
Tools
Additional reading
- American Academy of Child and Adolescent Psychiatry (AACAP) and the American Psychiatric Association (APA). Anxiety Disorders: Parent’s Medication Guide. 2020.