ADHD & Anxiety
Kids with ADHD are three times more likely to have an anxiety disorder than kids who don’t have ADHD. Some studies put the rate of anxiety amongst children with ADHD at 18% or even higher.
Anxiety manifests as excessive worry, tension or uneasiness even when there is nothing to fear. Feelings are more frequent and excessive in comparison to normal fears and can affect thinking and behaviour. Generalised anxiety typically emerges when children reach school age.
Anxiety can affect children differently. Some kids may draw attention to themselves, whereas others might sit quietly and try not to be noticed. Some children may work very hard to cover up their anxiety, but they may often ask frequent questions in new situations such as:
“What’s going to happen?” or “What if … ?”
Possible Behaviours Linked to Anxiety in Children with ADHD
- Clowns around too much in class
- Lies about schoolwork or other responsibilities they haven’t met
- Scared of asking or answering questions in class
- Feels the need to be a perfectionist
- Finds it hard to perform in tests
- Inattention or impaired concentration
- Daydreaming
- Withdraws from people, perhaps by retreating to the bedroom
- Plays video games or watches TV non-stop
- General worries e.g. health, school, money, safety, world events
- Excessive worry or sense of impending doom
- Afraid of new or unfamiliar situations
- Seeks constant reassurance
- Seems irritable or argumentative
- Refusal to participate in certain activities
- Unexplained tantrums
- Panic attacks
- Feelings of unreality
Physical Signs of Anxiety
- Stomach aches or digestive upsets
- Headaches
- Nausea
- Tiredness or fatigue
- Insomnia
- Muscle tension
- Palpitations or fast heart beat
- Dizziness or feeling faint
- Sweating
- Trembling
- Sighing
- Shortness of breath
These symptoms may not be purely anxiety-related and should be checked out with your doctor too.
Children might find falling asleep at night difficult due to excessive worrying about the events of the next day or may be anxious about being alone in their room or the dark.
It is common for children to worry a lot at times, but if you feel their worrying is affecting their enjoyment of life, or if it continues for longer than six months, it is worth seeking professional help.
Take a look at the ADHD Directory to find a professional suited to your needs.
Anxiety can sometimes be misdiagnosed as ADHD – see Conditions that Mimic ADHD.
What Can Cause Symptoms of Anxiety?
There are many reasons why someone may suffer from anxiety.
ADHD
Many of the challenges that kids with ADHD typically face can make them feel anxious.
In a typical day, an ADHD child may struggle with time-keeping, organisation, focusing in class, impulsive behaviour, learning difficulties, how to study for a test, or problems with friends.
Their issues with working memory, organisation and time management may make it hard to follow daily routines, leading to chronic stress.
Kids with ADHD often have more trouble managing stress than other kids due to their emotional regulation difficulties, so it’s no wonder anxiety can become a problem for them.
However, the causes of anxiety could be many and varied, so it’s wise to look for any root causes that can be corrected.
Possible Root Causes of Anxiety
- Traumatic life experiences
- Current life situations
- Stress and other psychiatric conditions
- Genetic susceptibility
- Digestive disorders
- Nutritional factors
- Allergies
- Environmental exposures
- Infections/PANDAS
- Insomnia or sleep problems
As you can see above, the causes of anxiety can be psychological or physical.
Psychological Causes
Anxiety could stem from an ongoing traumatic situation such as bullying or a past experience such as abuse.
Physical Causes
Caffeine
Drinking too much coffee or other high-caffeine drinks can cause anxiety, especially in slow caffeine metabolisers. Children metabolise caffeine slower than adults, and it can also affect sleep quality.
If you suffer anxiety, remove caffeinated foods or drinks from your diet.
Sensitivities and Environmental Factors
Foods high in histamine, phenolic or salicylate contents, additives, flavourings and colourings can trigger anxiety. Chemicals in personal care or cleaning products, Wi-Fi exposure, or side effects from medications or drugs can also contribute.
Blood Sugar Balance
Low blood sugar can cause anxiety, weakness, sweating and irritability. Avoid high GI foods and choose low GI options like unprocessed grains or sweet potato.
Nutritional Factors
Micronutrients like zinc, vitamin B6, calcium, magnesium, omega-3 fatty acids and vitamin D are vital for brain health. Deficiencies or imbalances can lead to anxiety or depression.
The Gut-Brain Connection
90% of serotonin and 50% of dopamine are produced in the gut. An unhealthy gut microbiome can disrupt mood, cognition and behaviour.
Genetic Susceptibility
Mutations such as MTHFR C677T can predispose individuals to mood disorders. Supporting the methylation cycle through diet and lifestyle can help.
PANDAS
PANDAS is Paediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus. It can cause sudden onset of anxiety, OCD, ADHD and other issues following a strep infection. More information: pandasnetwork.org.
How You Can Help
Children with ADHD should be checked for anxiety and depression. A thorough evaluation is key to understanding whether your child has ADHD, an anxiety disorder, or both.
Seek help from any of the following:
- Integrative GP
- Naturopath
- School counsellor
- GP or paediatrician for a referral to a child psychologist
Use the ADHD Directory to find a practitioner.
Tips for Talking with Your Child
- Ask what’s worrying them and look for behavioural patterns.
- Acknowledge and validate feelings.
- Brainstorm solutions together.
- Model positive coping strategies.
- Help them decompress after school in healthy ways.
If anxiety is severe and limiting their enjoyment of life, consider professional counselling.
Health Tips
- Check gut health
- Identify food sensitivities/allergies
- Correct nutritional deficiencies
- Check for environmental toxins
- Balance hormones
- Ensure optimal thyroid function
Diet Tips
- Avoid caffeine
- Reduce sugar/carbs
- Balance blood sugar with small, regular low GI meals
- Try gluten/dairy-free and/or grain-free diet
- Eat adequate protein
- Consume high magnesium foods
- Avoid excessive alcohol
- Eat oily fish 2–3 times per week
- Consume flax and linseeds
- Avoid known allergens
Lifestyle Tips
- Epsom salt baths
- Massage
- Essential oils
- Optimise sleep
- Acupuncture
- Regular exercise
- Yoga, Tai Chi or relaxation activities
- Deep breathing
- Meditation
- Time in nature
- Get sunlight
- Avoid recreational drugs
Where Can I Find Professional Help?
Check the ADHD Directory for suitable practitioners.
If you live near Sydney’s Northern Beaches, join our monthly ADHD speaker evenings.
More info and bookings: Events page.
Recommended Books
- The Anti-Anxiety Food Solution
- A Mind of Your Own
- Nutrient Power
- Additive Alert
- Dirty Genes
- Gut & Psychology Syndrome
Picture Books for Children
For more book recommendations, see our Resources section.
References
Nutrients
- Magnesium & Adolescents
- Essential Elements in Anxiety/Depression
- Magnesium & Borderline Disorders
- Junk Food & Adolescents
- Omega 3 & ADHD in Adolescents
- Sugar Consumption & Emotions
- Zinc & Copper in Aggressive Males
