The 4 most common anxiety disorders associated with ADHD: Anxiety and ADHD

The DSM-IV Defined Anxiety Disorders

The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) published by the American Psychiatric Association defines 12 anxiety disorders:

1. Separation Anxiety Disorder
2. Panic Disorder – with and without agoraphobia
3. Agoraphobia –  without history of Panic Disorder
4. Social Phobia – exaggerated fear of embarrassment or humiliation
5. Specific Phobia – e.g. of spiders, elevators, flying, etc.
6. Obsessive-Compulsive Disorder (OCD)
7. Post Traumatic Stress Disorder (PTSD)
8. Acute Stress Disorder – symptoms< 30 days
9. Generalized Anxiety Disorder (GAD)
10. Anxiety Disorder due to a General Medical Condition
11. Substance-induced Anxiety Disorder
12. Anxiety Disorder Not Otherwise Specified

The 4 most common anxiety disorders associated with ADHD

1. Generalized Anxiety Disorder (GAD)
2. Separation Anxiety Disorder
3. Social Phobia
4. Post Traumatic Stress Disorder (PTSD)

The remainder of this article will talk in more depth about the unique characteristics of each of these anxiety disorders.

Generalized Anxiety Disorder (GAD)

General Anxiety Disorder is a serious issue for the ADHD community.  It is far more likely to occur during the lifetimes of children with ADHD than in the general population (25% ADHD versus 2.9 – 4.6% general population).  Half (52%) of adults with ADHD will experience GAD in their lifetimes – opposed to only 5% of adults in the general population.

General Anxiety Disorder is the big anxiety disorder that people tend to miss.  With the others – Post Traumatic Stress Disorder, separation anxiety, and social phobia – it’s more obvious when you have it.  And, since GAD often comes along for the ride with depression, substance abuse, and other anxiety disorders, it may be relegated to a back seat in terms of recognition and treatment.

General Anxiety Disorder is characterized by 6 months or more of chronic, exaggerated worry and tension that is unfounded or much more severe than the normal anxiety most people experience.  People with GAD usually expect the worst.  They worry excessively about money, health, family, or work, even when there are no signs of trouble.  They are unable to relax and often suffer from insomnia.  Sometimes the source of the worry is hard to pinpoint.  Simply the thought of getting through the day can provoke anxiety.  General Anxiety Disorder may also grow worse with stress.  In addition to excessive anxiety and worry, people with GAD have at least 3 of the following symptoms:

• Restlessness or feeling on edge
• Fatigue
• Difficulty concentrating or mind going blank
• Irritability
• Muscle tension
• Difficulty sleeping

Separation Anxiety Disorder

About 10 times as many children with ADHD will have separation anxiety compared with the rate in the general population of 2.4%

Separation Anxiety Disorder develops in childhood and can persist into adulthood.  Basically this means a child is fearful of being separated from his or her safety net (familiar place or person).  The child may develop excessive worrying to the point of being reluctant or refusing to go to school, being alone, or sleeping alone.  The child may also experience repeated nightmares and complaints of physical symptoms such as headaches, stomachaches, nausea, or vomiting.

Social Phobia (a.k.a. Social Anxiety Disorder or SAD)

18% of people with ADHD will have a lifetime occurrence of Social Anxiety Disorder – half again as common as in the general population.

Social Anxiety Disorder is an intense fear of becoming humiliated in social situations, specifically of embarrassing yourself in front of other people.  It includes performance anxiety issues.  It often runs in families and may be accompanied by depression or alcoholism.  Social phobia often begins in early adolescence or even younger.  The person recognizes that the fear is excessive or unreasonable.  About 13% of the general population will experience social anxiety at some point in their lives.  Social Phobia is actually the third most common psychiatric disorder in the United States after depression and substance abuse.

Post Traumatic Stress Disorder or PTSD

Although there isn’t a lot of information on PTSD and ADHD specifically, there is some evidence that people with ADHD are more vulnerable to developing PTSD.  For more information consult Adler LA, Kunz M, Chua HC, Rotrosen J, Resnick SG. (2004). Attention-deficit/hyperactivity disorder in adult patients with posttraumatic stress disorder (PTSD): is ADHD a vulnerability factor?  Journal of Attention Disorders.  Aug; 8(1):11-6.

How to manage your anxiety

Anxiety disorders are highly treatable, but you have to recognize first that they exist.  If you think this might be you, seek the advice of a professional and find out what your options are.

An ADHD coach can also help you learn to identify your anxiety triggers and things you can do to keep your anxiety under control.

Watch for part 3 of our ADHD and Anxiety series where we will talk about some steps you can take to help you manage your anxiety.

Do you have ADHD and anxiety?  What have you done to keep it under control?  We invite you to share your story here and help others learn what you have to keep your edge! You don’t have to live with anxiety, sign up for an Edge Coachand start taking charge of your life today.