Millions of adults in the United States struggle with either attention-deficit/hyperactivity disorder (ADHD) or generalized anxiety disorder (GAD).
In recent years, research into these two disorders has revealed a significant overlap. Rates of ADHD among people who have GAD (and, conversely, the prevalence of GAD among people with ADHD) are significantly higher than the statistics listed in the previous paragraph.
Acknowledging this overlap is an important step toward developing a more in-depth understanding of these two disorders and identifying better ways to treat people who esxperience their negative consequences.
Generalized Anxiety Disorder: Basic Facts
Generalized anxiety disorder, or GAD, is one of several mental health concerns included in the anxiety disorder category in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
Many anxiety disorders (such as specific phobia, separation anxiety disorder, or social phobia) are characterized by symptoms triggered by a certain object, event, or circumstance. But in the case of GAD, a person may experience symptoms at any time, with no apparent external cause or trigger.
Common signs and symptoms of generalized anxiety disorder include the following:
- Overwhelming and uncontrollable fear or worry
- Persistently feeling restless or “on edge”
- A foreboding sense of being in danger or otherwise at risk of being harmed
- Difficulty focusing or concentrating
- Frequently expressing agitation or irritation for no apparent reason
- Persistent muscle tension, often in the jaw or shoulders
- Recurring stomach aches and/or headaches
- Racing heart rate
- Elevated body temperature
- Excessive perspiration
It is important to note that a person can have generalized anxiety disorder without experiencing all the symptoms listed above. As established in the DSM-5, a diagnosis of GAD applies if a person reports the presence of several symptoms for most days over a period of six consecutive months.
What Are the Symptoms of Adult ADHD?
Most people think of ADHD as a disorder that affects children and adolescents. And while it is true that young people constitute the majority of those who are diagnosed with ADHD, adults can also be impacted.
In some cases, children or adolescents who are diagnosed with this disorder continue to experience symptoms as they transition into adulthood. In other cases, adults who never realized they had this condition when they were younger can be diagnosed for the first time.
Adults who have ADHD may exhibit the following types of symptoms:
- Problems maintaining focus or attention
- Difficulty remaining organized or following instructions
- Distractibility and forgetfulness
- Attempting to avoid tasks that demand sustained mental effort
- Inability to remain still and quiet
- Excessive talkativeness
- Tendency to interrupt or intrude
Depending on the nature and severity of their symptoms, as well as if they receive an accurate diagnosis and proper treatment, an adult who has ADHD may struggle at work, in school, in the context of their friendships and romantic relationships, and in other important areas of life.
The Prevalence of Co-Occurring GAD and ADHD
In February 2022, the Journal of Affective Disorders published a study that focused on the prevalence of ADHD among adults who also have generalized anxiety disorder. This study, which was conducted by a team of experts from the University of Toronto, involved a review of data that had been collected from 6,989 adults (aged 20-39) through the 2012 Canadian Community Health Survey.
The research team’s analysis of this data yielded the following findings:
- Among the study subjects who had GAD, one in nine (or 11%) also had ADHD. Among the subjects who did not have GAD, the rate of ADHD was one in 33 (or 3.03%).
- This means that the prevalence of ADHD is 263% higher among adults with GAD than among adults who have not been diagnosed with an anxiety disorder.
- Among study subjects who had ADHD, about 25% also had GAD. Within the general population, the lifetime prevalence of GAD is about 5.7%. This suggests that ADHD can increase a person’s risk of developing generalized anxiety disorder by more than 300%.
- Factors that appeared to raise a person’s risk of having both GAD and ADHD include being female, making less than $40,000 per year, having a lifetime history of a depressive disorder, and having a low number of close relationships
“The high co-morbidity between ADHD and GAD emphasizes the need for targeted intervention to support these often overlapping disorders,” the researchers wrote.
What Causes this Overlap?
Trying to understand why a person develops a mental health disorder typically requires a thorough assessment of a variety of genetic and environmental factors. When another illness is added to the mix – and when this co-occurrence involves millions of people – identifying a single cause or small group of risk factors can be exponentially more difficult.
This is the nature of the challenging facing researchers who are attempting to understand why so many people with generalized anxiety disorder also struggle with attention-deficit/hyperactivity disorder. However, the complexity of the challenge has not prevented them from seeking answers.
The researchers who conducted the February 2022 study that we discussed in the previous section did not draw any definitive conclusions about why ADHD is so common among adults who also have generalized anxiety disorder. They did, however, refer to a March 2021 study in the journal Research on Child and Adolescent Psychopathology that may have found a possible explanation.
That study, which was conducted by a team from the Department of Psychological and Brain Sciences at the University of Massachusetts Amherst, looked at the overlap between generalized anxiety disorder and ADHD and asked three questions
Does the presence of ADHD in childhood predict future struggles with generalized anxiety disorder?
Are children who struggle with anxiety at a young age predisposed to also develop symptoms of ADHD?
What effect do parenting practices have on the development of co-occurring GAD and ADHD?
This study involved young children. The subjects were 3 years old at the outset of the study and 6 when it concluded. At the end of that period, the researchers drew the following conclusions:
- ADHD symptoms predict the later onset of anxiety symptoms.
- Anxiety symptoms do not appear to raise a child’s risk for ADHD.
- Parental practices did not seem to mediate the relationship between ADHD and anxiety.
One possible reason for the connection between ADHD and anxiety is that children with ADHD often receive criticism for disruptive behaviors that are symptomatic of their condition. Over time, the researchers proposed, this repeated criticism may become a source of anxiety for the children, eventually manifesting as generalized anxiety disorder.
Effects of Co-Occurring Generalized Anxiety Disorder and ADHD
On their own, either generalized anxiety disorder or attention-deficit/hyperactivity disorder can have a powerful negative impact on a person’s life. When someone struggles with both of these mental health disorders at the same time, their risk for significant harm may increase dramatically.
The potential effects of co-occurring GAD and ADHD can include the following:
- Conflicts in relationships with friends, colleagues, family members, and romantic partners
- Disciplinary problems and substandard performance in school or at work
- Frequent job-hopping, which can hamper a person’s career progress
- Exacerbation of certain symptoms of both disorders
- Increased risk for certain additional co-occurring mental health concerns
- Withdrawal or ostracization, both of which can lead to social isolation
- Substance abuse as a means of self-medication, which can lead to addiction myriad other physical and psychological health concerns
It is no exaggeration to note that co-occurring GAD and ADHD can undermine a person’s quality of life. Thankfully, as we will discuss in the next section, both of these disorders are treatable. When a person receives proper professional care that addresses the full scope of their mental health needs, they can achieve improved health and live a more hopeful and satisfying life.
Treatment for Co-Occurring Anxiety and ADHD
People with generalized anxiety disorder and attention-deficit hyperactivity disorder often receive a combination of medication and therapy.
For people who have ADHD, stimulant-based medications such as Ritalin and Adderall are typically the first option. The good news for individuals who have both ADHD and GAD is that research shows that these types of medications can also relieve symptoms of anxiety.
Clinicians often incorporate antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) into treatment for people who have GAD and ADHD.
Determining which medications and dosage levels are right for each person can sometimes be a matter of trial and error. This underscores the importance of receiving care from a provider who can identify and address the full scope of a patient’s mental health needs. Focusing solely on GAD or ADHD while ignoring the other condition can hamper a person’s ability to make sustained progress toward better health.
In addition to medication, therapy can also play a vital role in a person’s care for co-occurring GAD and ADHD. The therapeutic component of treatment can help people in areas such as:
- Understanding the nature of their mental health concerns
- Identifying triggers that may prompt or intensify symptoms
- Adopting strategies for managing symptoms not eased by medication
- Developing better stress-management and conflict-resolution skills
- Building an effective personal support network
- Becoming an informed self-advocate
- Connecting with community-based resources that can offer long-term support
To learn more about treatment options at Crownview Psychiatric Institute for adults with acute symptoms of generalized anxiety disorder and co-occurring ADHD, please visit our Contact page or call our center today.