Have you been misdiagnosed? ADHD & Anxiety I think that one of the more common yet under-addressed situations I've seen is the mishandling of the ADHD / anxiety situation. Anxiety can manifest in so many different ways, and many of these impair focus, organization, prioritizing and general cognition. Think about what people act like when they're nervous, what their thoughts would be like, how comfortable they feel, how easy it is for them to stay on task. It obviously draws a lot of parallels with the symptomology we associate with ADHD. With that in mind, wouldn't it make sense to screen someone for an anxiety disorder when a person describes inattention as their primary complaint? Sure, but it doesn't usually happen like that.



If you asked 50,000 people if they'd rather have an anxiety problem and be medicated with SSRIs and downers or an ADHD problem and be medicated with speed, which do you think most people would choose? That's probably why a lot of ADHD / Anxiety and Anxiety / ADHD misdiagnosed patients start off with getting tested for ADHD and not an anxiety problem. Also, consider how the anxious mind works. There is usually a great deal of self-doubt, performance anxiety, worry about production and over-responsibility going on in there. They may feel like what they're doing isn't enough and have irrational fears that are contributing to their perception that they are ADHD.



Stimulant medications have a very interesting effect on anxiety. For some, the stims are too intense from the beginning and they're able to identify immediately that the medication is just not going to work for them. For others, say.. someone who has had such struggles with anxiety or depression that any amount of change into a different state of mind is going to be preferable, they will likely feel "better". The feel-good euphoric impact of the medication will keep them on it and they will likely feel short-term relief of their anxiety and any depression resulting from it. Stimulants might mask anxiety, turn the volume down on it and allow you to focus through it or "augment" it, but they certainly don't actually medicate it and they will almost always make it worse in the long run.



It isn't sustainable, and once you become used to your dose, all of the good feelings dissipate and you're left with exacerbated anxiety. Anxiety + The ability to focus extremely well on things = Excessive rumination, negative obsession, avoidance, depression, etc. People try to raise their stimulant dose thinking it will make it better, mostly because they've now given themselves the idea that ADHD is their sole issue and that more ADHD medication is going to help - This can go on for a while. Eventually, the medication is stopped (probably the best idea) or an additional medication for anxiety is prescribed and added to the stimulant (probably not a great idea). Here's why.



The evaluation of an anxiety medication has a lot of moving parts. You're on a stimulant medication that has probably made your anxiety worse - How is it that you're going to be able to fairly and accurately evaluate the therapeutic benefit from an SSRI, benzo, etc when you're really just medicating the side effects of another medication? Could it be possible that you really just had an anxiety problem, and you'd have adequate (or better) relief from your symptoms with just an anxiety med? You won't know, because you're now adding additional meds left and right trying to figure out why you can't get something going that works. Ask a person with an anxiety problem how terrified they are to quit any medication, ever, especially one that made them feel slightly better for a period of time - Their stimulant medication could be causing them to grow a third arm, and they would probably stay on it out of fear for what would happen if they didn't.



ADHD and anxiety are commonly found together in people, this is a well-established fact. When people have both, they get to experience the unfortunate journey of trying to ride the line between two medication types, both of which commonly make their other issues worse. Regardless if both your ADHD and your anxiety diagnosis are sound or you've been mistakenly diagnosed one way or the other, the potential to be put in an extremely difficult medication situation is very high. Adderall and benzos are the two most addictive psych meds on the market, you've now found yourself on both of them, you need both of them to offset the other and they both lose effectiveness / cause tolerance over time. Psychiatrists don't really explain it that way, but that's essentially what you're getting into. It doesn't take long to become unnecessarily overmedicated for a number of problems that could have been fixed by taking a few steps back rather than several large ones forward.



My advice to all ADHDers who have had problems with anxiety would be to seriously evaluate your condition and ask yourself which of the two is the bigger problem in your life. Are stimulant medications worth the additional anxiety? Would I be better off trying to deal with my anxiety problems first, and then approach the attentional struggles? There are many paths medication can lead a person down, and recovery is just one of them - Don't let a doctor or fears you might have remove your heart and brain from the equation, think about what you're doing and if you really need all the stuff you're taking. Sometimes, less is more, and in dealing with ADHD and anxiety, it can be the difference between finding a comfortable, balanced medication situation or finding yourself with a lot more problems than what you started out with.

