Loading summary
Transcript1 lines
- [00:04]
A
You are listening to the Navigating Adult ADHD podcast with your ADHD coach and expert, Xena. Hello, hello, hello, my friend. Welcome back. We are navigating adult ADHD together. Yes. You know the drill. That's what we're doing. Before we dive in though, I did want to share that I have a current hyper fixation. I've had this one for a while now, which is doing was jig jigsaw puzzles. If you're not familiar with them, they're kind of like back the front. How do I say it? Basically the picture on the box is not what you are making. You have to do it from somebody else's viewpoint or you know what happens next. So you've got a rough idea to work with. But basically the picture is not what you're making at all. They're hilarious. So anyway, I'm obsessed with them. I have been doing them, I would say most of this year. Anyway, the other day I discovered on Facebook Marketplace that somebody was selling a whole bunch of them. And they were some that I hadn't done because there's lots here in New Zealand that are really easy to get. But I've done all of those ones. So I'm like, come on, where are the other ones? You can buy them from overseas. They take forever to get here. They're really expensive, what have you. So somebody was selling some and I was like, oh my God. Yay. And they were only like $5 each and they're like $30 new. I was like, oh my God, this is amazing. So it's. Anyway, I messaged them and I was like, I want to take them all. Can I please buy them all? How many have you got? And guess what? I ended up with 24. 24 was chig puzzles. So they're all stacked up right here in my office. Yeah. So I am basically sorted puzzle wise for the rest of the year. Yeah. So I was a crazy cat lady. Now I am also a crazy puzzle lady. Yes, I am. There we go. I thought you'd probably get that. Right. Like hyper fixations. It'll be so funny if I like get over this current joy I have of puzzling. And then I'm left with all of these puzzles. But anyway, you know what I mean. You know what I mean. So today, my friends, we are talking about ADHD and anxiety. This is something that I really wish someone had sat me down and properly to me earlier in my ADHD journey. Okay. Anxiety. Specifically the relationship between ADHD and anxiety. Because for so many of us, anxiety isn't just a little extra stress or the occasional sort of worry or spiraling. No, it can be a constant companion. Right? The anxiety is that thing that wakes you up at 3am running through everything you forgot to do or that conversation you had and what you should have said. It's the voice in your head that says, oh, you're going to fuck that up before you've even started. It's the reason you've cancelled plans at the last minute or avoided phone calls or convinced yourself that everything is about to fall apart. Okay, so again, anxiety is often a really constant companion for so many of us with adhd. Now, I wanted to start out with the anxiety definition. The reason I'm choosing to do this is I have found it so interesting as I have been coaching so many humans, right? So, so many humans. But recently I have noticed that some of the people I have had the honour of supporting have had anxiety without knowing that they have anxiety. So I might say to them, could that be anxiety? And then they'll sort of stare at me and go, oh, maybe. I don't really know. Because they're not sure that they, that what they're feeling actually is anxiety. They haven't had that pointed out to them before. They didn't know that that is what anxiety looks and feels like. Okay? So while it is a term that is very well known in today's world and it is, you know, sort of thrown around and used a lot, not everyone is familiar with what it actually feels like to be experiencing it. Not everyone is able to identify it when they are having it. Okay? So anxiety, the definition, it is an emotion. Okay? Anxiety is an emotion. So it includes feelings of tension, worried thoughts and physical changes like having a rapid heartbeat or perhaps sweaty palms. Okay? It is your body's natural fight or flight response to stress. So it's your body's natural response sort of preparing you to face the perceived threat of some danger. Now, typically that danger is not that you're at the zoo and they've called over the loudspeaker, hey, a lion has escaped the enclosure. Run for your life. Like, it's not an actual life or death situation. It's often you wake up at 3am and realize that you forgot to reply to that urgent email and that feels like a very serious threat or danger. Okay? And here's what nobody told us. For a lot of people with adhd, that anxiety isn't a separate problem. It is deeply messily. Is that a word, messily? I don't know. It is deeply messily. Almost inseparably linked to our adhd. Okay? So today we are going to pull that apart. We're going to look at why ADHD and anxiety so often show up together and how to tell which one is which and why so many of us were, you know, treated for anxiety for years without anyone realizing or picking up that actually underneath the anxiety is adhd. Okay. And of course, we're going to talk about what actually helps. What can you do if you are experiencing anxiety? Okay, let's get into it, my friend. So starting off with some numbers, because I find it genuinely comforting when the research, like, backs up something that I am struggling with or something that I experience when the research tells me, hey, it's not just you, it's actually really common. So what I discovered is that over half of adults with ADHD also live with an anxiety disorder. That is not a small number. Right. It's around 51% of adults with ADHD live with anxiety. Right. That's more than one in two of us. I don't know how I said that, but I did. So that means, right. If you're sitting there thinking, yeah, I have ADHD and, you know, I'm an anxious mess, hey, you're in good company, my friend. Okay? Anxiety has been a constant companion of mine for so, so many years. And I would say, and this is something we're going to get into. Ever since getting my ADHD diagnosis and being correctly treated for my adhd, my anxiety now is not a very frequent companion. But when it does show up, I'm very quick to identify it and manage it in healthy ways, which, of course, we are going to talk about. So all of that to say, I know anxiety and I know it really fucking well, my friend. Okay? So I want to be clear as well, but we're not just talking about, you know, feeling a little bit stressed sometimes. No, everybody gets that. We are talking about, like, clinical anxiety, generalized anxiety disorder, social anxiety, panic disorder. Right? These are diagnosis, diagnoses, I think is the word in their own. Right, okay. And they are disproportionately common in people with adhd. In fact, research consistently shows that adults with ADHD are more likely to have anxiety or an anxiety disorder in comparison to those without adhd. Okay? So before we get into any more of the science, I want to tell you about someone, and I'm going to call her Sarah. Okay? Meet Sarah. So. So Sarah was 38 when she was diagnosed with ADHD, but she had been in therapy on and off for, I want to say, roughly 10 years, about a decade, okay, before finding out that she had adhd. So more than once she was told that she had generalized anxiety. Okay? She had an anxiety disorder. And the thing is that she did have anxiety, okay, that part wasn't wrong. But here's what her doctors were missing. Sarah's anxiety was the result of 38 years of losing things, of forgetting things, of saying the wrong thing at the wrong time, of arriving late to everything, of starting projects with this huge excitement and then, you know, failing to finish them over and over and over again, right? Sarah had been told she was smart, she'd been told she had a lot of potential, and yet somehow she could never quite get her shit together, and she just couldn't figure out why. So her brain, the incredibly resourceful, creative, pattern seeking brain that it is, developed anxiety as a response to that, as a coping mechanism, as a way to try and stay on top of things. Because if she was worried enough, maybe, just maybe, she wouldn't drop the ball this time, right? The anxiety was the brain's attempt at a solution. Just, you know, not a particularly useful one. But it was trying to be helpful. Okay? The brain was trying to be helpful. So when Sarah finally got her ADHD diagnosis and started understanding why she struggled so much, something shifted. Now, the anxiety did not just disappear overnight, but it started to make more sense. She started to understand it better, and for the first time, she was actually treating the right thing. Now, a while back, what was it? Episode 112. Hang on, I wrote it down. 112. We had a guest on the podcast. Her name is Pauline Crowley. And that episode 112 is called Alcohol and Addiction. And she gave this really great visual, which I want to share again. And the visual is of a layered cake. You know, like those wedding cakes where they've got like three tiers on the cake or what have you. Now, I want you to imagine that the bottom layer of your cake is your adhd. The layer above that is your anxiety. And then the layer on top of that might be alcohol or something that you do to numb the anxiety. For me, over the years, I've used alcohol and food as a way to numb the anxiety. Okay? So when we think about it like that, so often what somebody might be treating is the alcohol, right? The addiction, the thing that you're numbing, maybe it's food or an eating disorder. So you're at the top of your layer cake, and what's below that is anxiety. So once you get below that first top layer, you discover, oh, actually this is stemming from anxiety. So now let's treat the anxiety. But hang on a minute. Is the anxiety stemming from something else? Yes. At the very base of our layer cake is the adhd. And if we treat the adhd, that's gonna help Everything that follows that everything that follows on. So why do ADHD and anxiety show up together? I think that this is where things get really interesting. Okay? And there are actually a few different reasons ADHD and anxiety tend to, you know, be such frequent flatmates, shall we say? They're not all the same. So reason one, the ADHD brain creates conditions for anxiety to thrive. So if you think about what ADHD can actually look like day to day, for example, forgetting things, struggling to start tasks, Time blindness, right? You look up and two hours have just evaporated. Saying something impulsive in a meeting and then instantly regretting it. Missing deadlines, double booking yourself, losing your keys for the fourth time that week, and of course, running late. Now, imagine living that way for years, often without knowing why it keeps happening, without knowing you have adhd, yet your brain starts to learn. Things go wrong. I can't trust myself. Therefore, I need to be on guard. I need to be on edge. Hello. That, my friend, is a recipe for anxiety. I like to think of it like a smoke alarm that has been going off so often because of a dodgy oven, okay? So the smoke alarm keeps going off because of this dodgy oven, and now the smoke alarm just is permanently beeping all of the time, 24 7. Now, the alarm isn't broken. It just learned that fire does happen here and it's just not able to distinguish any more between, oh, is there an actual danger, or is it simply a Tuesday morning? So reason number two, why these two things, ADHD and anxiety, show up together? So some ADHD symptoms and anxiety symptoms actually look almost identical. So this is where it can get genuinely confusing, not only for us, but also for the professionals who are trying to support us or to diagnose us and help us to figure out what's going on. Difficulty concentrating, restlessness, trouble sleeping, avoiding things, racing thoughts, right? Those tick both the anxiety and the ADHD boxes. And if you are high functioning, meaning that you have, you know, appear, by all outward appearances, you appear to be doing well. Right? That was me. I appeared to be doing well. I appeared to have my shit together, whatever, right? If you are really good at masking, then there is a high likelihood that you were given the label of anxiety long before ADHD became part of the conversation. So the difference is Often in the flavour of the experience. I'm going to explain that. So with adhd, you might struggle to concentrate because your brain is off chasing something more interesting, okay? You know, the whole typical, ooh, squirrel, something more interesting. With anxiety, you generally can't concentrate because you are busy catastrophising, worrying about what might go wrong. With adhd, you avoid the task because it feels overwhelming or boring, or you just don't know where to start. With anxiety, you avoid it because you're terrified of failing, of being judged, of getting it wrong. Same behaviour on the outside, but often it's a different engine underneath the bonnet. Okay, now number three, for some people, reason three, they can genuinely have separate conditions running in parallel, right? It's not always the case that the anxiety is caused by the adhd. Right, back to the layer cake. Sometimes people have both independently, Meaning you've got two cakes next to each other, two different layered cakes, not just the one, okay? You've got two separate neurological and physiological things happening at the same time. So the ADHD is structural, it's how the brain is wired. Now, the anxiety might have its own roots, okay? It might not just be, you know, on top of the adhd, it might be from trauma, from early experiences, from, you know, the way that you were raised in childhood, temperament, what have you. In these cases, both need attention, but understanding which is, which matters a lot when it comes to treatment, okay? And here's something that makes me genuinely pissed off on behalf of every late diagnosed ADHD, is that research shows women with ADHD, and I will say to some extent men too, especially men that I have come into contact with, but particularly women, right, are more likely to be diagnosed first with anxiety or depression. Right? Significantly more likely. This is what the research shows, that we are more likely to be diagnosed with anxiety or depression. And not because that diagnosis is wrong, exactly, but because the ADHD underneath is missed. Okay? And yes, this does happen for a really understandable reason. When you walk into your, you know, GP's office or a mental health professional's office and you're struggling, what are you presenting on the surface? Like what's at the top of your layer cake? Maybe you're overwhelmed, you're not coping, you might be emotional, you might be exhausted, you're not sleeping, you're worried about everything that can look like anxiety, that can present as anxiety or maybe that also looks like depression. And yes, it can absolutely be those things, my friend, but if nobody looks deeper, if nobody asks about the lifelong pattern of things, about childhood about how you've always operated. Our ADHD gets missed, and you spend years treating the smoke without ever finding the dodgy oven. I have spoken to so many people in this community who were in therapy, you know, or counseling for anxiety for a long time, on antidepressants for years, doing all of the right things and still not feeling like they were getting on top of it. Because underneath it all, the unmanaged and untreated ADHD was still there and generating more anxiety, generating more shame. Now, getting the ADHD diagnosis does not magically fix everything. There is no magic pill or anything like that. Yes, you will have access to ADHD medication, of course, but, you know, it does mean when you get that diagnosis, hey, you finally got the right map with which to work. Okay, so now I want to talk about somebody else. Let's call him Daniel. Right. Daniel is 45. He's been anxious as far as he can remember for, like, his whole life. Sweaty palms before meetings, you know, that dread on Sunday evenings, A constant low hum feeling of, you know, something bad is about to happen or the other shoe's about to drop. Okay? He was diagnosed with anxiety, anxiety at age 32 and treated for it. Now, the therapy he had, it did help a bit. Yes, Medication also helped a bit, but he always felt like he was swimming against the current, right? Managing, but never really getting ahead. Then, at 44, he was diagnosed with ADHD, and he told me something that I think about a lot, okay? He said, it's like I spent years being treated for a fear of water, and it helped a little bit, but what nobody noticed was that I was standing in a river. Okay? The anxiety was real, the treatment was valid, but the current, which was the adhd, it was still there, okay? And until somebody acknowledged the river, that he. He was always going to be exhausted. So after getting proper ADHD support and treatment alongside his anxiety management. Right, so he's doing both together. Daniel described this as being the first time in his adult life he felt like he could actually stand still. Right? Like he wasn't being thrown around in this river. So, look, my friend, I am not here to diagnose you by any means, okay? That is definitely a job for the medical professionals, of which I am not. But I do think that there are some really useful questions to sit with if you're trying to understand your own experience and pull apart your ADHD and your anxiety or even, you know, identify if you are experiencing anxiety alongside your adhd. Okay? So here are some things that you can ask yourself. Number one, when did this start? So anxiety that comes from ADHD tends to have a pretty long history, even if you didn't call it anxiety at the time. Because when I was going through schooling, right, even through my teenage years, it wasn't until my 20s that somebody told me I was anxious. It was my best friend at the time was like, you know, you're like really anxious, eh? And like she bought me some anxiety tea one day and I was like, why are you doing that? She's like, to help with your anxiety. But I didn't have the words for that for so long. Right. So again, typically anxiety with ADHD tends to have a pretty long history. But even if you didn't call it anxiety at the time, it often shows up as this general sense of like bracing for things to go wrong. Right? Always being on edge, not quite trusting yourself to be able to manage or hold things together. It goes way back. Pure anxiety disorders can also have long histories, but they often can be tied back to specific situations. Maybe it was relationships or events that have happened throughout life. Okay. Something else to ask yourself is, what am I actually anxious about? What I see is that often ADHD driven anxiety circles around doing so, tasks, deadlines, responsibilities, things you might forget or mess up. It is very executive function flavored. Okay. Whereas more classic anxiety might tend to be broader. Worrying about your health, worrying about the state of the world, just a general sense of dread without a specific trigger. Okay, now again, you might be experiencing both. You may have anxiety that stems from your adhd. You may also have alongside that a separate layer cake. Right? Which is your generalised anxiety or a type of anxiety disorder? Another question to explore is, does the anxiety get better when the ADHD is managed? Okay, this is a big one. A lot of people, and this was me, find that when their ADHD is properly supported, whether that's with medication, with coaching, with tools, with therapy, what have you with that ADHD support and treatment, a lot of people will find that the anxiety quietens down significantly. Okay, again, that is 100% me. It's not that the anxiety disappears completely, but it is noticeably less. And in most cases it is easier to manage, especially with the right tools and the right support. So if that happens for you, it is a strong signal that a good chunk of your, a good chunk of your anxiety was being fed by that unmanaged, untreated adhd. Okay, so if we just explore and talk about treatment for a moment, this is where things get a little bit. What do I want to say? Complicated, nuanced, And I want to be really honest with you about that. Okay. Treating ADHD and anxiety is not always straightforward and also the order in which you address them can definitely matter too. So some people find that treating the ADHD first reduces the anxiety naturally. Right. When the chaos settles, when things stop falling through the cracks quite so much, the nervous system gets to take a bit of a breath, so the anxiety eases. Others find that anxiety needs to be addressed first because it's so overwhelming that they can't really engage with the ADHD strategies or tolerate medication well until that anxiety is more managed. Okay. And some people need to have both treated at the same time simultaneously. Right. Again, we need to work with professionals who understand both ADHD and anxiety. Okay. So there's also the medication piece, of course. So ADHD stimulant medications such as Ritalin, Rubifin, Dexamphetamine, Concerta, Vyvanse, etc. The stimulant based medications can sometimes worsen anxiety. Okay. Particularly early on or at higher doses. I have shared my experience of medication multiple times on this podcast. And the very first type of medication I started on for my adhd, over a period of months, it did hugely increase my anxiety and it dropped my mood. I then switched to a different type of, of stimulant based medication and eventually found something that has been very supportive of, you know, my ADHD and my anxiety as well. But again, stimulant based medications can, for some people, you know, particularly early on or in higher doses, can sometimes make the anxiety worse. So that's something you really want to pay attention to as you find the right treatment for your adhd. And I'll say this again, I know I've said it before, I do think it can take on average a year to find the correct medication for your adhd, the correct, you know, type of stimulant, the correct dosage, all of the things, because it's about finding what we best respond to, what works best for our brain. And that is a process, my friend. I can speak from experience and from the experience of hundreds, thousands of ADHD is that I have supported on their journeys. Okay, so give it time, give it time. Now there are non stimulant based options that exist. Okay. Non stimulant based, meaning you need to build them up in your system, much like an antidepressant or an anxiety type medication. It's something that builds up in your system over a period of weeks. And again, you've still got to find the correct dosage. But those non stimulant options may suit some people with anxiety better. So again, this is absolutely a conversation to have with your medical professionals, your gp, your psychiatrist, all of that. Do not suffer in silence. If the medication is making your anxiety worse, please say something, because I promise you, there are so many different options available. Okay? What I can tell you, and this is backed by both the research and the stories I hear from our community, is that people who get support for both, both the anxiety and the ADHD tend to do significantly better than those who only treat one. Okay? So again, you deserve to have that full picture looked at every layer of your cake, my friend. So let's get to the practical stuff, because that's probably why you're here. You're like, okay, yeah, yeah, but tell me, what do I do? What do I do with my anxiety? What will actually help? I am going to share five things that you can do to help with and support your anxiety. Number one, name what you are dealing with. Now, that sounds super simple, but it's not, okay? There is real power in being able to say, this is anxiety. I am feeling anxious right now, okay? And the science backs this up. Science shows that naming emotions creates a shift in the brain. And that shift can reduce the impulsivity, right? The way that you react or respond to the emotion, it can turn down the intensity, the volume, the grip that that emotion has on you. I will often say you've got to name it to tame it. Okay? Just naming it. This is anxiety. I am feeling anxious. That creates a bit of separation, a bit of distance, okay, between you and the emotion that you are feeling. Number two is reducing the inputs. So a massive driver of ADHD anxiety is cognitive overload, meaning too much in the brain, too much in your mental bathtub. It's overflowing, okay? Not enough, you know, of that brain stuff sort of organized or somewhere outside of your brain. This is where externalizing is so helpful, as in, get all of this shit in your head, out of your head, my friend. This helps to reduce the number of things that your brain has to anxiously hold onto to worry about. This is why I keep telling you all to do brain dumps. Literally, get everything in your head. Get a piece of paper and just dump it all out. I will tell my clients often, hey, word vomit onto a piece of paper. Just word vomit, right? Word vomit it into an email and hit send to me, okay? Again, you don't need to worry about editing it or altering it or spelling or grammar or any of that shit. You can literally tear it up or burn it afterwards, it does not matter. Get everything in your head out. Doesn't have to have a fancy system, it just has to get it outside of your head. Okay? This will take a huge load off. It's going to turn down the noise in your head. For me, personally, I find this so helpful. It helps me to make decisions about where to start, about what to do next, but immediately it just reduces the intensity on the emotion. Whether it be that I'm feeling overwhelmed or it is anxiety, specifically that I'm feeling, it will again create a bit of a separation and turn down the intensity, the volume on that emotion, the grip that it has. Okay, Number three is to work with your nervous system and specifically practice some emotional regulation skills. All right? Our ADHD brains, they are running hot. We are prone to emotional dysregulation. We talk about emotional dysregulation a lot on this podcast, my friend. Okay? You pile anxiety on top of that and your nervous system is basically a phone that is running 12 different apps with a 4% battery. Okay? So things like walking EFT, tapping, right? The emotional freedom technique, tapping, I'm a massive fucking fan of that. It's so. It's been a life changer, life changer for my anxiety, I promise you. Life changing. But walking eft, tapping, breath work. I know, I know, yes. Breath work, time outside. They're not just fluffy suggestions. They are research backed, genuine nervous system regulators. Okay? They will help reduce anxiety, they will help to turn down the volume on the intensity of the feelings. Right? Those things, although they sound simple, literally will help you to regulate your emotions, support your nervous system. Okay? Number four, get support that understands both. So if you are, for example, in therapy for ADHD and your therapist does not know much about anxiety, which I find hard to believe, it's probably more likely to be the other way around, right? You're in therapy for anxiety, but your therapist doesn't know much about adhd, what have you. Tell them, okay? Or find someone else who does who understands both. If you are working with a therapist, I always say make sure you have a therapist who understands adhd or educate them if they're willing to learn. Right? Anxiety treatment with someone who understands ADHD is significantly more effective than just general anxiety support. Okay? Now, cbt, which stands for cognitive behavioral therapy, which is something that I preach and teach, it's part of my own coaching practice. It can be incredibly hard helpful when anxiety and ADHD are together. However, it often needs a bit of adaption for ADHD brains. That is definitely what I have learned over the years, meaning more structure, more practical tools, maybe shorter sessions and more repetition. But again, it can be absolutely life changing, game changing, that is cbt, cognitive behavioural therapy. Now, if therapy hasn't worked for you in the past, it might not be that the therapy didn't necessarily work. It might just be that it wasn't adapted for your brain. So again, finding somebody with a really good understanding of adhd, right? ADHD and anxiety in this case is going to be so helpful. I definitely want to suggest giving it another crack, my friend. Number five is be patient with the process and be really kind to yourself, okay? This is not an all or nothing thing. This is not a, you know, take a pill and magically the anxiety goes away and you never experience ADHD symptoms again. No, right. This is something that takes time. Please be nice to yourself, my friend. If you, for example, spent years being treated only for anxiety without anyone spotting the adhd, that is not your fault. Faults, that is a gap in understanding that the medical system is very slowly starting to catch up on. Right? You have been doing the best that you could with the information you had available, okay? Please be kind to yourself. So I want to leave you with something as we wrap up, okay? ADHD and anxiety together can feel like an absolutely exhausting combination. Okay? You might feel like you just can't think clearly. You can't stop worrying about the fact that you can't think clearly, right? It can be exhausting. But here's what I want you to know. The anxiety you have been carrying, a lot of it makes complete sense given what your brain has been navigating without support for so long. There's nothing actually wrong with you and there is nothing wrong with your brain. In fact, your incredibly resourceful brain has been doing its best to protect you in a world not designed for the way in which you are wired. Okay? So understanding the relationship between your ADHD and your anxiety can be one of the most useful things that you can do. Because once you understand the system, you can start to change it, you can start to support it. You don't have to keep swimming against the current. My friend, thank you so much for being here. I genuinely appreciate you. If this episode has resonated and you know of somebody else who might benefit, please share it with them. If you feel moved to leave a review. That is so helpful. It helps more people with ADHD to find us to get support to feel understood again, so helpful. So until next time, my friend. Huge, huge love to you. Take care. Hey, friend. If you want some more help navigating and thriving with adhd, and some help applying everything that you're learning here on the podcast, then head over to our website, navigating adultadhd. Com.