Is It ADHD or Anxiety? (The TRUE Difference)

foreign is that lack of focus a symptom of ADHD and when is it a result of anxiety here to answer that question more the psychiatrist Dr Christy lamb hi Kyle great to see you thanks for having me well let's talk about how ADHD and anxiety can often be misconstrued for one another and off and also in the same breath there are overlapping symptoms for both absolutely so I very commonly will have someone come in for an initial evaluation thinking that they have ADHD with concentrational issues difficulty kind of sustaining to finish a task distractibility a lot of symptoms that um would be significant in regard to an ADHD diagnosis but when we finish the interview when I get really clear in regard to evaluating them in regard to anxiety we can notice that a lot of these signs and symptoms are actually related to a primary anxiety diagnosis and so the overlap here is very common misdiagnosis versus overlap so the idea that someone may have just anxiety that results in a lot of symptoms that look like ADHD or someone who has ADHD and has anxiety and then it becomes a little bit of both and the anxiety will almost always exacerbate those specific symptoms of ADHD of attention and focus so it can be really helpful to kind of tease these out out so great topic for today well let's begin on teasing them out because I think understanding a solution requires us to really first understand what we're actually dealing with so if I'm somebody in the workplace who just cannot focus I cannot I mean I'm sitting here I'm trying to do it but I can't seem to grasp the focus how do I start to determine if this is due to unmanaged anxiety or actual ADHD great yeah so the first thing that I would ask someone to do would be to check in with their bodies that if we by definition look at anxiety as a physiological um symptoms in the body that anxiety is not our thoughts it is not just distractibility but that we will often find signs in our bodies that let us know that we are anxious so being really clear and understanding what anxiety is at its core can be really helpful to help differentiate so if someone has a bouncing leg now this happened across the board with lots of different people but a bouncing leg is a sign of anxiety discharge it can be with excitement it can be with productivity that people's legs starts to bounce when they get excited about something the physiology of the body is getting activated but I would suggest that a bouncing leg a tight chest checking in on our breathing to see does somebody have a deep full breath or is their breath really restricted do they can they think straight and clearly meaning not that they can put sentences together they are thinking and cognition is not impaired but they're just distracted this is a big difference between anxiety and ADHD so lower levels of anxiety are going to have physiological stress response in the body tight muscles fidgety that kind of thing as it gets higher it can go into the smooth muscle we can have some stomach upset that kind of thing so if stomach upset is coming with a migraine headache is coming with the distraction we're going to be looking more at an anxiety picture rather than an ADHD picture the highest level of anxiety is when our minds kind of go offline so people who lose time people who it's not that they're just distracted they literally can't kind of get their thoughts to kind of form linear processes when I see a patient who has this highest level of anxiety where their brain's kind of gone offline they start to speak a little bit what did you say that their thinking is off so it's not just a distractibility but their brain is actually struggling to do the processes that it would normally do if these signs or symptoms are coming up we have a much clearer much clearer picture that this is an anxiety related loss of concentration as opposed to an ADHD underlying concentrational issue when you brought up the restlessness of the bouncing leg which could be due to anxiety or it could also be due to excitement it reminded me of something that someone once told me which is that excitement and nervousness are two opposite ends of the same coin so the same feeling I could feel when I'm actually nervous about something maybe giving a speech in the in a group of people or doing a presentation at a conference or something is the same type of energy that I would feel if I was really excited to go on a roller coaster not that I would be excited to go to roller coaster but for someone who would be excited about that is that true that excitement energy and that nervous energy is coming from the same space absolutely if we think about physio physiology right the the nervous system gets triggered um and an activation happens in the autonomic nervous system that first starts in the somatic nervous system the nervous system that we have control over so the somatic nervous system is the motor control we have to clench our jaw to fidget with our hands this is actually the first thing that gets activated when we are excited or anxious and then it moves into the autonomic nervous system which we don't have control over which is our breathing pattern our heart rate all of the things that activate us for Action right and this makes sense whether we're activating for Action like a performance that could be really fun and exciting or activating for Action in that fight or flight oh my goodness there's something in my environment that I have to get away from so the nervous system activation to activate is the same pathway and this is one technique that some people use to actually regulate their anxiety is to notice oh actually I am excited about this I am looking looking forward to it that we can put a positive Spin and kind of a cognitive reframe on obviously not on everything that makes us anxious but on many things um that we get anxious about there is a way to kind of twist it to be able to see actually this is something really exciting and if I can allow myself to enjoy that these Sensations in my body I can categorize as excitement rather than a fearful anxiety and nervousness just from a statistical standpoint Dr Lam what are the chances an adult in America would have ADHD versus anxiety great question I think this helps clarify all of the people coming in with ADHD and noticing that there's a much higher prevalence of of anxiety that I've seen in my practice so statistically it's about eight percent of um U.S adults who will have a diagnosis of ADHD where it's 30 percent of adults in the U.S who at in the past year will have been identified with a diagnosable anxiety disorder and so we can tell there's going to be as I mentioned there's going to be overlap but there is a much greater prevalence of anxiety and so teasing that out is actually in my opinion is imperative before even getting an ADHD diagnosis so that we can clear out any anxiety symptoms that may be exacerbating and then often we may find somebody who still has concentrational issues but may not need medication when they regulate their anxiety they're really able to use kind of Behavioral tools that can help them Focus in a way that really mitigates the diagnosis being hugely impactful in their life when you've got ADHD plus anxiety you're really a setup for having consequences in your life and um and more exacerbated symptoms and so getting that diagnosis clear and clearing out the anxiety or dealing with the anxiety concurrently is really important at its highest level ADHD and anxiety can keep people from actually completing the tasks a lot of times with some anxiety we can grit through that but at its worst we cannot so when we are at a point where we cannot for whatever reason get these tasks at work completed when should we be looking at ADHD symptoms versus anxiety symptoms so I think that it's always appropriate if your symptoms regardless of whether or not you understand where they're coming from whether it's anxiety or ADHD it's always appropriate to get consultation to reach out to get support potentially to be tested the really kind of gold standard in regard to ADHD is neuropsych testing to be able to really be tested to tease out the difference between anxiety and concentrational kind of underlying ADHD issues that being said when tasks are being hard to finish we want to kind of tease out a little bit is the issue that my again my brain goes offline I can't think straight or is it that I'm distracted that as I try to sit down and focus my brain goes to another place a distinction that we could kind of use is overactive brain versus brain that's kind of shut off now these can look physiologically somewhat similar that someone's sitting down and their heads going over to the other you know staring out the window it may be staring out the window as they're trying to regulate and bring their anxiety back down they may be staring out the window thinking about their grocery list and what they need to do this afternoon and maybe if I go down this Loop the ADHD brain that can go down lots of rabbit holes may look distracted in a similar way as somebody whose brain is offline so we really have to ask the person who's navigating what's your experience and we can tease this out with nuances of looking to see any other signs or sensations of anxiety the person who's distracted with ADHD is often in a pretty calm State they might be excited about the mental kind of rabbit holes that they can go down and get excited about going down certain paths that can have them pull away from the original task but they're not usually going to be physiologically anxious in a way that somebody who is experiencing a distractibility because of anxiety would I also want to highlight that while the most common thing that I see for people who are really different differentiating ADHD from anxiety when they come in to see me there is that their brain is kind of offline there's also distractibility and avoidance that can come with anxiety that if certain things make me anxious I may avoid them because they make me anxious and choose to go somewhere else to say I don't want to have to deal with this it brings up too much inside of me and often people with anxiety will have an awareness of like it's it makes me too anxious I pull away from it as opposed to you know the you know For Better or Worse the analogy like squirrel like it just I just move away without really conscious control or deciding whether or not to do it that may come with a more foundational ADHD diagnosis so whether it's anxiety or ADHD there are plenty of people who are struggling to focus at work they can't help but be restless at work and in the worst case like we just mentioned they can't finish these projects is there any evidence-based strategies you can provide that could help these individuals go through these challenges a when it's happening at work I'm in it I need a solution right now and B something I can do maybe at home to prepare myself for the work day wonderful yeah so I think that um there are lots of great techniques in regard to ADHD I think that um what I would love to highlight is the notion that when we are anxious ADHD symptoms are going to be worse so if we don't know whether this is anxiety or ADHD I would start with an anxiety regulation technique so one of the most important things that we can do is first do a body scan I will often recommend that my patients when they are starting to feel distracted when they are starting to get into self-attacking thoughts the resultant kind of symptom that they may see after they get anxious I can't focus or gosh I'm ruminating in some way if I can notice when I'm doing that come to my body and just start a body scan to check in and see okay is my brow furrowed no can I relax it is my jaw clenched oh a little bit can I release my biting surface is my chest tight can I take a deeper breath can I go all the way down through my body checking to see for areas of tension for breath anywhere that I might be you know clamping that I can then release that just attuning to our bodies can help regulate and bring down the anxiety if we can can do this in conjunction with some nice deep breaths we're going to be able to bring down the anxiety and hopefully come back to some of that Focus that will that is a part of the ADHD presentation or the anxiety presentation now I love the fact Kyle that you're talking about in in real time and then also at home and I think that the number of people that I have talked to who do the opposite who don't use in real time the stuff that they've actually been practicing at home is actually pretty shocking I do meditation in the morning I do breath work at night I don't realize that I need to do that when I'm actually in game time and when this is actually happening so I will often talk about the analogy of basketball of practicing a free throw that when I was young and played basketball right I would dribble dribble spin follow through that was to do the free throw every time in a quiet gym no one was there that the technique just became second nature dribble dribble spin follow through dribble dribble spin follow through every shot was the exact same so that it became a habit when we practice breath work mindfulness body scans in a calm and safe space it becomes habit and our bodies are kind of natural memory system of habit starts to just kick in when we remind ourselves that we need to do this but then when we're in the moment we need to remind ourselves to do this so the exact same thing that I do in the workplace practicing that at home whether first thing in the morning or in the evening in a quiet time when you don't need it right is a great way to even have some awareness to be able to say huh I'm I'm uh you know I'm really somebody who holds my jaw I can start to know myself a little bit better so that when I'm in the game time I can know oh wow I know that first before I take that dribble dribble spin fall through I need to release my jaw a little bit right I get to know myself and my nuances around regulation that can be really helpful so having anxiety regulation techniques that are useful and helpful in the environment and then being able to practice them at home when it's not game time well said Dr Lam as always and we have a fabulous series on anxiety and ADHD with other Med Circle doctors we will link to those in the description of this video thank you for watching this video and checking out our other Med Circle content I'm Kyle Kittleson remember whatever you're going through you got this [Music]

Channel: MedCircle

Views: 141,778

Keywords: adhd, anxiety, anxiety disorders, attention deficit hyperactivity disorder, difference, anxiety disorder, mental health, fear, psychology, brain, stress, overthinking, mental health awareness, psychiatrist, how to deal with anxiety, mental illness, what is adhd, adhd symptoms, adult adhd, adhd test, adhd medication, do i have adhd, how to adhd, add, disorder, adhd in women, how to know if you have adhd, adhd tips to stay focused, adhd and productivity, medcircle, video, youtube, signs

Id: yJM_GeKdZ6c

Length: 15min 33sec (933 seconds)

Published: Fri Oct 14 2022