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ADHD & Anxiety – Managing the Impact on Relationships


On June 3, 2013, I was privileged to speak at the CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder) center in New York City on the topic of ADHD and Anxiety: Managing the Impact on Relationships.

You can view my presentation here, or read below for a brief rundown of the highlights.

Link Between ADHD and Anxiety

In my practice and study, I have found that a portion of individuals with ADHD often struggle with anxiety disorders as well. Here are some statistics to demonstrate the link between ADHD and anxiety:

  • 5-15% of the childhood population will have an anxiety disorder.
  • 15-35% of children with ADHD will manifest significant anxiety.
  • 20% of adults with ADHD also have an anxiety disorder.
  • According to some research, the prevalence of anxiety disorders in individuals with ADHD can be as high as 50%.

This link between ADHD and anxiety has far-reaching consequences in people’s lives, especially as it relates to the ability to have meaningful, stable, healthy, and lasting relationships. Since I’m devoted to helping individuals with ADHD and anxiety disorders, I believe this connection certainly warrants some attention and exploration.

Why ADHD and Anxiety?

Why do some people with ADHD also suffer with anxiety? One of the trademarks of ADHD is decreased cognitive inhibition. Cognitive inhibition is the mind’s ability to tune out stimuli that are not relevant to the task at hand. It includes deliberately preventing an act, behavior, or response when it is not desirable. For example, when you’re at work it may be necessary to tune out your coworkers’ conversations in order to complete your tasks on time.

Cognitive inhibition is vital to appropriate social behavior. Think about it: if you are unable to ignore outside stimuli, how can you carry on a meaningful relationship? If you cannot put down your cell phone long enough to listen to another person or spend time with them, they will not feel valued in the relationship. When cognitive inhibition is lacking, it can definitely interfere with the progression of relationships. This failure can cause serious anxiety in a person’s life as they internalize their inability to keep a relationship alive.

Research has shown that anxiety may increase over time, as the demands placed upon individuals in adulthood increases.

How ADHD and Anxiety Impact Relationships

Anxiety is characterized by thoughts about the future that you fear, and generally have no control over. In relationships, anxiety and worry manifest themselves as:

  • failure to be present in relationships
  • believing there’s no way the relationship can work out
  • projecting the potential for bad things to happen in our relationships
  • disorganization in relationships

The following are characteristics of ADHD that may cause further anxiety in relationships:

  • past experiences with failed relationships cause more anxiety in current relationships
  • inability to read social cues
  • poor planning
  • lack of follow-through
  • not listening
  • lack of awareness of how we are impacting others
  • inattentive types may be more susceptible to anxiety because they have a tendency to internalize problems

How to Minimize Anxiety and Improve Relationships

If you suffer from ADHD, it IS possible to have meaningful, fulfilling relationships! Here are just a few strategies for minimizing your anxiety and improving your relationships:

1. Be an Observer

Look at your thoughts rather than from your thoughts. Take the time to really consider your thoughts and feelings before reacting to them. Don’t let your thoughts drag you around – there is a difference between having a thought and buying a thought.

2. “Mind Train” Exercise

This exercise comes from Dr. Stephen Hayes, author of Get Out of Your Mind and Into Your Life: The New Acceptance & Commitment Therapy. The basic premise of the exercise is to sit up straight and close your eyes, then imagine you are standing on a bridge, looking down at three railroad tracks. On each track is a different train. The one on the left is carrying sensations, perceptions, and emotions. The one in the middle is carrying only your thoughts. The one on the right is carrying your urges to act, your pull to avoid, and your efforts to change the subject.

Now, sit comfortably, sit up straight, close your eyes. Begin by thinking about something you have been struggling with lately, then picture the tracks with your eyes closed. It is your job to stay on the bridge, looking. Do not engage with the thoughts but look down and observe. How do you feel?

3. Practice Mindfulness

Mindfulness is the practice of getting in touch with your own experience moment by moment, in a nonjudgmental and accepting way. It is taking the time to tune into your thoughts, to notice what you are saying to yourself without passing judgment, and taking a moment to pause and reflect before you do anything, to determine whether or not that action would be beneficial.

4. Stay Organized

A large part of managing your ADHD is staying organized. You may need to have a coach or therapist to help you stay organized, or you may have developed your own system of organization with your planner or iPhone.

  • Have daily check-ins with yourself
  • Do one thing at a time (Honestly, no one is good at multi-tasking!)
  • Overestimate how much time it will take you to do something, so you will not be late

Other ways to manage your ADHD and minimize anxiety include being involved in people’s lives, spending quality time with them and finding out what is important for them; actively listening to people without interruption; and practicing meditation.

Above all, be patient with yourself as progress takes time and practice. Let go of judgmental thoughts, and celebrate every victory in your daily life, no matter how small. You are worthy of meaningful relationships – it will happen!