Many children with ADHD also have a learning disability, depression or an anxiety disorder. When a child can’t sit still to read a book or can’t complete a task, she is often labelled: ADHD. If she has excessive worries, the label is Anxiety Disorder…The problem is that we sometimes see the smoke and miss the fire. Or we see the smoke and conclude incorrectly what is causing the fire. Stress and anxiety are a normal part of life for children. Moderate anxiety helps children push themselves to succeed at home and in school. When the level of anxiety is greater than expected, we suspect that there is an Anxiety Disorder and pure anxiety may cause restlessness that can be interpreted as hyperactivity. An accurate diagnosis is critical to develop an appropriate treatment plan. It should be determined whether the anxiety is primary or secondary. Distinguishing between these conditions requires a full evaluation by a professional who is willing to dig deep for clues. I insist on a thorough consultation with a Educational Psychologist before starting any treatment. Parents need to understand that the diagnostic process can be complicated during the treatment phase-there is no quick fix!
Patience is key.When a child with ADHD also have an anxiety disorder or another co-morbid condition, the disorder might be so minimal that there are no symptoms. Taking a stimulant, however, may exacerbate a low-level condition. When this happens, it is important to deal with the anxiety disorder first. Once that is treated, it is generally safe to reintroduce the stimulant without causing a flare-up of anxiety.
Case 1: The patient has ADHD with anxiety secondary to frustrations, failures, and negative feedback experiences: Your doctor will treat the ADHD whilst working to address the social, emotional, and family problems associated with the anxiety disorder.
Case 2: The patient has ADHD and an Anxiety Disorder: here both disorders need to be treated to maximise success. Children are under tremendous pressure to perform. Parents should constantly reassure their children that they are good enough. Only when a child feels safe and secure, can the next steps in diagnosis and treatment be taken.