A Deep Dive Into ADHD And Anxiety

What if your symptoms of anxiety are better explained as ADHD?

But first,

Check out this tree guys.

It's a nice tree.

It's got nice leaves,

But this tree represents anxiety.

Let's call it the anxiety tree.

Okay,

That's such a bad joke.

This tree is actually two different trees with two different roots.

One of those trees is a lemon tree,

And for today's video,

That's going to be our tree that's rooted in anxiety.

And the other tree is a lime tree.

The leaves look the same,

Thanks for watching.

It still has anxiety leaves,

But it's actually got different roots.

This tree is better explained as ADHD.

Okay,

Up to 50% of people with ADHD have an anxiety disorder.

The symptoms can look super similar and they have a ton of overlap from racing thoughts to difficulty sleeping to memory problems.

Today,

We're going to be talking about the overlap between anxiety and ADHD,

The two separate root causes,

And how brain differences might explain why this is happening.

And of course,

The whole point of this is if we look at some forms of anxiety as being fueled by ADHD,

That gives us some great options for treating it.

When I learned the crucial role that executive function plays in processing emotions,

It completely changed how I manage my own anxiety and how I help clients.

Okay,

Do you know that feeling where your thoughts bombard you and everything feels awful and frightening and overwhelming?

We can describe this as anxiety,

But it also sounds like ADHD sometimes.

Now here's how ADHD looks like anxiety for me sometimes.

The best way I can describe it is when your thoughts are flying by so fast and there's usually three of them at once.

I'll look at my messy kitchen and I'll think,

I need to cook dinner,

But I can't cook dinner until I do the dishes.

Then I'll think,

Oh my gosh,

I'm such a bad mom and the house is so messy.

And then I'll think,

I can't even think with this music on.

Maybe if we were and then I'll think oh gosh like if I if only maybe if I was just more chill that would solve everything Then I'll be like,

Where was I?

Oh,

Yeah the dishes.

Oh,

What is that fan noise?

Also,

I need to order groceries Alexa add almond milk to the shopping list.

Why is this music so loud?

What should I make for dinner?

I hate cooking and I can't even start cooking Because the kitchen's so messy,

I hate everything.

Almond milk is already on your shopping list.

That's how it feels okay,

It could be very loud in here it seems like there's always something important I'm forgetting and it feels like something bad is just around the corner So ADHD and anxiety have a ton of symptom overlap like the leaves of a tree Oh,

Yeah,

My my team would not let me say ADHD and anxiety are like pants with one waist Anxiety and two different legs right executive function worry and avoidance Alright,

So we're going with the lemon tree analogy,

But we're gonna be talking about symptoms Overlap and there are just so many symptoms that overlap from worry to hyperactivity to getting stuck in overwhelm to Overthinking difficulty focusing trouble sleeping and if you know me,

You know that I like charts to explain this stuff But I also don't want to bore you with all the details So I'm gonna include a link in the video description where you can download a free PDF of this whole chart But for now,

Let's just look at a few of these symptoms and how they overlap so Let's talk about worrying.

Worrying is actually a maladaptive habit of trying to prevent bad things from happening.

And it's actually very reinforcing to the brain.

The brain likes it.

So it thinks,

Oh,

As long as I worry about something,

I can prevent it.

And this leads to a cycle of like anxiety,

Leads to worry to prevent that bad thing from happening.

And then the bad thing doesn't happen.

So your brain's like,

Cool,

That worked.

I'm going to increase my anxiety and I'm going to worry more,

Right?

That's the anxiety cycle in a very small nutshell.

With ADHD,

When you aren't thinking about anything,

Your brain runs your default mood network.

This is like the background noise of your brain and it often just turns to worrying without you noticing it.

And with ADHD,

Hyperfocus can make it difficult to switch thoughts away from something worrisome.

So the symptom is worrying,

But with anxiety,

It's more of a maladaptive habit around avoidance.

And with ADHD,

As we're going to discover,

It's about executive function.

With hyperactivity,

Right?

You've got fidgeting,

You've got jiggling,

Legs,

You have this need to constantly move.

With ADHD this is often called driven by a motor,

Like you have the gift of lots of physical energy and poor inhibition.

Now this is great if you've got physical problems to solve,

But it can still be pretty problematic if you have to sit still or try to relax.

From an anxiety perspective.

You're stuck in the fight flight freeze response to perceived danger.

So your body's pumping out stress hormones.

So you've got the energy to run away from a tiger,

Which is great if you're actually running away from a tiger,

But it's not great if it's actually your emails that are frightening.

So both ADHD and anxiety,

You might see hyperactivity,

But they've got two different fuels.

All right,

Let's talk about focus.

With ADHD,

There seems to be an inherent difficulty maintaining attention for tasks that aren't the right level of stimulation.

With anxiety,

Your brain is constantly scanning for danger.

It's like,

Why would I pay attention to homework when I'm being chased by a tiger,

Right?

With sleep,

With ADHD,

Your brain has difficulty with impulse control and behavioral regulation.

This leads to difficulty calming your mind and body.

Your brain hates being bored.

So while you're laying there,

It's going to pull all sorts of random ideas and think about everything when you're trying to sleep.

With anxiety.

Worries keep the body's sympathetic state active,

That fight-flight-freeze response,

And those racing thoughts that preventative worrying keeps you on high alert.

Now,

There are tons more overlapping behaviors,

But you get the idea,

Right?

ADHD and anxiety can look very similar on the surface,

But the symptoms are rooted in two very different functions in the brain.

So what's the fundamental root difference between ADHD and anxiety?

It's executive function.

So executive function is the brain's ability to manage thoughts and emotions and actions to reach a goal.

It includes skills like planning,

Focusing attention,

Remembering instructions,

And regulating impulses.

With ADHD,

There seems to be a predisposed deficit in executive function,

And this makes it hard to process emotions like anxiety.

When you feel anxious about all the homework you need to do,

Poor executive function makes it hard to choose which task is most important.

And that makes it hard to remember why school is important,

Which drains your motivation.

You might have a hard time getting started because you have less dopamine than the average person.

And then you might look at your clock and realize it's 1 a.

M.

And then you pull an all-nighter and then you have much worse executive function in the morning because executive function is worse when you don't sleep well.

Now you're late to school,

You can't find your keys because you're slightly more disorganized than the average person,

Then when you finally get to school,

Because of all this stress and lack of sleep,

You actually have a harder time paying attention in class than usual.

Okay?

Now it feels like school's impossible and you're worried about your grades,

Right?

Here comes the anxiety.

Now this all stems from difficulty organizing and initiating tasks the day before.

It starts with poor executive function and executive function is generally in this part of the brain,

The prefrontal cortex.

Now with anxiety,

There is perhaps or usually an overactive amygdala or HPA axis.

This leads to a heightened fear response.

So when you perceive that you're in danger,

Like a tiger is chasing you or your friend is going to reject you,

Your brain doesn't care about making a budget or planning out tomorrow's task list.

The brain channels that energy away from the thinking part of the brain into reactive responses like running away.

It decreases big picture thinking or value based decision making.

So then you're going to make choices that avoid problems or situations.

So like you might avoid doing your homework because you're afraid you won't do it perfectly.

Or there's another form of avoidance,

Which is avoiding failure,

A big threat,

By trying to do your homework perfectly.

And all that avoidance fuels the anxiety cycle where your anxiety increases,

Which increases avoidance,

Which increases worry,

Which is another type of avoidance,

Which impacts your ability to function.

It makes it harder to choose to do things,

Harder to think more clearly,

And harder to relax.

So that's the anxiety cycle.

And with an anxiety disorder,

We'll often see heightened responses in the amygdala.

Okay,

So executive dysfunction often shows up as trouble regulating emotions.

30 to 70% of people with ADHD struggle to regulate their emotions.

And here's where it gets messy.

When we have poor executive function,

It fuels emotional dysregulation.

And when you're highly emotional,

It's hard to slow down and think clearly.

That's because the fight-flight-freeze response is channeling resources like blood and oxygen away from the prefrontal cortex into the more primitive survival parts of your brain.

So poor executive function can fuel anxiety,

And anxiety can fuel poor executive function.

This is why ADHD and anxiety are often connected,

But they stem from differences in how the brain processes information and responds to stimuli.

So ADHD stems from poor executive function.

Anxiety stems from a habitual avoidance response.

But anxiety can also decrease executive function.

So it's hard to think clearly when you're scared.

We can often treat the symptoms of anxiety when you have ADHD by improving executive function.

We're gonna get into that,

But let's first take a deep dive into what might be causing this poor executive function in the ADHD brain type Okay,

So one of the things that we see with ADHD.

I just really wanted to show you that page clearly I did not read that page Okay,

So one of the things we see with ADHD is something called a cognitive profile scatter,

And I hope you're ready for a deep dive I promise we're gonna talk about some helpful practical strategies soon,

But I love talking about the brain science here So you've probably heard of IQ IQ scores.

It's one measure of intelligence.

Most people think they're just one number,

Like 140 is genius,

100 is pegged as average,

Below 70 is considered an intellectual disability,

And most people score between 85 and 115.

But most people don't know that your IQ score is actually an average of subtests measuring four different skills,

Verbal reasoning,

Working memory,

Problem solving,

And processing speed,

Okay?

And here's the thing with averages,

A smart average person without ADHD might score like 110,

111,

107,

And 112 in those four subcategories.

And their overall score would be 110.

Did I do that math right?

I think so.

Okay.

But then one of the things,

So you see they're slightly above average and they're doing fine.

Even one of those scores could be slightly below average and one slightly higher.

It does not matter because they're tightly grouped here.

One of the things that we often see with ADHD is someone might have the exact same IQ score,

110,

But their processing speed is like 130.

It's super fast.

And their working memory is terrible.

Like 90 just under average.

So it's not a problem.

It's not like their processing speed is that bad.

The problem is they have a much bigger gap,

Like 40 points between their processing speed and their working memory.

As Russell Barkley says,

That's like a race car engine with bicycle brakes.

And these gaps in mental skills are pretty typical with ADHD.

So a common pattern of cognitive profile scatter with ADHD is high processing speed and low working memory.

Working memory.

Is how many things you can hold in your attention at once.

It helps you hold and sort through thoughts.

I'm feeling anxious because I have a deadline,

But.

.

.

I've done this before.

That's two thoughts in your head at once.

Hold those in your head while trying to remember your system,

Pull out your calendar,

And pretty soon the ADHD brain will give up.

It's like it has less capacity to hold multiple ideas in its head at once.

Working memory is also really essential for holding emotional information.

It's like you could compare this to past experiences that requires you to hold your memory in one hand and your current experience in the other be like,

Oh I've done this before,

It's okay,

Right?

In ADHD,

Working memory is often impaired,

Which makes it harder to pause and think before reacting emotionally.

And so does executive dysfunction,

Right?

Impulse control.

This can lead to impulsive emotional outbursts or difficulty calming down.

A slower working memory also inhibits your overall executive function.

So imagine your brain's like racing ahead,

Your fast processing is cranking out a flood of ideas and emotions like,

Oh my gosh,

What if I fail my test?

What if my teacher gets mad at me?

What if I never get a job?

What if I,

What if I,

Right?

Catastrophizing.

That verbal processing is just flying down the road.

But your ability to like slow down.

And organized.

And self-soothe.

Lags behind.

It's like that lower dot on the IQ score,

Right?

So these are things like adding in here,

Like you're going to be okay.

Remember to breathe.

This is just your brain making words.

There is no evidence that you're going to fail your test.

That's what many people with ADHD experience.

Their thoughts and feelings move fast,

But the tools to regulate those feelings,

The metaphorical breaks,

Cannot keep up.

So anxiety,

Overwhelm,

And emotional outbursts take over.

These aren't just behavioral issues.

They're not a lack of willpower.

They're regulation issues.

You might desperately want to stay calm or focused,

But your cognitive systems aren't working in sync.

And over time,

This can lead to chronic anxiety,

Low self-esteem,

Fear of failure,

Especially when you're misunderstood or punished for something you can't yet control.

And like this reminds me,

Like I've been having this dream lately.

I wake up in the middle of night,

I'm like sleepwalking and I have this idea or this thought,

Like I forgot to take care of one of the animals.

And now they're starving,

Right?

So like that anxiety around like,

What have I forgotten?

What have I missed?

Right?

Not only that,

But you just have a harder time regulating your emotions.

And,

And it's not just that either.

Like parents or teachers will incorrectly think that this kid or this adult right here is super smart,

But unmotivated,

Right?

They have so much potential.

So for example,

A child with ADHD might think quickly and talk fluently.

They might seem so smart.

They have high processing speed,

But then they struggle to hold thoughts in their mind,

Or they struggle to stay grounded in the present moment,

Or they struggle to initiate tasks.

This is low working memory or poor executive function.

So these kids are more likely to be punished or corrected because they seem so smart.

They should know better.

But the smart part of their brain is actually making it harder for them to process their emotions.

That race car engine is making it hard for the brakes to keep up.

And this is not because the person is too sensitive or dramatic.

But it's because of how their brain works.

Okay,

So let's give an example.

Let's say your friend criticizes you.

Okay,

This example is about me.

You keep interrupting me,

Emma!

In response,

I might feel a flood of emotions.

Like,

Defensive of this,

I do not.

Indignation.

Oh,

You're not so good yourself.

You're always talking about yourself.

Or immense shame,

Like,

I'm such a bad friend.

I suck at relationships.

With a delayed prefrontal cortex,

Emotions hit fast and hard.

It's hard to slow yourself down,

Hard to soothe yourself or think clearly in the moment.

So then I might react or storm off or get overwhelmed or shut down.

Without knowing what to do with those emotions,

I might feel anxious that I'll lose her as a friend or depressed that I can never maintain relationships.

I might shut down or withdraw or blow things up and that might make me more anxious or depressed in the future.

Now,

If my prefrontal cortex were activated,

Instead of replying right away,

Executive function would help me.

I would pause.

I would take a breath.

I would use my working memory to remind myself that my friend cares about me.

I would acknowledge that it hurts that she said that while also asking,

Is it true?

I would calm myself down enough to ask her what that looks like,

And then I would check in with my values.

I would say something like,

Oh,

I do value being a better listener,

And I do value my friendships.

And then I'd create a plan.

To become a better listener,

Which might look like watching some videos on how to be a better listener.

Or practicing or asking for some feedback.

And what I'm describing here is emotion processing.

It's a multi-step process that requires you to slow down,

Soothe yourself,

Make some space,

And then clarify and organize your thoughts and feelings into choosing valued actions.

The skills of emotion processing are really essential.

And with ADHD,

Poor executive functioning is basically tripping you up at each step.

If you don't give it support and scaffolds to work through this.

And that's the whole point.

If you identify with ADHD or if you've been diagnosed with it,

That's not just some new excuse for why you can't be happy and get stuff done.

Knowing that ADHD limits your executive function gives you the roadmap to build up the scaffolds and tools that are going to help you solve problems and be super awesome.

You don't need more pressure or discipline.

You need tools for co-regulation.

Memory supports.

Emotion processing.

Okay,

So how do we do that?

How do we help anxiety from an ADHD approach?

Let's talk about.

Three practical strategies that can help anxiety if we take an executive function approach.

Do you guys like my posters?

I worked hard on them.

Okay,

So let's see how supporting executive function will slow down the race car,

Build up the brakes,

And get you a good pit crew.

Okay,

So how do we slow down the race car?

Exercise is shown to directly support executive function and inhibition.

It's also great for anxiety.

Meditation.

Okay,

Meditation feels terrible for many people with ADHD.

It's not a coping skill,

It's a training skill.

You're training your brain to slow down and improve attention.

Medication.

ADHD meds are stimulants.

They stimulate the executive function parts of the brain to help you slow down and like talk with your doctor,

Right?

How else can we slow down this race car?

Writing.

Writing about your feelings can be one of the most effective ways to process through them.

This is my number one favorite way to sort through the clutter in my head.

You do not have to journal every night,

But when you're feeling super emotional,

Sit down and write about it.

It'll help you slow down and clarify what's going on.

But let me give you an example.

I had a friend who I worked with and he and his wife were going through marriage therapy.

And they would get so heated when they argued that the therapist said,

Okay,

Hang on there.

We're not going to argue verbally anymore.

You're welcome to keep arguing,

But you have to write it down.

So they had a notepad and he would write down what he was thinking or feeling,

And then he would pass it to his wife.

She would read it and then she would write it down and then she would pass it to him.

And all this is doing is an example of a structure,

A scaffold that helps support executive function inhibition.

Is an aspect of executive function,

Slowing yourself down.

So let me give you another example.

You're freaking out about whether your friend hates you because of something you said.

Write it down.

What are your thoughts?

What are your fears?

Like,

Oh,

She'll never talk to me again.

Or,

I just suck at this.

Why even try?

Or,

No one would ever want to be my friend.

Now,

You can add some helpful thoughts.

What would you say to someone else who was thinking that?

Write those down.

Might be something like,

Oh,

It's probably not as bad as I think.

Or real friendships work through stuff like this all the time.

Or what steps could I take to check in with her and make it right?

Or there have been rough times like this in the past,

And I've always got through them okay.

I can do this,

Right?

So we're just slowing our brain down so we can turn on the thinking,

Planning,

Organizing part of our brain.

When we slow down the race car and look around,

We can often manage the anxiety better.

Okay,

Here's another example from my friend Sean,

Who has ADHD and anxiety.

He's also an executive function coach.

And I just lay that out there and I'm like,

Look,

I'm a success if I do that one thing today.

And every day I'll write something,

Whatever it feels like,

Hey,

If I walk away from this day and I did that,

I'm good.

So yesterday was like,

Or last week was deliver a great executive function coaching academy class.

I did that,

I'm like,

All right,

My day is accomplished.

I can enjoy it.

So I think really always trying to minimize like what I need to accomplish rather than expand it and be like,

I gotta do this,

This,

And this.

That's just like,

Oh my God,

I'm a failure.

And you know,

It's like the shame cycle kind of just,

That's probably.

Like if I rely on one thing more than anything,

It's minimizing the amount of things I feel like I need to do on any given day.

I love how he manages task number one by writing one phrase at the beginning of each day.

Okay.

The last one is.

Pause.

Impulsivity can fuel ADHD and anxiety.

So you get upset at work,

Then you impulsively quit your job,

And now you're super anxious about paying rent,

Right?

To support impulsivity,

We need to train ourselves to pause.

Take a breath or take a walk instead of reacting right away.

Bite your tongue.

Put your hands behind your back.

Sometimes it's good to sleep on a problem or set up a new rule that you have to take 48 hours before making a decision.

So want to break up with your girlfriend or buy something that costs more than $100?

Set a timer for 48 hours.

These are behavioral strategies that you can practice until you make a habit of them.

Another thing you can do is like just Do less stuff.

This is one of the best ways to make yourself disorganized and anxious is to overbook yourself and run around like a chicken with its head cut off.

Scheduling time every day to slow down and work through feelings and to plan to look at your calendar and to rest and do self-care.

The second way we improve our ability to work through anxiety from an ADHD lens is we strengthen the weak parts of our car.

The bicycle brakes need extra support or in the case of ADHD it's usually working memory and impulse control that need extra support.

Now this video cannot begin to touch on all of the different skills to support executive functioning,

But let me just list a few.

You'll have to do your own research to figure out how to build systems that work for you.

But here's some of the things we do.

You keep visual reminders around you.

For people with ADHD,

Out of sight is literally out of mind.

If I feel panicky.

Then it seems impossible to remember that I've gotten through this before and I'll feel better after going for a walk.

So.

Reminders on your walls.

Put up routines on your walls.

Put your coping skills in an obvious place.

Put your red flags or warning signs that you need support in an obvious place.

With ADHD,

Planning and organizational skills might be more helpful than mindfulness or CBT.

That's like an anxiety approach,

Right?

You could work with an executive function coach to create a calendar system that works for you.

You can make your calendars more visual,

Like whenever possible,

Use routines and systems with checklists.

And the channel How to ADHD has some great examples for this.

Another way to support executive function is to set reminders on your phone for important things.

This could be like scheduled worry or journaling or breathing slowly or even to just hug your spouse.

And then process emotions physically,

Not just mentally.

So because our brains kind of jump around a lot,

It might be easier to just like diagram your feelings on a piece of paper,

Or do a brain dump,

Or make a mind map,

Right?

Or you work through the steps of the emotion processing course.

And like this is basically how I created the emotion processing course,

Not because I'm the best at processing emotions,

But because I needed like a 30 step system to work through my own huge and overwhelming feelings.

With my mediocre working memory.

We're almost done.

The third way to decrease your anxiety by addressing ADHD deficits is to get support.

So in other words,

We're going to help your race car out with a good pit crew.

A therapist or executive function coach can help you slow down,

Be less impulsive and reinforce good strategies.

They can help you process your emotions and build healthier habits.

Body doubling is one way to do this.

So it's like getting someone to do the hard things with you.

So for example,

You help your friend clean out their garage and they help you clean out your garage.

It might sound scary to impose on someone like this,

But a friend will actually enjoy spending time with you and help you be a better version of yourself.

Say it out loud.

Racing thoughts can go in circles in your head,

But when you say them out loud,

It's easier to make sense of them.

So you can talk to a friend or you can just talk into your voice memos or even to your favorite AI.

In the end,

The goal is to support your executive function so that you can make choices that line up with the life that you want to be living.

With ADHD,

Usually that's about supporting executive function first,

And that's going to help you solve problems and soothe your emotions.

Now,

I'll just give you a quick preview with anxiety disorders.

When anxiety is the root it's often about reversing behaviors and thought patterns that keep fueling avoidance and fear and then that's going to help your executive function kick into gear.

So either way when you support your executive function you'll be better at thinking clearly and solving problems and anxiety and ADHD will be easier to live with.

Okay thanks for sticking all the way to the end of this very long and nerdy video.

I really appreciate it.

I hope this video is helpful.

Thank you for watching and if you'd like to see more videos like this or videos about ADHD please comment below so I can know what you're interested in.

Thank you for watching and take care.

Hi there!

If you found anything in this video helpful,

I would really appreciate it if you could give it a thumbs up or share it with someone who could benefit from it today.