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ADHD and anxiety: two disorders that often coexist

ADHD and anxiety: two disorders that frequently coexist

Anxiety is one of the most common comorbidities of ADHD: around 30 to 50% of people with ADHD also have an anxiety disorder. This coexistence creates a complex clinical picture in which the two disorders feed off each other and require specific management.

Why ADHD and anxiety so often coexist

The link between ADHD and anxiety is bidirectional. On the one hand, ADHD generates anxiety: the repeated experience of failure, reprimands and misunderstood difficulties creates a permanent anxious anticipation. A child with ADHD who has learnt that their behaviour triggers negative reactions becomes anxious in new and demanding situations. On the other hand, anxiety can worsen ADHD symptoms by monopolising already limited cognitive resources and making concentration and emotional regulation even harder.

The specific manifestations of this dual problem

When ADHD and anxiety coexist, the clinical picture can be particularly confusing. Anxiety can mask ADHD: a highly anxious child who over-controls themselves to avoid making mistakes may appear attentive while developing considerable fatigue. And ADHD can mask anxiety: motor restlessness may be interpreted as pure hyperactivity when it is partly a manifestation of anxiety.

Management that addresses both dimensions

Managing ADHD comorbid with anxiety requires particular attention, because some ADHD treatments, notably stimulants, can worsen anxiety in some patients. Psychotherapy, notably CBT, must address both disorders simultaneously. And in some cases a specific medication for anxiety may be considered alongside the treatment for ADHD.

The role of psychoeducation

Psychoeducation, learning about one’s ADHD and anxiety, their mechanisms and their interactions, is particularly important for this dual comorbidity. A child who understands that their anxiety is an understandable but not inevitable reaction to their ADHD difficulties can begin to defuse it. For resources on anxiety associated with ADHD, aidtoi.fr offers practical guides for families.

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