Anxiety and Inattention

Do you ever wonder if your child’s inattention and fidgeting is actually due to anxiety and feelings of being overwhelmed? This is a question I am asked about all the time. With stress and negativity on the rise, we are all seemingly less able to concentrate on the things we need to get done, and sometimes even the things we actually enjoy. 

Most of the time I work with kids whose parents bring them in due to behavioral concerns. The second most common concern I hear about is parents asking about ADHD. Usually after a few questions it becomes clear that the child is actually experiencing anxiety that presents as ADHD, because these two conditions present so similarly. 

There are several symptoms of inattention attributed to ADHD. They include: 

• difficulty giving close attention to details 
• difficulty sustaining attention
• difficulty following through with directions, especially those with several steps
• difficulty with organization
• avoidance of tasks requiring sustained attention
• difficulty sitting still
• fidgeting/restlessness
• often losing important objects
• forgetfulness
• easily distracted 

When a person struggles with an anxiety disorder or even short term situational anxiety, often times the anxiety can be so overwhelming that the ability to pay attention is inhibited. Symptoms of Generalized Anxiety Disorder (GAD) include (but are not limited to):

• excessive worry
• difficulty controlling worry
• anxiety associated with at least three of the following: feeling on edge, easily feeling tired, difficulty concentrating, irritability, muscle tension, and sleep disturbance.

Very briefly, here is what happens in the brain when a person is experiencing anxiety: When an actual threat is present, a person responds to the threat with the “fight or flight” response (a heightened sympathetic nervous system). A person with anxiety may also perceive a threat when one is not actually present, which then also triggers the “fight or flight” response. This “fight or flight” response triggers the brain to release hormones in order to eliminate the threat, whether real or perceived. The presence of these hormones tells the brain that a threat is present, even when it might not be a physical threat right in front of the person, but rather a fear in the moment or in anticipation of something to come. The more the brain experiences the release of these hormones in the brain, the more the brain becomes wired to experience (and becomes used to) anxiety. This means that people with anxiety, if unmanaged, tend to feel the symptoms much of the time! It is well known that anxiety is linked to memory problems, which can also present as restlessness and the inability to pay attention. And, the presence of stress hormones affects areas of the brain responsible for coding memories, meaning chronic anxiety affects a person’s ability to actually make memories. 

While GAD and other anxiety disorders are diagnosable, even mild anxiety cause symptoms and bodily responses. Think about it, if a person is having difficulty with symptoms of anxiety listed above, it would be very difficult to pay attention. Often times, people struggling with anxiety are concentrating so much on the thing causing the anxiety that they are unable to pay attention to anything else going on around them. It is said that one in four children 13-18 years of age will experience some kind of diagnosable anxiety disorder (NIMH, 2022). Anxiety disorders are the most common disorders diagnosed in all people with almost 30% of adults likely to be diagnosed with an anxiety disorder at some point in their life (NIMH, 2022).

Administering medication to treat symptoms of ADHD, especially with young children, should be used as a last resort. Reduction of symptoms after administering medication is not a confirmation that the diagnosis is present. ADHD medications will seemingly work on anyone, whether the diagnosis is present or not. While medication can be helpful to manage ADHD symptoms, symptoms can also be managed successfully without medication with a consistent and supportive treatment plan. 

This brief discussion gives a quick look at why it is important to understand the root of the problem and to manage it accordingly. There is a great deal of information available about the links between attention deficit and anxiety. Both attention deficit problems and anxiety disorders are treatable with proper assessment and course of therapeutic interventions.