Attention deficit hyperactivity disorder (ADHD) and anxiety disorders are among the most prevalent conditions in kids. In fact, around 30% of children with ADHD also have anxiety. Both anxiety and ADHD symptoms tend to persist into adulthood, so adults must equip kids with the tools they need to support themselves as they age. To do that, parents must first understand the conditions themselves.
A child's diagnosis or how it will affect them is often not explained when they receive it. It’s also true that both conditions will affect each child differently. So, what should you know?
First, let's talk about understanding ADHD and anxiety in kids. Then, we'll discuss helpful tips and practical advice parents can use to boost their parenting skills, support a child's well-being, and manage stress.
Understanding ADHD and Anxiety In Children
Parents may not realize certain behaviors are due to a child's ADHD or anxiety. They may not know the ways ADHD can affect a child's life outside of what they see externally. As an example, you can see impulsive behavior, but you might not see rejection sensitivity. Kids may try their best but feel down on themselves or grow increasingly frustrated when adults don’t see their efforts.
On the same note, a child with anxiety might experience disproportionate distress surrounding various subjects and situations, and why they feel so fearful about certain things could be confusing for someone who isn't in their shoes. All in all, it's common for these children to feel misunderstood.
When anxiety and ADHD co-occur, some symptoms might "cancel" each other out (e.g., stress from anxiety might cause kids to be perfectionistic or high-achieving, which may make them appear "unlike" ADHD stereotypes). Alternatively, the conditions can sometimes make one another seem "worse." For example, anxiety could lead to additional trouble focusing, procrastination, or cause restlessness.
Since anxiety can manifest in diverse ways, one child might be quiet and timid, but another could have emotional outbursts. The same is true with ADHD: One child could be primarily inattentive, whereas another could have primarily hyperactive/impulsive or combined type ADHD.
Learning about the diverse effects ADHD and anxiety can have on kids may be helpful. Often, this will be a parent's first step to knowing how to best support a child with both ADHD and anxiety.
The effects of ADHD on learning and behavior
The things that support behavior and learning for other children might not work the same way for kids with ADHD. With ADHD, children may experience hardships with behavior and learning due to the following:
- Deficits in working memory. A child with ADHD may not remember things like instructions as well as other kids.
- Trouble focusing or concentrating. A child with ADHD may get easily distracted or face difficulty with activities that require sustained mental focus, like school assignments.
- Impulse control, hyperactivity, and behavior problems. A child with ADHD might move when they are to remain seated in class, speak out of turn, or otherwise act without thinking.
The impact of anxiety on a child's well-being
Anxiety disorders can come with both mental and physical symptoms, some of which are hard to detect. While it's not an extensive list, kids with anxiety may experience the following:
- Gastrointestinal problems (nausea, vomiting, stomach pain, stomach aches, etc.)
- Challenges separating from parents, caregivers, or other trusted adults.
- Racing thoughts, catastrophizing, or expecting the worst.
- Difficulty with social interactions.
- Trouble sleeping or nightmares.
- Excessive worry.
Tips For Parenting Kids With ADHD And Anxiety
When kids face adversity of any kind, including mental or behavioral health challenges, the right tools and strategies are empowering and can have life-long benefits. Use the following parenting tips for a child with ADHD anxiety to navigate symptoms, behavior, and possible setbacks.
Try Joon, The To-Do App That Plays Like A Video Game
Using Joon is an excellent way to establish routines and structure for a child with ADHD and anxiety. Designed by and for kids with ADHD and related disorders, Joon is an ADHD app geared toward kids ages 6-12+. Here's how it works:
Parents install the Joon Parent App first and customize a to-do list for their children. You can add as many tasks, routines, and habits as you want. For example, homework, eating meals, or household chores. Children connect with a separate app called Joon Pet Game. When the child completes the tasks assigned by their parent(s), they get rewards in the Joon Pet Game that allow them to take care of a virtual pet called a Doter.
Joon acts as a reward system and encourages independence, self-esteem, and task completion in kids. 90% of kids who use the app finish all their tasks, and many users say it's improved their parent-child relationship.
Understand your child's unique needs
All kids are different. Your child's symptoms may affect their behavior, so it's essential to look at what needs their behaviors attempt to communicate. What is something that your child could use more of? For example, more defined routines, physical activity, or better sleep?
If so, there could be solutions, such as giving kids more structure, involving kids in more movement-based hobbies, using strong sleep hygiene practices, or working with their pediatrician to address ongoing sleep problems.
Is there something that causes them distress, like trouble in friendships or wanting to know how to approach other kids and make friends more? Practicing social skills like taking turns and asking other children to play at home may help.
Of course, paying attention to what your child tells you is also essential. Listen attentively when kids communicate and validate their feelings, working together as a team.
Establish routines and structure
Routine can make a world of difference for children with ADHD and anxiety for more than one reason. When a child has structure in their life, it can help them:
- Build good habits. When a task like doing homework, brushing their teeth, and doing specific chores, is part of a child's regular routine, it becomes a habit.
- Organize activities. Routines with clear-cut steps aid organization and help kids with ADHD stay on track.
- Avoid feeling overwhelmed. Time will be better managed with routines, which can reduce overwhelm.
- Know what to expect. When kids have routines and schedules to refer to, they know what to expect. This can be particularly helpful for kids with anxiety, who may not cope well with the unexpected.
Consider using a chart or calendar to write out a child's weekly schedule so kids can see it in front of them.
Use positive reinforcement to encourage good behavior
Positive reinforcement for good behavior is powerful for all children, especially kids with ADHD or behavioral concerns. Give verbal praise directly after a child engages in good behavior. For example, if they ask for something kindly, you might say, "That was a wonderful way to communicate that. Thank you so much!"
Reward systems can be key when it comes to managing ADHD and helping kids complete necessary tasks. Reward ideas include but aren’t limited to an extra hour of television time, token systems, small objects, and experiences, like going to the park.
Set boundaries and consequences
While it's not always easy for parents to implement them, boundaries and consequences are critical when kids experience behavior problems.
Give children clear instructions and expectations when you want them to do something or refrain from a particular behavior. Preemptively decide what the consequence will be if they don't follow through (e.g. if they hit a sibling when you say that hitting is not allowed and won't be tolerated). Then, let your child know the consequences and stick to your word.
Note that kids who present challenges with impulsive behavior often do not understand the connection between their actions and the consequences. Be willing to provide a sincere and caring explanation to a child if this could be part of the reason behind your child's behaviors.
Get support from teachers, counselors, and other professionals
ADHD treatment is crucial for children with the disorder. Your child's treatment may vary based on various factors, such as their unique needs, current age, and goals. Here are some standard forms of support to consider if you haven't already:
- Medication. Combined therapy and medication are the ideal treatment for kids ages 6+. Many people with ADHD describe the experience of taking medication as "having a quiet, clear head for the first time." Stimulant medication is the most well-known type of ADHD medication and has a high efficacy rate. For those who can't tolerate stimulant medications or don't find success with them, there are other options.It is important to note that medications for ADHD may be ineffective or cause more side effects if anxiety is not first managed, so concomitant treatment of anxiety is recommended.
- Parent training. Behavioral parent training, also known as parent training in behavior management, is typically recommended first for kids under age 12. Studies have shown that behavioral parent training (BPT) for ADHD reduces child noncompliance and related parental stress. It's something that could be valuable both for you and your child.
- Individual therapy. Individual behavioral therapy is the standard recommendation for kids and teens 12+ with ADHD, but some younger children also benefit from it. Therapy for anxiety can also be very helpful for kids of all ages, providing a chance to gain an expanded understanding of oneself and healthy ways to cope.
- Parent-teacher communication. Working with a child's teacher is a must when it comes to school. You may be able to get kids accommodations for ADHD, anxiety, or both. Many teachers don't have a strong understanding of ADHD or mental health conditions, so it can be integral to work together and help them understand what your child needs.
Family therapy, occupational therapy, and a number of other forms of support may be worthwhile in some cases. Work with your child's pediatrician and ask them for recommendations based on your child's specific symptoms.
Strategies For Managing Your Own Stress And Emotions
Many parents find that worrying about their child's symptoms or working feverishly to get their child's needs met comes with added stress and high emotions. Sometimes, there's a heavy waiting game when it comes to finding the right approaches to navigating negative behavior, getting medical care, or something else. A child's behavior might disrupt family life, or a child's school might call often due to behavioral challenges. All of these things can make life hectic, to say the least.
It's important that you don't forget to take care of yourself. Use these strategies to manage your stress and emotions at this time so that you can not only be the best parent you can be but also protect your health.
Self-care looks different for everyone and generally includes a combination of practices. Here are some things to consider adding to your self-care routine:
- A "basic needs" check-in. Basic needs such as getting enough sleep, drinking enough water, and eating regularly (every 3-4 hours) can slide when we are stressed out. It's important to check in with yourself frequently and notice whether your basic needs are met.
- Enjoyable activities. Parents need downtime, too. Planning time with friends and engaging in hobbies (reading, doing puzzles, gardening, art, etc.) when you can to bring joy to your life all matter. Kids can be involved in some of these activities.
- General well-being. There are many self-care practices people use to improve their mental and physical health outside of tending to basic needs, but they may differ from person to person. A regular exercise routine, skincare, or doing guided meditations before bed are all examples. Notice what makes a difference for your brain and body; try to make those things a part of your routine.
- Positive self-talk. Self-compassion is perhaps one of the most important parts of self-care. Don't beat yourself up. Recognize that you're doing the best you can with the resources you have, and use positive self-talk regularly, congratulating yourself for what you do.
Seek support from other parents and support groups
With ADHD, parenting can look a little bit different, and it can feel lonely when your family's situation is unlike other people's. Other family members and parents might not understand, so finding other parents of kids with ADHD can be a big deal.
You will be able to find local support groups through a quick web search in many areas. You should be able to find groups for parents of other children with ADHD, anxiety, learning disorders, and most other concerns.
There's also an extensive range of online support groups, including those that meet over video regularly (much like a typical support group) and forum-based groups. These can be ideal for those in remote areas or who can't find specific groups nearby.
Consult with a therapist or counselor
Getting professional help for yourself can be just as valuable as it is for your child. Working with a therapist for parent training can help you learn behavioral techniques to use with your kids, but getting individual therapy for yourself might be more advantageous than you know. If you feel strained emotionally or notice yourself experiencing stress's mental or physical effects, it's a sign that it may be time to seek help.
Prevalence Of ADHD And Anxiety Disorders In Children
Sometimes, living with anxiety or ADHD can make it feel like you’re alone. Parents, too, may feel like they are the only ones with the worries that can come with parenting a child facing additional challenges or stress from the conditions. However, this is not the case.
Both ADHD and anxiety disorders are diagnosed using the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM). They both require a diagnosis from medical providers, but parents are often the first to notice symptoms based on a child's behavior.
ADHD is the most widespread neurodevelopmental disorder affecting children, with around 9.8%* of kids ages 3-17 obtaining an ADHD diagnosis at some point in their life. While it may seem that ADHD is more prevalent than it used to be, there's an easy explanation for this. First, attention deficit disorder (ADD) no longer exists and is now typically diagnosed as ADHD. Second, we have started to gain more information on how people with ADHD can present differently. Specifically, the diverse ways ADHD can present and how it can get overlooked in certain populations. For example, girls with inattentive type ADHD who aren't disruptive in class might not get a diagnosis as quickly, but while their challenges differ, the disorder still impacts their life and well-being long-term.
Similarly, anxiety disorders are among the most common mental health conditions affecting kids, with about 9.4% of those ages 3-17 getting diagnosed with anxiety disorder at some point in their life. It's relevant to note that anxiety disorders affect people with ADHD at a higher rate. In fact, it's said that 33% of kids with ADHD also have anxiety. So, if your child has both ADHD and anxiety, you aren't alone.
The best thing you can do is continue to love your child and support them in the ways they personally need. Kids with ADHD and anxiety often have many gifts and can build a life where they thrive.
ADHD and anxiety are both common in children and are often lifelong. Understanding what kids with anxiety and ADHD face can be the first step to knowing how to help them most. Parenting strategies like the use of routines, focusing on understanding and addressing a child's specific personal needs, and getting support from medical professionals can all be important steps to take. It's also vital to manage your own stress and emotions. Self-care practices, meeting parents who also have children with ADHD, and seeking professional support can all be helpful.