Work at Home Success By Jill Hart
Mom Laughs By Cheryl Moeller
Simplifying Motherhood By Trish Berg
Ask A Twin Mommy By Cheryl Lage
Mothering By Heart By Cheri Fuller
Jelly Mom By Lisa Barker
Family Check-up By Sheila Wray Gregoire
Parent to Parent By Jodie Lynn
Moments for Mom By Elisabeth Corcoran
Making the Most of Marriage By Paula Friedrichsen
ADHD and Anxiety Disorders
By Jean Jardine Miller
The many theories about the causes of Attention Deficit/Hyperactivity Disorder (ADHD) accepted before 1980, including minor head injuries, brain damage due to infections or birth complications, poor parenting, dysfunctional homes and sugar and food colourings in the diet have all been discredited over the past quarter century. Recent studies are showing that as many as 25% of all children with ADHD have an anxiety disorder and 25% of children with anxiety disorders have ADHD.
While hyperactivity decreases in adults with ADHD, an internal restlessness replaces it and other disorders are likely to develop; primarily alcohol abuse, closely followed by anxiety disorders. Until recently, there was little awareness among primary care physicians, of the possibility of psychiatric conditions being present in patients with ADHD or ADHD in patients diagnosed with psychiatric conditions and it is, in fact, only in recent years that there has been any awareness of the symptoms of adult ADHD at all. The continuing into adulthood of such ADHD symptoms as inattention, impulsivity and overactivity was reported in various studies in the 1970s, but it was not until the 1994 DSM-IV that there were criteria for diagnosis of adult ADHD.
Three subtypes are now defined: predominantly inattentive, predominantly hyperactive and a combined type in which there are elements of both. Symptoms of the inattentive subtype include such things as inability to maintain attention, whether or not the activity is one that is enjoyed, inability to organize activities, avoidance of applying sustained mental effort, not listening, not following through and being easily distracted. The hyperactive subtype is evidenced by fidgeting, running out on responsibilities, inability to remain quiet engaged in an activity, etc. In adulthood, this hyperactivity and impulsiveness becomes an inner restlessness, a low tolerance of frustration, recklessness and irritability. Difficulty in finishing things and bad time management result in people with the inattentive subtype. Either way, there is great difficulty in learning and maintaining life skills.
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About 4% of the population is estimated to have adult ADHD. Of these, up to 50% have an anxiety disorder. Children tend to be diagnosed with ADHD and the concurrent anxiety disorder is missed. With adults, it is the other way around the anxiety disorder is diagnosed and the ADHD is missed.
History of ADHD diagnosis in North America.
Prior to 1980 - Condition known as Hyperkinetic Syndrome.
1980 DSM-III - Name changed to Attention Deficit Disorder, with diagnostic criteria focusing on inattentiveness and impulsivity and not always including.
1987 DSM-III-R - Name changed to Attention Deficit/Hyperactivity Disorder, with more prominence given to overactivity symptoms. Symptoms persisting into adulthood acknowledged.
1994 DSM-IV - Impulsive and hyperactive symptoms are identified separately with distinction being made between inattention and other symptoms. Criteria for diagnosis of adult symptoms of childhood onset ADHD.
The situation is changing... Clinical studies have found that the most used stimulant treatment, Ritalin, worsens the anxiety symptoms in some children yet appears to reduce them in others. The addition of an SSRI to stimulant treatment can help in the former situation. Alternatively, tricyclic antidepressants are often preferred because of their positive effects on anxiety disorders. Neuroscience, Inc., the clinical trial research facility in Bethesda Maryland in currently engaged in trials of a non-stimulant medication for children with both ADHD and an anxiety disorder.
The most important outcome of the various trials is that the importance is now being stressed for primary care physicians to recognize anxiety disorder symptoms in the children they treat with ADHD and ADHD symptoms in adults they treat for anxiety disorders.
© Jean Jardine Miller, 2004-
Jean Jardine Miller is the author of KIRSTIN’S STORY: no place to stand and compiler of Songs of My Soul. More information on these books, and where to purchase them, is available at designandcopy.ca/jardinemiller.