ADHD Medication and Anxiety

While ADHD medications do not usually cause anxiety, it is not uncommon for people with ADHD to also have a co-occurring anxiety disorder. Because the two conditions share some symptoms, such as restlessness, it is important to rule out anxiety or other conditions when making an ADHD diagnosis.

Attention-deficit hyperactivity disorder (ADHD) is a common neurotype that affects an estimated 4% of the world’s population. While it is usually identified in childhood, ADHD is lifelong. It is characterized by patterns of inattention, hyperactivity, and impulsivity that can make it difficult for people to pay attention and control their behaviors.

Various methods can be implemented to help manage day-to-day tasks and tendencies. This includes medication, therapy, social skills training, lifestyle changes, and special accommodations.

This article will explore which medications can cause these symptoms as well as alternative treatment methods that can be utilized. Additionally, general coping mechanisms will be discussed to further support and help your journey.

What Is ADHD?

Though it is sometimes mistaken for a learning disability, ADHD is actually a neurodevelopmental disorder that affects the brain’s development and ability to function.

While ADHD traits do vary from person to person, there are three major presentations with their own unique characteristics:

1. Inattentive: This type of ADHD is characterized by symptoms of inattention, disorganization, a lack of focus, and a short attention span. This type of ADHD is sometimes referred to as attention deficit disorder (ADD); however, this term is outdated and not regularly used anymore.
2. Impulsive/Hyperactive: This subtype is the most commonly recognized when discussing ADHD. Individuals with this type are restless, fidgety, and often act without thinking.
3. Combined: This is the most common ADHD subtype. Individuals with this type of ADHD usually document experiencing a mixture of impulsivity, hyperactivity, and inattention symptoms.

Which Medications Are Used to Help With ADHD?

Medication for ADHD comes in two groups, stimulants and non-stimulants. The type of medication suitable for a person will depend on their specific traits.

Stimulants

Stimulants are considered the first-line treatment for ADHD; thus, they are the most common type of medication to help with ADHD tendencies while they are active in the body. But how does this process happen?

The chemicals norepinephrine and dopamine play a key role in regulating attention and executive function. These chemicals tend to be lower in those with ADHD, so stimulants work by increasing their availability in the brain. They do this by slowing down the rate of dopamine reabsorption in the neural network. Thus, the activity and communication of the parts of the brain that rely on these chemicals increase, and the symptoms of ADHD decrease.

Non-stimulants

Non-stimulants are another treatment option for ADHD. This option is usually recommended to those who don’t experience any changes on stimulants, experience severe adverse side effects from stimulants, and/or those with health conditions that make stimulants an inappropriate option. It is also important to note that there may be instances where a doctor may prescribe both.

Does ADHD Medication Cause Anxiety?

Stimulant medications generally do not worsen anxiety symptoms; however, ADHD and anxiety often co-exist, and they can also exacerbate the effects of each other. For instance, around 50% of adults with ADHD also have a comorbid generalized anxiety disorder (GAD) diagnosis.

Additionally, some stimulant-based ADHD medications can make anxiety symptoms worse initially, such as Adderall or Ritalin. However, these symptoms usually tend to subside after some time.

“Some symptoms — like fidgeting and trouble concentrating — are hallmarks of both ADHD and anxiety. As a result, clinicians must rule out anxiety and other mental disorders when diagnosing ADHD, and vice versa," says Damaris Chukwura, Psychiatric Nurse Practitioner at Heading Health.

Other Side Effects of ADHD Medication

While ADHD medication is very effective at helping people manage their symptoms, as with all medication, there is the potential for side effects. It is important to note that not everyone who takes the medication will experience the same side effects to the same severity. Additionally, many of these adverse effects can subside with time.

Stimulant-based medication to treat ADHD can cause the following:

• Weight loss
• Decreased appetite
• Insomnia
• Headaches
• Mood changes
• Nausea
• Tics
• Rebound effects

To minimize the side effects of ADHD medication, medical practitioners can implement a range of techniques.

This includes starting off with a low dose and titrating the medication to find your body’s ideal balance. In some instances switching your medication may be recommended. This can happen in two ways — switching from an amphetamine-based ADHD medication to a methylphenidate-based one or a long-acting agent to a short-acting agent (and visa-versa). There is also the option of taking “medication holidays.”

Additionally, it is common for your doctor to recommend regular check-ups initially. This is so they can monitor your weight, blood pressure, heart rate, and general well-being.

Can You Take ADHD Medication With Anxiety Medication?

As mentioned above, individuals with ADHD are more likely to have an anxiety disorder than individuals without the condition. “Some symptoms — like fidgeting and trouble concentrating — are hallmarks of both ADHD and anxiety,” says Chukwura. Therefore, it is vital to have your clinician rule out anxiety and other mental disorders when diagnosing ADHD.

Additionally, for some individuals, stimulant medication can be enough to reduce the impact of anxiety. For example, a 2016 study on children with ADHD found that both atomoxetine and methylphenidate-based medication reduced the symptoms of ADHD and anxiety.

How to Cope With ADHD and Anxiety

While there are many techniques your medical practitioner can implement to help with your ADHD, there is a range of other methods you can carry out yourself. Here are some tips you can try:

1. Create a schedule with breaks and make it visible: Creating a structured routine is very helpful when it comes to keeping track and being engaged with tasks. However, it is important to remember to schedule some breaks, too, so you don’t overextend yourself. “Writing in your planner, putting a calendar on your wall or digital calendars are great for reminding us to take scheduled breaks,” advises Chukwura.
2. Implement exercise and movement into your routine: Evidence shows that exercise can lead to an immediate improvement in ADHD symptoms and cognitive functions. It doesn’t need to be anything strenuous either. “Make sure to incorporate movement every day, especially when working from home. Walking meetings are also great!” she says.
3. Maintain healthy habits and lower your expectations: In today’s culture, it is very common for everyone to feel overwhelmed at one point or another. Therefore, it is vital to give yourself and your body the best internal environment to face daily challenges. “Exercise, sleep, eating nutritious foods while limiting caffeine and alcohol are effective in managing ADHD and anxiety,” says Chukwura.