Saturday, May 26, 2007

Is it ADHD or an Anxiety Disorders?

When you are having some sort of difficulty and you go to get help, the primary goal of the clinician is to figure out the underlying problem or diagnosis. This is not any different when the topic is ADHD, yet figuring out the problem accurately has significant implications when it comes time to provide treatment. Many children and adults have difficulties focusing and paying attention. It is crucial to undersand that not every child or adult who squirms or gets distracted has ADHD. At times, both children and adults are readily tried on medications without taking the time to figure out the underlying problem that is causing the symptoms. At times it is perfetly normal to be distracted, have difficulty focusing or to be forgetful. Of course these are three symptoms of someone who might potentially have ADHD, but they could also be just normal.

My primary concern in this article is in differentiating between anxiety and ADHD because both syndromes can mimic each other and there are sometimes challenges in differentiating between the two. It is not uncommon in my practice to see someone for consultation because none of the ADHD medications have helped them so they are looking for the next medication option. This is where there is a tremendous value in getting a thorough diagnostic evaluation to figure out some of the potential reasons for the lack of efficacy of the medications as welll as to confirm the diagnosis.

Anxiety by itself can cause someone to be fidgety, unfocused, easily distracted, forgetful, disorganized, etc... Once again these are some of the hallmark symptoms of ADHD; however they also tend to show up when there is an underlying anxiety disorder. One of the ways to differentiate between the two syndromes is that the aforementioned symptoms tend to be most prominently exhibited in an episodic manner or in a cyclical manner in anxiety. In those who have ADHD, their symptoms tend to be persistent across settings and tend to be consistent over time. The nature of anxiety is that it breeds worries, fears, nervousness, obsessions, compulsions and avoidance behaviors while those with ADHD tend to be impulsive. It is totally possible to suffer from both syndromes which can complicate matters when it comes to treatment. Since both of these syndromes can be so similar, yet have very different treatments, it is imperative to get a thorough evaluation prior to initiating any treatment.