Highlights
- “Anxious ADHD” isn’t a recognized subtype, but the idea can help some people understand how anxiety interacts with ADHD symptoms.
- Anxiety and ADHD often appear together. Research suggests up to half of people with ADHD also meet criteria for an anxiety disorder.
- A licensed provider can diagnose ADHD and anxiety based on DSM criteria and rule out other explanations for symptoms.
Anxiety and attention-deficit hyperactivity disorder (ADHD) often show up together. One psychiatrist, Dr. Amen has proposed the concept of “anxious ADD” to describe a pattern in which anxiety is a prominent part of ADHD symptoms.
Although this is not a formally recognized subtype of this condition, it may help you understand what anxiety and ADHD look like when they show up together.
A note on language: Dr. Amen, the psychiatrist who came up with the idea of “anxious ADHD,” continues to use the term “attention-deficit disorder” or “ADD.” However, the accurate medical term is “ADHD,” whether or not hyperactivity is present. In this article, we will use the correct term “ADHD” unless referring directly to Amen’s claims.
What Is Anxious ADD?
“Anxious ADD” is one of the seven types of ADHD described by Dr. Daniel Amen. It is not a recognized condition, and it’s not listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM).
According to Dr. Amen, anxious ADHD is like “inattention and anxiety combined.” It’s characterized by conflict avoidance and excessive worrying. Dr. Amen states that, unlike other people with ADHD (who often have a hard time with impulsivity), people with anxious ADHD don’t tend to seek excitement or risk.
Amen is a psychiatrist who claims that there are distinct types of ADHD that can be diagnosed through SPECT brain scans. Anxious ADHD is the seventh subtype in his model.
In addition to anxious ADHD, other types in this model are:
- Classic ADHD: Common symptoms like inattention, impulsiveness, disorganization, etc.
- Inattentive ADHD: More symptoms of inattention, including trouble focusing, time management problems, and excessive daydreaming.
- Overfocused ADHD: A type characterized by hyperfocus, tendency to getting stuck in negative thoughts and holding onto their opinions, among other symptoms.
- Temporal lobe ADHD: Core symptoms are accompanied by temporal lobe problems like issues with memory and learning, mood swings, and anger.
- Limbic ADHD: This type is claimed to be caused by underactive prefrontal cortex with symptoms like low energy, moodiness, social isolation, etc.
- Ring of Fire ADHD: Is thought to be caused by higher brain activity, which results in sensitivity to noise or textures, rigid thinking, racing thoughts, and fast speech.
Note that there is no official evidence to support this 7-type system, and Dr. Amen has faced backlash and controversy in the scientific community. It’s important to see a licensed healthcare provider who uses standardized methods for an ADHD assessment and offers evidence-based treatments.
ADHD and Anxiety: How Are They Connected?
What Dr. Amen calls “anxious ADD” could more adequately describe co-occurring ADHD and anxiety.
There are a few possible explanations for this:
- Children with ADHD often receive constant criticism or correction from adults, which creates long-term stress and anxiety.
- Executive function challenges can make it harder to regulate emotions and cope with stress, which could increase the likelihood of developing anxiety.
- Anxiety can also mimic ADHD symptoms, especially when worry makes it difficult to focus or stay present. So it could be anxiety under the guise of ADHD.
Anxious ADD Symptoms
Since anxious ADHD isn’t recognized, there is no official set of symptoms. The only descriptions of it come from Dr. Amen’s website and books.
According to Dr. Amen, the symptoms of anxious ADHD include:
- Excessive anxiousness or nervousness
- Frequent tension and stress
- Always predicting or fearing the worst-case scenario
- Avoiding conflict
- Fear of being judged by others
- Becoming anxious and freezing in social situations
- Physical stress symptoms, such as headaches or stomachaches
- Fear of public speaking
Many of these symptoms may be categorized officially as some type of anxiety disorder, like social anxiety disorder. However, it’s important to see a healthcare provider for a comprehensive mental health assessment.
In addition, Amen states that there are “core symptoms” that everyone with ADHD experiences. These symptoms are closely aligned with the diagnostic criteria laid out in the DSM:
- Difficulty focusing
- Being easily distracted
- Disorganization
- Chronic procrastination
- Forgetfulness
- Having a hard time with follow-through and instruction-following
- Impulsivity
Having the symptoms of anxious ADHD — or co-existing ADHD and anxiety, if diagnosed this way — can cause challenges in any area of life. Inattention, disorganization, and constant worrying or fears can affect job performance, friendships, family dynamics, and even ordinary daily responsibilities. It’s important to seek help to receive the right diagnosis and personalized help.
Causes and Risk Factors
There isn’t one single cause of ADHD. Research does show that genetics plays a role, but estimates of heritability range
- Differences in brain structure, function, and activity.
- Prenatal and birth issues, like low birth weight or prenatal exposure to certain substances.
Dr. Amen states that differences in brain activity cause anxious ADHD. According to him, people with this subtype have increased activity in the basal ganglia and reduced blood flow to the prefrontal cortex and cerebellum.
These areas of the brain — along with many others —
When it comes to the symptoms of anxiety, they may also have various causes. As was mentioned above, untreated ADHD itself can increase the risks of developing anxiety. In addition, traumatic experiences, stressful events, chronic health conditions, and even certain personality traits can play a role. If you experience bothersome symptoms, it’s important to consult a professional and identify the root cause.
Diagnosing Anxious ADHD
Because anxious ADHD (nor any of the other types in Amen’s model) are officially recognized, you can’t be diagnosed with it. It’s just a way you may use to better understand your symptoms.
Amen’s claims that he can use SPECT scans to differentiate between different “types” of ADHD are not supported by scientific evidence. He has declined formal offers to blindly evaluate SPECT scans to verify his findings.
To be diagnosed with ADHD, you need to get an evaluation by a licensed healthcare provider. They may use clinical interviews, standard questionnaires, and observation of your symptoms and behaviors. They’ll compare your symptoms with the formally recognized diagnostic criteria listed in the DSM.
There are three officially recognized types of ADHD that you can be diagnosed with:
- Predominantly Inattentive Type: Characterized by a lack of focus and high distractibility
- Predominantly Hyperactive-impulsive Type: Characterized by frequent impulsive behaviors and restlessness
- Combined Type: Experiences symptoms of both
If you relate to Dr. Amen’s description of anxious ADHD, then it’s possible that you also live with a co-occurring anxiety disorder. Anxiety disorders are diagnosed in a similar way: a provider will look at your symptoms and how they affect your functioning before deciding whether they meet criteria for an anxiety disorder.
It’s important to see a licensed provider instead of self-diagnosing because anxiety and ADHD can overlap in many ways. For example, difficulty sleeping, racing thoughts, and lack of focus are symptoms that can appear in both. Some people with ADHD are misdiagnosed, which leaves them without treatment that may actually help.
A licensed provider can help you get the right diagnosis, whether you have a primary anxiety disorder, ADHD, or both.
Anxious ADD Treatment
ADHD, regardless of the type, is treated with medication, therapy, or a combination of both. Effective medications for ADHD include:
Dr. Amen states that stimulant medications can sometimes increase anxiety. Research has found that increased anxiety is a side effect of stimulants for some people. But
If you live with both anxiety and ADHD, it’s critical to talk to a healthcare provider about your treatment options. A personalized treatment plan can help ensure that all of your symptoms are well-managed. Note that during an assessment, your provider may conclude that your symptoms are caused by anxiety, not ADHD. Then, you’ll be recommended anxiety-specific treatments, which may include therapy or medications like SSRIs (selective serotonin reuptake inhibitors) or others.
Therapy can also be helpful, especially if you live with co-occurring anxiety. Some therapy methods that may be effective include:
- Cognitive-behavioral therapy (CBT)
- Mindfulness-based cognitive therapy
- Exposure therapy
Coping Strategies and Daily Management
ADHD is a chronic condition, and it doesn’t go away with time on its own. But treatment can help you manage its symptoms. Coping strategies and lifestyle habits also can help, even though they aren’t a replacement for comprehensive treatment.
Dr. Amen gives some recommendations in this regard. He suggests:
- Finding ways to relax, like meditation. This can especially be helpful if you live with co-occurring anxiety. Research shows that practices like deep breathing can reduce symptoms of anxiety.
- Taking calming herbal and nutritional supplements like GABA, L-theanine, and magnesium. There is
some evidence[6] that these supplements can reduce symptoms of both ADHD and anxiety, especially sleep difficulties. But they should never be used in place of prescribed medication, and it’s important to consult your provider before taking supplements. - Eating a high-protein, low-carb, balanced diet. This is often recommended for many healthy adults. Make sure you check with your doctor before making drastic diet changes, especially if you live with other health conditions.
- Laughing more frequently. There is
some evidence that laughing can reduce stress[7] . - Connecting with loved ones. Especially if you have social anxiety, it can be tempting to isolate yourself. It’s important not to do this — support is essential, especially while you’re learning how to manage your symptoms.
It’s important to establish routines and explore ways to reduce stress that will work for you. If you find it difficult, having an ADHD coaching session or getting another type of professional support may help.
When to Seek Help
You can reach out for support at any time. You don’t need to wait for your symptoms to reach a crisis point. You deserve to feel your best.
If any symptoms are affecting your daily life or functioning, that’s a sign to reach out sooner. Watch out for these signs:
- You spend most of your day worrying about worst-case scenarios.
- You’re having difficulty sleeping, to the point where it’s affecting your functioning or mood.
- You can’t function in important areas of your life, like at work or school.
- You feel very emotionally distressed about your symptoms.
- Your symptoms are severe to the point where they’re getting in the way of living the life you want to live.
At MEDvidi, you can get online treatment for ADHD and anxiety right from home.
Conclusion
“Anxious ADHD” isn’t an official diagnosis. But many people relate to the label because it gives them language for what they’ve experienced.
The most important thing is focusing on the symptoms you live with and how they affect your life. Getting the right treatment is far more important than falling into a neat category or “subtype.” A licensed provider can walk you through an evaluation and help you understand what’s actually going on.
With MEDvidi, you can connect to a licensed provider who can help you get these answers. Make an appointment today; you may be able to have your first appointment within 24 hours.
Frequently Asked Questions
What does brain type 7 mean?
“Brain type 7” could refer to Dr. Amen’s 7th type of ADHD, which is what he calls “anxious ADD.” But this isn’t a recognized medical diagnosis. It’s a term he created based on his own model.
What does anxious ADD look like?
Amen describes anxious ADD as ADHD symptoms mixed with anxiety, but the official DSM doesn’t include this subtype. Clinically, this combination is more consistent with co-occurring ADHD and an anxiety disorder.
Can anxiety be a symptom of ADD?
Anxiety isn’t a symptom of ADHD, but the two often appear together. Restlessness and concentration problems from anxiety can also look similar to ADHD symptoms.
Will ADHD medications make my anxiety worse?
Some people notice increased anxiety with stimulant medication. If this happens, a provider can adjust the dose or switch to another option.
