Hyperactive disorder and attention deficit(ADHD) is a neurobehavioral disorder that causes people to display patterns of hyperactivity, inattention, and impulsivity. It is not uncommon for people with ADHD to have a co-occurring anxiety disorder, including social anxiety. Social anxiety is characterized by an intense fear of social situations.
Although any anxiety disorder can coexist with ADHD,social anxiety disorder(SAD) is one of the most common. Although estimates vary, research suggests that 60-70% of people with ADHD also have social anxiety disorder.
Learning the differences between the two conditions is important in managing and treating both conditions. In this article, we discuss the link between ADHD and social anxiety disorder, including how one condition affects the diagnosis and treatment of the other.
The Link Between ADHD and Social Anxiety
It is quite possible that anxiety disorders are much more common in people with ADHD than in the general population. However, more research is needed to understand why ADHD and SAD coexist in some people and not in others.
While experts aren't exactly sure why ADHD and SAD tend to coexist, some believe they do.Factors that play a role in ADHD– Genetics, environmental toxins, or premature birth may also play a role in anxiety disorders.
Still others believe that ADHD symptoms themselves contribute to anxiety. ADHD symptoms, such as inattention, hyperactivity, and impulsivity, often put a person at greater risk of being teased, bullied, or socially rejected. Fear of further rejection, many close in on themselves,avoid any social settingthat they find threatening.
A person with ADHD may be more likely to develop social anxiety if:
- You have a family history of anxiety disorders.
- They have negative social experiences, such as peer rejection, bullying, or other interpersonal conflicts.
- You have a timid, reserved or inhibited temperament.
- They experience sudden social changes, such as starting a new job.
ADHD Complications and Social Anxiety
When ADHD and social anxiety occur together, a number of complications can occur.
overlapping symptoms
On the surface, SAD and ADHD can sometimes seem the same. The following are just a few ways that ADHD and SAD symptoms overlap:
- Difficulty socializing: People with SAD may have difficulty making and keeping friends because of fear of rejection. Someone with ADHD is likely to have poor impulse control and difficulty picking up on social cues, making it difficult to maintain friendships.
- inattention: A person with SAD may appear disconnected, but is really just distracted by worry. People with ADHD do not pay attention due to differences in the brain that affect focus.
- Problems completing tasks: People with SAD can get stuck on a task and be too anxious to ask for help. People with ADHD are unable to turn off a task due to lack of planning skills and forgetfulness.
Fehldiagnose
Having both conditions at the same time can also contribute to a misdiagnosis.Unfortunately, some SAD symptoms can be misinterpreted as ADHD symptoms, and it's only through outward behaviors, such as weight loss, insomnia, or a refusal to attend social services, that social anxiety becomes more apparent. As a result, SAD often goes undiagnosed in people who also have ADHD.
when to the doctor
When social anxiety symptoms cause you great distress and affect your ability to perform daily activities, it's important to talk to a doctor. If you experience panic attacks or avoid school, work, or other social engagements because of social anxiety, talk to your doctor or mental health professional.
Diagnosis of ADHD and social anxiety
To diagnose ADHD and social anxiety, a doctor or psychotherapist will ask questions about symptoms, perform psychological evaluations, and take a medical history.
ADHD
ADHD can be classified intothree subtypes: inattentive type, hyperactive type and combined type. To be diagnosed, children and adults must have symptoms of inattention or hyperactivity for six months or more. Such symptoms can be:
- effort to pay attention
- make fleeting mistakes
- not following instructions
- Problems organizing tasks.
- remaining difficulty skill
- talk excessively
- interrupting others frequently
The symptoms must begin before the age of 12, be present in two or more settings, and interfere with the person's ability to perform daily activities. These symptoms must also not be the result of any other mental disorder or medical condition.
social anxiety
To be diagnosed with social anxiety disorder, a person must:
- You experience fearful reactions that are out of proportion to the dangerousness of the situation.
- The symptoms must interfere with a person's ability to function in their daily life.
- People have to experience this fear in almost all social situations.
In addition, the social anxiety symptoms must have been present for at least six months and not be due to substance use, a medical condition, or other mental illness.
ADHD and social anxiety treatment
There are no clear or published guidelines for the treatment of comorbid ADHD and SAD. Only after your doctor has determined how your anxiety works can they develop the best treatment plan to meet your needs.
For example, if your anxiety and ADHD work independently, your doctor may decide to treat both conditions at the same time. Or they may choose to treat the condition causing the most problems before moving on to the other condition.
However, if your doctor believes that your anxiety is being caused or strongly influenced by your ADHD, you may choose a different treatment approach.
medicine
If your anxiety is a result of ADHD, your doctor may decide to treat you with medication first, as this may reduce your anxiety symptoms. Common medications used to treat ADHD include:
- stimulants:Although stimulants primarily treat ADHD symptoms because ADHD symptoms are controlled, you may also experience some relief from your anxiety. In a study that examined children and adolescents with comorbid ADHD and SAD,ritalin(Methylphenidate) has been associated with significant improvement in ADHD and SAD symptoms.A similar study found the same improvements in adults taking extended-release Ritalin.
- not stimulants: Selective norepinephrine reuptake inhibitors (SNRIs), such asStrattera(atomoxetine) can attack both ADHD and anxiety symptoms. One study found that Strattera improved both ADHD and comorbid SAD in adults.
psychotherapy
While medication has historically been the first line of treatment for ADHD, many people also benefit from non-drug therapies, and this is especially true for people who are also living with an anxiety disorder.
approaches likeCognitive behavioral therapy (CBT)it can address many of the underlying challenges of ADHD and SAD, as well as the complicated symptoms that overlap between them. The purpose of CBT is to provide anxiety management techniques and exercises for people with SAD.
One specific technique that your therapist may recommend isexposure therapy, a type of CBT most commonly used in the treatment of SAD, in which you and your therapist work together to gradually expose you to anxiety-provoking situations so that you can develop healthy coping mechanisms, and the situations create less anxiety over time . . In other types of CBT, you can learn and practicesocial skillsmirelaxation techniques.
How to deal with ADHD and social anxiety
If you have ADHD and social anxiety, there are many coping methods that can make your life easier.
Changes in lifestyle
There are several lifestyle changes that can help make problematic ADHD traits easier to manage. These strategies can also alleviate feelings of social anxiety. Some you can try are:
- Meditation:Meditationit can be a useful relaxation tool that can combat anxious feelings and boost self-esteem.
- write diary:write diaryIt can be a helpful form of self-expression that can ease feelings of anxiety and help you identify patterns and triggers that tend to make your symptoms worse. Writing things down can also help people with ADHD combat forgetfulness.
- create routines: A structured routine can be helpful in dealing with stress and anxiety. For people with ADHD, it can also be a way to complete tasks without getting distracted. Instead of getting distracted, you'll be more aware of where you're supposed to be and what you're supposed to do.
Support groups
Support groups can be a great source of encouragement, resources, and advice. You can talk to people who have had similar experiences and get advice on how to deal with different aspects of your condition.
Of course, the idea of joining a support group can be intimidating for many people with social anxiety disorder. One way to deal with this is to join aonline support group. This allows you to gradually practice interacting with others in an online format. Over time, you may find that attending support meetings in person can also be helpful.
Finding an ADHD support group
Summary
It is not uncommon for people with ADHD to have co-occurring medical conditions, including social anxiety disorder. The exact reasons why they often coexist are unclear, but genetics and environmental factors may play a role. Features of ADHD can also make people feel more anxious in social situations.
While both conditions can lead to complications and make diagnosis difficult, there are treatments available that can help. Medications, talk therapy, and lifestyle changes can help people manage the features and symptoms of both disorders to function better in daily life.
A word from Verywell
A co-diagnosis of SAD can be a lifelong reality for someone with ADHD. It's okay to feel overwhelmed. Learning more about the connection between these two conditions is the first step in reducing their impact on your life. Take a deep breath and know that with the right support, you can manage ADHD and SAD and thrive in life.
Conditions that can produce ADHD-like symptoms