ADHD Medication and Anxiety

It is not uncommon for people with attention-deficit hyperactivity disorder (ADHD) to also have a co-occurring anxiety disorder. Because the two conditions share some similar symptoms, such as restlessness, it is important to rule out anxiety or other conditions when making an ADHD diagnosis.

Additionally, stimulant-based medication can sometimes cause anxiety symptoms to worsen. Learn which medications can cause anxiety symptoms, as well as alternative treatment methods that can be utilized. We also share general coping mechanisms to further support and help with your mental health journey.

What Is ADHD?

ADHD is a common neurodevelopmental disorder that affects an estimated 4% of the world’s population. A neurodevelopmental disorder is a group of conditions that have their onset in the developmental period and generally present early in life in ways that affect the brain’s development and produce impairments in functioning.

While it is usually identified in childhood, ADHD is lifelong. Traits can vary from person to person, with three major subtypes that each have their own unique characteristics:

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 This type is sometimes referred to as attention deficit disorder (ADD); however, this term is outdated and not officially used anymore.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

Various methods can be implemented to help people with ADHD manage day-to-day tasks and tendencies. This includes psychotherapy, social skills training, lifestyle changes, and special accommodations, but also certain medications.

Which Medications Are Used to Help With ADHD?

ADHD medications fall into two groups, stimulants and non-stimulants. The type of medication most suitable for a person will depend on their specific symptoms and circumstances.

Stimulants

Stimulants are considered the first-line treatment for ADHD and often the most effective; thus, they are the most common type of medication to help with ADHD symptoms while they are active in the body. But how do they work?

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. When the activity and communication of the parts of the brain that rely on these chemicals increase, ADHD symptoms decrease.

Non-stimulants

Non-stimulant medications are another treatment option for ADHD. This option may be recommended for those who don’t experience adequate improvement on stimulants, experience severe adverse side effects from stimulants, and/or if the healthcare provider wants to pair a non-stimulant with a stimulant to increase medication effectiveness.

Does ADHD Medication Cause Anxiety?

ADHD and anxiety often co-exist, and they can also exacerbate the effects of each other. For instance, around 25% of adults with generalized anxiety disorder (GAD) also have a comorbid ADHD diagnosis.

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

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

Other Side Effects of ADHD Medication

While ADHD medication is effective at helping people function in everyday life, 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:

• Weight loss
• Decreased appetite
• Insomnia
• 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 with a low dose and titrating the medication to find your body’s optimal dose. In some instances, switching to a different medication may be recommended.

This can happen in two ways : switching from an amphetamine-based ADHD medication to a methylphenidate-based one, or switching from 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 physicians to recommend regular meetings, particularly initially. This is so they can monitor your symptoms, side effects, and the medication's impact on your weight, blood pressure, heart rate, and general health and well-being.

Can You Take ADHD Medication With Anxiety Medication?

As mentioned, individuals with ADHD are more likely to have an anxiety disorder than individuals without the condition. In cases such as this, it is important to treat both conditions. Psychotherapy and several types of medications are used in the management of anxiety disorders.

Additionally, for some individuals, stimulant medication can 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," says Chukwura, "especially when working from home. Walking meetings are also great!”
3. Maintain healthy habits and lower your expectations: In today’s age, it is 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, and eating nutritious foods while limiting caffeine and alcohol are effective in managing ADHD and anxiety,” says Chukwura.