In case you’ve just done a double-take, I should say up front that there’s a proven link between anxiety disorders and ADHD in some children – which is why I’m talking about ADHD in a blog about anxiety!
The American Academy of Pediatrics says that about a quarter of children who have an ADHD diagnosis will also have an anxiety disorder (which is also a diagnosis, by the way).
In addition, a quarter of children with an anxiety disorder diagnosis (of any kind) will have a diagnosis of ADHD.
Which kind of anxieties are we talking about here?
Well, a diagnosis is often given for anxiety that has continued for some time and is disrupting life (note, that’s a generalised statement). This might therefore include
Of course, on this site we talk about these anxieties at an earlier stage so you can help your child overcome them before a diagnosis and treatment become necessary.
But “diagnosis” is a good word to bear in mind for a moment – because the point of me writing about anxiety disorders and ADHD here is to help us think about what we want for our children and their life span and happiness. Medical treatment? Therapy? Help to see things differently? Behaviour modification help at home? Acceptance of genetics and personality?
It's usually the ADHD diagnosis that brings on the offer of medication (maybe after other "parent-training" help). But bearing in mind those stats, we'll assume your child might have both issues.
However, we know your child can be helped at home to deal with anxiety before it gets out of hand.
So what about ADHD? Could the same apply? Annoying as a group of symptoms are, is there enough medical proof to justify drugging a child up before exploring other avenues?
But proof aside for the moment (see the book I mention at the bottom of this post)...
What are the main issues when considering ADHD medication? We can summarise them like this.
Points for the use of medication:
Points against the use of medication:
Let’s look at them in turn a little more.
Effectiveness in symptom management:
Medication has been shown to effectively reduce the core symptoms of ADHD that are the most obvious if you have a child in the house showing the classic symptoms: inattention, hyperactivity and impulsivity.
Medication therefore allows your child to better focus and engage in daily activities.
Improved academic performance and focus:
School results matter so much more since the introduction of rigorous SATs etc. (School used to be about inspiring and enabling your child to love learning!)
However, it’s understandable that, as a result, one possible use of medication is to enhance concentration and improve academic performance in your child. What parent wouldn’t want to help their child succeed in life?
Enhanced social and behavioural functioning:
Impulse control, social skills, and behavioural regulation have become ultra important in today's society geared to conformity to the latest thinking.
If medication can help your child with ADHD symptoms fit in better, it’s an alluring treatment. It’s clearly led to improved interactions and relationships with peers, family and teachers.
Reduction in impulsivity and hyperactivity:
Medication that aims to calm your child obviously has the potential to decrease impulsive and hyperactive behaviours. This allows your child to join in with tasks and activities with greater self-control and reduced disruptions.
Teachers and wider family members love this – although it begs the question of which actual dosage calms without producing lethargy.
Long-term benefits and improved quality of life:
So far, research has only some limited long-term proof of consistent medication use. But the assumption is that when medication is prescribed appropriately, it can contribute to long-term benefits for children with ADHD – with or without anxiety symptoms – such as improved overall functioning, self-esteem and better quality of life .
This is, of course, rated against the norms of society where children with ADHD symptoms are noticed and disliked for their behaviour!
I’ve tried to be fair here, despite my dislike of labelling and medication, so hold fire on judging till we’ve looked at the “against” lobby!
Potential side effects and health risks:
Medication for ADHD may be associated with various side effects, ranging from mild to severe, which you need to carefully consider before opting in – or at least have them monitored by a doctor.
There have been accounts of bad results and a few deaths. I don’t know the individual circumstances, so this is really just a comment that all medicines come with some form of risk, and our children’s brains are still growing.
Over-reliance on medication as a solution:
This dependency aspect is what doesn’t make sense to the “against medication” lobby. Why depend solely on medication without addressing other aspects first?
Avoiding medicine where possible is obviously a great idea. "Pills and more pills" has become something of a norm in adult life, and it’s starting to feel very wrong. Especially where our children are concerned.
Neglecting alternative interventions and therapies:
As indicated above, relying primarily on medication can lead to overlooking potential benefits of alternative interventions, such as behavioural therapy, counselling or making changes in the classroom.
These can often effectively replace the idea of medication if they work sufficiently well to lessen whatever issue is bothering you about your child.
A possible bonus is that these alternative interventions give power to your child.
Individual differences in response to medication:
This one is serious. Your child with anxiety and ADHD symptoms may respond very differently to the child down the road who has been helped.
Finding the right medication and dosage for your child can be a trial-and-error process, requiring close monitoring and adjustments. Not many of us parents want our child to be a guinea pig first and foremost!
Ethical concerns surrounding the use of medication in children:
Some concerns include
I cannot come down for or against medication for anxiety and ADHD symptoms, because your child is yours and you live with them and know the problems first-hand. I just wanted to air the issue and help you think.
The best way I can finish this post, therefore, is to leave you with the theoretical "diary entry of a parent" who's also facing the issue.
It's been a challenging journey lately, watching my child struggle with what seem to be symptoms resembling ADHD and anxiety. As a parent, my heart aches to see them facing difficulties in their daily life, be it at school or in social situations.
I can't help but constantly question what the best way forward is to help them overcome these challenges and find the support they need.
On one hand, I find myself considering the option of medication. I've heard stories of how it can effectively manage the core symptoms of ADHD, offering relief and allowing my child to focus and engage more effectively.
It's hard to ignore the potential academic benefits they could gain, which might ultimately boost their self-confidence and open doors to a brighter future.
The idea of improved social and behavioural functioning is also appealing, as it could help my child build stronger relationships and navigate the world with greater ease.
However, on the other hand, I can't help but worry about the potential side effects and health risks associated with medication. The thought of subjecting my child to these risks makes me hesitate.
I also question whether relying solely on medication would be the best solution. I've read about the importance of holistic approaches, such as therapy and lifestyle changes, which can address the underlying issues and provide my child with comprehensive support.
Would solely focusing on medication neglect these alternative interventions that could potentially be beneficial for their overall wellbeing?
And I just can't ignore the individual differences in how children respond to medication. What if it doesn't work for my child or causes adverse effects?
The trial-and-error process seems daunting, and I fear the uncertainty of finding the right medication and dosage. I want the best for my child, and the thought of inadvertently causing harm or relying on a solution that might not be effective adds to my concerns.
And daft as it may seem, ethical considerations weigh heavily on my mind as well. I question whether the diagnosis is accurate and worry about the influence of pharmaceutical marketing.
Am I making the right choice for my child, or am I falling into the trap of over-diagnosing and medicating because those companies make it sound so convincing?
These thoughts make me reflect on the long-term effects and potential consequences of my decisions.
OK, I'm done now. I need sleep. But it's helped me to put down on paper these thoughts and conflicting emotions I'm feeling as a parent. It's a challenging decision to make.
I just want to find the best way to help my child navigate their struggles and thrive. I think that reading more research, maybe consulting with a specialist, and considering the unique needs of my child will ultimately guide me toward the right path.
Wishing you strength and wisdom as you decide how to best help your child if you find yourself in these circumstances. No one said parenting decisions were easy! Go for it?
And a book that will astonish you!
If you have a moment and want to get a clear perspective on the history of diagnosing ADHD, this is an astonishing read and will help you think. It doesn't mean you have to be for it or against it, but it does give a truer picture of the situation.
And the good news? You only need the first chapter and you get all of that with the free sample download! You have nothing to lose and a lot to gain to help you think about your child's behaviour and possible anxiety issues.
Obedience Pills: ADHD and the Medicalization of Childhood by Patrick D Hahn (2022)