For many people with ADHD, worrying can become a serious health concern. Research suggests that nearly 40 percent of people with ADHD also have comorbid generalized anxiety disorder (GAD),1 the physical and emotional manifestations of which can include the following in these times:
- Loss of sleep due to worry
- Lack of concentration, particularly as you attempt to work from home
- Changes in appetite and/or irritable bowel symptoms
- Using drugs or alcohol as a coping mechanism
For some people, anxiety manifests as germaphobia or obsessive-compulsive disorder (OCD), a serious anxiety disorder characterized by intrusive thoughts and repetitive behaviors that, if left unchecked, can severely restrict the ability to function and maintain a healthy quality of life.
“When there is uncertainty about what will happen — as observed in other situations (snowstorms, for example) — people often flood the grocery stores buying up toilet paper and canned food,” says clinical psychologist Laurie Perlis, Psy.D. who specializes in the evaluation and treatment of OCD, GAD, and specific phobias. “This likely provides a sense of control and comfort in terms of feeling as prepared as possible for what’s to come, but there is a difference between this type of behavior and pathological behavior such as excessive hand washing or hoarding supplies.”
The good news is that these unusual times are temporary and experts say we aren’t powerless. “There are things you can do to control your anxious thoughts so you feel better,” says ADHD expert William Dodson, M.D. To help you cope with these troubling times and ADHD-related anxiety — and to help you understand a relatively normal reaction to a stressful situation — here is insight and advice from Dodson and Perlis.
10 Tips for Understanding and Navigating Anxiety Today
#1. Understand appropriate levels of stress and anxiety in response to a perceived threat versus behavior indicative of a disorder.
“Anxiety is our brain’s early warning system. It instructs us to focus our thoughts and actions on the perceived threat and to take action to protect ourselves,” Perlis explains. “For example, we are being instructed to wash our hands with greater frequency to mitigate a real threat. Anxiety about getting sick or infecting others is driving most of us to take that action in an appropriate and measured way. In contrast, an individual with OCD who has specific contamination-related fears may wash their hands to excess in the absence of a specific threat or in an overestimation of the potential likelihood and severity of a threat. Of course, the current situation is likely very triggering for individuals with these underlying conditions.”
#2. Create a routine and stick to it.
Homeschooling and working from home are the new, uncomfortable normal for many. The key to alleviating anxiety around this is to structure to your day religiously. Find a way to make your home space peaceful and your routine regular. It’s easy to cut back on basic hygiene like showering when there’s no place to go, but you’ll feel better if you try to keep normal routines in place as much as possible. During this temporary but challenging time, eat your meals on a regular schedule, go to bed at your regular time, and keep up with basic grooming every day.
#3. Exercise every day to protect your mental health.
The physical benefits of daily activity are well documented, but did you know that exercise boosts your mind and mood as well?2 Physical activity releases proteins that improve brain function. It also promotes more restful, restorative sleep. Exercise isn’t just good for your body; it alleviates anxiety and depression, too. A brisk 15-minute walk will help; copious apps and web sites, like Peleton and Beachbody on Demand, are offering free trials for two weeks or more right now.
#4. Meet your irrational thoughts with logic.
It’s true that the risk of contamination is real and this virus is extremely contagious, but meaningful protective measures do exist. You can take important steps to lessen the risk of exposing yourself, your family, and vulnerable populations — the elderly, smokers, and those with underlying health conditions. “In my work with families and adults, I use the idea of the brain having two sides — the thinking brain and the worry brain — to help them see they have agency over their thoughts; they aren’t powerless,” Perlis says.
#5. Trust the guidance of trusted sources.
If you are following the Centers for Disease Control and Prevention (CDC) guidelines and staying home, keeping a safe distance from others, and avoiding touching your face, especially your nose and mouth, then you are doing what you need to be doing to protect yourself. Take consolation in that.
#6. Know the numbers.
“Even if the absolutely worst thing happens and you get sick with the disease, remember that roughly 98 percent of people recover and apparently have immunity against the virus after that,” Dodson explains. “It’s a very communicable illness, but most of the people who have died so far were over the age of 70 or had a severe, pre-existing respiratory disease.”
#7. Keep the threat of the virus in perspective.
Practicing social distancing and isolation isn’t that big of a deal in the grand scheme of things. “Think of our great grandparents. They went off to fight a war that engulfed the entire world. You are being asked to stay home for a few weeks — you can handle this,” Dodson says. “This is a time of testing for the U.S. We can all rise to this challenge.”
#8. Feel good about being a good citizen.
“Remember the reasons that we self-quarantine,” Dodson says. “It’s not to protect ourselves; it’s to protect those most at risk. This is a time to step up, stop being so self-absorbed, and start taking care of each other. We need to start behaving like we’re all in this together — because we are.”
#9. If you have OCD, float through it.
“People with OCD know their fear is irrational, but it still hurts and impairs them. If they try to resist the compulsive behaviors (like excessive hand washing), it only makes it worse because the ritualistic behavior actually alleviates the anxiety,” Dodson explains. “Accept that there will be large chunks of your day taken up by rituals and obsessions. Attempt to float through those difficult periods — rather than fight them. Reassure yourself with the knowledge that things are going to get better; that your future isn’t lost forever. You’re thinking about now and that’s triggering extra anxiety.” If you’re in therapy, it’s important to continue seeing your therapist. If an in-person session isn’t possible, reach out to see if you can connect by phone or video conference.
#10. For OCD and severe anxiety, learn more about cognitive behavioral therapy (CBT).
“People with pre-existing OCD and other anxiety disorders are likely to feel worse for the duration of this world-wide crisis,” Dodson says. “With nowhere to go and extra time at home, this is a great time to practice CBT techniques, which are extremely effective… For people with OCD, therapists and psychologists are better than medical doctors. My favorite manual is Stop Obsessing: How to Overcome Your Obsessions and Compulsions (#CommissionsEarned) by Edna Foa, Ph.D. Have it delivered to your house and start the behavioral strategies today.”