adhd anxiety symptoms differences challenges strategies sarah hardy walsh

ADHD and Anxiety in Kids

The terms anxiety and ADHD are becoming commonplace in discussions about children’s mental well being. In this guest post, naturopathic doctor (and lactation consultant) Dr. Sarah Hardy Walsh, who addresses these concerns in her practice, shares some insight on how the two differ but why it can be difficult to tell them apart. You can also listen to her discuss the topic on the Pickle Planet Podcast; the link is at the end of this post, or search for us on iTunes and Spotify.

ADHD and anxiety are two of the most prevalent mental health conditions in children.

Did you know that on the outside, they can look very similar?

Or that while some kids will experience ADHD and others experience anxiety, some experience both?

And, when a child is struggling with both, the two conditions can feed one another, making symptoms even worse?

Over the course of more than a decade of practice, I’ve seen many families in my office, concerned about their child’s behaviour – some wondering if ADHD is a possibility and others arriving with the diagnosis – all wanting to explore ways to support their child, beyond the pharmaceutical medications recommended.

More recently, I’ve been seeing a lot of children whose teachers and parents have concerns about ADHD symptoms at school, but in the relaxed environment in my office, they’re calm, focused, responsive to my questions and easily sit through the hour-long initial consultation with puzzles, colouring books or other simple activities.

That’s what prompted the creation of this image:

diagram ADHD vs Anxiety symptoms children mental health sarah hardy walsh diagram

The overlapping area in the centre shows the behaviours that can be similar between ADHD and anxiety – in both cases, related to a reduction of activity in the prefrontal cortex, an area at the very front of the brain.

Through specialized imaging (SPECT scans), Dr. Daniel Amen has shown that when we concentrate or focus on something, the activity in this prefrontal cortex increases. For individuals with ADHD, however, activity in this area of the brain decreases when they try to concentrate and focus. Dr. Amen says “the harder they try, the harder it gets.” This, along with some shifts in certain brain messengers (neurotransmitters), contributes to the typical behaviours we associate with ADHD – inattention, distraction, restlessness, difficulty concentrating, difficulty remembering, disorganization.

Anxiety is often connected with the recurrent triggering of the stress response, which shifts blood flow in the brain to the structures at its centre. This response focuses our brains on survival at the expense of more complex thought processes. That means, when we’re anxious the activity in the prefrontal cortex is reduced. And while the process behind the scenes is different – the reduced activity in the prefrontal cortex can result in anxious kids behaving similarly to those with ADHD, with inattention, distraction, restlessness, difficulty concentrating, difficulty remembering, disorganization.

How then do we know which one it is – ADHD or anxiety?

For kids with anxiety, when they feel calm and safe, the ADHD symptoms disappear.

And, often kids with anxiety will experience certain physical symptoms when they’re feeling anxious – headaches, stomach aches, sleep challenges, racing heart, muscle tension.

Sometimes though, it’s not that easy to distinguish the two conditions – especially if both are at play. And, for these kids, the experiences of the two conditions together can feed into a cycle that feels difficult to break.

Here’s what that might look like:

diagram ADHD Anxiety Cycle children symptoms behaviours help sarah hardy walsh

Looks challenging, right?

How do we interrupt this vicious cycle? How do we reduce the symptoms of ADHD and anxiety? And, how do we figure out whether our child is struggling with ADHD, anxiety, or both?

The first step focuses on observing your child. Notice when the ADHD-like behaviours are being expressed. Track any other symptoms they complain about or that you notice – tummy aches, head aches, muscle tension, difficulty with sleep. It’s likely your health care provider will ask about these.

Next, consider a detailed assessment with a pediatric psychologist. This is often required for definitive determination of which condition(s) are at play. And, this detailed assessment and the resulting recommendations will also help your family access other support resources – at school and in the community.

On a waiting list for evaluation? Have the diagnosis and wondering what else, beyond medication and counselling support is available?

Consider support from a qualified naturopathic doctor, who has experience working with children. Whether your child has ADHD, anxiety or both, the naturopathic approach can look similar – especially early on. There are four key components that we begin with:

  • Reduce stress.
  • Heal the gut.
  • Reduce inflammation.
  • Calm & balance the nervous system.

Each of these components relate to and influence the functioning of the others.

When stress is reduced, the gut functions optimally, inflammation is reduced and the nervous system works more efficiently.

When the gut is healthy, stress and inflammation are reduced and the nervous system functions optimally. (Did you know that several of your brain’s messengers – neurotransmitters – are made in and around the gut? True story. One for another time!)

When inflammation is reduced, the stress response is reduced and all tissues in the body are happier – including the gut and the nervous system.

In all cases, the nervous system is more calm and balanced and the symptoms of ADHD and anxiety are reduced.

How do we begin? We start with creating clarity around the factors that contribute to stress, gut health, inflammation, and nervous system health, in kids. Tracking nutrition and lifestyle habits along with sleep, digestion, and behaviour helps us understand your child’s present experience, along with some key influencers of ADHD and anxiety symptoms.

I invite you to download my Health Clarity Journal. Then, for one week, track each health influencer listed on the journal for your child. With the awareness created by tracking these health influencers, consider what might be triggering the stress response, irritating the gut and/or triggering inflammation in your child’s body:

  • Intake of processed foods
  • Exposures to food intolerances/sensitivities
  • Exposures to environmental toxins (pesticide residues on foods, conventional cleaning products in our homes, conventional bath & body care products)
  • Sleep challenges
  • Lots of screen time
  • Lack of daily physical activity
  • Health history requiring antibiotic use

If you’re interested in seeking support from a qualified naturopathic doctor, you can find a listing here. For families in the Moncton area, I’m available for consultations at Clinique Natturra by calling (506) 382-1560.

Dr. Sarah Hardy Walsh is a naturopathic doctor and lactation consultant. She provides individualized care to women (and children), including preconception care, pregnancy, breastfeeding and mothering support. You can follow Dr. Sarah on Facebook and enjoy some of her other contributions to Pickle Planet Moncton, shared below.

Pickle Planet Podcast: Feeling Touched Out

Breastfeeding Support in Moncton


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