Introduction:
Psychological disorders are one of the most common chronic conditions of modern times. They often remain undetected due to a lack of knowledge or social hindrances. Every one out of eight people in the world is suffering from mental health-related disorders. Almost 970 million people in the world suffer from such psychological complications. Around 4 percent of the global population suffers from anxiety disorders. Surprisingly, the prevalence of anxiety among children is very high and common. According to the Centers for Disease Control and Prevention, in the United States alone, 9 percent of children between ages 3 to 17 suffer from anxiety-related complications. Globally, around 7 percent of the adult population suffers from attention deficit hyperactivity disorder. Similar to anxiety, the prevalence of attention deficit hyperactivity disorder among American children is 9.8 percent. Due to this, researchers are now looking for a connection between anxiety and attention deficit hyperactivity disorder.
What Is Anxiety?
Anxiety is linked to fear and future anticipation of negative outcomes. It is a complex cognitive, affective, physiological, and behavioral response system manifested due to negative thoughts. Sometimes, it is associated with threats, danger, or inappropriate situations. Several factors like medications, physical and mental trauma, substance abuse, and panic disorders can cause anxiety. Neurotransmitters like norepinephrine, serotonin, dopamine, and gamma-aminobutyric acid (GABA) are believed to play a key role in anxiety within the central nervous system. The disruption in the modulation of the central nervous system mainly causes anxiety. Serotonergic and noradrenergic neurotransmitters are responsible for this. All these factors are responsible for changes in the amygdala of the brain. Moreover, the amygdala and other structures within the limbic system are interconnected with various prefrontal cortex regions. Abnormal activation patterns between the prefrontal cortex and limbic system can be reversed through psychological or pharmacological interventions leading to stress.
Symptoms:
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The feeling of nervousness or restlessness.
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Weird feeling of impending danger, panic, or doom.
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Increased heart rate, sweating, and rapid breathing.
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Difficulty in thinking and concentrating.
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Altered sleeping patterns like lack of sleep, oversleeping, and awakening in the morning.
What Is ADHD?
ADHD is known as attention deficit hyperactivity disorder. This is a psychiatric condition mainly affecting children. It is characterized by cognitive and functional deficiency caused by brain abnormalities. Persons often show symptoms like inattentiveness, hyperactivity, or impulsiveness. It is mainly seen in children from seven to seventeen. Such symptoms are often visible at a young age with a behavior pattern like lack of attention, concentration, organization skills, difficulty completing tasks, forgetfulness, and loss of things.
ADHD is mainly caused by either environmental factors or genetic factors. The risk factors associated with this are viral infection in pregnancy, smoking in pregnancy, substance abuse in pregnancy, nutritional deficiency, and alcohol exposure in the fetus.
The cognitive and functional deficiency of ADHD is attributed to the anterior cingulate gyrus and dorsolateral prefrontal cortex of the brain. The relatively smaller size of the brain is related to ADHD, which causes a reduction in the activity of the frontostriatal region. Also, smaller areas of the total cerebrum, cerebellum, and the four cerebral lobes can be observed.
Symptoms: According to the criteria put forward by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, six out of nine symptoms should be present among the children for diagnosing ADHD. These symptoms are;
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Lack of attention to the tasks.
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Missing small details during work or in the task.
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Rushing during the task.
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Lack of attention while listening.
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Difficulty in organizing things.
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Habits of leaving work without finishing it.
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Forgetfulness.
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Disliking tasks that require mental effort or take longer time to finish.
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Hyperactivity symptoms like; fidgeting, excessive talking, and habits of interrupting others.
What Is the Link Between Anxiety and ADHD?
Over the years, scientists have used several scientific methods like MRI, functional magnetic resonance imaging (fMRI), and positron emission tomography (PET) to collect neuroimaging data. These data help correlate anxiety with ADHD. According to studies,
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ADHD is negatively correlated with brain activity in the left frontal pole of the brain., This part of the memory is associated with working memory. Anxiety did play a role in how ADHD severity related to brain activity in the right cerebellum area. In individuals with low levels of anxiety, ADHD severity correlated positively with brain activity. On the other hand, for individuals with high levels of anxiety, the correlation was negative.
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Reduced brain activity in the caudate nucleus, putamen, and thalamus is further associated with a correlation between ADHD and anxiety. ADHD with comorbid anxiety might be responsible for decreased information filtering.
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Stress and the presence of inflammatory mediators are closely associated factors with anxiety and ADHD. Stress leads to the secretion of inflammatory mediators like interleukins and cytokines. These substances act on the brain and disrupt the hypothalamic–pituitary–adrenal (HPA) axis. This disrupts the brain activity. As a result of which anxiety and ADHD can be seen.
How To Treat Anxiety and ADHD?
The treatment starts with the identification of the presence of both disorders. Psychological counseling with measures to reduce stress should be taken. Therapies like cognitive behavioral therapies can be useful in reducing anxiety. Specialized educational planning based on the child’s difficulties and parent training is helpful for children with ADHD. In severe cases, medication such as alpha agonists like Clonidine and Guanfacine can be used. Stimulant drugs like amphetamines and methylphenidates can also be prescribed. These drugs increase intrasynaptic catecholamines by inhibiting the presynaptic reuptake mechanism and releasing presynaptic catecholamines. However, these drugs may cause cardiovascular side effects.
Conclusions:
Anxiety and attention deficit hyperactivity disorder are psychiatric disorders. Both of these conditions are related to each other and can be seen in young adults. Changes in the brain activity in various parts are responsible for such conditions. Also, stress and the presence of inflammatory mediators are associated with co-existence of anxiety and ADHD. Proper history and diagnosis are important in such cases to establish diagnosis. Cognitive behavioral therapy is helpful in such conditions. Also, in severe cases, medication can be used for treating patients.
