Generalized Anxiety Disorder, ADHD  and Stress

Stress makes everything worse.

When you go to a therapist, the first thing they will ask you about is often stress. That's because it impacts everything!

This page will look at some of the research and what it shows about generalized anxiety disorder and stress. This is important because women with adhd are five times more likely to have generalized anxiety disorder, and stress exacerbates both adhd and gad.

Points on this page about generalized anxiety disorder and stress management

• Generalized Anxiety Disorder (GAD) and adhd get worse with stress.

• Getting a good sleep, exercising, and eating healthy will help both your adhd and GAD.

• Mindfulness-based stress reduction ( MBSR) has good evidence for helping symptoms of gad.

• MBSR has been found to impact several biomarkers related to stress, immune response, and overall health  in those with GAD

• Evidence shows rumination (continuously thinking the same negative thoughts) plays a substantial role in GAD and ADHD

• Rumination often increases anxiety symptoms, response to stress, and depression in people with GAD and ADHD .
• Some suggestions well be presented to help with that

What helps people with GAD  with Stress?

Generalized anxiety disorder is often chronic, it may last a lifetime. It's also associated with physical symptoms such as:

• Muscle tension
• Restlessness or feeling keyed up
• Being easily fatigued
• Difficulty concentrating or mind going blank
• Irritability
• Sleep disturbance

30 -60 percent of people who have GAD don't achieve remission with therapy and medication treatment!

Therefore, trying everything you can to help yourself is a good idea.

Two specific areas of importance can immediately and dramatically help people with their GAD and ADHD: techniques that target rumination and emotional regulation.

Mindfulness-Based Stress Reduction and GAD

Studies show that people with GAD report:

•  More intense emotions
•  Difficulty understanding emotions
•  Trouble calming and soothing themselves after they have negative emotional experiences
•  A more significant adverse reaction to emotions

We know these are also the same areas many women with ADHD have difficulty, as emotional regulation is a common executive functioning issues ADHD women struggle with.

If this is you, you might find yourself impacted by your emotional experiences and easily overwhelmed when stressful things happen.

People who have GAD generally also have lower levels of mindfulness.

Interventions that help you learn how to be mindful of managing your stress and anxiety are usually good ideas if you struggle with a GAD.

In particular, mindfulness-based stress reduction (MBSR ) is an excellent generalized anxiety disorder stress management technique.  MBSR strategies show you how to learn to be more aware of your present moment, thoughts and emotions, and bodily sensations, and develop a more accepting attitude towards yourself by being less judgmental and compassionate.

Stress and Hormones

Chronic stress causes abnormalities in the stress hormones and inflammatory markers. Both Generalized Anxiety Disorder (GAD) and Attention-Deficit/Hyperactivity Disorder (ADHD) can contribute to experiences of chronic stress.  This chronic stress increases the risk of physical illness such as heart disease. Miraculously, one study has shown that MBSR  reduces these biomarkers. This makes the argument for MBSR as an intervention for generalized anxiety and stress management even more compelling.

Want to try out MBSR?  Here is the program free or you can seek out an MBSR group in your area. They have them everywhere.

Rumination and GAD

Another significant finding in the research on generalized anxiety disorder and stress management is that people who have generalized anxiety disorder ruminate when stress happens. Rumination is essentially dwelling on the negative in a stuck and circular way.

Can't stop thinking about something terrible that happened or is happening? Is it making you feel awful, worried, or depressed? You are likely ruminating.

People with ADHD and GAD, especially women, may experience increased levels of rumination, which is the process of continuously thinking about the same negative thoughts or situations. One reason for this could be the "attentional filter" – a term that refers to our ability to decide which thoughts or stimuli we pay attention to and which we ignore. In individuals with ADHD and GAD, this filter might not work as effectively, causing them to have difficulty pulling away from negative thoughts or situations. As a result, they may spend more time dwelling on negative ideas, leading to more intense rumination.

Research shows that Rumination:

• Increases our response to stress

• Increase our physiological response to stress.

• This causes us to react stronger and more intensely to stress.

• Increases our recovery time from stress

• Increases our depression and anxiety symptoms

Generalized anxiety disorder also increases stress sensitivity, so you have a double whammy when you pair this with rumination!

Strategies to help with rumination

Learning how to let go of ruminative thinking is key to managing your stress.

I have a page written on rumination where you can learn about the strategies here.

Here are some other mindfulness strategies below.

1. Leaves on the Stream. Work on letting your thoughts go like leaves floating down a stream. Do this without judgment, or struggle, noticing the tendency to want to ruminate, but understanding that it is not a helpful choice.

2. Practice noting. Stating in a non-judging way what is happening in your mind and body when you begin to ruminate, and gently pull your mind back to the task at hand. Do this as you would to a dog on a leash who was pulling you somewhere you didn't want him to go.

3. Acknowledge your emotions without pushing them away. They are impermanent and will pass.

4. Keep a journal where you can note what the triggers are for your rumination to be aware of why your mind began to do so. Be prepared in the future about what the triggers are.

5. Think of your mind as a train station. When you have gotten on the wrong train, what happens? If you begin to ruminate, you have boarded the wrong train. Take a deep breath, and pick another train to get on. Label your rumination trains: " The victim train," "The guilty train," "The angry train." Steer clear of those. Pay attention to trains that provide you with calmer states of mind. We call this cognitive defusion.
You can learn more about it here.

Some of these strategies may be more or less helpful, as they are strategies for neurotypical based people with GAD; however, mindfulness strategies have been shown to be helpful in several studies with adhd people. If you try mindfulness strategies and they increase your adhd symptoms, it's crucial for you to trust yourself and discontinue these strategies immediately.

References

Mennin, D.S., Heimberg, R.G., Turk, C.L. and Fresco, D.M. (2002), Applying an Emotion Regulation Framework to Integrative Approaches to Generalized Anxiety Disorder. Clinical Psychology: Science and Practice, 9: 85-90. doi:10.1093/clipsy.9.1.85

Hoge, E. A., Bui, E., Marques, L., Metcalf, C. A., Morris, L. K., Robinaugh, D. J., . . . Simon, N. M. (2013). Randomized Controlled Trial of Mindfulness Meditation for Generalized Anxiety Disorder. The Journal of Clinical Psychiatry, 74(08), 786-792. doi:10.4088/jcp.12m08083

Hoge, E. A., Bui, E., Palitz, S. A., Schwarz, N. R., Owens, M. E., Johnston, J. M., . . . Simon, N. M. (2018). The effect of mindfulness meditation training on biological acute stress responses in generalized anxiety disorder. Psychiatry Research, 262, 328-332. doi:10.1016/j.psychres.2017.01.006

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Medical information obtained from this website is not intended as a substitute for professional care. If you have or suspect you have a problem, you should consult a healthcare provider.