ADHD Anxiety Is More Than Just A Feeling
To fully understand ADHD anxiety symptoms you/we must understand a new form of anxiety: unmanageable cognitive abundance. I've been speaking and writing about ADHD and cognitive anxiety for more than 16 years now, not just the OCD subset, with its focused obsessional topics, but counterproductive excessive thinking that ranges across the landscape of Everyman's everyday realities. The key operational word for ADHD diagnosis and treatment considerations: counterproductive.
If you're stuck in thinking, if you are thinking too much, it's counterproductive to your development, your work, your family, your education. Excessive stuck thinking can result directly from problems with working memory – the pre-frontal cortex becomes relatively frozen in time.
But before we cover those three new Cognitive Anxiety subsets, let's consider the background noise:
An Anticipated Retort: “No Problem”
At first you may say, as many do, ADHD itself is not a problem, everyone suffers from attentional problems. Quickly, following that first denial point, a reductionistic thinker, a label seeker, a 100% name caller looking for the “only” silver bullet – the categorical answer, would say, “anxiety's not a problem – everyone thinks too much at times.” Since it's not a 100% a problem, even if anxiety is 99% active and debilitating, creating profound counterproductive time loss, it's not a categorically correct, all-the-time problem. [Notice how time and context keep sneaking in to the discussion?] If it's not a 100% problem, – it “looks like” it's not a problem. 😕
My response: yes, quite so -everyone does think too much at times – but then permit a deeper question: do they suffer from the thinking problem, does that thinking problem create unmanageable circumstances for their lives, does it encumber their decision-making, does it arrest their development, does it put them out of sync with changing reality?
If so, consider ADHD. Consider the strong likelihood that Executive Function is disordered. Then consider these three presentations:
The Three ADHD Anxiety Subsets
1. Frozen Thinking – Unmanageable Cognitive Abundance – Without Worry: Without affect, not feeling constrained, but nevertheless stuck with thinking too much about inconsequential items – small stuff. These folks think so much they become exhausted, and with encumbered mental lives they often make untimely decisions. They are operationally too stuck, too often, for their own interpersonal comfort. They can still make decisions and often flip this presentation around to micro-managing so they can control – correct – the thinking.
2. Frozen Thinking – Abundance With Iindecision And Worry: These folks get overtly stuck – not a little stuck – and more often, not all the time, [but way too often] they either can't make that decision or make it too darn late. The indecision becomes relevant in their interpersonal relationships, at home or work.
3. Thinking With An Anxiety Feeling: In this ADHD presentation, the feelings arise as derivative from the mental/mind thinking too much, then move into indecision and worry, the appear going down into the body. They feel it in their chest, their stomach – it becomes somatic instead of, or in addition to, mental.
Two Essential Conclusions – Thinking Anxiety Is Different Than Feeling Anxiety
1. These three subsets, to the extent they are more cognitive than affective, more mental than somatic and emotional – most often respond to dopaminergic, ADHD medications. Yes, these can occur separately or all together, depending on circumstance and context – the realities of life.
2. Affective anxiety, feelings, somatic, chest and abdominal anxiety, sweaty hands and labored breathing, arise most often from more serotonergic origins – and often respond best to an SSRI/SNRI. See the Video Playlist below on Dosing to break down those details.
ADHD Video Playlists For More Specific Medication Details:
ADHD Meds Tutorial – Overview: http://bit.ly/medstutorial
ADHD Meds Dosage: http://bit.ly/dosevids
ADHD Meds Problems – Mind and Gut: http://bit.ly/mindgut
ADHD Meds & Allergies – Milk and Wheat: http://bit.ly/mawimmun
ADHD Meds & Allergies – Street Immunity: http://bit.ly/IorWJs
And By The Way – Attention “Deficit” Is Only The Default Appearance
Another Big Diagnostic ADHD Correction is in order: The problem dear readers, for both the informed practitioner and the informed patient is a functional one – “attention abundance” is the problem, not “attention deficit,” … too much thinking is the most prevalent cognitive abundance problem, not too little. It looks like too little if you aren't thinking correctly about the thinking process.
But if you know about Cognitive Anxiety it considerably changes your thinking about thinking. Think about it if you have ADHD, do you feel that the DSM missed you, and they you have had to suffer with a negative connotation of stupidity when your real problem is that you are smart and suffering with too much thinking, not too little?
The current ADHD label inaccurately describes the mental condition, it only punctuates what is observed, not what the Reality is. ADHD is static, categorical, reductionistic and inaccurate vs functional, data and brain-process driven.
This ADHD nomenclature problem is pervasive, global, and quite important enough to change the diagnostic code – but as you may recall, don't count on it for DSM 5, the Paleolithic “new” Diagnostic bible. The tenure seekers, the psychoanalysts charged with diagnosis, aren't thinking about brain dynamics, they are thinking only about observable behavior, not reported mind activity.
We really don't need affirmation from the DSM-5 to scrap the “deficit” and focus on this very real and correctable Executive Function Disorder – EFD, which embraces both deficit and abundance [not EFDD with the negative “deficit disorder” carried forward].
Do Tell Your Friends:
The new ADHD is now EFD. EFD is more accurate, less derisive, and sets more clear treatment targets. Please Tweet, RT and forward this important message with LinkedIn, or Facebook – the ADHD community can use a different Holiday gift – one that's done with outdated and ineffective name calling. [Recently at the national CHADD meeting Dr Russell Barkley agreed 😉 – …but he liked EFDD! – and btw, I sent him a note on this different perspective before sending out this post…] Russ is on the right track with the Cognitive Anxiety we have been seeing and treating in the office since 1996.
If you write, think, treat or otherwise reflect upon these ADHD matters, please do pass this along. The downstream effect will be constructive for those who suffer with Cognitive Anxiety and haven't yet been treated.
Please drop a comment here, and weigh in on your personal observations about cognitive anxiety from your personal experience.
Dr Charles Parker
Author: New ADHD Medication Rules – Brain Science & Common Sense
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