When my psychiatrist first prescribed medication for my ADHD, I remember reading the side effects and asking him, “This isn’t going to make my anxiety worse, is it?” His response was basically, “we’ll just have to wait and see.”
Just like coffee isn’t known to relax people, stimulants in general are recognized for their potential to exacerbate anxiety, and that extends to ADHD meds including amphetamine and methylphenidate. Because anxiety was one of the main factors that led me to seek out mental health treatment, I wasn’t thrilled about the idea that taking one step forward in my ADHD symptoms could mean taking two steps backward in terms of anxiety.
Trying medication for my ADHD was a revelation. I saw what it was like to function with a clear mind, being in control of my thoughts rather than the other way around, not constantly feeling like I needed to get up and find something more interesting to do.
But on top of that, ADHD meds improved my anxiety. I discovered that having a sense of agency in how I used my brain meant not being at the mercy of every anxious thought that crossed my mind. Being able to organize my thoughts meant being able to focus on the things I wanted to focus on, not necessarily on anxiety-inducing hypothetical possibilities.
Many people with ADHD also have anxiety disorders, so I doubt I’m the only one who’s found that ADHD meds have the ability to improve two disorders with one pill.
Surprisingly, though, hardly any research has been done on whether ADHD medications can precipitate real improvements in anxiety in people with ADHD. The standard psychiatric advice cautions that stimulants can make anxiety worse and stops there.
That might be changing, though.
A new case study by psychiatrists from Wayne State University and University of Michigan describes a 31-year-old woman whose symptoms of generalized anxiety disorder more or less entirely disappeared after starting ADHD medication.
Like many adults with ADHD, the woman, “Ms. A,” initially sought out help not for ADHD but for anxiety. In the course of diagnosing her, though, her doctors found that she experienced difficulty concentrating as well as restlessness and forgetfulness, and psychological testing confirmed their diagnosis of ADHD.
Ms. A’s anxiety symptoms prevented her from going to the gym and from visiting the city, and they made her terrified of crowds. So her doctors prescribed a slew of antidepressants, which didn’t help.
Thus far, her doctors were intentionally avoiding prescribing her stimulants – because you don’t prescribe stimulants to someone with anxiety, right? However, when the antidepressants didn’t work, her doctors decided to bite the bullet and write her a prescription for methylphenidate.
At this point, I’m happy to say that Ms. A experienced a miraculous turnaround. Not only did her ADHD symptoms improve – her anxiety also melted away. Ms. A started visiting the city, going to the market, museums and games. A year later, the authors of the case study report that Ms. A was going to the gym regularly and had been promoted at work.
It’s lucky for Ms. A that her doctors finally decided to take the risk of prescribing ADHD medication to someone with anxiety. You have to wonder how many more Ms. A’s there are out there whose lives could be radically improved if we had a better understanding of how stimulants affect anxiety symptoms
For now, Ms. A’s story is a story about one woman, so the scientific lessons we can draw from it are limited. We don’t know what portion of people with ADHD and anxiety might find that their anxiety symptoms benefit from stimulant medications, or whether some types of anxiety are better able to be treated with ADHD meds.
But what does seem clear is that this is a promising area for future research and that ADHD medications have at least some potential to treat not just ADHD but comorbid anxiety.
Image: Flickr/Brian Auer