What is anxiety, anyway?

When most people hear the word "anxiety," they picture a person who is scared of thunderstorms or having panic attacks. Think Piglet in the beloved classic Winnie the Pooh. An anxious person would be huddling in a corner, rocking and sobbing because anxiety disorders only occur in people who are weak or not functioning.

What I have seen in my patients with ADHD and Autism is that anxiety looks very different. Instead having worries and specific fears, your thoughts might get stuck in a loop. You cannot stop picturing the horrible catastrophes that could happen. Anxious thoughts are thoughts that your brain keeps returning to again and again, even when you don't want to think about it. My favorite visualization for this is someone "jumping on the anxiety train and taking it to Alaska!" (Wheee!) For example, this could be a teenager who cannot stop thinking about a test the next day when they are trying to fall asleep. This could be a parent that keeps picturing ways their child's life could go wrong (so many ways!) and not being able to enjoy the current moment with that child. This could also be thoughts about what you’ve done in the past, like a painfully embarrassing social situation that keeps running through your mind even when you don’t want to be thinking about it anymore. (Who hasn't said good bye to your boss or teacher by saying "I love you?" Ouch.)

Anxiety looks different when it is affecting a patient with ADHD and/or ASD. Those annoying thoughts may make a person have a shorter fuse - they are irritable, easily frustrated, on edge. For a teen who has poor frustration tolerance, a small tiny stressor causes them to explode. (Before you say "isn't this most teens?," YES. Adolescence can be one mortifyingly embarrassing moment to the next for some kids...) Children often get stuck on wanting to be able to control their world and wanting things to go their way - how dare you not read their mind and hand them the wrong cup?

Why is it important for us to think of anxiety this way? Because when we understand the triggers and the cause, we can look for a way to help. Once we understand the sticky thought that is getting your brain stuck, we can find ways to help your brain hop off the anxiety train. It's not easy, it's not always pretty, but there is help.