Getting to Know the ADD Types – Type 7: Anxious ADD

In part 7 of this 7-part blog series, you’ll learn more about anxious ADD, its signs and symptoms, what SPECT scans show about this type, and science-backed strategies to reduce symptoms.

WHAT IS ADHD?

ADHD, or ADD, is a neuropsychiatric disorder that is characterized by problems with focus, impulse control, and hyperactivity (in some cases). Commonly diagnosed in childhood, ADD/ADHD may persist throughout adulthood.

Some people may have signs and symptoms of ADHD but go undiagnosed as children. These individuals may struggle with symptoms for years or even decades before finally getting diagnosed with adult ADHD.

WHAT IS ANXIOUS ADD/ADHD?

Among patients at Amen Clinics, anxious ADD/ADHD is becoming more prevalent. Unlike the other types of the condition, people with this type typically don’t seek excitement and conflict.

In fact, it’s more common for these individuals to avoid situations that cause stress or conflict.

People who have anxious ADD/ADHD often latch onto the worst possible outcome and fixate on it. Those with this ADD/ADHD type frequently freeze in situations that trigger anxiety, such as taking a test or giving a big presentation.

How does anxious ADD/ADHD differ from anxiety disorders? In general, anxiety disorders tend to fluctuate over time, while anxious ADHD symptoms typically remain constant.

WHAT ARE THE CORE ADHD SYMPTOMS?

Core symptoms of ADHD that are seen in all 7 types of the condition include:

• Problems paying attention

• Being easily distracted

• Being disorganized

• Procrastinating

• Being forgetful

• Having trouble with follow-through

• Being impulsive

People may have some or all of these symptoms, which can range from mild to severe.

ANXIOUS ADD/ADHD SYMPTOMS

In addition to the common symptoms listed above, the signs and symptoms of anxious ADHD include:

• Frequently anxious or nervous
• Tense and stressed out
• Predicts the worst
• Conflict avoidant
• Fear of being judged
• Tendency to clam up in social situations
• Physical stress symptoms such as headaches
• Dislikes or gets excessively nervous speaking in public

As with the core symptoms, these can vary in terms of severity.

ANXIOUS ADD/ADHD IN THE BRAIN

At rest and concentration there’s increased activity in the basal ganglia. With concentration, there is decreased activity in the prefrontal cortex and cerebellum.

As with most of the 7 ADD/ADHD types, this type is associated with abnormal brain function. During concentration, blood flow to the brain decreases, which lowers the ability to focus or pay attention.

On SPECT scans of people with anxious ADD/ADHD, blood flow decreases are seen in the prefrontal cortex and the cerebellum. Reduced blood flow in these areas is associated with difficulties with planning, focus, organization, impulse control, empathy, and judgment.

What’s unique about brain activity in these individuals is that there is also increased activity in an area called the basal ganglia. This uptick in brain activity is seen at rest and during concentration.

In the images below, red and white represent the highest levels of activity, while blue indicates average activity. In the anxious ADD/ADHD SPECT scan, there is overactivity in the basal ganglia.