What anxiety are we treating?
Anxiety with ADHD can be difficult to assess and is quite difficult to treat. Often, no matter what drugs are used, they simply do not work effectively, and many can significantly contribute to the emotional deterioration of impulsivity and depression. Most often overlooked anxiety is alarming. and the reason why it is overlooked is simple: descriptively, on the surface, it looks like OCD - obsessive-compulsive disorder. Obsessive thoughts may be part of, may be a symptom, but let me take a deeper look at the cause.
And do not be surprised if your doctor does not agree with these next comments, they are not included in the standard diagnostic text.
7 tips for recognizing cognitive alarms:
- Look first at Worry, at Uncontrollable Cognitive Abundance. Anxiety in our offices when it becomes uncontrollable, when life hardens from indecision. Thinking too much can lead to three repetitive results, discussed below.
- Remember that cognitive alert is a subtype, and if you do not look, you will not see it. Many have so many cognitive anxieties that they simply do not recognize it. If you ask a simple question: “Are you worried?” The most frequent answer is no. Ask the question as follows: “You are worried, you think too much about the little things and think that you cannot achieve so much - that you feel depressed?” This form is the most often lost form of counterproductive thinking.
- OCD is not the only cognitive diagnosis: Do not ask a question only in the search for OCD, - yes, OCD can be associated with cognitive abundance. But OCD can be a sign of a spectrum of impairment, not just ADHD. Use history to view ADHD data over time. ADHD most often has an academic history, with the exception of the final form below.
- A - Jammed form: One form of ADHD with cognitive anxiety becomes stuck on the details and represents crowded and indecisive They think so much about so many details, they just cannot decide. They need a life partner to decide the next steps. These people begin to fall apart into 5, 6 or 7 grades, most often the 6th due to changes in workload.
- B- Decisive form: This form of ADHD is obsessively determined, hardworking, does not show “inattention”, but rather works around fixation and decision making to avoid thinking a lot. They often decide quickly, often do it well, but they come because they are also full of micromanagement and legible details, thinking that they are the only ones who can do it right. These people often succeed in school, become professionals, and have no idea what makes them compulsive. engine driven by the engine. They can not tolerate garbage in the mind.
- C- Combined form ; Some people with widespread cognitive anxiety wax and decline between the two two subtypes. At work, they can be strong and decisive, because they understand the context and master this game. At home they may have problems with the family, with errands and lack of structure. The spouse often wonders why they are so effective there, but so ineffective here.
- Cognitive anxiety: If cognitive anxiety is primarily ADHD in origin, it should be carefully treated with stimulants. See details in many other Therapeutic windows here regarding dosage strategies. As noted above, watch for SSRI reactions and drug interactions, detailed on my website below, if the diagnosis includes depressive elements. SSRIs exacerbate ADHD when they are not combined with a stimulant strategy.
