A recent one study revealed that some people with attention deficit hyperactivity disorder (ADHD) cope best during periods of high stress.
Maggie Sibley, a clinical psychologist and psychiatry professor at the University of Washington and the study’s lead author, initially found out if it was possible for adults to recover from ADHD. In an earlier study, published in 2022she examined a dataset from the National Institute of Mental Health that tracked 600 patients with ADHD over 16 years, beginning in childhood.
“What we found was this pattern of fluctuating ADHD, and most of the people who got better, they would then relapse back into ADHD,” she said.
For the more recent study, published last week in the Journal of Clinical Psychiatryshe went back to that same data set to try to figure out what conditions might lead to relief of ADHD symptoms.
Sibley thought that ADHD patients would experience the most relief during periods of low stress. What she found was more counterintuitive.
Her study identified three distinct groups of ADHD patients: those who experienced periods of apparent full recovery, those who experienced partial remission, and those whose ADHD symptoms remained constant over time.
People who experienced temporary full recovery were most likely to experience it during times of “high environmental demand”, or, more simply, stress. Those who had periods of partial recovery were also more likely to have associated anxiety.
Arij Alarachi, a psychology PhD student at McMaster University who has researched ADHD and anxiety with St Joseph’s Hospital in Hamilton, Canada, says it makes sense that ADHD would respond differently to different circumstances.
ADHD brains may not change that much, Alarachi said, but people can adjust their circumstances to better manage their ADHD. As Sibley’s study shows, though, even among people with ADHD, those strategies can look different, since “ADHD comes in many different shapes and sizes,” Alarachi added.
“ADHD patients do best when they have to rise to the occasion. And we see this at the micro level … deadlines [could feel] useful, or when things are more urgent, you can be your most productive and hyper-focused,” Sibley said.
Although it is impossible to completely unravel how much of this is the result of ADHD patients choosing to absorb more stress when their symptoms are in check.
Sara Vranes, who was diagnosed with ADHD at 36, relates to this idea. She said she sees her ability to hyperfocus under pressure as a “superpower”. Vranes now works with homeless communities, but before that had 15 years of experience as a midwife and doula, and she says she was very calm in crisis.
“I don’t want anyone to get hurt, but I could handle it because my brain can only hyperfocus. I could see everything clearly and see a process in my mind and react to it in real time.” However, during downtime she is often anxious and unable to focus.
More than half of adults with ADHD also experience anxiety. However, Sibley’s study shows that this may not always be a bad thing.
to newsletter promotion
“We call it a protective factor in ADHD,” she said, explaining that several studies have found that children with ADHD and anxiety respond better to behavioral treatment, such as cognitive behavioral therapy, than children who only have ADHD.
Alarachi said that in her research, she has also encountered people with ADHD who say anxiety helps them control impulsivity. They will say, “My anxiety [has] kind of helped me stop myself from maybe acting on some of those impulses, or it kind of made me think about some of the consequences.”
“Think of it like the gas and the brakes in a car, right? The ADHD might be the gas, and then the anxiety hits the brakes, like making people inhibit a little bit,” Sibley said.
Anxiety and impulsivity can be more extreme in people with ADHD, “but somehow they cancel each other out in a way that makes neither of those processes as problematic as they might be on their own, which is kind of a interesting concept,” Sibley added.
Alarachi and Sibley agree that people with ADHD need to look within to figure out how best to relax and keep their anxiety at a reasonable level where it’s helpful. Vranes struggles to relax just in front of the TV, but says playing phone games and watching TV at the same time can help keep her mind from wandering.
Sibley has encountered ADHD patients who are most relaxed while exercising and socializing.
“I always tell people with ADHD, you have to learn to write your own user manual,” Sibley said. “So you have to figure out, what is your brand of relaxation? What is your brand of decompression?”
