ADD, as the single cause of cognitive anxiety, is often overlooked: generally speaking ADD/ADHD is one of the most frequently overlooked diagnoses seen everyday in the office. Missed in children, most often missed in adolescents and adults.
At this moment in time no one asks about cognitive anxiety.
Even today few grasp the evidence that ADD is genetically inherited, can have a high .25 heritability index [25% have it] in children with an ADD parent, and .82 heritability index in identical twins. While those rates are high, some say the incidence of heritability is higher than these numbers. ADD is biological, not character malformation. But what and where with the biology: What part of the brain?
In an earlier comment here an interesting and experienced coaching consultant Lyle Lachmuth, “The Unsticking Coach” over at Creative Careers Unleashed, sees these problems often with some of his most interesting clients. But Lyle is caught like many of us waiting for the right test results to proceed.
So just what is this odd thing called Cognitive Anxiety?
Friends, we won’t be able to cover this complex question in one post. It is so interesting and so pervasive, and, the good news, so very treatable. When I get started on this subject I can go on for hours, so let’s keep Monday simple:
Cognitive anxiety is: unmanageable, or barely manageable, cognitive abundance. Thinking too much, worrying, fretting, indecision, paralysis of analysis… ever seen any of that? Somewhere in my machine is my paper on this very subject – you will get a kick out of the title: “Multivariant Thinking: The Clinical Implications of Unmanageable Cognitive Abundance.” A bit over the top for Monday, but you catch my drift.
Said another way, cognitive anxiety is mental anxiety, affective anxiety is felt somatically, in the body.
The new title for that paper: “Racing Thoughts…” – but what quickly comes to your mind with “racing thoughts?” Let’s see… bipolar?
Remember this: cognitive anxiety is cognitive, can be associated with bipolar, but not with your successful exec who has struggled for years with board meetings, or the car salesman who cannot stand his promotion to manager. In this subset of ADD too many variables at once decreases executive function unless it is life and death.
Have a surgeon patient with ADD who is totally on when the blood flows, is totally off with financial reports.
The brain biology of thinking too much we can see on SPECT scans. We can demonstrate what everyone already knows, slowing in the prefrontal cortex with diminished executive function. This slowing can be demonstrated in qEEG’s for neurofeedback evaluation, and with a variety of other tools. Evidence is there, the person is suffering, and we are wondering: does this disorder count? Am I being scammed? If I give meds will that make him medication dependent? What do we do in the office?
The most frequent ADD presentation in the office: Cognitive anxiety, period. More about what we do next post.
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