ADHD and Anxiety: ADHD Looks Like OCD

by Dr Charles Parker on May 31, 2009 · 200 comments

You can’t judge a book brain by it’s cover.

So much of our work with ADHDis based upon necessary, but limited pre-technology diagnosis. For years we had to rely on appearances, and didn’t have the means to measure function, much less see specific areas of the brain as they function. As a consequence of using only one set of myopic glasses we still use phenomena and appearances as targets, while far too many critique, regarding peer reviewed findings regarding hard brain evidence.

As you will see in this video, ‘anxiety‘ can take on many different faces – and cognitive anxiety, you heard it first here, is simply not in the books yet – strange, but true. If we don’t look for it, we just can’t see it – and so much of ADHD symptoms are associated with anxiety. I see so many who say they aren’t anxious, but suffer from complete mental shutdown from cognitive anxiety. You will get it with this video.

Sign up either on the blog here for email updates or over at my Channel on YouTube to keep up with the many planned ADHD and  CorePsych videos. Might as well stay posted for these small, but useful tidbits from years of ongoing office work, – evolved from when we couldn’t see what we were shooting at.

And, of course, not all OCD is ADHD, but with a history and significant additional findings we will get the medications dead wrong if we miss ‘dopamine‘ and only make the ‘serotonin‘ diagnosis.

My new book ADHD Medication Rules, covers this OCD/ADHD Cognitive anxiety attribute in considerable detail.

Drop me a comment to see what you think about these findings.

cp

 ADHD and Anxiety: ADHD Looks Like OCD

Digitally available now at Nook, Kindle, Barnes and Noble.
ADHD Medication Rules – PDF For Your Desktop  
ADHD Medication Rules | Paying Attention To The Meds For Paying Attention – Kindle Version


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[..YouTube..] I often like mood disorder for filing insurance, but don't like it from the point of view it address nothing of value regarding treatment implications or brain function.

[..YouTube..] @fetalbetal I often like mood disorder for filing insurance, but don't like it from the point of view it address nothing of value regarding treatment implications or brain function.

[..YouTube..] Labels can be so detrimental to patients with these issues, almost anyone can fit the criteria for bipolar and if this is obsessively researched.. well, it can truly unhinge someone who could benefit from well thought out treatments. ADHD seems to be over diagnosed as well, but, at least the stigma isn't as overwhelming and the root cause remains debatable. My most recent diagnosis is mood disorder n.o.s. I think it's the nicest way of describing what I can't explain.

[..YouTube..] That's exactly how I feel about bipolar diagnoses.

[..YouTube..] @DrCharlesParker That's exactly how I feel about bipolar diagnoses.

[..YouTube..] do pop over to my site and go to Services - there we can arrange a brief phone chat to see the details and often do long distance evaluations based upon brain function, not appearances.

[..YouTube..] @DjCosmicRush do pop over to my site and go to Services - there we can arrange a brief phone chat to see the details and often do long distance evaluations based upon brain function, not appearances.

[..YouTube..] Brilliant! I am diagnosed ADHD and 19 years old. I have a lot of what you described as cognitive anxiety. I've been diagnosed depression but I have a strong feeling I do not have it. I do think I get depressed a lot but not due to a neurological disease. I am very well versed in psychology, neurology, and other sciences. You seem to really know what your talking about. Maybe you can help me? I am heading towards school failure and can not figure out a diagnosis or if I'm having a natural respon

[..YouTube..] Kind words, thanks, cp

[..YouTube..] @2454014 Kind words, thanks, cp

[..YouTube..] Sounds like you are cooking on the right path Jack - bipolar becomes almost an emotional platitude: "He is upset from time to time, and sometimes it's pretty intense... and I don't know what to call that upset so I'm pronouncing him bipolar simply because I have no other perspective for consideration." Stay tuned Jack, I have a post coming out on ADHD psychosis - that one will be a "barn burner." Glad to hear you're over the hump and traveling on. Best, cp

[..YouTube..] @JackMack02660 Sounds like you are cooking on the right path Jack - bipolar becomes almost an emotional platitude: "He is upset from time to time, and sometimes it's pretty intense... and I don't know what to call that upset so I'm pronouncing him bipolar simply because I have no other perspective for consideration." Stay tuned Jack, I have a post coming out on ADHD psychosis - that one will be a "barn burner." Glad to hear you're over the hump and traveling on. Best, cp

[..YouTube..] I wish he was my doctor, damn.

[..YouTube..] Once Again Thanks Dr. Parker,love coming back here to just see how others describe cond.,cope,etc...Did a 2 week sub-acute program at Cape Cod Hospital,very good experience in that just busting up predictible patterns of thinking, new settings, empowerment stuff, and solid staff...my meds are pretty much on now..It took lots of patience,with a history,substances.used at times of corse for escape...then this..but i gotta work it, still lots to explore..thanks again

Madelyn, You da woman! Tight thinking, as they say in the South, tight as a tick on a dog! Appreciate your good humor and support out here! cp

[..YouTube..] And bipolar is what everyone calls it when they don't look at the detaisl and simply shoot from the hip.

[..YouTube..] @JackMack02660 And bipolar is what everyone calls it when they don't look at the detaisl and simply shoot from the hip.

[..YouTube..] Thanks pink!

[..YouTube..] good stuff

[..YouTube..] Really pleased that the OCD breakdown on cognitive anxiety worked for you. Do take a look at my last blog post at CorePsych Blog that breaks the anxiety piece down even more effectively than this vid... - thanks, Peace, cp

[..YouTube..] @zjayzjay Really pleased that the OCD breakdown on cognitive anxiety worked for you. Do take a look at my last blog post at CorePsych Blog that breaks the anxiety piece down even more effectively than this vid... - thanks, Peace, cp

[..YouTube..] This really describes me, my therapist has already had me sign release forms for seeing a MD for ADD. And he promised to go over ocd for me. I mean i would think and owrry so much that i would get sick. You are SO funny.

[..YouTube..] These two subsets are, without doubt, the most frequently missed ADHD subsets, the most frequently overlooked executive function disorders on the planet. You are in big numbers company, as those two subsets are the ones I routinely see on "complex" second opinions. - Not so complex if you can see the path.

[..YouTube..] @lambymorreale These two subsets are, without doubt, the most frequently missed ADHD subsets, the most frequently overlooked executive function disorders on the planet. You are in big numbers company, as those two subsets are the ones I routinely see on "complex" second opinions. - Not so complex if you can see the path.

[..YouTube..] Dr, Parker--thank you so much for your video blogs. Between this one here and the "avoidance" video, you have explained my issues precisely. It's been difficult to find a doctor who sees this with me, primarily because i am not physically jittery, and I can answer their questions quickly, but they're not exactly the "right" answers, the "truth", for me. So they push anti-depressants/anti-anxiety meds, I politely decline, and leave frustrated and depressed. I wish I lived closer to your office...

[..YouTube..] Never heard the comparison to Pres Bush - certainly can't hurt being compared to the Pres, unless I get caught not remembering what I am talking about!

[..YouTube..] @JackMack02660 Never heard the comparison to Pres Bush - certainly can't hurt being compared to the Pres, unless I get caught not remembering what I am talking about!

[..YouTube..] .I tend to ramble-just threw those spript numbers up there..if that seems reasonable just your input if you wanna..thanks...Checks in the mail.,lol.thanks again, take care!!! Anyone ever say you kind of,(mannerisms,way of speaking) remind them of younger pres Bush???.Thx again!!!!!

[..YouTube..] @DrCharlesParker .I tend to ramble-just threw those spript numbers up there..if that seems reasonable just your input if you wanna..thanks...Checks in the mail.,lol.thanks again, take care!!! Anyone ever say you kind of,(mannerisms,way of speaking) remind them of younger pres Bush???.Thx again!!!!!

[..YouTube..] Thanks for response..! ya now i'm in sub-acute care and at peace with it for the most part..The brain saturation became a 5 hour replay on one single thought,,This sharp acute increase of ocd dwelling, locked in that crap..it was kind of needed..Thanks for the words, i get it, pos.reinforcement. If you wanna respond ,that would be awesome--(.5 klonopin x2, seroquel(sleep)75-100mg 10 pm..clonodine.05 am ,.10 pm effexor 150 am adderall 20xr am. 10 ir 2-3 pm..ty

[..YouTube..] @DrCharlesParker Thanks for response..! ya now i'm in sub-acute care and at peace with it for the most part..The brain saturation became a 5 hour replay on one single thought,,This sharp acute increase of ocd dwelling, locked in that crap..it was kind of needed..Thanks for the words, i get it, pos.reinforcement. If you wanna respond ,that would be awesome--(.5 klonopin x2, seroquel(sleep)75-100mg 10 pm..clonodine.05 am ,.10 pm effexor 150 am adderall 20xr am. 10 ir 2-3 pm..ty

[..YouTube..] Hey Jack, just remember this less complicated point: You have but one life - think of the thousands that have completely passed in years gone by with never a twit of recognition that their challenges were correctable. They died thinking they were stupid, bad, guilty, and irresponsible - you have a new life and speaking from my aging perspective, you are a young guy with many miles to go before you sleep. Carry on!

[..YouTube..] @JackMack02660 Hey Jack, just remember this less complicated point: You have but one life - think of the thousands that have completely passed in years gone by with never a twit of recognition that their challenges were correctable. They died thinking they were stupid, bad, guilty, and irresponsible - you have a new life and speaking from my aging perspective, you are a young guy with many miles to go before you sleep. Carry on!

[..YouTube..] Thanks Dr. Parker, You nailed it with your descriptions ,AND what responses and behaviors are associated with an ocd/add/adhd/anxiety condition. I had been diagnosed bi-polar couple years ago... i knew that wasn't right, because of that mental ocd aspect that had manifested to mask an extreme fluctuation in mood . So yes,thought patterns ,behaviors and the huge anxiety factor..so i guess i gotta own it now, and at 44, the regrets..cpippling..

[..YouTube..] Also, is it typical for thoughts to be exaggerated and overwhelming?

[..YouTube..] @DrCharlesParker Also, is it typical for thoughts to be exaggerated and overwhelming?

[..YouTube..] @DrCharlesParker @DrCharlesParker Ah! That makes more sense! I have a bit of OCD with ADHD, so I constantly mental check or mental track to see if the objects, tasks etc. trigger thoughts or images. I am having a lot of trouble breaking those habits. Yes, that seems to be the stereotypical "ADHD" person nowadays. :/

[..YouTube..] @DrCharlesParker - Ah! That makes more sense! I have a bit of OCD with ADHD, so I constantly mental check or mental track to see if the objects, tasks etc. trigger thoughts or images. I am having a lot of trouble breaking those habits. Yes, that seems to be the stereotypical "ADHD" person nowadays. :/

[..YouTube..] The mental checking is quite typical of the cognitive abundance - almost anything can trigger this phenomenon - it irritates me that so many raise the poor choice of humor about flashy objects when in fact anything not nailed sufficiently down may stimulate more efforts at understanding and control.

[..YouTube..] @NyraLunaEXE The mental checking is quite typical of the cognitive abundance - almost anything can trigger this phenomenon - it irritates me that so many raise the poor choice of humor about flashy objects when in fact anything not nailed sufficiently down may stimulate more efforts at understanding and control.

[..YouTube..] Is it typical for an ADHD/OCD sufferer to constantly "mental check"? You're not exactly focussed on the task at hand, but instead fretting if tasks or objects etc. trigger a thought or image?

When my son was 2 they thought he may have asperger's, we've pretty much left it untreated except with OT and some behavioral counseling.  He is now 6 and still shows A LOT of the same symptoms. He's going to see a psychiatrist to see where he is now.  I still think that he's on the Autism specturm.  His OT thinks its ADHD, Anxiety, and OCD.  He does fit those but I think that's part of the asperger's - do these things exist comorbidity? I'm at a loss as to what to think... any ideas? Thanks Mandy  

Mandy, I don't know what to think either without an exam... but I can tell you this - generally speaking, Autism and Asperger's are too often diagnosed as the end point, and the patient is left with their symptoms having been codified into this nether world. Both have their own OCD/ADHD symptom pictures - and if they look "autistic" we really must, every time, look for comorbid metabolic challenges. Measure, then treat! cp

Colin, You are so right, my friend. This very question has been an important theme of almost every ADHD presentation since 1996. Yes, there are overlaps and some folks need a serotonergic kick with it [antidepressant to balance deeper structures] as affective anxiety is more centrally mediated. OCD has many levels and some OCD does respond quite well to straight SSRI's thus the proven effectiveness of Luvox for years - but most of the more purely cognitive abundance, the mental disorganization downstream from too much thinking does, as you so accurately point out respond well to stimulants. I too like Vyvanse, and most of the time one can trim it up so that it lasts 12-14 hr DOE. e.g. If it is lasting till 3 PM from 7 AM the Duration [DOE] is 8 hr, and the dose most often is too small, and can be increased by 10mg for an additional 2 hr DOE with good result. I always increase by 10 mg increments unless the coverage is down to 5-6 hr DOE, then can leap to 20 mg increase with your doctor's approval. cp

[..YouTube..] and thanks for your kind remarks on the thinking with ADHD and OCD

[..YouTube..] @roDinski584 and thanks for your kind remarks on the thinking with ADHD and OCD

[..YouTube..] @anitar7111 If meds need mixing to cover both presentations, need to be careful with drug-drug interactions, specifically prozac/paxil and the amphetamines. Otherwise it will fall to your doc and you regarding their/your choices of the best combo-

[..YouTube..] By the way, I like this point: "My point on this: Many are treated for thinking problems - without specific thinking about the thinking process." I think it is really in the right direction towards diagnosing these disorders. Thanks for sharing and I hope it goes far.

[..YouTube..] Like, for example, although the dopamine levels are triggering these behaviors there is another issue, such as a certain thought or event or a problem with non-associative lobes addressing other lobes not associated with be causing these levels to go out of whack? Why would I experience such severe symptoms if the real cause is a serotonin/dopamine levels between either the synapse or just in the negative feedback loop? Would it be safe to assume that my real issue is not be based on [ ]?

[..YouTube..] @DrCharlesParker Thanks for the response and info Since there isn't any blood tests that I know of that would directly state which is the governing issue towards the disorder (dopamine/serotonin levels), could there be a different contributor to why these symptoms be problematic? Since dopamine is also associated with the cognitive activities, would the root cause be the dopamine levels or is there other issues, being either the wiring of the brain, that is causing these levels to be off?

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