Mindfulness, Cognitive Behavioral Therapy, and ADD with Anxiety

Anxiety is frequently associated with Attention Deficit Disorder in Adults. Each case is slightly different. Some who state they are anxious are instead worried. Often, this worry is reasonable: tasks incomplete, work lacking, frequent mistakes at work, forgotten or incomplete jobs. The worry is rational: you might get fired, injured, or injure someone else! The worry abates and resolves often when the patient gets on task, completes jobs on time and with high quality, and to the satisfaction of supervisors or the boss. Worry isn’t necessarily anxiety.

Anxiety is commonly a physical phenomenon with tremor, rapid heart rate, sweaty palms, and chest tightness. It is caused by adrenalin. Some make too much adrenalin, while some are very sensitive to normal amounts of adrenalin. Adrenalin is a “fight or flight” hormone made by the adrenal gland. It is intended to get any animal in danger (including human animals) out of danger by fighting a threat or fleeing a threat. When the “threat” is not physical, the adrenalin surge causes paralysis and poor decision making, even leading to panic or paralysis.

If I were to inject someone with adrenalin, they get trembly, sweaty, develop a rapid heart rate and breathing. Their thoughts become broken and confused. This is what many individuals suffering from anxiety feel and exhibit. While tranquilizers or anti-depressants often decrease anxiety and anxiety symptoms, they also change the brain, sometimes permanently.

Once individuals are made aware of the symptoms from adrenalin, then made mindful that it is only a hormone, not a real threat, then the opportunity to “talk it down” becomes a rational option and is accepted. This “talking it down” is called cognitive behavioral therapy—meaning being consciously aware and consciously implementing strategies to redirect the energy causing anxiety. This can be done with exercise, counseling, music, meditation, touch therapy (massage), and a host of other non-medication options. They all work. They all work better when they are part of a conscious plan to reduce adrenalin secretion and reduce the response to the adrenalin.

Cognitive behavioral therapy takes training, time, and some expense. It is not a quick fix. Exercise must be performed daily to reduce adrenalin. Meditation takes time and training in addition to good meditation strategies. This is difficult in our insanely busy world.

I have found that simply blocking the effects of adrenalin by beta-blockers or alpha-blocking medications has a similar effect to cognitive behavioral therapy. These medications simply block the effect of adrenalin on the brain. No heart racing, no sweaty palms, no heavy breathing or chest pain, and no tremor—no physical response. When the “conscious” brain notes that a situation that would have caused such a reaction no longer does so, the “conscious” brain thinks, “that wasn’t so bad, I didn’t die”. Then repeated exposures without reactions eventually “desensitizes” the brain and behavior becomes more rational and normal.

Obviously, doing all these interventions is best. Sometimes we must do what we are able with limitations of time and money, but all of these interventions are available and doable to anyone.

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