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Anxiety and Stress Disorders (Children)

Generalized Anxiety or Attention Defict Disorder

04/28/2008

Question:

Can generalized anxiety disorder mimic the signs/symptoms of ADD? My son was tested for ADD at age 7 and the results were borderline (more towards being ADD). He is now 11 and is currently taking Focalin XR 30 mg; it seems as though stimulants have never really helped a great deal with his focus and schoolwork (he has tried Stattera, Ritalin, and Concerta) and he gets very irritable and jittery with them. Off of them his attention/focus does seem to worsen. He has always been an anxious child (as early as age 3) and gets `nervous` often; for example when playing sports even though he really enjoys playing. He gets frequent headaches, has difficulty staying asleep, has decreased focus, attention, and memory even with the Focalin. His father and paternal grandmother do have a history of GAD. He is also on Zoloft as he was diagnosed with depression. This does make sense as depression runs on the maternal side of the family. I am concerned that he may not actually have ADD, but GAD, and the stimulant is making his anxiety worse. He does see a child psychologist, although is has been infrequent as of late. He also visits a psychiatrist for med management every 3 months and as needed. I am at a loss for how to help him.

Answer:

Attention deficit disorder is often combined with other behavioral problems and in fact it is "comorbid" with either anxiety or depression about 40% of the time, so it is entirely possible that you child may have two disorders. I take it that Zoloft is not effective for inattentive symptoms, perhaps suggestive that ADHD is also a problem for you child.

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Response by:

Floyd R Sallee, MD
Professor
College of Medicine
University of Cincinnati