How to Deal with Anxiety and ADHD in Children: Insights from St. Louis Anxiety Therapists at Compassionate Counseling St. Louis

At Compassionate Counseling St. Louis, we work with angry, anxious, and easily overwhelmed kids, teens, and college students. We also work with parents through our parent coaching program.

We've talked earlier this summer about the connection between anxiety and ADHD. And we’ve noticed that more and more people are reaching out to us about therapy for their child who has anxiety and potential ADHD.

We know that anxiety is not a symptom of ADHD, but it can show up with ADHD. A diagnosis can include both an ADHD disorder and an anxiety disorder. You may also notice that your child who has anxiety or ADHD is experiencing explosive anger issues as well.

Our therapists at Compassionate Counseling St. Louis specialize in anxiety, anxiety-driven anger, and managing overwhelming emotions. And because of this specialty, we'd like to share with you some frequently asked questions we get on anxiety, ADHD, and anger issues.

What are the common signs of ADHD in children, and how can I differentiate them from typical childhood behavior?

Common signs of ADHD in children include inattention, hyperactivity, high distractibility, and an inability to stay still and focus. If you're describing a highly impulsive child who is 5 years old, it is likely that your 5-year-old is acting like a 5-year-old. Or perhaps even more likely, your 5-year-old is acting like a 5-year-old more so than your child has ADHD.

Image Credit: Unsplash Kenny Eliason @neonbrand

However, as your child gets older, goes into the classroom setting and continues to exhibit difficulties with staying in one place, staying focused, completing their work, or not getting in trouble at school, and you also notice that they have trouble keeping their body still and focusing at home, you might start to consider getting assessed for ADHD. In terms of how anxiety can show up, you may notice that kids who have anxiety can often look like this too.

Kids can have an inability to focus because their anxiety is keeping them focused on other things. Trouble sitting still may show up because their anxiety is telling them that they need to be in fight, flight, or freeze mode. Difficulty completing work because they are hyper-focused on their worries and also getting into trouble in the school setting because their anxiety-driven anger is leading to explosive outbursts, trouble getting along with their peers or difficulty following instructions. So there is an anxiety and ADHD overlap in terms of how it is presenting.

How can I create a supportive and structured home environment to help my child with ADHD feel secure and manage their emotions?

When it comes to helping your child with ADHD in home and school settings, it is important to have clear and reasonable expectations for them. 

Another recommendation we have for parents is to give directions with one step listed at a time. So often we give multi-step directions. "Get ready for school," for example, includes so many different pieces: put on your shoes, put on your clothes, brush your teeth, pack your bags, pack your backpack, and get your water bottle. You might find that your child with ADHD gets lost by step two.

Instead, take the time, even with your 8, 10 or 12-year-old, to break down your goals into bite-sized pieces. With my daughter, we do a four-things rule. So before you go to school, you need to do four things: brush your teeth, get dressed, put on shoes and put on sunscreen. Of course, there are other things that we do together to get ready. But she can choose the order of those four things, and we make sure we tick off each of those four things before we can go to school. If she cannot do those four things, we cannot go to school.

Are there specific therapies or interventions that are particularly effective for children with ADHD who also have anxiety and anger issues?

In terms of therapy interventions, at Compassionate Counseling St. Louis our anxiety therapists root a lot of their work in Cognitive Behavioral Therapy (CBT). CBT is how we break down our thoughts, feelings, and behaviors into different components of the cognitive system. We ask ourselves, what am I telling myself in my brain right at this moment? How is that impacting my emotions, and what behaviors is that leading to? And then at each part of that triangle, what can I change? What's a more helpful thought I can tell myself? A better behavior to choose? Or a way to lower my emotions elevator so that my emotions are not feeling so overwhelming? 

CBT can be really helpful for children who have ADHD to give them language around what's going on in their brain and their body.

And on top of CBT, we also want to make sure we're really focused on building up executive skills. So how can I train my brain to listen, to focus, to get things done and to break down tasks into manageable pieces.

What are some signs that my child's ADHD, anxiety, or anger issues may require professional intervention like counseling or even medication?

If your child's ADHD symptoms, anxiety symptoms, or explosive anger outbursts are having an impact on you at home, or impacting them at school, we would recommend getting evaluated by a counselor, therapist, psychologist, psychiatrist, or pediatrician. Medication can be a really great help for kids who have ADHD, but it's not the only intervention that you have available to you.

Research has found that medication plus behavioral interventions like anxiety or ADHD therapy often has the best outcomes. The medication can lower the severity of the symptoms and the therapy can help build the skills that your child or teen needs to succeed at home and at school.

Really what we ask parents is do you think that there's a problem? And if the answer is yes, or if the answer is I don't know but maybe, it is a good idea to at least set up a free consultation call with us. We can talk through what's going on, figure out the best next steps and get you scheduled with one of our therapists if that's what feels like the best fit to you.

How can I take care of my own mental health and well-being while supporting a child with ADHD, anxiety, and anger management issues?

If your kid has ADHD, anxiety symptoms, or issues with anger management, you as a parent are probably also experiencing your own anxiety, stress, or even anger management issues. It is so frustrating to have to review things day after day, to deal with a child who is getting in trouble, to handle a kid who can't handle their own emotions.

We want you to be able to take time for yourself, to build in your own self-care, to notice when your emotions are becoming overwhelming, and take a step back. We also encourage you to consider signing up for therapeutic parent coaching at Compassionate Counseling St. Louis. 

Over six sessions, we plan to talk about what you're dealing with as a parent, give you a space to process, but also help build up skills, strategies, and tools that you can try at home to help support your child. If you're on the fence, or if you want to learn more, you can visit our parent coaching page and schedule a free consultation call.

If your kid has ADHD, anxiety, and anger management, you are not the only one dealing with this. We know from our call volume alone that this is becoming a more prevalent concern. Look out for the signs and symptoms, reach out for help when you need it.

Curious to hear more, or are you a little reluctant about counseling? Compassionate Counseling St. Louis provides specialized anger management and anxiety therapy in St. Louis for kids, teens, and college students. We work in Clayton, MO and serve kids, teens, and college students throughout St. Louis City, St. Louis County, Ladue, University City, Town and Country, Webster Groves, Creve Coeur, Kirkwood, Richmond Heights, and Brentwood. You can set up your free phone screening to see if we’re a good fit for your needs right on our website.