What is the impact of social challenges for people with ADHD?

Anxiety is one of the most common co-occurring conditions

Social anxiety and general anxiety can take the joy from life, while struggling with ASD can make it difficult to enjoy social interactions. Treating ADHD can help alleviate some of the stresses caused by anxiety.

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ADHD Awareness Month
Reframing ADHD
Discovering New Perspectives

But there’s many who have the impact of anxiety, that they get very anxious about encountering people that they are not already comfortable and familiar with. One of the most common comorbidities for adults with ADHD is social anxiety. And that’s different – on the one hand, you’ve got social anxiety, which is basically worrying way too much about what other people are thinking about you – excessively – and the other is generalized anxiety and these are people who just seem to worry about almost everything. But the social anxiety is more encapsulated around issues of how I think people might be thinking about me, how they might be looking at me.

And the most common problem that goes with the social anxiety is avoidance and that is: I just don’t want to go. You know, I’m going to stick with what I already know. I don’t want to have to address that. And so social anxiety is one that’s a very big problem and often that needs some treatment in itself which is why it might be an SSRI medication or some anti-anxiety medication of one kind or another. Or some psychotherapy may be important for it. If it’s a depression and the person is feeling hopeless, and particularly if their eating and sleeping are getting messed up, then they’re likely to need some antidepressant medication and also some support.

I don’t want to make it seem as though pills are the answer to everything because they’re not. It’s also very important to have somebody who understands these things to be able to talk with the person and assess what things might be addressed by medication most effectively, and what things just need to be talked about and thought about and understood, and getting support for it.

And to focus on the other side of it, there’s been a substantial neglect of the autism spectrum in relationship to ADHD. And the studies vary, but if you look at the data on it, over the course of a number of studies, the percentage of people on the autism spectrum who also have ADHD ranges from 30 percent to 85 percent depending on which studies you’re looking at. But what is clear is that many people on the autism spectrum who also have ADHD very often benefit from treatment of their ADHD, as well. And there’s about 30 percent of people with ADHD who also have some autistic features.

You know, I’ve just published a new book talking about ADHD and Asperger’s syndrome, which is a diagnosis that was taken out of the diagnostic manual a few years back and I think that was a mistake. But these are the people with average or above average intelligence who have a lot of difficulty in being able to understand where other people are coming from emotionally, and that often interferes with their social relationships and also with their work relationships. And one of the purposes of that book is to be able to bring together the importance of the treatment and the attention to be paid to ADHD when it’s co-occurring with somebody on the autism spectrum, particularly those people who are often not paid that much attention to.

The research on autism has been mostly focused on those who are more intellectually disabled, but there’s a good 40 percent of the people on the autism spectrum who used to be called Asperger’s syndrome as their diagnosis, where now we no longer have that diagnosis in the diagnostic manual – I think that should be fixed. But the fact is those people who struggle with these more severe difficulties in terms of interpersonal relationships benefit from having their ADHD treated and then getting also the support that they need to be able to learn how to navigate the social interactions which most people are going to pick it up as kids just watching what other people are doing. But the people who are on the higher end of the autism spectrum – higher, meaning higher IQ – often struggle a lot because it’s very difficult for them. They may be very bright, but it’s very difficult for them to read where other people are coming from emotionally and to adjust their behaviors accordingly.

About the Speaker

Thomas e brown

Thomas E. Brown earned his PhD in Clinical Psychology at Yale University and served on the Yale faculty for 25 years. He is now Director of the Brown Clinic for Attention and Related Disorders in Manhattan Beach, CA, is an elected Fellow of the American Psychological Association, and has published numerous articles and six books on ADHD. His website is www.BrownADHDclinic.com