A recent one study It has been found that some people with ADHD (Attention Deficit Hyperactivity Disorder) cope best with periods of high stress.
Maggie Sibley, a clinical psychologist and professor of psychiatry at the University of Washington and lead author of the study, initially wanted to investigate whether it is possible for adults to recover from ADHD. In an earlier study published in 2022she examined a dataset from the National Institute of Mental Health that followed 600 patients with ADHD for 16 years, starting in childhood.
“What we found was this pattern of fluctuating ADHD, and most of the people who got better then got ADHD again,” she said.
For the more recent study, published last week in the Journal of Clinical Psychiatry, she went back to that same data set to try to figure out what conditions might lead to relief from ADHD symptoms.
Sibley thought that ADHD patients would experience the most relief during periods of low stress. What she discovered was more counterintuitive.
Her research identified three distinct groups of ADHD patients: those who experienced periods of apparent complete recovery, those who experienced partial remission, and those whose ADHD symptoms remained stable over time.
People who experienced a temporary full recovery were most likely to experience this during times of ‘high environmental impact’, or, more simply, of stress. Those who had periods of partial recovery were also more likely to have comorbid anxiety.
Arij Alarachi, a psychology doctoral candidate at McMaster University who has studied ADHD and anxiety at St. Joseph’s Hospital in Hamilton, Canada, says it makes sense that ADHD responds differently to different conditions.
ADHD brains may not change that much, Alarachi said, but people can adjust their circumstances to better manage their ADHD. As Sibley’s research shows, these strategies may look different even among people with ADHD, because “ADHD comes in many different shapes and sizes,” Alarachi added.
“ADHD patients perform best when they have to seize the opportunity. And we see that at a micro level…deadlines (can be) helpful, or when things are more urgent, you’re able to be your most productive and hyper-focused,” Sibley said.
Although it is impossible to fully disentangle the extent to which this is a result of ADHD patients choosing to take on more stress when their symptoms are under control.
Sara Vranes, who was diagnosed with ADHD at age 36, relates to this idea. She said she sees her ability to hyperfocus under pressure as a “superpower.” Vranes now works with homeless communities, but previously had 15 years of experience as a midwife and doula, and she says she was most calm during a crisis.
“I don’t want anyone to get hurt, but I could deal with it because my brain can just hyperfocus. I could see everything clearly and see a process in my head, and act on it in real time.” However, during her free time, she is often anxious and unable to concentrate.
More than half of adults have ADHD also experience fear. But Sibley’s research shows that this doesn’t always have to be a bad thing.
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“We call it a protective factor in ADHD,” she said, explaining that multiple studies have shown this to be the case in children with ADHD and anxiety respond better to behavioral treatment, such as cognitive behavioral therapy, than children who only have ADHD.
Alarachi said that in her research she also encounters people with ADHD who say anxiety helps them control impulsivity. They will say, “My fear has helped me somewhat to stop myself from acting on some of those impulses, or it has made me think about some of the consequences.”
“Think of it like the gas and brakes in a car, right? The ADHD can be the gas, and then the anxiety puts the brakes on, like you’re letting people slow down a little bit,” Sibley says.
Anxiety and impulsivity can be more extreme in people with ADHD, “but somehow they cancel each other out in a way that doesn’t make any of these processes as problematic as they could be on their own, which is quite an interesting concept. Sibley added.
Alarachi and Sibley agree that people with ADHD need to look inward to figure out how best to relax and keep their anxiety at reasonable levels where it’s helpful. Vranes finds it difficult to simply relax in front of the TV, but says playing phone games and watching TV at the same time can keep her mind from wandering.
Sibley has encountered ADHD patients who were most relaxed when exercising and socializing.
“I always tell people with ADHD, you have to learn to write your own owner’s manual,” Sibley said. “So you have to figure out, what is your type of relaxation? What’s your brand of decompressing?