AD/HD, Anxiety AND College?

Barbara Howard, LCPC, CADC

Ext. 408


Did you ever feel like you just couldn’t stay focused on school work no matter how important it was? Have you struggled with knowing how much time an assignment might take and with being organized with different classes, and ended up putting off things until you missed the deadline, had to turn it in late, or forgot to turn it in at all? Did you feel really stressed about your classes and assignments and maybe worried about life in general?


Ginny was a college sophomore who had forgotten assignments, didn’t complete a major paper, had trouble studying and completing her work and then sometimes forgot to turn it in. She barely passed her classes her freshman year of college and was so worried about how she would get through her sophomore year. She was so stressed out that she was worrying all the time. What if she failed? What would her parents say? What if she made a fool of herself in class when she had to present? What if she just could never be successful? She had trouble sleeping and was drinking a ton of coffee to try and stay on top of things. And she said she would feel stupid asking for help, because she should know how to do this, so she suffered in silence afraid to look stupid or be judged.


Many people, like Ginny, struggle with symptoms of Attention Deficit/Hyperactivity Disorder (and despite the name, you don’t have to be hyper at all, you may just have the attention issues). And too much anxiety is the most common emotional issue people have to deal with. All of this can make the idea of college especially daunting and people can decide they are not college material when often they just need to figure out what they need to do to be successful and, with the right support, commitment, and plan, can achieve a college degree and beyond. 


AD/HD is an interest-based disorder, meaning that if there is strong interest in a subject, there is often very little to no attention issue and there can even be hyper focus, where one stays interested for hours with little regard for sleep or eating.  However, If the interest is not strong, or there is no interest, one’s attention will wander and it can be extremely difficult to focus, concentrate, and complete work in that area. (Impulsivity and hyperactivity can also be prominent symptoms that cause a problematic pattern of behaviors.) Yet unlike the long days and sameness of high school, in college a person can take 1-3 classes, have only one or two classes a day, and once they choose a major they are interested in, be able to focus on that subject. This does not mean it is easy, as attention, organization and time management can still be challenging areas but there are skills that can be learned which can help a person be very successful.


Anxiety can show up in various ways and can feel like stress, nervousness, irritability and/or panic.  Everyone is different but one of the hallmarks of anxiety is “if I just avoid the thing that is making me feel anxious, then I will feel better”. Avoidance works beautifully for the immediate gratification of reduced anxiety, relief, but in college is can look like not going to class, not doing the work, not asking for help and even failing.


Sometimes a person with undiagnosed AD/HD  experiences anxiety directly related to undiagnosed AD/HD as an unfortunate result of having to live so long with an un-detected attention issue.  AD/HD expert, Russell Barkley, Ph.D., has compared it to how anxious someone would be if they went years with being nearsighted without it being detected.  Therefore, once the AD/HD is diagnosed and treated the anxiety might greatly lessen or even go away completely.


When Ginny came to therapy, she was able to learn in a supportive, caring environment:

1.      About anxiety - understanding what events, situations, and people might trigger it.
2.      To listen to her thoughts, to what she was telling herself, learning to understand the worries, appreciate how she was trying to protect herself from anything bad happening, and then learning how to work through the feelings so she could be successful.
3.      About AD/HD and how her symptoms were affecting school, work and relationships.
4.      How to help herself improve concentration, time management and organization.
5.      How to find the academic help from her school counselors and/or tutors when she needed it be successful.


Every time she succeeded, the feeling of accomplishment started to rebuild her battered self-esteem and her confidence in herself, allowing college to not only be doable, but exciting, and the insight and self-compassion she learned extended to not only college, but every area of her life.