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Stress and ADHD: Causes and Work/Life Impact – Managing Your Mind

Written by Dr. Geri Markel on February 4, 2019

Stress and Adult ADHD

Harris completed his residency in Hematology and plans to move out of town for a new job. Although he’s competent, he’s hassled because of upcoming specialty board examinations, wedding plans, and a new job. This scenario would be stressful for anyone. But for a professional with ADHD-Inattentive Type, it is the perfect storm for stress to exacerbate ADHD symptoms. Already tired from the rigors from years of training, he feels especially overwhelmed by all he needs to do in a few short weeks. He stays up even later than normal, skips meals, and snaps at coworkers, friends, and family. As his stress level increases, Harris’s attention to detail, memory, and organization decreases. He loses the check required by the medical licensing board and has a tough time studying for the boards. Every time he begins to study, he gets a queasy feeling in his stomach. This is an example of stress heightening the symptoms of ADHD and the symptoms of ADHD triggering stress.

Harris is not alone.

According to some experts, millions of Americans suffer from stress each year. 3 out of 4 people say they experience stress at least twice a month. Too much stress can contribute to physical problems including heart disease, high blood pressure, or strokes. You may be more likely to catch colds or slip in various addictions.


What is Stress and How Does it Relate to ADHD?

ADHD adults experience more stress than the average person because of their symptoms. For example, they may feel stress when overwhelmed by too much to do or clutter. ADHD adults may feel stressed by feelings of dread. This occurs when they need to perform on the spot (job interview) or under time pressure (taking a high-stakes test).

As with any type of situation, stress can be two things: your perception of some pressure or danger and your body’s response to the stress. Stressful events can occur from two types of situations. From an external environment, like a vicious looking, barking dog running toward you. Or from an internal event, the fear of losing your job. In either case, your body prepares for the danger: fight or flight. For many with ADHD, freeze is common. In the latter situation, you shut down and can’t respond as you would like. When your body senses stress, it releases chemicals into the blood, giving your body more energy and strength to deal with the issue. The body’s reaction is meant to solve short-term, very dangerous problems.

In today’s society, many adults experience continuous triggers of stress response for non life-threatening situations. This includes constant traffic jams, a co-worker yelling, losing your keys or wallet. The above is especially true for those with ADHD.

It is important to discriminate between internal and external (or environmental) stress. Internal stress relates to your emotions and thoughts. In such situations, you trigger stress with negative thoughts, fears, and “what ifs.” ADHD adults may suffer from internal stress based on unsuccessful school/work performances or unfulfilling interpersonal interactions. External stress may occur from the setting. For example, people making unrealistic requests, trains or buses that are late, or slow processing when needing to do highly detailed work.


Can ADD/ADHD be Caused by Stress?

Stress does not cause ADD/ADHD. According to research, when you experience high stress or anxiety, you can function as if you had ADHD. See this helpful article on identifying triggers, such as high stress or anxiety.  What is true is that ADHD adults are more vulnerable to stress, particularly when they’re tired and overworked. Stress builds up and takes a toll on your body, especially when it takes a long time to get things done and you don’t take breaks.


ADHD Adults ask, “Is All Stress Bad?”

During regular work/life situations, some stress can be helpful. For example, good stress results in feeling “pumped up” or ready for a challenge such as a sporting event, interview, or a happy occasion.

But when stress is extreme and long-term, it is harmful to your physical and emotional well-being. For example, for Harris, stress is negative. He is overloaded and can’t focus and perform effectively. He has negative thoughts and physical symptoms of stress such as a headache or butterflies. Although he manages his ADHD symptoms under ordinary circumstances, external events are triggering significant new pressures. His unmanaged stress aggravates his common symptoms of ADHD, such as sleep problems.


Can Stress Cause ADHD?

Stress does not cause ADHD. However, several factors make ADHD adults more vulnerable to stress. These include poor sleep, daytime fatigue, too much caffeine, and overstimulation. For example, a person with ADHD may feel bombarded by too many sights and sounds such as amusement parks, loud parties, or busy malls. Also,  persons with ADHD may suffer from overstimulation from electronic or digital devices such as computers, cell phones, or television. All these can increase vulnerability to stress.

There is a dynamic and constant interaction between the symptoms of ADHD and stress. For example, you have trouble focusing or remembering and your stress level rises. You’re irritated by a co-worker, your stress level rises. Then you are more distracted and forgetful than ever. When symptoms are severe, ADHD may cause a perpetual state of stress and forgetfulness.


Can You Have ADHD and Anxiety?

Some ADHD adults experience continued high levels of stress. In some cases, they are diagnosed with clinical anxiety, as determined by a physician or psychologist. If anxiety is triggered by ADHD symptoms, then treatment of the ADHD symptoms is advised. That can include cognitive behavior therapy or medication to reduce anxiety.

In other cases, adults have anxiety independent of their ADHD.  Again, therapy and/or medication may be prescribed. Some stimulant-drug treatments for ADHD may worsen anxiety symptoms. Monitoring anxiety symptoms and possible side effects of medication is advised.


Types of Stress Experienced by ADHD Adults

All stress is not alike. It is easy to see that some stress is more intense and long-term than others. Stress can be classified into four different types:

  • Acute stress: you experience agitation, moodiness, irritability, headaches, and/or gastrointestinal upset.
  • Episodic acute stress: you suffer from migraines, high blood pressure, emotional difficulties, and serious gastrointestinal distress.
  • Chronic stress: you are more vulnerable to systemic illnesses. It compromises your immune system. Although it can be reversed, it usually takes time and professional intervention.
  • Traumatic stress: You experience this after personal or other tragedies. Post traumatic stress disorder can be a result of a catastrophic event such as a hurricane, foreign war, violence, or death.


ADHD and General Stress Symptoms

Adults with ADHD can avoid sliding into a negative stress situation or cycle, by understanding both the physical and psychological symptoms of stress.

Physical Symptoms

  • Gastrointestinal upset
  • Sleep disturbances
  • Sweating palms
  • Tense muscles
  • Headaches

Psychological Symptoms

  • Short attention span
  • Poor memory
  • Poor organization
  • Irritability
  • Mood swings
  • Fatigue
  • Increased risk of emotional problems including depression

Watch for and take stress seriously since it exacerbates ADHD symptoms. And in turn, ADHD symptoms make you more vulnerable to stress.


ADHD Adults: Identify Examples of Your Stress

From a list of the top ten causes of life stress, check all that you have endured in the last 12 months:


___ Onset of an illness or management of a chronic disease

___ Serious illness or accident of a loved one

___ Departure or death of a partner, family member, or dear friend

___ Change or loss of job or promotion

___ Change of residence or place of business

___ Home or business reconstruction projects

___ Financial setback or economic downturn

___ Introduction of a child into one’s life through birth or adoption

___Feelings of social, career, or personal failure


If you’ve confronted the challenges of any one of the top ten causes of stress, think about the symptoms of stress you might have experienced. Self-awareness of stress is a first step toward managing stress and enjoying work/life productivity. 

After you understand the symptoms of stress, remember that major life changes and transitions sow the seeds of stress. Especially if someone faces more than one of these changes simultaneously. No one is immune from the effects of life interrupting life. Even those with high intellectual potential and well-developed coping skills can be brought to their emotional knees by the stress associated with life changes. Harris, the physician with ADHD, experienced new and intense stress when facing several life-changing events.


When Too Much Stress is Too Much Stress

Once you engage in a self-check of stress, ask “How serious is my stress condition on a scale from 1 to 10 with 10 being the most serious level of stress?”

If your stress level is high, don’t ignore the stress. Begin to deal with it as a potential barrier to your personal or professional role. Reach in for greater self-awareness and reach out to others about ways to circumvent it or better manage it. Talk about the results with a friend or counselor who can help decide how acute your stress is. They can help also help with ways to reduce or better manage workplace stress. 


If you think coaching might help your productivity and lessen stress, contact Geri for information on possible services or workshops. Go to or email,


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