Agoraphobia and ADHD: Living with Both

The evidence for agoraphobia coexisting with attention deficit hyperactivity disorder (ADHD) is mixed.

The research suggests a wide range between 4.6% and 81% of individuals with ADHD have comorbid agoraphobia.

While some evidence suggests that the link between the two conditions may be due to common genetic risk factors, other research highlights the influence of overlapping symptoms and the COVID-19 pandemic.

Recommended treatment methods for agoraphobia and ADHD include:

• Cognitive Behavioral Therapy.

• Mindfulness meditation.

Agoraphobia and ADHD Comorbidity

Comorbidities are common in people with ADHD. The National Resource Center on ADHD proposes that up to 53% of individuals with ADHD have at least one comorbid condition.

Anxiety disorders are one of the most common coexisting conditions. It is estimated around 50% of US adults and up to 30% of children with ADHD also experience an anxiety disorder.

However, the statistics vary when it comes to the coexistence of ADHD and agoraphobia.

• A 2011 study found that around 19.1% of individuals with ADHD also had agoraphobia.

• In contrast, a 2018 study discovered that of 277 women with ADHD, 20 had agoraphobia, and out of 271 men, 5 were agoraphobic.
  
  This was a total of 4.6% across both genders. Interestingly, in general, agoraphobia is found more commonly in females than in males.

Agoraphobia & ADHD Prevalence Rates

What’s the Link Between Agoraphobia and ADHD?

Genetics

One potential explanation for the co-occurrence of ADHD and agoraphobia is genetics.

In a study looking at the genetic risk factors for ADHD, Biederman et al. (1992) found that agoraphobia was more common in relatives of those had both ADHD and agoraphobia.

This finding may suggest that ADHD and agoraphobia share common risk factors, an idea supported in a later 1996 study.

However, it’s worth noting that the effect Biederman and colleagues found was no longer statistically significant when they controlled for confounding variables.

Therefore, the supposed link between genetic risk factors for ADHD and agoraphobia may be due to the interaction of other variables, such as intactness of the family and socioeconomic status. 

More research is needed to identify the exact role of genetics in the comorbidity of these two disorders.

Misdiagnosis

Another potential explanation for the link between the two conditions is misdiagnosis.

ADHD and anxiety disorders tend to have overlapping symptoms:

• Inattention: Inattention is a well-known symptom of ADHD, but anxious individuals can also display inattention, mainly when preoccupied with negative thoughts and worries.

• Poor peer relationships: Individuals with ADHD may struggle with impulse control and social skills, making sustaining friendships challenging. Similarly, a socially anxious person may struggle with peer relationships due to fears of rejection and embarrassment.

These overlapping symptoms can complicate diagnosis, resulting in frequent misdiagnosis.

Therefore, some individuals diagnosed with ADHD may be suffering from an anxiety disorder instead, and vice versa.

COVID-19 Pandemic

Much of the research looking into the influence of the COVID-19 pandemic on ADHD and agoraphobia is yet to come.

Nonetheless, some evidence illustrates that the comorbidity of these two conditions may have increased due to this event.

The Centers for Disease Control and Prevention showed a 5.1% increase in depressive and anxiety disorder symptoms from August 2020 to February 2021. 

This may suggest that anyone, not just those with ADHD, may be more at risk of developing a mental health condition such as anxiety or depression.

Further evidence has looked into the effect of the COVID-19 pandemic on individuals with ADHD specifically.

In a 2020 cross-sectional study, it was found that stress levels were higher in adults with ADHD during the pandemic. But don’t worry; when participants maintained their ADHD treatment, the effects of the pandemic on their mental health were mild.

Treating Agoraphobia and ADHD

There are several ways to treat ADHD and agoraphobia, some involving a mental health professional and others without.

Let’s look at two of the most recommended treatment methods.

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy (CBT) is a form of talking therapy that addresses negative thought patterns. A CBT practitioner aims to swap these harmful, often irrational thoughts with more constructive ones.

• CBT, specifically aimed at treating those with ADHD, focuses on coping with executive function difficulties, organization, and planning and, in the process, eases some of the debilitating symptoms of ADHD.

• CBT is also one of the most widely used treatment methods for anxiety disorders. Evidence suggests that CBT can be a helpful technique for managing Agoraphobic symptoms up to 2 years after treatment.

Mindfulness

Mindfulness is a self-help technique you can use to manage your ADHD and anxiety symptoms.

Research shows that mindfulness can assist with ADHD through two key ways:

• Mindfulness can raise dopamine levels, helping alleviate ADHD symptoms, as individuals with ADHD seemingly have lower-than-normal amounts of dopamine.

• Mindfulness also supposedly thickens the prefrontal cortex, an area of the brain involved in planning, impulse control, and concentration.

In terms of agoraphobia, it’s been found that a mindfulness training program could lessen anxiety and panic symptoms, making conditions like agoraphobia, generalised anxiety disorder, and panic disorder easier to manage.

The Bottom Line

Agoraphobia and ADHD frequently coincide, but evidence of the exact prevalence of this comorbidity is conflicting and seems to differ across age and gender.

Research suggests that shared genetic risk factors, overlapping symptoms leading to misdiagnosis, and most recently, the COVID-19 pandemic may play a role in the co-occurrence of agoraphobia and ADHD.

If you’re suffering from both conditions, try Cognitive Behavioral Therapy and mindfulness meditation; these methods are thought to lessen ADHD and anxiety symptoms.

Related posts:

Agoraphobia and Autism: Are They Intrinsically Linked? Agoraphobia and OCD – Are they related? How Does Agoraphobia Affect the Brain? Agoraphobia and Extraversion: Social Yet Scared