Anxiety vs. Shame… with a little ADHD

I may have had an epiphany of my own when working with a client last week. He and I got very specific about how he was feeling and differentiated his anxiety from his shame. And, what I realized is that they have different behavioral levers and can cripple in different ways. I’m still exploring this. But I figured I’d share what I’m working on with my 24 devoted readers and you hundreds of bots that Google keeps telling me are real people trafficking my site every month. 

Anxiety is a sinister and crippling problem. I deal with it in a myriad of ways. Pharmacologically with my antidepressant and with benzodiazepines. I also use exercise, self talk, mindfulness, meditation, generally self care, and other ways. I’d estimate that about 80% of my clients also deal with anxiety. Over the years I think that has made me somewhat of a lay expert… if that’s not an oxymoron. I’ve also done some training in CBT which I have incorporated into my coaching for many years now. 

What I know about anxiety, particularly in how it affects ADHDers, is that we put things off because they make us anxious (and because of the ADHD reasons that we put them off.) But there are two competing anxieties at any given time. There is the anxiety of doing Thing A and the anxiety of not doing Thing A. Because our time sense is wonky, we aren’t good at the concept of “later.” So the anxiety of not getting Thing A done is relatively low as we put it off for a period of time. Meanwhile the anxiety of not doing Thing A slowly builds based on our theoretical knowledge that we should do it, that we might not have time (whatever that means,) there will be consequences eventually if it doesn’t get done. As the deadline approaches, our time sense activates, the deadline becomes real, our fear response kicks in, our lizard brain produces adrenaline, and that adrenaline produces dopamine in the prefrontal cortex. Boom. Attention. At least that’s how the ADHD side works. The anxiety side depends on the fear of not getting it done to eclipse the fear of doing it at some reasonable point. 

To understand that, It’s useful to think of this from a CBT framework of exposure therapy. Anxiety about Thing A exits. It increases as we initiate the activity. It peaks as we fully engage. It usually begins to recede as we realize Thing A isn’t as bad as we thought it was. But even if it is, the anxiety fades as we complete Thing A and then it’s gone once the task is complete. A total win. Anxiety Vanquished!

But what I realized is that once you get SHAME involved the dynamic is completely different. Shame isn’t alleviated by the performance of Thing A. In fact, the easier Thing A is, the more shame one might feel about not having done it sooner or faster or better. And that shave persists, even if the anxiety abates. Often that shame begins as soon as the Thing A hits the radar and isn’t done immediately. And as that shame grows, it gets out of control so quickly that there is almost no amount of positive outcome from doing Thing A that can counteract it.

LIke I said, I’m still working on the ramifications of all this and how to coach a client through it. But I feel it is important enough to start talking/writing about. I hope y’all found it interesting. I’ll keep y’all updated on where I go with this in the future. In the meantime, don’t shame yourselves. It’s not worth it. 

Standard Disclaimer:  In an effort to foil my own perfectionist tendencies, I do not edit my posts much… if at all. Please excuse and typos, mistakes, grammatical errors, or awkward phrasing. I focus on getting my content down. In my humble opinion, an imperfect post posted is infinitely better than a perfect post that goes unfinished.

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