Why Using Anxiety To Manage Your ADHD Isn't A Good Idea

Running your business on anxiety feels like productivity. It isn't. It's a system built on urgency, and it burns out fast.

Research suggests that goal-focused interventions can reduce anxiety in adults with ADHD. What they don't appear to do is meaningfully improve executive functioning. Skye and Will break down a Norwegian randomized controlled trial on goal management training, what it found, and why that gap between feeling less anxious and actually getting more done matters for how you run your work.

What We Cover

• Why using anxiety as a task manager is a direct path to burnout
• What the research found about goal management training and anxiety reduction
• Why the study's results showed little change in executive functioning despite structured intervention
• The difference between reducing mental load and building systems that improve output
• What's missing from most ADHD support frameworks when it comes to actual mechanics

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Transcript

SPEAKER_02 0:00

I find a lot of people with ADHD treat their ADHD through anxiety because I just need to get stuff done. If I feel anxious about it, I'm going to get to it. It's a bad way to treat your ADHD, and that's a big factor in burnout, is being just like, oh, I'm just running on anxiety. In this episode, we're going to be discussing a paper called Improvement of Anxiety in ADHD following goal-focused cognitive remediation, a randomized controlled trial. And this is a study that investigates goal-focused interventions and then looks if they can improve executive function and emotional well-being for adults with ADHD.

SPEAKER_01 0:29

Before we get started, we have a couple of spaces left for our Invisible Systems program. If you're a business owner who struggles with ADHD, you're making over 100K in a service business and you know that it's time to get your operational layer sorted. Click the link below to book a free business build-out and we will build your operational layer for you and for your ADHD brain. So this paper is from Norway. And really what they were looking for was whether having a particular kind of intervention for ADHD, particularly goal-focused intervention, we'll get into what that means in a second, whether it was going to help with ADHD symptoms and associated symptoms like anxiety, for example, over and above your standard support and your standard treatment.

SPEAKER_02 1:18

But there is some like interesting caveats to when we're like looking at this paper too, because of like looking at who they had as participants, being very focused on being people that are motivated to do this kind of thing. So that's I was like, this is, I understand, because you want to have people complete the study, but then is that factor alone going to be enough?

SPEAKER_01 1:38

Yeah. So there are a few limitations that we'll talk about. But do we want to start by just saying what is goal management training? Because for a lot of people, goals are just a thing that you set, they're not a thing that you train. So do you want to take us through what this is?

SPEAKER_02 1:52

Yeah. So for their goal management training procedure, they had a structure of like eight weekly sessions where they're, you know, these have these 45-minute periods where they're going through and participants are losing learning strategies for setting goals. They have things like stop. Stop is a technique with the stop state split. It is a technique to kind of break that mental circuit where you're in auto mode. So you kind of like stop what you're doing, and then you kind of figure out what state you're in to kind of combat that goal loss idea. And then if it's the task is feeling overwhelming, you can like split the task into smaller parts and figure out how to do that kind of thing. So but yeah, so a lot of this goal management training is about teaching how to set goals and then how to follow through with that goal setting.

SPEAKER_01 2:39

Yeah. And it's interesting. So what they're really trying to do here is they're trying to support your working memory by splitting things in half. They're trying to, you know, avoid that reactive dopamine-seeking attention switching that we can do when we are sort of like halfway through a task and then we suddenly wake up, if you will, and we find ourselves halfway through a third task. They're trying to keep you in the zone and keep you focused, which I think a lot of ADHD interventions are doing in multiple different ways. And to your point, then the people that they mentioned and the people that they actually asked if they wanted to do this study were people who were diagnosed with ADHD. So we are we are looking at people who are specifically diagnosed, but they had said that they were motivated, which is a very loaded word in the ADHD world, to work on executive problems to increase coping in everyday life. So they were not doing this against their will, if you will. And I get that. I mean, if I one of the things I always ask people who I work with is do you want to learn new systems, try new things? Are you comfortable reaching out if you need help? All of those kinds of things. You're not really gonna get any results if you don't, but it's different from our purely pharmacological interventions.

SPEAKER_02 3:59

It's I mean, I think it's an incredibly important point because yeah, you don't get change happening unless you want the change. There's different levels of I want to change, but I don't know how versus I want to change and I'm just gonna go for it.

SPEAKER_01 4:11

Yeah, yeah. And and it's interesting to note, and I think it this will come up later, that both groups, so the people who got randomly assigned to the goal management system, and the people who just got assigned to talking to your psychiatrist, talking to your GP, both of those people were motivated to work on their executive problems.

SPEAKER_02 4:33

Additionally, we should also talk about the gas, the goal attainment scaling procedure that they used in conjunction with the goal management training. It was interesting because they had different results on like who finished what. Goal attainment was participants attending four individual 45-minute sessions. So this is like bi-weekly, and then they could set as many goals as they wanted in the session, although that averaged out to be 1.6. Some people were setting a lot, but a lot of people were not. And they were varying from, you know, getting out of bed before like 9 a.m. or you know, practicing the stop technique from the goal management training, and then each goal was measured on a scale to track the progression where it's like it's a five-point scale, but going from negative two to positive two. And then it's just a it was a method to measure the progress they were making on their goals.

SPEAKER_01 5:24

Yeah, definitely. And I think it's an interesting one when we talk about the GMT process itself and stating your goal. Some of this I would say, yep, that's really helpful. Others, if I'm being honest and I'm looking at the research into ADHD, I wouldn't use in my own work, for example, some of the processes. How did you feel about the actual GMT method that they were testing?

SPEAKER_02 5:52

I felt, especially with the fact that we had motivated people, like this was a lot of intervention. Like they're meeting quite frequently, you know, for eight weeks. So it's it's a long-term thing. And so I don't know if the particulars of what they were doing were the most important thing rather than they were keeping goal setting top of mind.

SPEAKER_01 6:13

Yeah, is the accountability what you want to do.

SPEAKER_02 6:15

So when I was like, okay, you have these workbooks that you're learning about absent mindness and automatic pilot and these mental slip-ups where you're doing the wrong thing. You know, like the I don't know about the stop state split. That's okay. It's I'm gonna cut to some of the results of the study real quickly. The biggest thing they saw was a reduction in anxiety, and that's kind of what this looked like it would be for me. It would be more of an anxiety program rather than a specific ADHD program.

SPEAKER_01 6:43

Yeah, yeah. And that was, I think, the tr the thing. Because yes, to to cut to the end and then to discuss it a little bit more, what they found was that people who were struggling with ADHD, you know, symptoms who did this didn't have much of a difference in terms of their executive functioning compared to the treatment as usual method. So this intervention didn't improve ADHD symptoms significantly. It was anxiety that it improved instead.

SPEAKER_02 7:17

Yeah, I can definitely see why. I mean, and there's no question, that's great. Reducing anxiety is, you know, that in itself can have, you know, effects on your executive function having less anxiety worrying about things. But again, it was just like, yeah, that kind of seemed what they were unintentionally aiming at. I didn't see anything specific that was like, oh, this is going to help with executive function.

SPEAKER_01 7:38

I think that's one of the problems with some of the system improvements that we use. Like if you type in if you ask ChatGBT, for example, how to support ADHD, it will give you a lot of support for emotional support, but not so much for actual executive function. Because I think it's just a more complicated, lesser known problem. Like, for example, when I was looking at the mental blackboard, they talked about this idea of limited capacity in your working memory, aka you have a mental blackboard and you can't put a lot of stuff on it. Totally makes sense. Really good. What do we do instead? That bit seemed, at least from what I'm getting here, to be missing. And that, like, we use the prioritization filter. We've talked about this on this podcast before, I'm sure. But it's that idea of you know breaking things down and how it works and how to filter it. And I feel like mechanically, if you're trying to support executive functioning, you need more mechanics that are gonna work for the ADHD brain.

SPEAKER_02 8:43

Because yeah, breaking down tasks is a fantastic way to get more stuff done and figure out what you need to prioritize. But that alone can't be your solution because it can become breaking down tasks and also become overwhelming when you're like, oh man, that was not one task, that's 50 tasks.

SPEAKER_01 8:58

I agree. I think it's great and then it's overwhelming. That was maybe the one thing that I found really interesting was how much this helped with anxiety because it made me wonder what the anxiety was about.

SPEAKER_02 9:10

I find a lot of people with ADHD treat their ADHD through anxiety, because I just need to get stuff done. If I feel anxious about it, I'm going to get to it. It's a bad way to treat your ADHD, and it's leads to like that's a big factor in burnout is being just like, oh, I'm just running on anxiety. Because yeah, if I'm I'm I I I have my task manager in my head, so I can't stop thinking about it because if I stop thinking about it, I'm gonna forget. Learning techniques to be like, oh, I'm not gonna keep everything in my head would reduce anxiety, but it might not necessarily increase the amount of stuff you're getting done.

SPEAKER_01 9:43

Yeah, exactly. And I think that's maybe the complicated part of this conversation is, you know, these people were very, very motivated to support their life and their executive functioning. And they were motivated enough to do a multi-step process that went over a lot of periods and was quite intense. In the end, I'm not completely, I know everybody's systems improved with accountability, but it did feel like there was a little bit missing from the mechanics of the support that was available to help them actually reach that goal. I think that was the piece that I felt the most. Sorry for people at the end, you know, going, well, they feel less anxious and they feel a little bit better, but there's probably a piece missing where they're still like, I'm gonna feel a little bit more overwhelmed soon once this very intense accountability drops off.

SPEAKER_02 10:32

Yeah, it'd be really interesting to then have another follow-up. So they have this like initial eight week and then another one after they're not doing any interventions. What has stuck? What has did it help in the long term rather than just while it was going while it was happening?

SPEAKER_01 10:47

But you know, in terms of what we can take away from this, I think we can say that like that support, that accountability, that intervention does have you know shifts and it does help. And also that, you know, it is good doing these kinds of stop, reflect, what am I doing, what am I doing next in terms of improving anxiety.

SPEAKER_02 11:07

If you are dealing with anxiety, yeah, definitely try out these techniques because it's something that we have data. So, yeah, this helps, but you just need to actually do it.

SPEAKER_00 11:15

Thank you so much for listening to this episode of the ADHD Skills Lab. If you liked it, leave us a five star review. It helps other people learn more about us. And thank you so much to our wonderful team for making us sound good, look good. We couldn't do it without you.