North Star Conversations Transcript: Understanding ADHD and Anxiety—Rebecca Cho, M.D.
Dr. Rebecca Cho explains how she distinguishes ADHD from anxiety and collaborates with families to guide individualized treatment.
Brandon Gimbel (00:00)
A parent asks: ADHD and anxiety can overlap greatly in presentation, what are some considerations you take into account when assessing a child and exploring where to start with treatment?
Rebecca Cho (00:11)
That's a common set of challenges. I like to go through the ADHD symptomatology, the anxiety symptomatology, and try to get a sense both from the parents and the child or teen, to figure out what seems to be the more challenging issue. That will help guide what medication treatment I may start first. There are times when both struggles seem to be present. I may either opt for a medication that may address both issues or collaborate closely with a therapist because in general, for ADHD, medications are first line whereas for anxiety, therapy plays a really crucial part in the treatment process. And then we determine from there is this working effectively? Do we need to pivot? The important goal of any psychiatrist is to help the families determine a path forward because there is no one- stop-shop algorithm. Every patient, every family is so unique that it's hard to easily predict how somebody is going to respond to a treatment.
Brandon Gimbel (01:27)
I tell my adult patients that it's a lot of trial and error, informed trial and error. And we don't know exactly what we're going to find when we start treatment. What you and I have is a lot of experience and a pretty good idea of what makes the most sense. But if your experience is anything like my experience, I'm always learning.
Rebecca Cho (01:43)
That's such an important point. For patients and families who come to us, that's understandably one of the most anxiety-provoking things because they're coming to us in a situation where they want clarity, they want certainty.
Brandon Gimbel (02:00)
Certainty is much better than uncertainty. We're trying to treat the invisible interplay between the mind and the brain. And as a team, we can do our best and we can do a good job, but it requires collaboration.