The Truth About Anxiety & ADHD: Life-Changing Tools From Renowned Psychiatrist Dr. Tracey Marks
- Guest
- Dr. Tracey Marks
- Read time
- ~5 min
- Uploaded
- 10 Apr 2025
- Duration
- 1:33:13
- Views
- 434.2K
KEYPOINTS
- 01
Anxiety is rising, and the goal is management, not a cure
Psychiatrist Dr. Tracey Marks, who has practiced for over 25 years, cites a World Health Organization report of a 25% global rise in anxiety that began with the pandemic and is still climbing. She blames 24-hour news, social-media comparison and information overload. Social anxiety and generalized anxiety are most common. Anxiety rises and falls like a wave, and some of it helps, such as prompting you to prepare for a presentation. The aim is to stop it from impairing your functioning.
- 02
Anxiety happens in the head and the body
Mind symptoms include worry and preoccupation with what others think. The sympathetic fight-or-flight response fires for imagined threats too, causing a racing heart, gut trouble and unnoticed muscle tension. That tension is why you can feel exhausted after 'just sitting' all day. Marks admits she felt performance anxiety during the interview itself: a dry mouth and overthinking her words.
- 03
You can't stop the gas pedal, but you can stop accelerating
The amygdala detects threats and steps on the gas; the parasympathetic system is the brake. Marks says the initial response can't be prevented, but its escalation into rumination, freezing and worst-case thinking can. Mel calls this a breakthrough after '56 years' of trying never to feel anxious at all. For anyone supporting a loved one, the goal shifts to helping them slow down, not making the anxiety disappear.
- 04
Interoceptive exposure breaks the link between sensations and fear
Many anxious people fear the physical sensation itself, like a stomach churn signaling a panic attack. Marks's technique, from her book Why Am I So Anxious? (pages 248-250), is to trigger the sensation on purpose in a safe setting so you learn it's survivable. Do jumping jacks if a racing heart scares you, or spin in a swivel chair for a minute if dizziness or 'nausea' does.
- 05
With phobias, avoidance becomes the bigger problem
Avoidance makes any phobia worse, and soon the avoiding causes more damage than the feared thing. Marks says the pandemic reinforced social anxiety ('I didn't want to go anyway'), and isolation feeds anxiety in turn. Gradual exposure works through small steps: arrive at the networking event, then walk into the room, then talk to one person, building proof that you can handle it.
- 06
Introversion and social anxiety are different
Introverts like Marks recharge through quiet time but don't necessarily fear people. Social anxiety is a disorder of being preoccupied with judgment to the point of avoiding situations, including performance situations like speaking in team meetings. When people glance at the door as you walk into a bar, a non-anxious person assumes they were expecting someone else, while a socially anxious person assumes 'they hate that I'm here.'
- 07
Sleep, diet and exercise change anxiety biologically
Marks says high sugar and ultra-processed foods drive inflammation and alter gut bacteria, sending negative signals to the brain. They can even change gene expression (epigenetics), for example in cortisol regulation. Sleep deprivation raises baseline anxiety because the brain needs sleep to process the day. Exercise boosts BDNF, which she calls 'fertilizer for the brain,' helping good habits rewire it. She ranks sleep first, with diet close behind.
- 08
ADHD and anxiety feed each other
Disorganized thinking makes people feel out of control, which creates secondary anxiety. ADHD involves low dopamine in the prefrontal cortex, which handles executive functions like time management, working memory and emotion regulation. A weaker prefrontal cortex manages the amygdala less well, so worst-case thinking takes over. Mel recognizes the hours she lost ruminating over an email from an annoyed business partner.
- 09
ADHD is about stimulation, not an inability to focus
People with ADHD can hyperfocus on what interests them, which is why a teen can game for hours but leave sneakers in the hallway. Partners often read that as not caring, which strains relationships. Marks thinks rising diagnoses reflect better awareness, not overdiagnosis: 25 years ago adult ADHD was barely recognized. Her own struggle is 'set shifting,' where one midday interruption, like taking her mom to the doctor, wrecks the whole day.
EXAMPLES
- 01
Oakley's 'nausea' and hand-shaking
Mel's college-age son asked by video about a spinning, nauseous feeling that sets off his anxiety. Marks suggested it may be depersonalization or derealization, a dissociative sense of losing touch with your surroundings, and recommended interoceptive exposure. For his unconscious hand-shaking when anxious, she said self-soothing is fine unless it causes problems. Noticing it is the cue to breathe and ease off the gas.
- 02
Bruised hands in fourth grade
Oakley came home with bruises from wringing his hands in class. He was first diagnosed with anxiety, then found to have undiagnosed dyslexia, dysgraphia and ADHD. Mel was treated for anxiety from high school until an ADHD diagnosis at 47, which she says is common for women whose kids are being evaluated.
- 03
Alyssa's fear of vomiting
A 23-year-old production assistant described lifelong emetophobia: she did virtual school to avoid classmates being sick, dislikes flying and rarely drinks. Marks, who once considered staying in New York after residency because it had few roaches, says crafting your life around a fear makes it worse. Phobias can be driven by disgust, not only fear.
- 04
Marks's 'paralyzed' morning
After a stressful week of hunching over her mouse with one shoulder raised, she woke unable to lift her head and briefly feared paralysis. Now she uses progressive muscle relaxation, contracting and releasing muscle groups from head to toe, and recommends five minutes at lunch.
- 05
Mel's ADHD tells
Lists everywhere, cabinet doors and faucets left open, endless saved social-media folders she never revisits, and 'time expansion,' believing she can do 25 things in three minutes. She can tape for nine hours straight but loses the thread after a single meeting.
OTHER RELEVANT
- 01
Vagal tools to hit the brakes
Splash cold water on your face or chest, hum, or use paced breathing: box breathing (4-4-4-4) or 4-7-8, where the long exhale stimulates the vagus nerve. Box breathing makes Marks feel short of breath, so simply breathing slowly and deeply is fine. For grounding, pick a color and name everything in the room that's that color.
- 02
Habit reversal for picking and biting
Body-focused repetitive behaviors range from nail and cheek biting to compulsive hair pulling. People with anxiety may do them to soothe tension, and people with ADHD for stimulation. Notice triggers like boredom, then substitute something, such as wearing gloves while watching TV for a couple of months. For severe cases, see a therapist. Tics are different: involuntary, worsened by anxiety, and sometimes by stimulant medication, which is worth raising with your doctor.
- 03
The five-minute rule and monthly small wins
For procrastination, which is often fed by past failures, commit to five minutes with permission to stop. For lifestyle changes, take an inventory and tackle one per month: a set bedtime, fewer chips, a weekly walk. Her parting words: you're not defective, just different.