'Mind wandering' and anxiety, depression, and ADHD

Recently, Sarah, an architect, attended an online meeting with her team and a prospective client. Despite the importance of the meeting, Sarah experienced 'Mind Wandering' (MW) throughout its two-hour duration. First, she was engrossed in an imaginary argument with her partner about who should cook dinner and do the shopping.

This argument felt so real that her palms grew sweaty, and her heart raced, prompting thoughts about resuming yoga classes to reduce her stress levels. From there, her mind drifted to worries about the impact of stress on her weight, the need for a holiday, and potential child-friendly destinations for the summer. Then, she fretted over what to do about their dog whilst the family took a holiday, a cockapoo with separation anxiety. She considered hiring a house sitter, consulting a dog behaviourist, or even getting a second dog.

Settling on a dog-friendly holiday cottage in Cornwall as a solution, her mind drifted to worrying about rain spoiling the holiday and endless hours caught in August traffic jams. After two hours of mind-wandering through these diverse topics, Sarah left the meeting without recalling what was discussed, feeling anxious, overwhelmed, and tired. If Sarah's experience seems familiar, it may be helpful to explore MW in more detail, particularly its links to anxiety, depression, ADHD, and PTSD.

What is 'mind wandering'?

MW refers to the state where the mind shifts away from the task, also known as 'zoning out', daydreaming, or experiencing intrusive thoughts. MW occupies an estimated 25-50% of our waking hours and can have benefits and drawbacks. Positive aspects of MW include its contribution to creative insights, problem-solving, providing mental breaks, and future planning. However, MW can reduce task performance, increase stress and anxiety due to negative thought patterns, and cause distractions in situations requiring sustained attention.

MW, anxiety, and depression

Research shows that individuals prone to frequent MW often experience higher levels of anxiety and depressive symptoms. Experimental studies support this link: participants asked to let their minds wander reported increased anxiety compared to those given specific tasks. Individuals with higher depressive symptoms tend to report more frequent and distressing episodes of MW.

Why does this happen?

Anxiety is often linked to negative and ruminative thinking. When the mind wanders, it can gravitate toward worries and anxieties, exacerbating these thought patterns.

Excessive mind wandering can increase cognitive load, mental fatigue, and stress due to the constant shift of attention, making it harder to complete tasks efficiently.- The brain's default mode network (DMN), active during mind wandering, has been shown to have heightened activity associated with increased anxiety and depression.

Following a diagnosis of post-natal depression, Micha found herself unable to focus on any tasks, as her mind became filled with intrusive thoughts about losing her partner. Her wife had recently started a role that required working from home twice a month. Micha ruminated about worst-case scenarios, particularly imagining that her wife would find a more interesting partner, less absorbed by a newborn. Having experienced depression and anxiety previously, Micha resumed therapy, finding her rumination and MW decreasing as her mental health improved.

MW and ADHD

ADHD is characterised by inattention, hyperactivity, and impulsivity, which can contribute to difficulties sustaining attention, following through on tasks, and maintaining organisation. There is a notable link between MW and ADHD, with individuals with ADHD often experiencing higher levels of frequent and uncontrolled MW.

Neuroimaging studies suggest that brain networks involved in MW (such as the default mode network) may be hyperactive or not regulated correctly in individuals with ADHD, contributing to their difficulty in maintaining focus. The impact of ADHD on an individual's capacity to focus may become more apparent if external stressors increase, such as increased demands from a work promotion, as experienced by Tim:

A 33-year-old account executive, Tim, struggled with mind wandering after a recent promotion. His previous role had been creative and project-based. Now, his promotion required him to attend meetings and manage a team. During meetings, his mind would drift to imaginary scenarios, and his mind seemed to jump from one association to another, making it challenging to focus on one task. Realising that his self-esteem had plummeted, Tim started working with a therapist and implementing strategies. Tim's ability to manage his mind wandering improved, leading to reduced stress. As his confidence increased, Tim could ask occupational health for the support he needed at work, better able to focus on his creativity and strengths. 

ADHD or trauma?

There is an established link between ADHD (Attention deficit hyperactivity disorder) and trauma, particularly in childhood. While ADHD is a neurodevelopmental disorder with a strong genetic component, research has shown that traumatic experiences can contribute to the development or exacerbation of ADHD symptoms.

It is important to note that not all individuals with ADHD have experienced trauma, and not all individuals who have experienced trauma will develop ADHD. However, the research highlights the potential impact of traumatic experiences on the development and manifestation of ADHD symptoms.

Exposure to traumatic events, such as abuse, neglect, violence, or other adverse childhood experiences (ACEs), can lead to chronic stress and dysregulation of the stress response system. This can affect brain development and functioning, potentially contributing to the manifestation of ADHD-like symptoms.

Trauma can impact the development and functioning of brain regions involved in attention, impulse control, and emotional regulation, which are also implicated in ADHD. Traumatic stress can affect the structure and connectivity of these brain areas, influencing cognitive and behavioural functioning. Individuals with ADHD often struggle with emotional dysregulation, which can be exacerbated by traumatic experiences. Trauma can contribute to difficulties in regulating emotions, leading to heightened impulsivity, hyperactivity, and inattention.

Some ADHD-like behaviours, such as hyperactivity or inattention, may develop as coping mechanisms in response to traumatic experiences. These behaviours may serve as a way to cope with or dissociate from the trauma.

Getting help if MW is problematic

Mind wandering is a typical cognitive process with benefits and drawbacks. When linked to negative thought patterns, it can exacerbate conditions like ADHD, anxiety, and depression, impacting daily life and overall well-being. However, individuals can learn to manage mind wandering more effectively by implementing strategies such as mindfulness, therapy, structured activities, and environmental modifications. It's important to seek professional help if mind wandering significantly impacts daily functioning or mental health.

When assessing and treating individuals with inattention or MW thought to be related to ADHD, it is crucial to consider the potential role of trauma and provide appropriate interventions, such as trauma-informed therapy or specialised ADHD treatment, to address both the neurodevelopmental and environmental factors contributing to the symptoms.