Many people are treated for anxiety for years before anyone considers ADHD. Others are diagnosed with ADHD and find their anxiety does not disappear with treatment. The two conditions occur together often enough that any good assessment considers both.
Why they overlap
There are several reasons the two appear together so frequently.
Living with untreated ADHD is stressful. Years of missed deadlines, forgotten commitments and the sense of falling short generate genuine anxiety. For some people the anxiety is a consequence of the ADHD rather than a separate condition.
Anxiety can be a coping strategy. Some people manage their ADHD through worry. Anxiety about being late produces the adrenaline needed to get out of the door. It works, but at a cost.
They can be genuinely separate. Sometimes both conditions are present independently and each needs its own treatment.
How they can look alike
Both conditions can produce difficulty concentrating, restlessness, sleep problems, and irritability. Someone whose mind is racing with worry looks inattentive. Someone with ADHD who cannot settle looks anxious.
The distinction usually lies in the pattern and the history.
- Timing. ADHD is present from childhood. Anxiety can begin at any age. If the difficulties are lifelong, ADHD is more likely to be part of the picture.
- What the distraction feels like. In anxiety, attention is captured by worry. In ADHD, attention drifts without a particular destination.
- Consistency. Anxiety often focuses on specific situations. ADHD difficulties tend to appear across most areas of life.
A useful question in assessment is not “are you anxious?” but “were you like this before you had anything to be anxious about?”
Why getting this right matters
Treating anxiety alone when ADHD is also present tends to produce partial results. The anxiety may improve while the underlying difficulties continue, and those difficulties keep generating new stress.
Equally, treating ADHD without addressing significant anxiety can leave someone better able to focus but no less worried. In some cases stimulant medication can temporarily increase anxiety, which is one reason careful review in the early weeks matters.
What treatment usually involves
Where both are present, the usual approach is to treat the more impairing condition first and see how the other responds. Frequently, treating the ADHD reduces the anxiety considerably, because the daily difficulties generating it start to ease.
Where anxiety is severe, it may need addressing first, since it can make an accurate ADHD assessment harder and can interfere with treatment.
Either way, both should be identified. A diagnosis that names only one when both are present leads to treatment that only half works.
What to mention at your assessment
Be open about anxiety symptoms rather than assuming they are irrelevant to an ADHD assessment. Worth describing: when the anxiety started, whether it focuses on particular situations, whether you were an anxious child, whether you have been treated for it before and what happened, and how you sleep.
At ADHD for All every patient completes brief screening questionnaires for depression and anxiety alongside the ADHD assessment, precisely because these conditions travel together so often.
Wondering if this sounds like you?
Take our free two-minute check, or book an appointment with Dr. Anand.
Book an appointmentThis article is for general information and is not medical advice. It cannot diagnose ADHD or any other condition. Only a licensed clinician can make a diagnosis, after a full assessment. If you are concerned about yourself or your child, please speak to a healthcare professional. If you are in crisis, call 911. For mental health support, call or text 988 at any time.