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Anxiety vs. ADHD: How to Tell the Difference

Written by:
Dorianne Green
MD
Reviewer:
Laura Maleknia
CRNP, FNP-C
The medications listed on this website are provided for informational purposes only.
Their inclusion does not guarantee they will be prescribed to any individual, as treatment decisions are ultimately at the discretion of healthcare providers. Healthcare providers may prescribe other medications, including non-stimulant options, or recommend non-pharmacological treatment based on the patient’s unique health circumstances and needs. Read more

Highlights

  • Although ADHD and anxiety are distinct disorders with unique diagnostic criteria, they might present with similar symptoms, such as poor focus and concentration and increased distractibility.
  • People with ADHD can have comorbid anxiety as a result of issues at work and home.
  • It is important to get the correct diagnosis because both anxiety and ADHD have different first-line management options.

You’ve been researching your symptoms online, and some sites talk about anxiety while others make you think you may have ADHD. You’re not sure where to go from here because, as you understand it, they are distinct disorders. Is it possible that they can have overlapping symptoms? Is it possible to discuss the symptoms of both conditions at once during a visit to a healthcare provider? 

Here’s an article that will clarify it for you and help you better understand these two mental health disorders.

Do you have emotional or mental challenges that are hard to describe or understand? MEDvidi is here to assess your symptoms!

Key Differences and Similarities Between ADHD and Anxiety

Let’s run through the basics of each condition.

In effect, the origin of anxiety [1*] is fear that is usually triggered by:

  • Biological factors such as genetics, and
  • Psychological factors, including trauma or unrelenting stress

The Anxiety and Depression Association of America confirms that anxiety disorders are the most common mental conditions [2*] . An anxiety disorder is diagnosed when the overriding or main symptom is continuous worry or fear; it overwhelms you and causes dysfunction in your life.

DSM-5 diagnostic criteria

In generalized anxiety disorder (GAD), anxiety and worry occur together with three or more of the following six symptoms [3*] , with at least some symptoms present for more days than not for the past six months:

  1. Feeling restless or on edge
  2. Getting easily tired
  3. Having poor concentration or a blank mind
  4. Feeling irritable
  5. Experiencing muscle tension
  6. Having trouble falling or staying asleep, or restless and unsatisfying sleep

Anxiety disorders can be further divided by specific trigger factors, situations, or symptom presentations. The types of anxiety include:

Anxiety disorder can develop due to other medical conditions, such as thyroid problems, low blood sugar, heart conditions, lung conditions, vitamin B12 deficiency, and brain conditions. There can also be an association between anxiety and other mental health conditions, especially depression and sleep disorders.

Next is attention deficit hyperactivity disorder (ADHD). Understanding ADHD is made easy by the American Psychiatric Association:

A behavioral condition [4*] that makes focusing on everyday requests and routines challenging… trouble getting organized, staying focused, making realistic plans, and thinking before acting.”

The diagnosis of ADHD hinges on the three primary behaviors below and is based on clinical history taken from adult patients themselves or, in the case of children, from parents and teachers.

  1. Low attention
  2. High energy
  3. Low impulse control

Depending on the most prominent presenting symptoms, the diagnosis is subdivided into a type of ADHD:

  1. Predominantly inattentive: This type predominantly has poor concentration, which may result in careless mistakes, not focusing on tasks or conversations, not following instructions, and being easily distracted.
  2. Predominantly impulsive or hyperactive: The hyperactive type is ‘on the go,’ twitchy, restless, or fidgety, and might interrupt conversations or tasks and not wait their turn.
  3. Combined: Combination of the above.

Can you see the similarities? Even though ADHD and anxiety are unique mental health conditions, they do have overlapping symptoms, such as inadequate attention [5*] resulting in poor concentration, as well as possible restlessness. Therefore, sometimes anxiety looks like ADHD, and on other occasions, the opposite is true. This is why seeing a mental health professional is essential for an accurate diagnosis.

What makes things complicated is that difficulty concentrating or staying focused is the single most common diagnostic criteria for many psychiatric disorders, as well as being a frequent patient gripe. Although it is a classic presenting symptom of ADHD, a recent study showed that 90% of GAD [6*] patients also reported it.

 

ADHD

Anxiety

The basic presentation

Low attention, high energy, and/or low impulse control that cause distress and decreased function.

Overwhelming worry or fear that causes distress and decreased function.

Onset

Usually presents in childhood but might be diagnosed later as adult ADHD.

Could present at any age.

Causes

A neurodevelopmental disorder.

The ADHD brain has poor

working memory due to executive dysfunction [7*] .

Low dopamine action [8*] in areas of the brain.

Biological plus psychological triggers:

  • Genetic predisposition
  • Medication
  • Trauma
  • Unrelenting stress

Psychological symptoms

  • Hyperactive and impulsive presentation
  • Poor time management
  • Excessive worry
  • Sleep problems
  • Trouble concentrating
  • Trouble focusing
  • High distractibility
  • Poor coping skills
  • Decreased motivation

Physical symptoms

 
  • Fatigue

Other common symptoms result from the fight-or-flight response:

Restlessness, pacing, and agitation

"Understanding the differences between anxiety and ADHD is crucial for effective treatment. Accurate diagnosis can significantly improve quality of life, allowing individuals to manage their symptoms more effectively and engage in meaningful activities."
Healthcare provider at MEDvidi

Can I Have Both ADHD and Anxiety at The Same Time?

Yes, you could have ADHD and anxiety [9*] or other mental health conditions together. The fancy medical term for this is comorbid disorders. This is especially true if a person with ADHD struggles with daily functioning, and relationships at work and home are affected. It makes sense that because of such additional stress, they are likely to experience anxiety or depression.

In fact, ADHD and anxiety are among the most common comorbid psychiatric disorders, with 1 in 4 [10*] ADHD patients also having anxiety, although it may not present typically. For example, caution because of worry may mask hyperactivity and cause them to have more sleep issues.

So, not only do they have similar symptoms, but you could be diagnosed with both if you have ADHD.

Accurate diagnosis is the first step to recovery. Book a video visit to go through an assessment in 24 hours.

How to Tell ADHD and Anxiety Apart

Because anxiety can be mistaken for ADHD and vice versa, only a specialist healthcare professional can make a proper diagnosis. They will take a thorough clinical history, evaluate your symptoms, and, if required, suggest physical examination to exclude other physical conditions such as thyroid, brain, heart, or lung issues. You can start with our free ADHD test to have a more detailed and informed discussion with an ADHD specialist.

Why It’s Important to Differentiate Between ADHD And Anxiety

It is crucial to tell the difference between ADHD and anxiety because they require different approaches to medication management and other supportive interventions. Inappropriate treatment can cause serious clinical implications.

In particular, stimulant ADHD medications may not be suitable in the following situations:

  • ADHD with comorbid anxiety or
  • an incorrect ADHD diagnosis in someone actually having an anxiety disorder.

In such cases, stimulants may exacerbate the symptoms of anxiety. Not to mention that they can cause anxiety even in correctly diagnosed patients with ADHD, as it is a known side effect.

Anxiety medications prescribed to someone actually having ADHD do not deliver the desired therapeutic effects either. This trial and error delays response to treatment while a person continues to struggle with symptoms.

"Both anxiety and ADHD can profoundly impact daily functioning. By recognizing the overlapping symptoms and the importance of a tailored approach to treatment, we can help individuals navigate their mental health journey with greater confidence and support."
Healthcare provider at MEDvidi

Misdiagnosis Statistics and Causes

Women with ADHD are often incorrectly diagnosed [11*] as having anxiety. The ratio of boys to girls diagnosed in childhood is 3:1, but the numbers are 1:1 in adulthood.

You are probably wondering why this is. This is most likely because women with ADHD present with more emotional troubles and men with behavioral issues. So, a study suggests [12*] that the emotional presentation might look more like anxiety or depression:

  • Poor self-esteem and social functioning
  • Emotional swings
  • Difficulty with close relationships
  • A general sense of no control
  • Lower life satisfaction

Because of this misdiagnosis and not receiving the right treatment, they struggle to reach their full potential. The amazing thing is the sense of relief these women experience when the proper diagnosis is made; just knowing they have ADHD makes them already feel a bit better, with less shame, anxiety, and depression.

The Significance of Support Systems: Psychological and Social

A sound support system is a great contribution to the effective treatment of any mental health disorder. This is called psychosocial management, which means mental and social support. This team will include people close to you and therapists.

If your diagnosis is ADHD, an ADHD coach might be part of this team, educating you on social, communication, and financial skills and motivating you to have a healthy lifestyle.

If you have any form of anxiety, your therapist will teach you the value of practicing breathing relaxation techniques. These methods usually focus on a longer out-breath, which activates the calming parasympathetic nervous system, canceling the fight-or-flight response.

However, other psychosocial methods work for both anxiety and ADHD treatment:

  • Family education: If loved ones learn more about a mental health condition, they can be more understanding.
  • Mindfulness meditation: Mindfulness has consistently been recognized as an effective way of regulating anxiety, but studies show [13*] that it also helps ADHD patients improve brain function, attention, and control emotions.
  • Patient support groups: Joining support groups helps you realize that you are not alone and get advice from people with the same diagnosis.
  • Dialectical Behavioral Therapy (DBT): This type of talk therapy is helpful if you experience intense emotions, have difficulty regulating them, and this results in unhealthy or harmful behaviors like self-harm, suicidal behavior, substance abuse, or eating disorders.
  • Cognitive-behavioral therapy (CBT): This talk therapy method helps you change how you think, feel, and act. By identifying unwanted thoughts and emotions, you can process them and decrease behavioral response to those feelings.

 These methods will form the baseline of your ADHD or anxiety management recommended by your mental health practitioner; however, your MD might suggest medication if your symptoms are still bothering you.

If you’re experiencing suicidal or self-harming thoughts and require immediate assistance, contact a crisis hotline, such as 911, 988 suicide & crisis lifeline (toll-free), or Samaritans (116-123 or via chat).

When to Speak With a Doctor

Both ADHD and anxiety disorders can significantly disrupt your life. As you’ve learned, it is always better to see a healthcare professional sooner rather than later; your goal should be to get symptoms under control before this happens.

That said, prioritize seeing a clinician for a professional evaluation in the following circumstances:

  • If you have thoughts of self-harm or suicide
  • Self-help techniques and a support network are not helping
  • You are questioning your current diagnosis
  • You are on medication, but you are feeling worse or not improving
  • A family member, friend, coach, or therapist suggests it

MEDvidi’s medical team specializes in both ADHD and anxiety and is just a click away. Take the step to feeling better and book your appointment today!

Sources

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13 sources
  1. Chand SP, Marwaha R. Anxiety. [Updated 2023 Apr 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.
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  2. Anxiety and Depression Association of America. Understand the Facts | Anxiety and Depression Association of America, ADAA. Adaa.org.
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  3. Munir S, Takov V. Generalized Anxiety Disorder. [Updated 2022 Oct 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.
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  4. American Psychological Association. Attention-Deficit Hyperactivity Disorder.
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  5. Robinson OJ, Vytal K, Cornwell BR, Grillon C. The impact of anxiety upon cognition: perspectives from human threat of shock studies. Front Hum Neurosci. 2013 May 17;7:203. doi: 10.3389/fnhum.2013.00203. PMID: 23730279; PMCID: PMC3656338.
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  6. Hallion LS, Steinman SA, Kusmierski SN. Difficulty concentrating in generalized anxiety disorder: An evaluation of incremental utility and relationship to worry. Journal of Anxiety Disorders. 2018;53(53):39-45.
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  7. APA PsycNet.
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  8. Volkow, N., Wang, GJ., Newcorn, J. et al. Motivation deficit in ADHD is associated with dysfunction of the dopamine reward pathway. Mol Psychiatry 16, 1147–1154 (2011).
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  9. Magnus W, Nazir S, Anilkumar AC, et al. Attention Deficit Hyperactivity Disorder. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.
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  10. D’Agati E, Curatolo P, Mazzone L. Comorbidity between ADHD and anxiety disorders across the lifespan. International Journal of Psychiatry in Clinical Practice. 2019;23(4):238-244.
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  11. Attoe DE, Climie EA. Miss. Diagnosis: A Systematic Review of ADHD in Adult Women. Journal of Attention Disorders. 2023;27(7):108705472311615.
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  12. Chand SP, Marwaha R. Anxiety. [Updated 2023 Apr 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.
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  13. Bachmann K, Lam AP, Philipsen A. Mindfulness-Based Cognitive Therapy and the Adult ADHD Brain: A Neuropsychotherapeutic Perspective. Borgwardt S, ed. Front Psychiatry Sec Neuroimaging. 2016;7.
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Written by:
Dorianne Green
MD
Reviewer:
Laura Maleknia
CRNP, FNP-C
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