Understanding the Link Between Anxiety and ADHD

ADHD vs Anxiety

ADHD is a neurodevelopmental disorder. This means that it originates in childhood and slows down or prevents normal development. It persists through adulthood, although coping mechanisms and medication can reduce the negative effects of ADHD symptoms in real life. 

It’s important to note that, unlike anxiety, ADHD is considered a neurodivergent condition. Although ADHD brains work differently than the average, there is nothing wrong or “broken” with them. Some symptoms are disruptive, but the goal of ADHD therapy and medication is to mitigate negative effects and find positive coping mechanisms, not to eradicate ADHD. It is not something that needs to be ‘cured’ or ‘fixed’, but rather something that should be understood and accommodated. 

Anxiety, on the other hand, is a mental health disorder. It is caused by a mix of genetic, environmental, and situational factors. It can onset at any time in a person’s life, and, with the proper medication and treatment, it does not last forever. The goal of anxiety therapy is to get to the root of what is causing anxiety and provide healthier coping mechanisms.

What is ADHD?

Recent estimates put the prevalence of ADHD at around 5-7% for youth and 2.5-6.5% for adults. However, some professionals believe the actual estimate is higher, as current diagnostic criteria have been criticized for not fully representing the symptoms experienced by women and BIPOC people with ADHD. 

Most researchers agree that there are three main types of ADHD: 

• Inattentive Type—Internal presentation of ADHD, including forgetfulness, difficulty paying attention, and disorganization. 
• Hyperactive Type—External presentation, including fidgeting, restlessness, disruptive behavior, and inability to sit still. 
• Combined Type—A combination of both inattentive ADHD and hyperactive ADHD. 

The only way to know for sure if you have ADHD is to get diagnosed by a medical professional, but you might have ADHD if you experience these common symptoms:  

Inattentive Symptoms: 

• Frequently makes careless mistakes
• Trouble holding attention, in both boring and enjoyable activities
• Difficulty focusing on speaker when being talked to
• Fails to follow directions, due to being distracted when receiving or doing tasks
• Disorganization, prone to losing items often

Hyperactive Symptoms: 

• Often fidgets, taps hands/feet, or squirms in seat
• Will leave seat in inappropriate situations
• Restlessness
• Difficulty engaging in leisure activities that require them to be quiet or still
• Talks excessively, cutting people off or when quietness is expected
• Blurts out answers or talks out of turn, difficulty waiting their turn
• Constantly feels “on the go” or as if “driven by a motor”

If you think you might have ADHD, talk to a mental health professional. Treatments are available to alleviate harmful and disruptive symptoms and highlight the strength of ADHD brains.

What Is Anxiety?

Anxiety is one of the most common mental health disorders—with a prevalence of 19.1%. Within people with ADHD, a quarter of them are also diagnosed with an anxiety disorder. 

Why is there such a large anxiety and ADHD overlap? Some researchers believe it’s because of their shared symptomatology; both disorders have similarities in their symptoms that could lead to exacerbating each other when they occur together. It’s also possible that anxiety and ADHD share many of the same risk factors, including genetic and environmental factors. 

Still, despite their close link, ADHD and anxiety are not the same thing. Symptoms of anxiety are: 

• Trouble concentrating or making decisions
• Feeling irritable, tense or restless
• Experiencing nausea or abdominal distress
• Having heart palpitations
• Sweating, trembling or shaking
• Trouble sleeping
• Having a sense of impending danger, panic or doom

There are many common symptoms between anxiety and ADHD, so much so that it can become difficult to parse out what is ADHD and what is anxiety. Understanding the difference between the two and their overlap will help us understand how to manage anxiety and ADHD.

How to Tell Anxiety and ADHD Apart

Anxiety and ADHD can closely overlap, making it difficult to differentiate the two. This can stop many people from receiving a secondary diagnosis and block them from getting the proper, holistic therapy they need. 

Although ADHD and anxiety are similar, there are some key differences. For one, anxiety can make it difficult to concentrate in some situations, but ADHD will make it difficult to concentrate in all situations (source). 

Other differences are explored in the chart below.

Is Anxiety a Symptom of ADHD?

Yes, anxiety can be a symptom of ADHD. But it can also be its own, separate disorder existing alongside ADHD.

ADHD involves many socially disruptive behaviors that can cause anxiety. For example, time blindness can make many adults with ADHD late to work, which can cause anxiety. Or, excessive talking and cutting people off can make social situations a stressful experience. In these cases, the anxiety is a symptom of ADHD. 

The presence of an anxiety disorder in addition to ADHD will look a little different. The anxiety will likely be more pervasive and respond to specific triggers. In these cases, ADHD and anxiety are influencing each other, at times making each other worse and at times masking the other’s disruptive symptoms but not directly causing one another.

Can Anxiety Mask ADHD?

Especially prominent in adult women, anxiety can mask disruptive ADHD behaviors. For example, you experience time blindness that makes you late to work, but you have so much anxiety over being late that you put in the necessary accommodations (and a lot of worry) to ensure you won’t be late. 

In a case where both anxiety and ADHD symptoms are present, researchers have found that anxiety often presents over ADHD symptoms, giving the impression of an anxiety disorder without ADHD. 

For example, in one study, researchers found that when faced with a threat, anxiety prevails above ADHD. Anxiety kicks the brain’s executive functioning into overdrive and it’s able to overcome the deficits associated with ADHD. 

What does this mean? When you’re stressed out, you’re more likely to present anxiety symptoms than ADHD symptoms. So when you have an anxiety disorder, and your stress levels are consistently high, you are less likely to be diagnosed or treated for ADHD. This huge gap in personal treatment can negatively impact overall well-being. 

The masking of ADHD does not negate its symptoms. Remember, in the above example, the case of worry was a direct result of a disruptive ADHD symptom. Although anxiety can seem like a coping mechanism for ADHD, it’s not a healthy one.

So, in conclusion, ADHD and anxiety can relate in many ways including: 

• They can inflame each other, making symptoms worse
• Anxiety can mask the disruptive symptoms of ADHD, preventing diagnosis 
• They can exist separately, affecting different aspects of living
• They can work in tangent, providing double presentation of symptoms. 

Let’s look further into these items and what it means for you.

What to Expect When You Have Both ADHD and Anxiety

ADHD symptoms, like time blindness, inattentiveness, and disruptive behaviors, often cause more anxiety. Anxiety can often mask ADHD, making it difficult to receive the proper accommodations and support. And without treatment, ADHD can wear a person down, resulting in ADHD shutdown, burnout, and panic attacks. 

Imagine a candle burning at both ends. One flame is ADHD and the other is anxiety. That candle is going to burn out a lot quicker than a candle lit with only one flame. 

The duality of ADHD and anxiety is one reason many people with the comorbidities are more likely to: 

• Cry more easily
• Experience moments of panic, including panic attacks
• Increased emotional dysregulation—difficulty in managing emotions—that can result in big mood swings and all-or-nothing thinking. 
• Diminished working memory 
• Experience increased sleep problems

Anxiety and ADHD in Adults

Anxiety often masks ADHD during childhood, leading many children with ADHD to grow up as adults with poor coping mechanisms. Managing ADHD symptoms through anxiety is a quick way to burn out. 

The difference between anxiety and ADHD in adults is less pronounced than in children. However, the core symptoms remain the same: Anxiety is a nervousness, sometimes intense and sometimes pervasive, and ADHD is a neurodivergent condition resulting in unique brain functioning. 

Some questions to ask yourself as you decide if a behavior, thought, or emotion is ADHD or anxiety include: 

• When do you experience this symptom? Anxiety will be triggered by some events, but ADHD symptoms will always.
• What is the reason behind this symptom? Anxiety will be rooted in nervousness, worry, or irrational thought, whereas ADHD might not have a concrete reason. 
• If you move to a new situation, does the symptom persist? Anxiety can often be handled by removing yourself from the triggering environment, but ADHD is likely to persist regardless of the environment. 
• How long have you noticed this symptom? Anxiety can ebb and flow, but ADHD is a childhood disorder that continues on through adulthood. Although symptoms can change, they are often longer lasting than anxiety. 

If you are an adult with undiagnosed anxiety or ADHD, talk to a medical professional. To receive the best proper care, it’s important to treat both issues.

Anxiety and ADHD in Women

ADHD in women is a topic of much research lately. In the past, it was thought women experienced ADHD less than men. However, recent studies have shown that ADHD is actually underdiagnosed in women. They’ve found that women are more likely to exhibit inattentive ADHD symptoms, which tend to be less socially disruptive and therefore slipped under the radar during childhood. As a result, many women are more likely to be diagnosed with ADHD as an adult. 

There is a stereotype surrounding ADHD, especially ADHD in children, that it is loud, disruptive, and chaotic. However, this image of ADHD neglects half of its symptoms. Inattentive type ADHD is more easily masked by anxiety because it is more internally disruptive than externally. Your friends, family, and coworkers are less likely to notice inattentive ADHD, and this can encourage further masking to fit in and be “normal” rather than seek a diagnosis. 

If you are a woman with ADHD, or think you might have ADHD, we encourage you to reach out to a mental health professional. It is exhausting trying to hide ADHD symptoms. Maybe you have it all together and look like the perfect story of success on the outside but are crumbling inside. Or, maybe you’re struggling with managing daily tasks and are burning yourself out with anxiety trying to fix it all. 

More research has to be done for ADHD in women, but there are resources out there. Don’t wait to receive help—you deserve it.

Treatments for Anxiety and ADHD

Treating anxiety and ADHD can feel like a landmine. How do you address the comorbidities? Can you recover from ADHD shutdown and burnout? Should you treat anxiety or ADHD first? 

Fortantutely, there are a lot of options available, and mental health professionals with years of experience who are ready to help. We’ll outline a few of the options here, but for a more in-depth plan for your personal case, reach out to an anxiety therapist near you.

Treating Anxiety and ADHD: Coping Mechanisms

Although therapy and medication may be necessary, they should always be used in conjunction with healthy lifestyle changes. Especially in the case of anxiety and ADHD in adults, you’ve likely picked up a few unhealthy coping mechanisms just to keep yourself afloat. It’s time to purge yourself of bad habits and let healthy habits take their place.

What is Emotional Regulation?

One of the best things you can learn to overcome ADHD and anxiety is good emotional regulation skills. The combination of ADHD and anxiety can result in intense, all-consuming emotions. When you feel a wave of these uncomfortable emotions, stop and ask yourself: 

1. What am I feeling? 
2. What am I thinking? 
3. What triggered this feeling?
4. Does this emotion point to a real, tangible problem? 
5. If so, how can I solve the problem? 
6. If not, how can I make myself more comfortable?

Common triggers include a thought, external stimuli, a notification, or something someone said. To make yourself more comfortable in a situation that doesn’t have a tangible solution, consider putting on headphones, going for a walk, or removing yourself from the situation.

Building Healthy Habits

It can be difficult to form habits when you have ADHD. Be patient with yourself and remember that it’s okay if you miss a day. Exercising once a week is better than not at all. Take small steps, find people you can lean on for support, and, above all, practice self-compassion. 

Coping mechanisms for combined ADHD and Anxiety:

• Structure Unstructured Time: ADHD, like a lot of neurodivergence, works best in a routine. However, ADHD also hates being on a routine, and sticking to one can be difficult. Anxiety, on the other hand, can force you into overscheduling yourself until every minute of every day is structured. To balance both needs, structure in daily, consistent time where you don’t have to do anything. If you fill this time with scrolling on your phone, that’s totally fine! This unstructured time belongs to no one, and there’s no guilt for doing nothing during it. 
• Exercise: You probably are tired of hearing about this one, but it’s repeated often because it works. Both anxiety and ADHD symptoms can be reduced through exercise. Do it often, preferably daily, but remember that if you skip or forget a day, it’s okay. Pick it up next time. 
• Dictate activities to their assigned duties: Don’t work in bed, and don’t scroll through your phone at your desk. Part of the balance between structured and unstructured that is required by ADHD and anxiety is clearly defining what spaces are for what. This is especially important if you work from home. 
• Be specific: If your to-do list says “Clean” your ADHD and anxiety brain is going to be overwhelmed. Clean what? How much? Should you deep clean? Run to the store and finally get that fancy vacuum? When writing to-do lists and schedules, be as specific as possible. Break down the task into doable chunks. Clean: do the dishes, wipe counters, sweep, and mop. 
• Practice Mindfulness Techniques: Both anxiety and ADHD can cause your brain to spin out of control into the realm of daydreams and “what ifs'. Mindfulness brings it back to the present moment. It gives you space to check in with yourself and your emotions, and gently correct unhealthy patterns. Try the 3-3-3 Rule for Anxiety, Box Breathing, or Color Scanning. 
• Practice Self-Compassion: Not every day is going to be a win. Sometimes, ADHD and anxiety work together in beautiful ways, and you end up accomplishing your entire to-do list in one day. Other times, you work hard for 8 hours with nothing to show for it. In those moments, give yourself some space, take a deep breath, and tell yourself “It’s going to be okay.” And it will be. Tomorrow is another day. Most things in life aren’t actually life or death, no matter what your anxiety tells you. It will be okay. 

Remember to start small. Creating a life in which ADHD and anxiety live in harmony may look like putting away one dirty dish today. It’s a start, and one you should be proud of.

Effects of ADHD Medication on Anxiety

ADHD medications are most often stimulants. They have been proven to increase functioning and decrease disruptive ADHD symptoms. But do ADHD meds work for anxiety? Sometimes, but not usually, since the cause of anxiety is different than that of ADHD. 

Many ADHD medications cause anxiety-like symptoms, including a racing heart and stomach issues. However, you won’t know until you try them. If you feel more anxious about ADHD medication, talk to your doctor about a non-stimulant option—like Wellbutrin.

Therapy for ADHD and Anxiety

Talk therapy works great for both ADHD and anxiety. Although therapy alone cannot solve many ADHD symptoms, it can provide healthy coping mechanisms that make living with ADHD comfortable. 

Common types of ADHD and anxiety therapy approaches a counselor might take include:

• Cognitive-Behavioral Therapy (CBT): CBT focuses on identifying and challenging negative thought patterns and behaviors. It helps individuals with comorbid anxiety and ADHD learn effective coping skills, manage their symptoms, and reduce anxiety levels.
• Mindfulness-Based Therapy: This approach emphasizes being present in the moment and cultivating awareness. Mindfulness techniques can help individuals with comorbid anxiety and ADHD reduce stress, regulate emotions, and improve attention and focus.
•  Dialectical Behavioral Therapy (DBT): DBT focuses on mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness. Through DBT, individuals can learn practical skills to manage their symptoms, improve their relationships, and enhance their overall well-being

For more information on how therapy can help anxiety and ADHD, reach out to our support team.

Conclusion

Comorbid ADHD and anxiety are a complex mental health problem. It is common in adults and women. Anxiety is often presented above ADHD, effectively masking its more disruptive symptoms, and can lead to misdiagnosis. If you think you have comorbid anxiety and ADHD, reach out to a mental health professional. Lifebulb’s therapists can diagnose both anxiety and ADHD and get you started with the right therapy. Don’t wait to seek help, find your calm now by reaching out to our team.

Talk to us