ADHD or Anxiety: How They Overlap and How They Differ

Why are ADHD and anxiety so easy to confuse?

From the inside, the two can feel alike. You cannot concentrate, you feel restless, and you sleep badly. Those descriptions fit symptoms listed for both ADHD and generalized anxiety disorder (GAD), one of several types of anxiety disorder.

The National Institute of Mental Health (NIMH) lists anxiety among the conditions that can cause symptoms similar to ADHD. It also notes that the two often occur together, which can make each one harder to diagnose and treat. So the useful question is not always one or the other. It can be which is present, whether both are, and which is causing the most trouble right now.

How do ADHD and anxiety compare side by side?

This table is a general comparison based on how NIMH describes ADHD and GAD. Other anxiety disorders, such as social anxiety and panic disorder, look different in some ways. It is a way to organize what you notice, not a way to diagnose yourself.

What questions can help me notice the difference?

No single question can sort this out, but these can help you describe your experience clearly to a provider. Try writing down a recent example for each one.

• When I lose focus, what is my mind doing? Is it on a chain of worries, or on whatever just caught my attention?
• When did this start? Do people remember it from elementary school, or did it begin at a particular time in my life?
• Does it happen when things are calm, or mostly when I am under stress?
• Do I put off tasks because I fear doing them badly, or because I cannot get started or stay with them?
• Do I have physical symptoms such as headaches, a tight body or stomach problems?
• Do I make careless mistakes, or do I check my work repeatedly out of fear of mistakes?

Can you have both ADHD and anxiety?

Yes. The American Psychiatric Association lists anxiety disorders among the conditions that can exist alongside ADHD, and also among those that can mimic it. Either one can be missed when the other is more obvious.

Having both can make treatment more complex. NIMH says that people with GAD and a co-occurring mental disorder may benefit from a plan that addresses all aspects of their mental health. It also notes that therapy is especially helpful when ADHD occurs with anxiety or depression. If you cannot tell where one problem ends and the other begins, that is a reasonable thing to say out loud at a visit.

Why does a careful evaluation matter here?

The two conditions can lead to different treatment plans. For GAD, cognitive behavioral therapy is well studied and commonly used, and antidepressants such as SSRIs and SNRIs, along with other anti-anxiety medications, can be options. For adults with ADHD, the most common treatments are medication, usually stimulants, and therapy such as behavioral and cognitive behavioral approaches. NIMH also cautions that medications for common problems, including anxiety, can interact with stimulants, so your provider needs to know everything you take.

A good psychiatric evaluation asks when symptoms began, how long they last, how often they occur and how they affect your life. It also looks for medical issues, since a physical problem can cause some of the same symptoms. Our guide on how adult ADHD is evaluated explains the steps, and normal worry or an anxiety disorder looks more closely at the anxiety side.

What can help while I figure this out?

A few habits are useful either way, though none replaces treatment. Getting enough sleep and regular exercise appear in NIMH guidance for both conditions. For anxiety, reducing caffeine and practicing stress management such as mindfulness can reduce symptoms when paired with standard care. For ADHD, writing things down, breaking large tasks into smaller steps and taking short breaks can help.

It also helps to notice whether a problem is starting to cause trouble at school, at work or with friends and family. NIMH describes that point as the time to seek professional help.

How does DanShalom Behavioral Clinic approach this question?

ADHD and anxiety are both among the main areas of experience for Victor Onodjacha, MSN, PMHNP-BC, a board-certified psychiatric-mental health nurse practitioner. The first visit lasts about 60 minutes and looks at both possibilities, along with sleep, mood, health history and daily life, instead of starting from one assumption. We share our impressions and discuss options with you, and you can read more on our ADHD and anxiety pages.

We see patients ages 5 to 65, in person in Sugar Land or by secure video if you are physically in Texas, Idaho, Arizona or Maryland at the time. A parent or guardian must be present at appointments for patients under 18. You can start with the request form, and information on plans, self-pay and the sliding scale is on our insurance page.

We are not an emergency service. If anxiety or any other symptom has you thinking about suicide, call or text 988. If there is immediate danger to life, call 911.