ADHD And Anxiety: Are They Connected?
Medically reviewed by Andrea Brant, LMHC
Updated April 17, 2024by BetterHelp Editorial Team
While attention-deficit/hyperactivity disorder (ADHD) and anxiety disorders are separate conditions, they often have some symptoms and can even occur together. In fact, estimates suggest that around 80% of adults with ADHD have a comorbid or co-occurring psychiatric disorder, approximately 50% of which are anxiety disorders. In this article, we’ll explore anxiety and ADHD as common coexisting conditions, their respective symptoms, and available treatment options for both conditions.
Coping with both ADHD and anxiety can be challenging
Understanding attention-deficit/hyperactivity disorder
As detailed by the National Institute of Mental Health, ADHD is characterized by a pattern of “inattention and/or hyperactivity-impulsivity that interferes with functioning or development.” These three main categories of symptoms that an individual may experience are:
- Inattention, or having difficulty staying focused on tasks. People with this symptom of ADHD may be easily distracted, have trouble staying organized, and/or have difficulty following detailed instructions.
- Hyperactivity, or the need for constant activity. Behaviors that represent hyperactivity in those with ADHD can include talking too much and/or over other people and fidgeting or constantly moving.
- Impulsivity, or the tendency to act quickly on impulse or emotion rather than through thought or reasoning. This may involve blurting out thoughts, going on spending sprees, or driving recklessly. Someone who is impulsive may be drawn to doing things that offer an immediate reward but are also high-risk.
ADHD can present in different ways in different individuals, affecting their daily lives or relationships with family members. Some individuals may experience symptoms primarily in one specific area, whereas others might show symptoms across all three areas mentioned. For example, individuals who have symptoms of both inattention and hyperactivity/impulsivity may be diagnosed with combined-type ADHD.
Attention-deficit/hyperactivity disorder is often first diagnosed in childhood and continues into adulthood in about half of individuals. However, childhood and adult ADHD are considered to be treatable conditions, often requiring tailored approaches that consider gender differences in symptoms and treatment responses. When left untreated, however, ADHD can interfere with a person’s daily functioning, work, school, relationships, and overall well-being.
Understanding anxiety disorders
While most people experience occasional feelings of worry, someone with an anxiety disorder frequently and persistently feels intense, excessive fear or concern that can cause significant disruptions to their life. There are several types of anxiety disorders, such as social anxiety disorder (SAD), generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD), and various phobia-related disorders, to name a few. Although clinical anxiety symptoms can vary from person to person, some general signs that could indicate that an anxiety disorder may be present include:
- Excessive worrying or irrational fears
- Feelings of agitation/irritation
- Feelings of restlessness
- Sleep disturbances
- Trouble concentrating
- Tense muscles, panic attacks, upset stomach, and other physical symptoms
- Avoiding public places, social situations, or other circumstances that might induce anxiety
The connection between ADHD and anxiety
Many people who have ADHD also have anxiety, especially among people with a history of premature birth, as it’s common to experience both conditions simultaneously. About half or more of people with ADHD meet the diagnostic criteria for one or more anxiety disorders. While the exact cause of this correlation is not fully understood, there are different theories surrounding the topic.
Research shows that having both anxiety and ADHD affects the brain in unique ways, not just a simple combination of the two. This complexity might help explain why research findings on ADHD and anxiety often vary. It appears that when ADHD and anxiety occur together, they could lead to difficulties in ignoring distractions. However, when anxiety levels are lower, different factors might influence how ADHD impacts memory and focus.
One systematic review discovered significant clinical implications of the effects of anxiety on children and adolescents with ADHD. It found that young people with ADHD who experience more severe anxiety symptoms tend to have more social challenges and fewer social skills. The influence of anxiety on how well they interact socially can vary based on factors like their age, gender, ADHD type, and other mental health problems they may face.
Some symptoms of the two conditions overlap—such as restlessness and difficulty concentrating. It’s also true that some symptoms of one may worsen the symptoms of the other. For example, a person with ADHD may know exactly what they need to do to accomplish a task for work or school, but they might have trouble with the organization required to get started or the focus required to finish. As a result, they may experience increased feelings of anxiety around their growing to-do list or approaching deadlines.
Treatment options for ADHD and anxiety
With a clinical diagnosis and an appropriate treatment plan, both ADHD and anxiety—even in combination—can be successfully managed. However, treatment often requires a multi-dimensional approach in both general practice and specialized care. Treatment for ADHD often includes psychotherapy, skills training, and stimulant or non-stimulant medications. Treatment for anxiety often includes psychotherapy and medications like antidepressants or anti-anxiety drugs.
Note, however, that the stimulant medications often used to treat ADHD can make anxiety symptoms worse. For example, ADHD medications like Adderall and Concerta can intensify anxiety symptoms in some patients due to their stimulating effects on the central nervous system, which may worsen feelings of nervousness or agitation. That’s why a proper diagnosis is so important in treating ADHD and anxiety. That way, the provider can ensure their recommended treatment methods won’t worsen symptoms of either condition.
In addition to traditional treatment methods, lifestyle changes like reducing exposure to environmental toxins and participating in regular physical activity may also help manage symptoms. It's crucial to work closely with healthcare professionals to create a balanced plan for alleviating symptoms while allowing you to meet obligations in work, school, and personal life.
Coping with both ADHD and anxiety can be challenging
Finding help for ADHD and anxiety
In addition to medication management, psychotherapy is usually a component of treatment for both ADHD and anxiety disorders. In most cases, you can choose between online or in-person therapy, depending on your preference, as research suggests that the two can offer similar benefits.
A 2022 study notes that “online interventions” for ADHD may be an effective treatment option, and a 2021 study indicates that online cognitive behavior therapy (CBT) and face-to-face CBT “created equivalent overall effects” in the treatment of anxiety disorders. If you feel anxious about meeting with someone in person or are having trouble locating a provider in your area, online therapy can represent a viable alternative. With an online therapy platform like BetterHelp, you can get matched with a licensed provider who you can meet with via phone, video call, or in-app messaging from the comfort of your home.
Takeaway
Anxiety disorders are a common psychiatric comorbidity of ADHD that can have some overlapping symptoms with ADHD. In other words, ADHD and anxiety symptoms frequently occur together. If you’re experiencing symptoms of anxiety and/or ADHD, you may want to meet with a qualified healthcare provider to discuss your options.
Frequently asked questions
Read more below for answers to questions commonly asked about this topic.
Is ADHD associated with anxiety?
Attention-deficit/hyperactivity disorder (ADHD) (sometimes incorrectly referred to as attention-deficit hyperactive disorder) and anxiety are distinct diagnoses, but there can often be some overlap of symptoms. Also, many people who live with ADHD also have an anxiety disorder. According to research published in BMC Psychiatry, as many as 80% of adults who experience ADHD have another mental illness, such as a mood disorder or anxiety disorder. Anxiety may make ADHD symptoms worse for some people, and ADHD may make anxiety worse.
Is overthinking ADHD or anxiety?
Overthinking can sometimes happen to anyone, including people with ADHD or anxiety. According to the Anxiety and Depression Association of America (ADAA), anxiety disorders are the most common mental health disorders, with approximately 19% of adults in the U.S. experiencing an anxiety disorder each year. Anxiety disorders tend to lead a person to ruminate. They may have difficulty not thinking about their present concerns.
Can untreated ADHD cause anxiety?
According to the ADAA, fewer than 20% of people with adult ADHD in the U.S. have received a diagnosis or treatment. Because untreated ADHD can affect a person’s career and relationships, it can lead to anxiety. For example, a person with ADHD may forget important events or get distracted during conversations, which can lead to relationship problems, which, in turn, can worsen anxiety symptoms. However, there are treatments available for both conditions. In some cases, a doctor may prescribe ADHD medications, such as stimulant medications. A doctor may also recommend therapy for ADHD, persistent anxiety, or chronic stress. Therapy may help to reduce anxious feelings and offer relaxation techniques to manage anxiety in your day-to-day life.
What does ADHD anxiety feel like?
Anxiety related to ADHD may feel like stress from lack of focus. A person with ADHD may have scattered attention and difficulty focusing on tasks. They may also have a tendency to be disorganized, which can increase stress and anxiety.
Can ADHD cause panic attacks?
ADHD and panic disorder are separate mental health diagnoses, but some people with ADHD also have an anxiety disorder, such as panic disorder. The ADHD symptoms listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) do not include panic attacks.
Do people with ADHD think faster?
People with ADHD may have difficulty focusing as a result of scattered thoughts. They may have a mind that feels restless at times. It may not be that their thoughts are faster; they may just have difficulty paying attention.
What do people with ADHD think?
People with ADHD can think about many things. There may not be common thoughts among people with ADHD, but one of the common symptoms tends to be difficulty focusing on tasks as a result of scattered attention.
Do people with ADHD talk to themselves?
Talking to oneself is not necessarily a sign of ADHD. People with ADHD may have a more active mind than others, but that doesn’t necessarily mean they talk to themselves.
Can anxiety mask ADHD?
Some people with ADHD experience comorbid disorders (or coexisting disorders), such as comorbid anxiety. (Comorbidity is often measured by instruments such as the National Comorbidity Survey Replication.) Anxiety can mask ADHD, and it’s possible that ADHD can go undiagnosed if someone doesn’t recognize the symptoms.
Does ADHD have obsessive thoughts?
Some people living with ADHD have obsessive thoughts. Some people live with both ADHD and obsessive-compulsive disorder. It may be helpful to speak with a mental health professional to obtain an accurate diagnosis.
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