ADHD vs Anxiety: Understanding the Overlap
by Lauren Beer, tLMFT
ADHD vs. Anxiety: Understanding the Overlap
It’s not uncommon for someone to sit on my couch and say, “I can’t focus, my mind is constantly racing, and I’m always overwhelmed. Is this anxiety, or is it ADHD?” The short answer? It could be either, or it could be both. In fact, nearly 50% of adults with ADHD also experience an anxiety disorder.
Because these two diagnoses share so many symptoms, they can be misunderstood or misdiagnosed. In this post, I’ll break down how they overlap, how they differ, and how you can begin to tell them apart.
The Overlap
On the surface, ADHD and Generalized Anxiety Disorder (GAD) look similar, so these diagnoses can be sneaky. If you look at what a person is experiencing day-to-day, both conditions regularly cause inattention, restlessness/irritability, sleep disturbances, concentration or memory issues, fatigue, and physical symptoms like digestive issues and muscle tension. Because a racing mind and a lack of focus are core to both, it’s easy to see why so many people get a diagnosis for one when they actually have the other, or miss the fact that both are present.
The Core Difference
The core difference lies in what is driving the symptom. To differentiate ADHD from anxiety, we have to look past what is happening and figure out why it is happening.
In anxiety, focus is disrupted by worry. Your brain is focused on scanning for threats, predicting worst-case scenarios, or managing fear. Your executive functioning suffers because your mental bandwidth is entirely consumed by anxiety.
In ADHD, focus is disrupted by dysregulation. Even in a state of calm with no present worries, the ADHD brain still struggles to regulate attention, filter out distractions, and track details. It is a neurodevelopmental difference in how the brain manages focus, not an emotional reaction to fear.
Other differences include impulsivity that may be present in ADHD, but not generalized anxiety, or excessive worry about a variety of topics due to perceived threat that is present in anxiety.
“Secondary” ADHD Anxiety
Another massive piece of the puzzle is what we call secondary anxiety. This is anxiety that is actually caused by having undiagnosed or unsupported ADHD.
If you have ADHD, you have to work significantly harder than neurotypical people just to keep up with daily life. Over time, you may develop a very logical fear of failure. You might constantly worry about missing deadlines, forgetting important details, losing your keys, mismanaging finances, or a number of other things associated with being unable to manage ADHD.
Generalized Anxiety tends to be consistent, pervasive, and often out of proportion to the actual risk. Secondary ADHD Anxiety is specific to executive functioning tasks. It’s a proportional stress response to the difficulty of navigating a world not built for an ADHD brain.
Questions to Consider
As a therapist, there are several questions I consider when working with ADHD, anxiety, or both:
What is driving the client’s lack of focus? Is the client’s mind struggling to stay on track because they are actively consumed by an anxious thought, or is it hard to focus even when their mind is completely at peace?
What are they actually worrying about? Is their worry a broad cloud of “what-ifs,” or is it strictly tied to their ability to execute tasks, remember details, and manage their time?
How long has this been happening? ADHD is neurodevelopmental, meaning traits are present from early childhood (even if you masked them well). Primary anxiety disorders can peak and valley, often hitting a high point in adulthood or during major life transitions.
Differentiating ADHD and anxiety isn’t necessarily about finding a label, it’s about getting the right support. Knowing the root cause helps us move forward with a plan that is right for you. If your anxiety is secondary to ADHD, learning executive functioning tools and exploring ADHD-specific treatment often causes that baseline anxiety to resolve. If it’s primary anxiety, modalities like CBT or ACT can provide relief and tools to help you manage it long term.
If you are wondering how ADHD, anxiety, or both are showing up in your life, consider reaching out to find a therapy provider that can help you determine next steps. You deserve support that addresses how your unique brain actually works.
