ADHD Vs. Anxiety: What Is the Difference?

What Is Anxiety?

Anxiety disorders cause worry and fear about various things, whether specific or more general (i.e., generalized anxiety disorder). This nervousness does not lessen over time, often worsening with age or lack of treatment. Anxiety also creates physical symptoms, such as shaking, sweating, racing heart, or difficulty sleeping.

Common symptoms of an anxiety disorder include:

• Excessive worry
• Fatigue
• Insomnia 
• Restlessness
• Rapid heart rate
• Irritability
• Racing thoughts

ADHD Vs. Anxiety: What Is the Difference?

The differences between ADHD and anxiety are numerous, but recognizing the subtle variances can be challenging. ADHD typically affects executive functioning skills, contributing to poor organization, attention, and concentration. On the other hand, those with anxiety experience excessive worries, often fixating on negative thoughts, actions, or circumstances.

Below are seven differences between anxiety and ADHD:

1. Worry & Nervousness

Nervousness often occurs as a reaction to stress or unfamiliar situations. Feeling apprehensive about something new and scary is normal. However, those with anxiety are overwhelmed by nervousness, contributing to altered perceptions of reality. Their ability to function in daily life decreases, and many may feel entirely unable to cope with their endless worries.

While a person with ADHD can experience anxiety, these worries do not overshadow other aspects of their life. Additionally, anxiety is not a characteristic or diagnostic symptom of ADHD.

2. Impulsivity

Impulsivity means acting without considering the consequences, and many people experience this as a symptom of ADHD. For instance, they may interrupt conversations, engage in reckless behavior, or struggle to wait their turn. Not everyone with ADHD will display impulsivity, but these and similar behaviors are common.

Conversely, those with anxiety err on the side of caution, gravitating more toward overanalyzing and catastrophic thinking. These individuals may fear reactions to and repercussions of any choice they make. For example, a person with social anxiety will likely refrain from speaking out of turn or blurting out their thoughts inappropriately.

3. Difficulties Following Instructions

Those with ADHD often struggle to follow instructions when completing a project or task. These challenges often relate to executive dysfunction, resulting in inattention and distractibility. On the other hand, people with anxiety do not typically experience these struggles. In fact, they may hyperfixate on following guidelines to a “T,” ensuring they meet expectations to avoid rejection or possible repercussions.

4. Inattentiveness

Inattentiveness in ADHD typically stems from executive dysfunction. Those with ADHD may struggle to sustain focus or concentration because of distractions or the constant noise and racing thoughts in their brains. In anxiety, inattention may occur due to endless worries and fears. A person may appear distracted because they feel lost in these negative thoughts.

5. Sleep Disturbances

Anxiety and ADHD can impact sleep for different reasons. Those experiencing anxiety are in a constant state of flight or fight, often contributing to sleep disturbances like racing thoughts at night, insomnia, or anxiety dreams. While people with ADHD also experience difficulties sleeping, these typically stem from lacking a mental “off” switch at the end of the day.²

6. Prioritization

Those with ADHD often struggle with task prioritization. They may jump from task to task rather than focusing on one thing to completion. They can also get distracted by less important projects, sometimes leading them to forget about responsibilities and obligations.

Conversely, those with anxiety may become so hyperfixated on ensuring they meet every deadline, expectation, or request. They may spend much time creating a set system for addressing each task, growing increasingly anxious if something disrupts this system or interferes with their plans.

7. Reasons for Anxiety

Those with anxiety may have specific triggers, as is the case with social anxiety. However, as mentioned, these disorders can also be general, meaning a person can feel anxious about anything. In other cases, a person may be naturally prone to anxiety because of higher levels of “neuroticism.”

On the other hand, anxiety is not necessarily a symptom of ADHD, and not everyone with the condition will experience anxious thoughts or worries. Like anyone else, they may experience periodic anxiety because of a major event, like a presentation, performance, or final exam. In these cases, the anxiety typically has a discernible cause or trigger.

Similarities Between Anxiety & ADHD

Anxiety and ADHD overlap in some ways despite their prominent differences. People with both disorders struggle with concentration, focus, and sleep, with many finding themselves overwhelmed and struggling to manage daily tasks. 

Similar characteristics between anxiety and ADHD include:

• Avoidance behaviors: People with ADHD and anxiety may engage in avoidance behaviors due to overwhelm, perfectionism, or fears of failure.
• Rejection sensitivity dysphoria (RSD): RSD is a phenomenon in which individuals are hypersensitive to perceived rejection or criticism. RSD is a common occurrence in ADHD but can also appear in anxiety when a person worries or ruminates about being rejected.
• Difficulty concentrating: Inattention and difficulty concentrating are primary symptoms of ADHD. However, anxiety also causes similar experiences due to worry and intense physical sensations of fear and tension.
•  Restlessness: ADHD and anxiety can both result in restlessness. While the reasons for these feelings differ, a person may struggle to sit still, feeling like they are “jumping out of their skin.”
•  Problems with sleep: ADHD and anxiety can affect the ability to fall asleep, stay asleep, or sleep restfully. ADHD can also cause disruptions to sleep/wake cycles.
•  Increased stress: Challenges associated with ADHD and constant worry from anxiety both release stress hormones, increasing the negative impacts of stress.  
•  Difficulty managing daily tasks: In ADHD, poor task management may be due to disorganization or inattentiveness. With anxiety, these difficulties are likely because of extreme worry and nervousness.
• Overwhelming thoughts: Those with anxiety often experience intrusive thoughts and catastrophic thinking. A person with ADHD typically deals with ADHD racing thoughts that can feel overwhelming.
• Hyperfocus:  People with ADHD or anxiety can become so focused on something they lose track of time. Those with ADHD may become hyperfocused on something challenging, enjoyable, or productive, whereas a person with anxiety may hyperfocus on their worries and fears.

Do I Have ADHD or Anxiety?

Seeking professional help is beneficial if you think you have ADHD or anxiety. A therapist, psychiatrist, or other physician can provide you with an accurate diagnosis and develop a treatment plan. However, you can ask yourself some questions first to help determine the root cause of your symptoms before reaching out for advice.

Below are questions to ask yourself about ADHD vs anxiety symptoms:

• Does something make me feel intense fear?
• Do I have a family history of ADHD or anxiety?
• Does my anxiety intensify when my environment changes?
• When do I notice anxiety most?
• Which symptoms are most prevalent in my day to day?
• How do my symptoms impact my relationships?

ADHD Vs. Anxiety: How Are They Diagnosed?

Only qualified mental health professionals can diagnose ADHD and anxiety. Both assessments will include interviews about mental health history, family history, and current symptoms. These tests are often sufficient for a diagnosis of anxiety. However, diagnosing ADHD requires additional evaluations. Many providers who prescribe medication for ADHD require a neuropsych exam and psychological testing.

Can Someone Have Both ADHD & Anxiety?

A person can have ADHD and anxiety if their symptoms are severe enough to meet diagnostic criteria. While ADHD does not cause anxiety directly, symptoms can contribute to the development of an anxiety disorder.

Can Anxiety & ADHD Be Misdiagnosed?

Because of their superficial similarities, differentiating between ADHD and anxiety symptoms can be challenging. Additionally, ADHD masking refers to hiding or covering up symptoms to adhere to social norms. This behavior can result in anxiety from the burden of overcompensating to conceal symptoms, sometimes leading to a misdiagnosis. When distinguishing between anxiety and ADHD, professionals will consider which symptoms are more prevalent.

ADHD Vs. Anxiety: Treatment Options

Treatment is an important aspect of living with ADHD or anxiety. Professionals may recommend medications in both cases to help manage distressing symptoms. In terms of therapy, be sure to find the right therapist knowledgeable in treating your specific condition(s). You can search for one using an online therapist directory.

Treatment for ADHD

Treatment for adult ADHD often includes a combination of therapy and ADHD medications. Finding a method that works for you will help you navigate challenges and reduce the impact of symptoms in your life. You may have to test a few options before noticing any improvements, but this is normal. Therapy, healthy coping skills, and medication are often the best approaches.

Treatment options for ADHD may include:

• Cognitive behavioral therapy (CBT): CBT for ADHD teaches a person to challenge the automatic negative thoughts they have about themselves. This approach can promote self-compassion and acceptance, helping reduce some of the shame and stigma associated with symptoms.
• Stimulants*/non-stimulants**: A psychiatrist may prescribe stimulants or non-stimulants ADHD medications depending on the individual, their treatment goals, and their symptoms. These medications help by increasing focus and attention while decreasing hyperactivity.
• Mindfulness: Mindfulness may not directly reduce symptoms but can help a person strengthen their focus on the present moment while learning to filter distractions.
• Psychoeducation: Psychoeducation provides people with ADHD and their families valuable information about ADHD and how to cope with symptoms.

* These medications have a black box warning, the most serious kind of warning from the FDA for a risk of medication misuse or abuse.

* These medications have a black box warning, the most serious kind of warning from the FDA for a risk of suicidal thoughts and behaviors in certain people. You should talk with your doctor about these risks before starting this medication.

Treatment for Anxiety

Like ADHD, treatment for anxiety typically incorporates both medication and psychotherapy. Therapy focuses on changing thought patterns and behaviors that contribute to anxiety while addressing triggers. Medications can also help manage symptoms both short and long-term.

Treatment options for anxiety:

• Cognitive behavioral therapy (CBT): CBT for anxiety teaches an individual to replace their anxious thoughts with healthier alternatives to make long-lasting behavioral improvements.
• Exposure and response prevention therapy (ERP): ERP puts clients in close contact with their triggers, which allows them to combat the associated anxiety.
• Benzodiazepines: Benzodiazepines*** often result in sedative effects, helping to reduce symptoms of anxiety. However, these medications can be addictive, and individuals should only take them as prescribed and with caution.
• Dialectical behavior therapy (DBT): DBT teaches mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness skills a person can use when experiencing intense anxiety or before entering a triggering situation.
• Selective serotonin reuptake inhibitors (SSRIs): SSRIs**** increase serotonin levels in the brain to help boost mood and reduce anxiety.

*** These medications have a black box warning, the most serious kind of warning from the FDA for abuse or misuse, risk of physical dependence, and risk of serious side effects, including death, when combined with an opioid.

**** These medications have a black box warning, the most serious kind of warning from the FDA for a risk of suicidal thoughts and behaviors in certain people. You should talk with your doctor about these risks before starting this medication.

How to Cope With ADHD or Anxiety

Healthy coping mechanisms are essential when living with ADHD or anxiety. Along with treatment, these skills can help alleviate symptoms and offer relief. Maintaining emotional self-care can also aid in remaining calm, relaxed, and balanced between therapy sessions or in moments of overwhelm.⁴

Below are tips for coping with anxiety or ADHD:

• Practice mindfulness: Mindfulness encourages a person to stay present in the moment rather than allowing their mind to focus on anxieties or fears. For example, use your senses to identify things you can touch, taste, hear, see, and smell in your environment.
• Try meditation: Meditation for anxiety provides an opportunity for you to refresh and soothe your fight-or-flight response.
• Journaling: Journaling offers a space to brain-dump negative thoughts clouding your mind. Physically removing these thoughts from your mind can help combat worry and distractions that impede your ability to focus.
• Create a routine: Routines provide balance in life, helping to reduce anxieties about the next task or responsibility. Those with ADHD can benefit from scheduling time slots to focus on specific projects.
• Reframe your thoughts: Instead of negatively seeing things, try a more positive approach. Rather than saying, “I need to get this task done,” say, “I want to get this task done because it provides me peace.”