ADHD vs. Anxiety: Understanding the Differences

What Is ADHD?

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that typically results in difficulties paying attention, hyperactivity, and impulsivity. The symptoms of ADHD can vary greatly depending on the individual. However, these are categorized into three presentations by experts–inattentive, hyperactive-impulsive, or combined. A person with a combined presentation does not display symptoms mainly from one category, rather a mixture of both. ADHD is commonly diagnosed in childhood.¹

Common symptoms of ADHD include:

Inattentive Presentation

• Easily distracted
• Poor short-term memory
• Rushing through tasks
• Not completing tasks
• Procrastination

Hyperactive-Impulsive Presentation

• Impulsivity
• Hyperarousal/hyperactivity
• Talking excessively
• Interrupting others

What Is Anxiety?

Anxiety is a disorder categorized by fear, worry, and nervousness. There are many types of anxiety disorders, and it is important to know which kind a person has to receive proper treatment. The symptoms of anxiety range in severity but can greatly impact one’s overall life and ability to function.

Common symptoms of an anxiety disorder include:

• Excessive worry
• Fatigue
• Insomnia 
• Restlessness
• Rapid heart rate

Differences Between ADHD & Anxiety

While symptoms of ADHD and anxiety can overlap, it’s important to recognize the distinct differences between the two. ADHD typically affects one’s ability to concentrate and stay organized due to issues with executive dysfunction and attention. On the other hand, anxiety relates to an excessive amount of worry or fixations on any number of thoughts, actions, or circumstances.

Below are seven differences between anxiety and ADHD:

Nervousness

Nervousness often occurs as a reaction to stress or in situations that are unfamiliar. Feeling anxious about something new and scary is normal. However, those with anxiety become so overwhelmed by nervousness that it begins to affect their perceptions of reality. A person with ADHD may feel nervous about failing to complete a task or falling behind on a project. But, they often do not allow this to overwhelm other aspects of their life. For example, intrusive thoughts that are often associated with OCD greatly differ from any experienced by a person with ADHD.

Impulsivity

Impulsivity is the tendency to act without thinking or consideration of consequences. This behavior is often exhibited by those with ADHD. This is certainly not the case for many with anxiety, as they may be fearful of reactions to and repercussions of any choice they make. For example, a person with social anxiety will most likely refrain from making risky decisions with friends or peers, as they fear social circumstances in general.

Difficulties Following Instructions

A person with anxiety is more likely to follow instructions than a person with ADHD, because they are fearful of the consequences that might follow if they don’t. Additionally, they may want to ensure they live up to the expectations placed upon their work by others or themselves. Conversely, those with ADHD have difficulty following instructions for a number of reasons, such as a wandering mind or ADHD racing thoughts.

Inattentiveness

Those with ADHD struggle with paying attention and focusing. This may be exhibited in their conversations with others, work-management skills, and other areas of life. However, while a person with anxiety may appear inattentive, this behavior is often caused by preoccupations on worries or distress.

Sleep Disturbances

Both anxiety and ADHD can impact a person’s sleep. For those with anxiety, their bodies are in a constant flight-or-fight mode, sometimes resulting in sleep disturbances such as racing thoughts at night, insomnia, or anxiety dreams. While people with ADHD also experience difficulties sleeping, these typically stem from not having a mental “off” switch at the end of the day.²

Prioritization

Prioritizing tasks can be tricky for a person with ADHD. In some cases, they may experience analysis paralysis when making a decision which can result in failure to complete important tasks. Those with anxiety don’t generally struggle to prioritize projects, but instead may hyperfixate on the amount that needs to be done. This can only increase their anxiety.

Fear of the Future

A fear of the future is often seen in those with anxiety. They can become stuck on thoughts about negative events or consequences, and spend endless time overthinking and overanalyzing a situation.

Similarities Between Anxiety & ADHD

Despite the differences between anxiety and ADHD, it can be difficult to distinguish between the two as certain symptoms may present in similar ways. Sometimes, these symptoms occur simultaneously as a comorbid condition.³

Similar characteristics between anxiety and ADHD include:

• Avoidance behaviors: People with anxiety and ADHD might engage in avoidance behaviors due to fears of letting others down or not living up to expectations.
• Rejection sensitive dysphoria: Rejection sensitive dysphoria is commonly seen in both anxiety and ADHD as individuals place unrealistic expectations on themselves and are upset when met with criticism.
• Guilt: While the reasons behind a person’s guilt may vary, this is a common emotion felt by those with ADHD and anxiety. Those with anxiety may feel guilty about something they said and ruminate on it, while another with ADHD may feel guilty about not following through on a task.
• Racing thoughts: While the nature of racing thoughts may differ in ADHD and anxiety, they can be difficult to control and navigate.

Is It ADHD or Anxiety?

If you are exhibiting symptoms of ADHD or anxiety, it’s important to seek the help of a medical professional. Whether you choose to see a therapist, psychiatrist, or other physician, they can offer you an accurate diagnosis so you can receive treatment. However, if you’re apprehensive about seeking advice just yet, there are some questions you can ask yourself to help determine the root cause of your symptoms.

To help distinguish between ADHD and anxiety, here are some questions to ask:

• Is there something that makes you feel intense fear?
• Do you have a family history of ADHD or anxiety?
• Does the intensity of your anxiety change when your environment changes?
• When do you notice anxiety most?
• Which symptoms are most prevalent in your day to day?
• How have your relationships been impacted by your symptoms?

How Are Anxiety & ADHD Treated?

Treatment is an important aspect of living with ADHD or anxiety. Medications may be prescribed in both cases, but they can lead to adverse effects and certain prescriptions cannot be combined. In terms of therapy, be sure to find the right therapist who is knowledgeable in treating your specific condition(s). You can search for one using an online therapist directory.

Treatment for ADHD

There are many forms of treatment for adult ADHD as well as medications for ADHD. Finding the method that works for you will help you feel better supported and able to navigate your life. You may have to test out a few treatment plans before you notice any improvements, but this is normal. A combination of therapy, healthy coping skills, and medication is often the best approach.

Treatment options for ADHD may include:

• Cognitive behavioral therapy (CBT):  CBT for ADHD is helpful as it encourages an individual to think of how their own thought patterns affect their behaviors, and change negative thoughts accordingly.
• Dialectical behavioral therapy (DBT): DBT encourages a person to recognize their emotions and the impact they have on their day to day.
• Stimulants*: Stimulants increase dopamine levels and can improve focus and attention in those with ADHD.
• Group therapy: Group therapy offers a person a place to learn from others who are experiencing similar symptoms and share experiences.
• Acceptance and commitment therapy (ACT): Through ACT, an individual engages in mindfulness techniques that will help them stay present in the moment instead of focusing on other stressors.

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

Treatment for Anxiety

There are many therapy options for anxiety and medications for anxiety. Research suggests that utilizing a combination of treatment approaches is more likely to lead to success.

Treatment options for anxiety:

• Cognitive behavioral therapy (CBT): The use of CBT for anxiety teaches an individual to replace their anxious thoughts with healthier ones. A therapist will work with an individual to look at how their thoughts impact behaviors.
• Exposure and response prevention therapy (ERP): ERP puts clients in close contact with their triggers, which allows them to combat the anxiety related to them.
• Benzodiazepines: Benzodiazepines often result in sedative effects, helping to reduce symptoms of anxiety. However, these medications can be addictive and should therefore only be taken as prescribed.
• Dialectical behavior therapy (DBT): DBT teaches mindfulness coping 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, resulting in improved mood. These can be helpful for those with 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.

***This medication has 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

There are many ways to adopt healthy coping mechanisms when it comes to living with ADHD or anxiety. Along with treatment, these can help alleviate symptoms and offer relief. Maintaining one’s emotional self-care is important as it allows you to stay calm, relaxed, and balanced in between therapy sessions or in moments of overwhelm.⁴

Some healthy coping skills to try include:

• Practice mindfulness: Mindfulness encourages a person to stay present in the moment rather than allowing their mind to ruminate on anxieties or fears. This can be done by using your senses to identify things in your environment that you can touch, taste, hear, see, and smell.
• Try meditation: Meditation for anxiety provides a relaxing space for one to refresh and get out of their fight-or-flight mode. This can be done individually or through the use of guided prompts.
• Journaling: Journaling allows an individual to brain dump negative thoughts that they may be focusing on.
• Get active: There are many mental health benefits of exercise, as it releases endorphins and improves one’s overall mood.
• Create a routine: Routines help provide balance in a person’s life, helping to reduce anxieties about what may be coming next. This can also help those with ADHD stay on task and focused.
• Reframe your thoughts: Instead of seeing things in the negative, try taking 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.”

Final Thoughts

While ADHD and anxiety may share similar characteristics, they are very different conditions with varying treatment approaches. If you have been diagnosed with anxiety or ADHD, make sure to seek support. While living with symptoms can be challenging, it is possible to experience relief.