Difference Between Anxiety and ADHD

ADHD · Anxiety · Understanding

Understanding the difference between anxiety and ADHD, why they look similar, how to distinguish them, and getting counseling support that addresses what you're experiencing.

Difference Between Anxiety and ADHD

The difference between anxiety and ADHD confuses many people because symptoms overlap significantly. Difficulty concentrating, restlessness, racing thoughts, trouble completing tasks, avoidance behavior, and sleep problems appear in both. You might wonder if anxiety is causing your attention problems, or if ADHD is the underlying pattern. Or both might be present simultaneously, creating compounding challenges. Distinguishing between them matters profoundly because support approaches differ. ADHD strategies don't address anxiety patterns. Anxiety-focused therapy doesn't help ADHD executive function challenges. And approximately 50% of adults with ADHD also experience anxiety, meaning both can co-exist, requiring support for each. Understanding what separates anxiety from ADHD, what connects them, and how to explore your patterns helps you access approaches that address what you're experiencing.

Sagebrush Counseling provides individual therapy for ADHD and anxiety throughout Montana, Texas, and Maine via telehealth.

Whether you're located in Bozeman, Billings, Missoula, or anywhere else in Montana; Austin, Dallas, Houston, or anywhere else in Texas; or Portland, Brunswick, or anywhere else in Maine, you can access expert support. All sessions via secure video telehealth.

Understand what's driving your symptoms. Individual therapy helps you explore whether your symptoms are anxiety-related, ADHD-related, or both, and develop strategies that address the underlying challenges. Serving Montana, Texas, and Maine via telehealth.

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Why Anxiety and ADHD Look Similar

Anxiety and ADHD create overlapping symptoms that make distinguishing them difficult without careful assessment. Both conditions affect attention, create restlessness, impair performance, and generate distress.

According to research from the Anxiety and Depression Association of America, adults with ADHD experience anxiety at rates significantly higher than the general population, with estimates ranging from 25% to 50% comorbidity.

Symptoms: Anxiety Only, ADHD Only, or Both

Primarily Anxiety

• Worry about specific concerns
• Physical tension and muscle aches
• Panic attacks
• Fear-based avoidance
• Catastrophic thinking
• Hypervigilance to threat
• Feeling on edge

Primarily ADHD

• Chronic disorganization
• Time blindness
• Impulsive decisions
• Hyperfocus on interests
• Interrupting conversations
• Losing/forgetting items
• Difficulty initiating tasks

Can Be Either/Both

• Difficulty concentrating
• Restlessness
• Sleep problems
• Racing thoughts
• Trouble completing tasks
• Procrastination
• Overwhelm
• Avoidance behavior

The overlapping symptoms column shows why confusion happens. Difficulty concentrating appears in both anxiety (because worry consumes attention) and ADHD (because attention regulation is impaired). Restlessness shows up as anxious energy and ADHD hyperactivity. Racing thoughts occur as anxious worry and ADHD thought patterns.

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Key Differences: What Separates Them

Despite overlap, anxiety and ADHD have distinct features that help differentiate them when you know what to look for.

Distinguishing Anxiety from ADHD

Onset and Course:

• ADHD: Symptoms present since childhood, even if undiagnosed. Lifelong pattern of attention and executive function challenges across all settings.
• Anxiety: Can develop at any age. May have clear onset tied to life stress or gradually worsen over time. Can improve or worsen based on circumstances.

Attention Problems:

• ADHD: Attention difficulties are pervasive and chronic. Present even when calm and not anxious. Affects ability to focus on wanted activities. See our post on how to describe ADHD to someone who doesn't have it.
• Anxiety: Attention impaired specifically by worry. When anxiety is managed or in low-anxiety situations, concentration improves. Can focus on non-anxiety-triggering tasks.

Executive Function:

• ADHD: Broad executive function deficits: planning, organization, time management, task initiation, working memory all impaired regardless of anxiety level.
• Anxiety: Executive function generally intact but overwhelmed when anxiety is high. Can organize and plan when not anxious.

Impulsivity:

• ADHD: Acts before thinking across contexts. Interrupts conversations, makes impulse purchases, blurts comments without filtering. Pattern present since childhood.
• Anxiety: Usually overthinks rather than acts impulsively. May avoid decisions due to worry. When anxiety is high, might act impulsively to escape discomfort.

Restlessness Source:

• ADHD: Physical restlessness and need for movement not tied to specific worries. Fidgeting and difficulty sitting still even when calm.
• Anxiety: Restlessness driven by worry and tension. Pacing or fidgeting while ruminating. Calms when anxiety reduces.

Avoidance Patterns:

• ADHD: Avoids tasks requiring sustained attention or executive function. Procrastinates on boring or difficult tasks regardless of anxiety. Struggles with task initiation.
• Anxiety: Avoids situations that trigger worry or fear. Can complete tasks if they don't provoke anxiety. Avoidance is fear-based, not boredom-based.

The key question isn't "Do I have attention problems and restlessness?" It's "What's causing these symptoms and when did they start?"

Get support understanding and managing ADHD or anxiety symptoms. Individual therapy throughout Montana, Texas, and Maine via telehealth.

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How ADHD Can Cause Anxiety

The relationship between ADHD and anxiety often runs one direction: ADHD creates life experiences that foster anxiety. Years of struggling with executive function, experiencing social difficulties, facing criticism and rejection, and managing chronic overwhelm generates legitimate anxiety.

Ways ADHD Leads to Anxiety

• Performance anxiety from executive function struggles. Knowing you'll likely be late, forget important details, or fail to follow through creates anxiety about any performance situation.
• Social anxiety from ADHD symptoms. Years of interrupting people, missing social cues, and being rejected for ADHD behaviors creates fear of social situations. Our post on ADHD social anxiety explores this.
• Anticipatory anxiety about time blindness. Chronic lateness despite best efforts creates anxiety about getting anywhere on time. See ADHD and time blindness.
• Worry about rejection sensitivity dysphoria. Knowing criticism triggers overwhelming emotional pain creates hypervigilance about any potential rejection.
• Anxiety about sustaining relationships. History of relationship failures due to ADHD symptoms creates fear that current relationships will also fail. Patterns explored in why ADHD couples fight so much.
• Generalized worry about life management. Living with undiagnosed or poorly managed ADHD creates pervasive anxiety about keeping up with adult responsibilities.

When ADHD causes anxiety, addressing only the anxiety doesn't resolve the underlying pattern. The executive function challenges remain, continuing to generate anxiety-producing situations. Effective support addresses the ADHD while also helping manage the secondary anxiety.

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When Both Patterns Co-Exist

Many adults experience both ADHD and anxiety patterns simultaneously. These aren't mutually exclusive. When both are present, each pattern needs its own approach.

Co-occurring ADHD and anxiety create compounding challenges. ADHD executive function deficits make managing anxiety harder. Anxiety impairs already-challenged attention and decision-making. Each pattern worsens the other without proper support.

Distinguishing symptoms becomes critical when both are present. Which attention problems stem from ADHD and which from anxiety? Which avoidance is executive function difficulty versus fear-based? Careful exploration teases apart the contributions of each.

Support for comorbid ADHD and anxiety often includes strategies for ADHD executive function deficits, therapy specifically for anxiety management (CBT, exposure work), ADHD coaching or therapy for executive function skills, and addressing any underlying trauma or attachment issues contributing to anxiety.

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Why These Conditions Get Confused

Confusion between anxiety and ADHD happens frequently, particularly in adults who didn't receive childhood ADHD identification.

Why Confusion Occurs

• ADHD missed in childhood, especially in girls. Inattentive ADHD without hyperactivity often goes unrecognized. People compensate until adult demands exceed coping capacity.
• Anxiety symptoms more obvious. People seek help for anxiety because it feels distressing. ADHD feels like personal failing rather than a condition needing support.
• Brief conversations focus on current distress. Quick discussions catch anxiety symptoms but miss lifelong ADHD patterns requiring detailed history.
• ADHD symptoms attributed to anxiety. Professionals may assume attention problems and restlessness are anxiety-driven without investigating whether they existed before anxiety developed.
• Self-awareness challenges. People with ADHD may not recognize their symptoms as ADHD. They attribute struggles to laziness, stupidity, or personal failing.

Understanding signs of neurodivergence helps recognize when symptoms might indicate ADHD rather than or in addition to anxiety.

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Understanding Your Symptoms with Professional Support

Understanding whether you're dealing with anxiety, ADHD, or both requires comprehensive exploration with a provider familiar with both conditions in adults. This includes detailed developmental history exploring childhood symptoms, understanding current symptoms across multiple settings, evaluation of executive function specifically, distinguishing primary from secondary symptoms, and consideration of other factors that can create similar symptoms.

What to Share in Therapy

• Childhood patterns of attention, organization, impulsivity even if you weren't formally identified
• When current symptoms started and what triggered them
• Whether attention problems exist when you're not anxious
• Executive function challenges: time management, organization, task completion
• How symptoms affect different life areas: work, relationships, daily functioning
• Family history of ADHD or anxiety
• Previous support and what helped or didn't help
• Specific examples of how symptoms manifest in your life

Self-report questionnaires alone aren't sufficient for understanding ADHD patterns. Comprehensive exploration includes clinical conversation, symptom discussion, review of school or work performance history when available, and understanding patterns over time.

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Support Approaches Differ

Why understanding the difference matters: approaches for anxiety and ADHD differ significantly.

ADHD Support Focus

• Strategies targeting attention and executive function
• Executive function skills training and coaching
• External systems and structures compensating for challenges
• Time management and organization approaches
• Understanding neurological basis to reduce shame

Anxiety Support Focus

• Cognitive behavioral therapy addressing thought patterns
• Exposure work for phobias and avoidance
• Relaxation and regulation techniques
• Therapeutic approaches targeting worry patterns
• Identifying and challenging cognitive distortions

Anxiety-focused approaches won't improve ADHD executive function. ADHD-focused approaches won't resolve anxiety patterns. When both are present, integrated support addressing each produces better outcomes than addressing only one.

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When Professional Help Is Needed

Consider professional support when you're unsure whether symptoms are anxiety or ADHD, when support for one condition isn't helping, when attention problems persist despite anxiety improving, when executive function challenges affect daily life, or when you suspect both conditions might be present.

Working with therapists who understand both ADHD and anxiety in adults ensures comprehensive support. ADHD-informed therapists recognize how executive function deficits create secondary anxiety and address both levels.

Our posts on ADHD and division of labor, ADHD and interrupting, and hobbies for ADHD adults provide additional context on how ADHD affects daily life. If ADHD is affecting relationships, understanding can a neurodiverse marriage work helps navigate partnership challenges.

ADHD and Anxiety Counseling at Sagebrush Counseling

At Sagebrush Counseling, we provide individual therapy for both ADHD and anxiety symptoms throughout Montana, Texas, and Maine. We help you understand the difference between these conditions, recognize when ADHD creates secondary anxiety, address comorbid ADHD and anxiety with integrated approaches, and develop strategies specific to your needs. We understand that getting the right support is essential.

We provide individual therapy via telehealth throughout Montana, Texas, and Maine. Whether you're in Bozeman, Billings, Great Falls, or anywhere in Montana; Austin, Dallas, Houston, San Antonio, or anywhere in Texas; or Portland, Brunswick, Bangor, or anywhere in Maine, you can access our services from home. All sessions are conducted via secure video telehealth.

We also work with neurodivergent couples. We specialize in neurodiverse couples therapy in Houston, Austin, and Dallas, Texas, as well as Portland, Maine.

For more information, visit our FAQs. Understanding dating as a neurodivergent adult provides context on how ADHD affects relationships.

Get Support for ADHD or Anxiety Symptoms

Individual therapy helps you understand what's driving your symptoms and develop strategies that address the underlying challenges. We serve adults throughout Montana, Texas, and Maine via telehealth. Get the support you need. All sessions via secure video from home.

Schedule Your Consultation Today

The difference between anxiety and ADHD matters profoundly for getting the right support. Both create attention problems, restlessness, and task completion difficulties, but from different underlying causes. ADHD involves lifelong executive function deficits present since childhood. Anxiety involves worry-driven attention impairment that can develop at any age. ADHD often causes secondary anxiety through years of struggle and rejection. Both conditions frequently co-exist, requiring support for each. Understanding which condition or conditions you're dealing with requires comprehensive exploration of childhood symptoms, current patterns across settings, and distinguishing primary from secondary symptoms. Support approaches for anxiety won't resolve ADHD. Approaches for ADHD won't address anxiety patterns. Understanding what you're experiencing ensures you receive effective help rather than continuing to struggle with approaches that don't fit your needs.

— Sagebrush Counseling

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References

1. Anxiety and Depression Association of America. "ADHD and Anxiety." https://adaa.org/
2. CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder). "Understanding ADHD." https://chadd.org/about-adhd/overview/
3. National Institute of Mental Health. "Anxiety Disorders." https://www.nimh.nih.gov/health/topics/anxiety-disorders
4. American Psychological Association. "ADHD Assessment and Diagnosis." https://www.apa.org/topics/adhd
5. Centers for Disease Control and Prevention. "ADHD in Adults." https://www.cdc.gov/adhd/about/index.html

This post is for informational and educational purposes only and does not constitute medical or therapeutic advice. If you're in crisis, call or text 988 (Suicide & Crisis Lifeline) or call 911 if you are in immediate danger.