Anxiety vs. ADHD: How to tell the difference

Anxiety and ADHD (attention-deficit/hyperactivity disorder) are two distinct disorders, but they share certain overlapping symptoms, like difficulty concentrating and restlessness, that can make differentiating between the two challenging.  

Sometimes the complexity of these disorders, along with the overlap in symptoms, can lead to misdiagnosis. For example, anxiety is sometimes misdiagnosed as ADHD, and vice-versa. Or, someone could have both ADHD and anxiety. If you think you might have either of these conditions, the best way to know for sure is to talk to a mental health professional, like a psychiatrist, so they can get you the right treatment.

In this article we’ll discuss the differences and similarities between ADHD anxiety, including how they’re treated.  

What’s the difference between ADHD and anxiety?  

ADHD is a neurodevelopmental disorder, which means it affects the way your brain develops and grows. Doctors aren’t sure exactly what causes ADHD, but research points to a strong genetic component, meaning it can run in the family. Symptoms are usually present from childhood onwards, but you may not be diagnosed until you are an adult. While ADHD presents a bit differently in everyone, there are three main categories of symptoms:

• Inattention: You may have difficulty focusing, get easily distracted, or often forget things.
• Hyperactivity: You might fidget a lot, feel like you can’t sit still, talk excessively, or always be on the go.
• Impulsivity: You may struggle with self-control, have trouble waiting your turn, or interrupt people during conversations.  

You can have a “combined presentation” if you have symptoms in all three categories, or you could have a predominantly “inattentive presentation” or a hyperactive-impulsive presentation. To learn more about the different types of ADHD, check out our explainer on attention-deficit/hyperactivity disorder.

Generalized anxiety disorder (GAD), is a mental health disorder where you have persistent and excessive worry and dread. This condition can develop at any time in your life. Similar to ADHD, doctors haven’t nailed down a specific cause for anxiety disorders, but there’s a genetic component here, too. External factors, like experiencing trauma or a stressful life event, could also play a role in developing an anxiety disorder.

If you experience anxiety, you may be aware that your anxiety level is disproportionate to the actual stress in your life, but you feel like you have no control over your worrying, and it takes over. Anxiety symptoms can show up both psychologically and physically. Here’s a rundown of common signs of anxiety:  

Psychological symptoms:

• Excessive worrying
• Ongoing feelings of dread  
• Intense fear
• Being unable to control anxiety
• Trouble concentrating
• Restlessness
• Insomnia
• Irritability
• Being easily startled

Physical symptoms:

• Drowsiness or fatigue
• Shortness of breath  
• Upset stomach or nausea
• Trembling or shaking
• Racing heart
• Excessive sweating
• Lightheadedness
• Trouble swallowing
• Headaches  
• Muscle tension or muscle aches

Comparing ADHD and anxiety

ADHD and anxiety have certain similarities, such as the absence of known specific causes and the potential for treatment with medication and therapy. However, they differ in terms of age of onset and symptoms discussed above.

How do I know if I have ADHD or anxiety?  

Online tests and quizzes can be helpful for understanding your symptoms, but mental health conditions are complex. If you suspect you have ADHD or anxiety, it’s best to see a doctor, specifically a mental health professional like a psychiatrist, for a formal diagnosis and treatment plan. Certain symptoms of ADHD and anxiety (like difficulty concentrating and restlessness) can present similarly. It takes a licensed, experienced professional to evaluate you and determine if you have ADHD, anxiety, or both.  

Before you receive a diagnosis, your provider will ask you about your family history (such as if anyone in your family has ADHD, anxiety, or any other mental health conditions), your personal history (like your upbringing or any traumatic or stressful incidents), and the symptoms you’re experiencing. They might use specific questionnaires, scales, or evaluations to better understand your symptoms and how they affect your functioning and quality of your daily life.  

Once you have a diagnosis, your provider can get you started with a treatment plan, which may include therapy, medication, or both.

If you think you have ADHD or anxiety, you can answer a few questions pertaining to each here and here to understand your symptoms.

Can I have both ADHD and anxiety at the same time?  

When it comes to neurodevelopmental disorders and mental health conditions, there’s often comorbidity, which means there are two or more conditions present at once. You can definitely have both ADHD and anxiety at the same time. In fact, it’s pretty common. Around 50% of adults and 33% of children with an ADHD diagnosis also have an anxiety disorder.  

Untreated ADHD might be causing you to have increased anxiety levels. Plus, if your anxiety is high, it can make your ADHD symptoms flare up more. Without treatment, this can become an unpleasant cycle.  

Research has suggested that the presence of anxiety (or other conditions like depression or substance use disorder) can make it easier for someone with ADHD to get misdiagnosed. For example, a psychiatrist might only diagnose someone with an anxiety disorder and treat them for that, while their ADHD goes undiagnosed and untreated. This is why it’s so important to tell your healthcare provider about all symptoms and your history to get the proper diagnosis.  

Related article: What’s the difference between OCD and ADHD? Can I have both?

Do ADHD medications help with anxiety?

If someone has an anxiety disorder but does not have ADHD, then ADHD-specific meds like stimulants won’t relieve their anxiety. On the other hand, if someone has untreated ADHD that’s causing them anxiety, ADHD medication can help with that anxiety. Additionally, if antidepressants are prescribed for ADHD, this could help with anxiety, too.  

Let’s take a step back and look at how each of these conditions is treated.

Treatment for ADHD  

When it comes to ADHD treatment, a category of medication known as stimulants is typically the first line of action. Common examples of these are Ritalin (methylphenidate) and Adderall (amphetamine and dextroamphetamine). Stimulants work quickly to affect chemical messengers in your brain known as neurotransmitters—specifically norepinephrine and dopamine. When these stimulants make more norepinephrine and dopamine available in your brain, it can help relieve ADHD symptoms, help you focus, lessen hyperactivity, and improve your overall executive functioning.  

If stimulants aren’t the right fit for you, your provider might prescribe a non-stimulant option.  

Examples of these are:

• Alpha-2 noradrenergic agonists
• Specific norepinephrine reuptake inhibitors (SNRIs)
• Specific serotonin reuptake inhibitors (SSRIs)
• Tricyclic antidepressants (TCAs)
• Atypical antidepressants, specifically norepinephrine and dopamine reuptake inhibitors (NDRIs)

A non-stimulant can be prescribed on its own or as an add-on to a stimulant. Treatment may also typically involve therapy or skills training to help with executive dysfunction. If you end up taking a non-stimulant, like Wellbutrin, these drugs can alleviate anxiety along with your ADHD symptoms.  

Treatment for anxiety

When treating an anxiety disorder, there are a variety of medications that your doctor might prescribe depending on your situation. Antidepressants known as SSRIs (selective serotonin reuptake inhibitors) are usually a psychiatrist's go-to for a first line of treatment. However, other medications that may help anxiety are:

• SNRIs  
• TCAs
• Monoamine oxidase inhibitors (MAOIs)
• Atypical antidepressants, like Trintellix (vortioxetine) and Viibryd (vilazodone)
• Benzodiazepines  
• BusPar (Buspirone)  
• Vistaril (hydroxyzine)
• Beta-blockers like Inderal (propranolol)  

In most cases, a psychiatrist will also recommend therapy on top of medication so you can uncover the root causes of your anxiety, learn coping skills, relaxation techniques, and more.  

Ultimately, your treatment plan will be unique to you. After your doctor determines whether you have ADHD, anxiety, or both, they’ll help you find the best medication, or combination of them, to relieve your symptoms and improve your quality of life so you can start feeling better. For many individuals with ADHD and/or anxiety, a combination of medication and therapy is extremely effective.  

If you’re looking for a psychiatrist, consider Talkiatry. We’re a national psychiatry practice that provide virtual, in-network care so you can get the treatment for ADHD and anxiety you need from the comfort of your own home. To get started, complete our free online assessment to get matched with a psychiatrist.  

FAQs

Here are more details about teh differences between anxiety and ADHD.

What is anxiety?

“Anxiety” is an umbrella term that includes various anxiety disorders, but most of the time, people are referring to generalized anxiety disorder (GAD). This mental health condition is characterized by ongoing, excessive, persistent anxiety, worry, and dread. The mental and physical symptoms of anxiety can severely impact someone’s day-to-day life and functioning.  

What is ADHD?

ADHD is a neurodevelopmental disorder that causes symptoms like forgetfulness, impulsivity, and an inability to complete tasks. Symptoms start in childhood and can affect you into adolescence and adulthood. ADHD can cause you to have issues with time management and struggle at school, work, or in relationships.  

Can ADHD be mistaken for anxiety?  

Yes, ADHD can be mistaken for anxiety, and vice versa, because many of the similar symptoms overlap between the two conditions Many people also have both ADHD and anxiety but are misdiagnosed as only having ADHD.  

How do you treat anxiety and ADHD?

The first-line treatment for ADHD is a stimulant medication. If a stimulant isn’t the right fit, a provider may prescribe a non-stimulant medication alone or on top of the stimulant.

The first-line treatment for anxiety is an antidepressant, typically an SSRI or SNRI. However, other medications like different types of antidepressants, benzodiazepines, beta-blockers, or other medications with anti-anxiety properties may also be prescribed. Therapy is also a key part of treatment.  

The information in this article is for education and informational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.