Although different disorders, ADHD and general anxiety disorder (GAD) often come as a package deal. About half of adults with ADHD will also struggle with comorbid (coexisting) anxiety. 

Think of them like the Olsen twins back in the 90s, only way less cute, and (unfortunately) they don’t just disappear after a few years.

So, how can they interact, and how can you tell the difference? 

That’s what we’re here to discuss.

We’ll review the symptoms of ADHD and anxiety, how they can exacerbate and inflame one another, and integrative treatment options to consider other than medication. 

How are ADHD and anxiety similar?

Anxiety and ADHD can present similarly. Both have been known to cause:

  • Fidgeting or restlessness
  • Difficulty concentrating
  • Trouble sleeping 

While the root causes of these behaviors may be different, they often overlap. 

For instance, a person with anxiety may struggle to focus because they are busy worrying about an upcoming event or ongoing circumstance. But a person with ADHD might have trouble concentrating because they can simply not self-motivate to complete the task at hand.

Individuals with ADHD will often experience anxiety over the inability to focus, making the two instances feel very similar. In fact, they can even be part of the same disorder.

How to Tell Anxiety and ADHD Apart

A child with ADHD but not an anxiety disorder may experience:

  • Extensive trouble focusing on daily activities at home or school
  • Restlessness
  • Trouble sleeping (often associated with sleep-disordered breathing, such as pediatric sleep apnea)
  • Frustration/stress as a result of specific perceived failures (“I won’t ever get an A in that class, but I’m doing my best!”)
  • Issues following direct instructions, especially those that require abstract thinking or executive functions to make decisions or complete tasks (“Clean your bathroom.”)
  • Forgetfulness
  • Frequent procrastination

In a child, anxiety without an ADHD diagnosis may look like:

  • Extensive trouble focusing on daily activities at home or school
  • Restlessness
  • Trouble sleeping (most likely, due to fear and excessive worry)
  • Persistent worrying/fearfulness without an apparent cause
  • Irritability/short temper
  • Frequent stomach or head pain
  • An overwhelming fear of trying anything new (from a new cereal to Disneyland)

A child with both mental health conditions may experience all of the symptoms on the above lists.

It can be difficult even for medical practitioners to diagnose these disorders correctly. While we suggest not attempting to self-diagnose (or to diagnose your child), some symptoms may help clue you into which disorder (or comorbid ADHD and anxiety) may be manifesting.

And remember, we all experience anxiousness and a lack of focus from time to time. Not all nervous feelings or inability to focus signal a clinical disorder.

Can ADHD cause anxiety? 

ADHD can lead to a highly stressed life, triggering an anxiety disorder. Difficulties in completing tasks at work or school due to inattention, hyperactivity, or impulsivity can lead to feelings of anxiety and tension. 

ADHD can also cause restlessness that results in difficulty sleeping, further exacerbating feelings of stress and anxiety. 

Ever heard that song “Stressed” by UPSAHL? Yeah, that about sums it up. 

All in all, if worries about the effects of ADHD on you or your child’s life become too extreme, it may result in an anxiety disorder.

That said, we don’t want to be too hasty in diagnosing an anxiety disorder. Speak to a licensed mental health professional about the consistency and the pervasiveness of the anxious behavior. 

Do people with ADHD have worse anxiety?

The symptoms of an anxiety disorder can be even more severe when ADHD is also present. It’s like a molotov cocktail, where ADHD is the alcohol fueling the fire of anxiety. 

To make matters worse, feelings of anxiety can also exacerbate the symptoms of ADHD, adding further fuel to the flame that already has your car (i.e., your life) on fire. 

The reverse is also true: Anxiety often manifests as difficulty dealing with uncertainty, and ADHD can be an uncertainty-generating machine.

Life for an individual who experiences ADHD can be characterized by “consistent inconsistency.” Due to struggles with self-regulation, focus, and time management, it can be challenging to know whether deadlines will be met, appointments will be made on time, etc. All of these uncertainties can spark anxious feelings and stress. 

Remember that molotov cocktail? Yeah, it works both ways.

How Anxiety Can Exacerbate Emotional Regulation Issues in ADHD

Another hallmark of ADHD that can be exacerbated by anxiety is difficulty regulating emotions. This is true for adults and children, although it can look slightly different according to age. 

Kids may seem irritable and argumentative, withdraw from social situations, exhibit specific, intense fear (such as being separated from their parents), and worry about something bad happening. Adults may show similar signs, as well as angry outbursts, difficulty handling criticism, and trouble sleeping.

How do ADHD and anxiety affect sleep?

You might have noticed that we mentioned trouble sleeping a couple of times. This is one of the symptoms of both disorders that can be more significantly impacted when the symptoms of one compound with the other. 

ADHD can cause restlessness, fatigue, and trouble sleeping through the night. Similarly, anxiety can cause difficulty sleeping as the mind stays active worrying over perceived negative situations or possibilities. 

Many of us have experienced that oh-so-fun cycle of not being able to sleep because you’re worried about some event, which makes you worry about not being able to sleep because you’re worried… and so on. With ADHD and anxiety, this is likely to happen almost daily.

The compounding issues lead to a whole lot of sleeplessness — and not just in Seattle.

Can ADHD medication make your anxiety worse?

With the ADHD and anxiety combo, you’ll want to be extra careful about turning to typical prescriptions. ADHD is often treated with stimulant medications that can worsen anxiety symptoms — one of the common side effects of stimulants is increased jitteriness and anxious feelings.

We always encourage our patients to treat medication as the last step in the treatment process. Addressing integrative factors such as diet, exercise, and detoxification often lead to drastic improvements on their own.

If you find that medication is necessary after addressing the potential causes of your or your child’s ADHD, talk to your doctor about non-stimulant prescription options. If stimulants are the only choice, ask about extended-release variations, which may not exacerbate anxiety as much.

Effective Treatments for ADHD with Anxiety

At The M Center, we believe many of the disorders affecting children and adults stem from the same root issues. When we address these root causes, we see significant improvement in our patients’ quality of life. 

Furthermore, if the anxiety your child is experiencing is a result of ADHD, addressing the latter will naturally improve the former. 

For effective anxiety and ADHD treatment, we address:

    • Nutrition: Identify nutrient deficiencies and recommend supplementary interventions as needed. We also advise and coach families on foods to avoid and add to their diet.
    • Inflammation: Remove known inflammatory foods such as sugar, casein, and gluten. 
    • Immune function: Detoxify the body and boost the immune system, removing unwanted chemicals from daily life (such as those in many toiletries).
    • Toxins: Detox any toxic compounds such as heavy metals, BPA, pesticides, and more that have been linked to ADHD.
    • Caffeine: Caffeine may actually help individuals with ADHD improve focus and clarity. But too much caffeine consumption can worsen anxiety symptoms in people also diagnosed with ADHD. Discuss limits on caffeine with your or your child’s provider.
  • Coping skills: Therapy, especially cognitive behavioral therapy (CBT), can give both you and your child the coping mechanics you need to navigate ADHD and anxiety.
  • Stress: Practicing relaxation techniques and meditation can improve focus and reduce stress.
  • Social/emotional support: Having broad support from friends, family members, and medical/mental health providers goes a long way in relieving worry and stress.

There is hope for your family.

While we know that dealing with ADHD and anxiety can be daunting, we want you to know that you are not alone! 

While ADHD and anxiety won’t disappear without intervention, there are treatment options and solutions for your entire family to achieve a more satisfying, fulfilled life. We strongly believe that a huge part of this is finding a community where you feel safe and can talk about your family’s issues. 

If you’re looking for a provider, please don’t hesitate to reach out to us! To set up an appointment, use the chat function on this page (bottom right corner), or contact us here.

Sources

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  4. Fuller-Thomson, E., Carrique, L., & MacNeil, A. (2021). Generalized anxiety disorder among adults with attention deficit hyperactivity disorder. Journal of affective disorders. Abstract: https://pubmed.ncbi.nlm.nih.gov/34799150/ 
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