ADHD and anxiety: what's the link?

Exploring the connection between attention deficit hyperactivity disorder (ADHD) and anxiety, and how you can tell them apart.

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Update on national shortage of medication to manage ADHD symptoms.

Please be aware that there is a national shortage in the supply of medication that helps to manage ADHD symptoms. This is due to manufacturing issues and an increase in global demand for the medication.

This shortage means we cannot prescribe medication to new patients until stocks are available. If you are currently taking medication as part of your ADHD treatment plan, please contact your prescriber for further advice.

Attention deficit hyperactivity disorder (ADHD) and anxiety are separate conditions, but due to the similarity in some of their symptoms, people often think that they come alongside one another. The connection between the two is well established; around 50% of adults with ADHD are also diagnosed with an anxiety disorder (source).

This piece explores the relationship between ADHD and anxiety, including the symptoms and how you can tell the two apart.

ADHD vs anxiety

People with ADHD can find it difficult to recognise that what they're experiencing are symptoms of anxiety, as they can sometimes mirror one another.

ADHD affects your ability to concentrate, leading to a number of behavioural symptoms like:

  • Trouble with organisation and time management
  • Easily distracted and finding it difficult to complete tasks
  • Fidgeting and unable to sit still
  • Hyperactivity
  • Forgetfulness

Anxiety disorders are more than just experiencing occasional worries. They're mental illnesses where a sense of worry or uneasiness is intense and consistent over a long period. Anxiety disorders can have a significant impact on a person’s relationships, wellbeing and work or school life, affecting them as they attempt to navigate through life.

Symptoms of anxiety can include:

  • Long-lasting and excessive fear
  • Extreme stress
  • Anger, irritability and impatience
  • Fatigued, tearful and emotionally tired
  • Headaches and tension

The symptoms of the two differ, but there can be overlap that makes it hard to work out if it's ADHD or anxiety driving the symptoms. Like ADHD, people with anxiety can sometimes find it difficult to concentrate or pay attention to a task. They might also experience restlessness and find it difficult to relax or settle down.

How can you tell the difference?

For a clinical diagnosis, it's important that you speak to a doctor or other professional. They'll be able to asses your symptoms and any underlying causes for them. They'll also be able to assess whether you're experiencing ADHD, anxiety or a combination of the two.

You can also try to monitor when and how you experience anxiety. For example, if you have an anxiety disorder there will be an underlying cause, such as certain scenarios or situations, that correlates with an inability to concentrate. If you have ADHD, you'll find it difficult to concentrate most of the time.

It might also be that your anxiety has come as a result of your ADHD. If this is the case, you'll feel anxious when your ADHD is causing you to feel frustrated. People with anxiety disorders might also have worries that relate to a wide range of issues, not just their ADHD.

Treatment for both ADHD and anxiety

ADHD can bring challenges to someone's life. If you happen to have an anxiety disorder on top of that, it can make functioning normally in everyday life very difficult. Speak to your GP about your experiences and they can help to outline any appropriate support.

Both ADHD and anxiety are conditions that can be effectively treated, minimising symptoms and limiting any negative impact they have on your life.

Cognitive behavioural therapy (CBT)

CBT can help to change the damaging thought patterns that are apparent in both ADHD and anxiety. A person with ADHD may be self-critical as a result of setbacks that have been caused by their symptoms in the past. CBT can help the person to identify these demoralising and distorted beliefs, and replace them with more logical and rational thoughts.

CBT works in a similar way with anxiety. It helps a person to identify the deeply-ingrained thought patterns that are causing them excessive worry, and challenge these dysfunctional beliefs so they can view situations in a healthier way in the future.

Mindfulness

Both ADHD and anxiety can cause a person to become preoccupied with worried thoughts about the past and future. These anxieties can take a person away from enjoying and living within the present moment.

Mindfulness teaches a person to observe their thoughts, feelings and bodily sensations moment-by-moment. It can help people to recognise and move beyond anxious thoughts about the past or future before they take hold and impact how they feel and behave. This skill gives people the opportunity to control their attention, focus on themselves and prevent impulsivity as they introduce it into their day-to-day life.

Medication review

Adjusting or changing any medications you're using for ADHD or anxiety can be helpful. Some medications for ADHD can make anxiety worse, so it's very important you speak to your GP, or a trained medical professional before changing any of your medication.

Page clinically reviewed by Dr Leon Rozewicz (MBBS, FRCPsych, MRCGP, MRCPsych), Consultant Psychiatrist and Medical Director of Priory Hospital North London

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