What should you do when your anxiety and ADHD overlap?

Anxiety and ADHD are among some of the most common diagnosed psychiatric disorders. In ADHD, comorbidity is the rule rather than the exception. The overall prevalence estimates that approximately 50 percent of adults with ADHD also suffer from anxiety.

Anxiety and attention deficit / hyperactivity disorder (ADHD) are among some of the most common psychiatric disorders diagnosed. Both conditions often present in childhood or adolescence in some form, tend to persist into adulthood, and often have a serious impact on many aspects of people’s lives. Both anxiety disorders and ADHD are often comorbid with other disorders: studies have found that 80 percent of people with ADHD will have at least one other psychiatric disorder at some point in their life; the two most common are depression and an anxiety disorder, such as obsessive-compulsive disorder (OCD) or generalized anxiety disorder (GAD).

What is ADHD?

Attention deficit hyperactivity disorder (ADHD) is a behavioral condition that includes symptoms such as inattention, hyperactivity, and impulsivity. It is usually diagnosed in childhood, and difficulties often persist into adulthood, although symptoms often improve with age.

The precise cause of ADHD is not known, but there appears to be a family link. Research has identified a number of possible differences in the brains of people with ADHD compared to people without the condition; And those with ADHD often tend to score differently on IQ tests than those without, specifically in the areas of working memory and processing speed. Other factors involved in ADHD include:

  • Premature birth (before 37 weeks of gestation).
  • Low birth weight.
  • Use of substances or alcohol during pregnancy.

Having ADHD can be very stressful for the sufferer. Executive functioning issues (difficulties with planning, organization, time management, inhibition of behavior, working memory, problem solving, flexibility, for example) can cause a state of anxiety in people with this disorder.

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People with ADHD often have problems with working memory, organization, and time management that make it difficult to follow daily routines and meet regular responsibilities and commitments. For example, they may have a hard time keeping jobs, remembering to pay bills, maintaining relationships, etc., and this can lead to chronic stress. Interestingly, people with ADHD can also experience more difficulty managing stress than those who don’t, as they often have a hard time regulating and controlling their emotions. Emotions can often be overwhelming and people can feel “flooded” and may struggle even harder than most to deal with the intensity.

ADHD and anxiety: prevalence

Several researchers have concluded that among those with ADHD, comorbidity is the rule rather than the exception. The overall prevalence estimates that approximately 50 percent of adults with ADHD also have an anxiety disorder, and adult ADHD symptoms that occur in conjunction with an anxiety disorder are believed to have a significant impact on daily functioning.
A recent study of 264 patients at an anxiety disorder clinic found that the lifetime prevalence of ADHD was more than 40 percent and higher than that of the general population. ADHD was most commonly associated with social phobia among all anxiety disorders.

Another study also found that the prevalence of ADHD in adult outpatient psychiatric clinics is substantially higher than in the general adult population, a difference of more than 20 percent to 4 percent. Among the ADHD patients in this study, 93% had two or more comorbid disorders, and anxiety disorders such as post-traumatic stress disorder, panic disorder, and GAD played a prominent role.

Another study found that ADHD characteristics in childhood were reported in more than 23 percent of panic patients and two-thirds of those who reported that their ADHD symptoms had continued into adulthood; Fewer had married or completed formal college-level education than those panicking alone.

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ADHD and anxiety: key diagnostic problems

1. ADHD may have been diagnosed, but comorbid anxiety has not.

2. Anxiety was identified and diagnosed, but ADHD has not been recognized.

3. Increased anxiety can be a side effect of a stimulant ADHD medication. Nervousness, insomnia, appetite problems, weight loss, dizziness, nausea and / or vomiting, and headaches are listed as side effects of the medication. They are also symptoms of anxiety, further confusing the diagnosis.

Symptoms that overlap with ADHD and anxiety

  • Poor concentration. Someone with anxiety may seem detached or concerned because worry is distracting; whereas someone with ADHD struggles with focus and attention due to cognitive differences.
  • Restlessness. An anxious person may show psychomotor agitation due to nervous energy; while someone with ADHD may be restless due to hyperactivity or impulse control problems.
  • Slow work pace. Someone with anxiety may work slowly due to perfectionistic tendencies; whereas a person with ADHD may struggle due to difficulties in initiating tasks and maintaining interest and focus.
  • Difficulty completing tasks. Someone with anxiety may have difficulty with a task or aspect of their work or life, but be too eager to ask for help; whereas someone with ADHD will experience problems with planning and working memory.
  • Relationship problems. Both those with anxiety and ADHD can struggle socially and with relationships. Again, the key difference lies in the process behind it: someone with ADHD may have difficulty picking up social cues, impulse control, or emotional outbursts due to her neurological diversity; someone with anxiety can too, but for different underlying reasons.
  • Difficulty sleeping. Insomnia is often present in both anxiety and ADHD, again with different etiology.
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What can be done for people with ADHD and anxiety?

The first and important approach is for people to identify the areas of difficulty that could be causing anxiety. Strategies can then be employed to manage executive function deficits, leading them to feel more in control, which can reduce any anxiety secondary to ADHD.


Drug therapy has long been the treatment of choice for ADHD for many doctors, but this may need rethinking, especially if the drug itself is the cause of the anxiety. Also, some studies indicate that people with ADHD and comorbid anxiety may respond less favorably to standard stimulant treatment and are more likely to experience higher rates of side effects, so they need a different approach.

Psychological approaches

Psychological approaches often offer the best approach to treating comorbid disorders, and unlike other conditions where it can be difficult to know which one to address first, approaches to anxiety and ADHD could be used at the same time. Many people with ADHD find that social skills training is one of the most beneficial approaches to managing the impact the disorder has on their lives and this can be done at the same time as psychotherapeutic approaches to anxiety, such as behavioral therapy cognitive or mindfulness. based approaches

Alternative therapies

Increasingly, people are also looking for alternative therapies (such as diet, exercise, herbs, or supplements) to manage disorders, and ADHD and anxiety are no exception. Theorists have proposed that specific diets and the use of certain supplements such as Omega oils can affect the symptoms of ADHD. One area of ​​growing interest is the use of CBD oil as anecdotal reports and research done so far (although still in its infancy) suggests many benefits for both conditions.

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