Child Development

Is There a Link Between ADHD and Anxiety?

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Attention deficit hyperactivity disorder (ADHD) and generalized anxiety disorder are two different conditions, but they do have some overlapping symptoms and people with ADHD commonly have anxiety as well. 

In this article, I’ll explain the connection between ADHD and anxiety, and the differences between them. I’ll also explain if ADHD makes anxiety worse, and the symptoms and treatment.

Are ADHD and Anxiety Connected?

Attention deficit hyperactivity disorder (ADHD) and anxiety are two different conditions, but nearly fifty perfect of adults and thirty percent of children who have ADHD, also have anxiety. 

It is unclear what causes the connection between ADHD and anxiety. However, it’s possible that genetics influences the likelihood of someone developing either condition. 

Researchers believe causes of ADHD include genetics, exposure to environmental toxins, and a mother’s lifestyle during pregnancy (such as smoking or alcohol use). Anxiety is not the only co-existing condition that’s commonly seen in people with ADHD. 

Other conditions include: 

  • Depression
  • Autism
  • Anxiety
  • Sleep disorders
  • Substance misuse
  • Bipolar disorder
  • Dyslexia

Is anxiety a symptom of ADHD?

Anxiety is not included as a symptom in the diagnostic criteria of ADHD. However, the link between the two conditions is still fairly strong.

Anxiety disorders range from social anxiety, post-traumatic stress disorder, and panic attacks. Some symptoms do overlap, such as fidgeting and trouble concentrating, which are shown in the chart below.

ADHD vs Anxiety

ADHD is different from anxiety in that it affects a person’s inattention, and causes impulsive and hyperactive behaviors, ultimately impacting the person’s daily life. 

A person with ADHD may find it difficult to complete tasks and sit still. Anxiety is a mental illness causing a feeling of distress and frequent worry. It can affect a person’s ability to go to school, work, or other daily activities. 

It’s important to note that a common symptom between both ADHD and anxiety is difficulty concentrating. However, difficulty concentrating from anxiety is often due to distractibility because of worrying or the mind going blank during stress.

Symptom ADHD Anxiety
Forgetfulness
Irritability
Difficulty completing tasks
Nervousness and fear without obvious cause
Difficulty concentrating
Trouble sleeping
Fidgeting
Difficulty with time management
Uneasiness
Headaches or stomach aches
Impulsive and hyperactive behaviors
Difficult to relax
A feeling of being stuck
Fearful to try new things
Difficulty following directions

Telling the difference

Identifying the differences between ADHD and anxiety can be challenging because some of the symptoms overlap with each other. You may want to ask a healthcare professional about your symptoms so they can provide guidance on how to address them.

Another way to tell the difference between ADHD and anxiety is to identify when your symptoms occur and if they’re accompanied by other symptoms. For example, if you feel anxious, you may have trouble sleeping and a feeling of fear. If you are having trouble due to ADHD, it’s not likely that you’ll also have a feeling of fear as a result of your ADHD.

Identifying where your anxiety is coming from

While anxiety may come as a result of ADHD (worrying about how you can stay focused and get tasks done), you may also have anxiety that’s unrelated to ADHD. It’s helpful to identify where your anxiety is coming from.

Your healthcare provider may ask you questions such as:

  • Do you worry about things that don't make sense?
  • Do you have a hard time controlling these worries?
  • Are you getting good sleep?
  • Are your fears and worries keeping you from doing your regular activities?
  • Do you feel anxious at least three to five times a week for an hour or more a day?
  • Have you had a big life event happen recently?
  • Do any of your family members have a history of anxiety?

Can ADHD Make Anxiety Worse?

People with ADHD may find it difficult to complete tasks, which can worsen anxiety. Other symptoms of ADHD, such as difficulty concentrating, feeling overwhelmed, and fidgeting can also feel intensified if experiencing anxiety. 

Since ADHD is a condition that impacts executive function (a set of mental skills that include working memory, flexible thinking, and self-control), and emotional regulation, symptoms of anxiety and ADHD can be more difficult to manage when occurring at the same time.

A study conducted on adults with ADHD showed that symptoms that stemmed from ADHD, like tardiness, procrastination, and the prospect of social stigma led participants to experience anxiety at many points in their lives, and while they experienced anxiety, the ADHD symptoms tended to worsen.

Treatment

When treating ADHD or anxiety, it’s important to talk to your healthcare provider so they can suggest the best treatment plan. It’s possible that treating your ADHD can help soothe your anxiety. ADHD treatment can help:

  • Improve your attention
  • You focus on what’s causing your anxiety

Some treatment options that have the potential to help ADHD and anxiety include:

  • Certain prescription medications
  • Cognitive Behavioral Therapy
  • Relaxation techniques to manage stress (such as meditation)

ADHD medication and anxiety

While some medications can help both ADHD and anxiety, certain ADHD medications, such as stimulants, can worsen anxiety. 

Stimulants (such as methylphenidate and amphetamines) are the most common medications for treating ADHD. They are fast-acting and considered highly effective. They work by increasing the brain’s production of the neurotransmitters dopamine and norepinephrine, both of which are involved in mediating motivation, action, and cognition. It’s possible for stimulants to worsen anxiety, but research has also shown that stimulants can reduce anxiety in children with ADHD. 

Non-stimulants (such as atomoxetine (Strattera) or viloxazine (Qelbree)) are also used for treating ADHD, but they have a slower onset rate and work by keeping brain receptors “on” and “alert” for a longer period of time. They are sometimes combined with stimulants or suggested for individuals who experienced side effects with stimulants. 

Talk to your healthcare provider to determine which medication is best suited for you

Antidepressants for anxiety

Antidepressant medications are used to treat depression, anxiety, and other mental health conditions.

Most antidepressants belong to one of these three groups:

  • Selective serotonin reuptake inhibitors (SSRIs)
  • Serotonin and norepinephrine reuptake inhibitors (SNRIs)
  • Atypical antidepressants, which are newer antidepressants that don't fit into the other groups

Some common antidepressants include:

  • Bupropion (Wellbutrin)
  • Desipramine (Norpramin)
  • Imipramine (Tofranil)
  • Nortriptyline (Pamelor)
  • Venlafaxine (Effexor)

It’s best to consult with your healthcare provider to decide if antidepressants are the best route to take for managing your anxiety. 

Managing Anxiety and ADHD

As previously mentioned, it’s best to discuss treatment options for anxiety and ADHD with a healthcare provider. There are, however, coping mechanisms that can support you in managing your symptoms.

Stick to a routine

Sticking to a routine creates structure, which allows for alleviating anxiety from the unknown of an unstructured day.

A study in Tel Aviv showed that predictable, repetitive routines are calming and can help reduce anxiety. Routines are also beneficial for people with ADHD because it helps set reliable expectations and build good habits. 

Move your body

Movement and exercise can help to lower symptoms of anxiety and stress. Exercise also helps to improve your mood and increase your self-confidence.

Exercise prompts dopamine release, which can help executive function and improve attention; ultimately improving symptoms of ADHD, as well.

Organize your space for different tasks

Try to define spaces for each task done. For example, sleeping in the bedroom, and studying at the table. This helps with habit formation and behavioral priming. 

Spend time outside

Spending time outside can promote dopamine and make us feel happier. It can also help to feel less stressed, and promote general well-being.

Regulate emotions

A productive and important way to manage anxiety is to regulate and recognize the emotions you are feeling in the moment. When you’re feeling discomfort and nervousness, try to ask yourself these questions to get to the root cause:

  • What am I feeling?
  • What is the problem?
  • What was the trigger?
  • Is the problem really a problem? If so, how can it be managed?
  • What’s the best, worst, and most likely outcome of the issue?

Bottom Line

ADHD and anxiety can impact a person’s quality of life, so it’s important to understand the symptoms and work with a mental health professional to identify your conditions. There are effective treatments available, but the right one will depend on the person.