ADHD or Anxiety? How to Tell the Difference (When You Have Both)

ADHD or Anxiety? How to Tell the Difference (When You Have Both)

If you've ever Googled "do I have ADHD or anxiety?", you're in good company. The two conditions overlap so significantly that they're frequently confused (and misdiagnosed), and it’s not uncommon for them to co-occur. Around 25 to 50% of adults with ADHD also have an anxiety disorder. So the answer to "which one is it?" is often…both. 

But understanding the difference matters, because the way you manage them isn't always the same. 

What ADHD and anxiety have in common

On the surface, ADHD and anxiety can look almost identical:

  • Difficulty concentrating

  • Restlessness, and an inability to sit still

  • Sleep problems

  • Irritability

  • Avoiding tasks

  • Racing thoughts

  • Feeling overwhelmed

No wonder so many people (and so many GPs) get them confused…

Where they differ

The key difference is usually why these symptoms are happening.

With anxiety, the difficulty concentrating happens because your mind is preoccupied with worry. You're catastrophising, running through worst-case scenarios, fixating on what might go wrong, and generally going round and round in circles in that head of yours. The restlessness comes from a nervous system in threat-response mode.

With ADHD, the difficulty concentrating happens because your brain struggles to regulate attention - not because it's busy worrying, but because it's either understimulated or pulled in too many directions at once. The restlessness is about needing movement and stimulation, not fear.

A useful question to ask yourself: when I can't focus, what is my brain actually doing? If it's worrying, anxiety may be the main culprit. If it's bouncing between seventeen unrelated thoughts or going completely blank, that's more characteristic of ADHD.

The ADHD-anxiety loop

Here's where it gets complicated. For many people, anxiety is a consequence of unmanaged ADHD rather than a separate condition. 

When you spend years forgetting things, missing deadlines, saying the wrong thing, losing your keys, and feeling like you're always behind - you develop anxiety as an unhelpful (although your own brain doesn’t view it as this) coping mechanism. Of course you do. Your nervous system has learned that things go wrong, that you'll be caught out, that you're not reliable. The anxiety is a rational response to years of ADHD chaos.

This is why treating the ADHD often reduces the anxiety significantly. When the root cause is addressed, the secondary anxiety frequently improves. 

When anxiety makes ADHD worse

The relationship goes both ways. Anxiety can make ADHD symptoms significantly worse (particularly task avoidance). When a task feels both overwhelming (ADHD) and anxiety-inducing (What if I do it wrong? What if I’m not good at it? What if I fail?), the result is paralysis. You can't start, you feel terrible about not starting, you’re mean to yourself because you think you should have done more by now…which only serves to increase anxiety, and make starting even harder.

Sound familiar?

What to do about it

First, get a proper assessment. Many people are diagnosed with anxiety and treated for years before anyone considers ADHD (our founder was) - particularly women, who are more likely to internalise their symptoms. If you've been treated for anxiety and it hasn't fully resolved, and find yourself those Tik Toks about the realities of living with ADHD hit a little too close to home - it's worth asking about ADHD. 

Second, know that you can manage both. ADHD tools -> structure, external accountability, body doubling, written systems - often reduce anxiety as a side effect (when you follow through with them). And anxiety management techniques like grounding exercises can help regulate the ADHD nervous system too.

Third, be kind to yourself. Living with either condition is hard. Living with both is genuinely exhausting, and the fact that you're trying to understand your brain is already a significant act of self-care. 

Explore our Anxiety Support collection for practical tools, our 54321 Grounding Anxiety Sticker for a reminder you can stick anywhere, and our free ADHD resources to help you get started.

 

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