If you’ve been managing anxiety for years and recently started wondering whether ADHD might also be part of the picture, you’re asking the right question. ADHD and anxiety overlap so frequently — and look so similar on the surface — that one often goes unrecognized until the other is identified.
According to research in Psychiatry Research, more than half of adults diagnosed with ADHD have at least one co-occurring anxiety condition. That means anxiety isn’t the exception for people with ADHD — it may be closer to the rule.
This article explains why ADHD and anxiety so often appear together, how to distinguish between symptoms that come from each, and what treatment looks like when both are in the picture.
If you’re unsure whether what you’re experiencing is ADHD, anxiety, or both, there are options worth exploring. Learn about ADHD evaluation at Josi Health.
- More than 50% of adults with ADHD have at least one anxiety condition
- ADHD and anxiety share symptoms like difficulty concentrating and restlessness — making diagnosis complex
- Some anxiety in ADHD is secondary (caused by ADHD); some is an independent disorder
- Treating ADHD can sometimes reduce anxiety — but not always
- CBT and medication both play important roles when both conditions are present
Why ADHD and Anxiety Are Such Frequent Companions
The Numbers Are Striking
A 2019 review published in International Journal of Psychiatry in Clinical Practice found that ADHD and anxiety disorders have a 25% comorbidity rate — meaning roughly one in four people with ADHD also has a diagnosable anxiety condition. And that’s among those who’ve been formally evaluated.
Research suggests this isn’t coincidence. A 2025 review in Frontiers in Psychiatry found that ADHD shares 8–34% of effector proteins with anxiety disorders, suggesting shared neurobiological pathways. Put simply: the same brain systems that contribute to ADHD can also predispose someone to anxiety.
Two Different Kinds of Anxiety in ADHD
Here’s something that often surprises people: not all anxiety in someone with ADHD works the same way.
CHADD, the leading organization for ADHD education and advocacy, distinguishes between two common presentations:
1. ADHD-induced (secondary) anxiety — This is anxiety that arises as a direct consequence of ADHD. When you spend years forgetting appointments, missing deadlines, struggling at work, and scrambling to keep up, your nervous system learns to anticipate failure. The anxiety is a response to the chronic experience of ADHD — not an independent condition.
2. Independent (primary) anxiety disorder — Up to 25% of people with ADHD also have a separate anxiety condition that exists alongside ADHD, not simply because of it. Generalized anxiety disorder, social anxiety, panic disorder, and OCD can all co-occur with ADHD.
Why does this distinction matter? Because it affects treatment. When anxiety is secondary to ADHD, treating the ADHD effectively often reduces the anxiety significantly. When anxiety is an independent condition, it typically needs its own targeted treatment.
> What This Means for You: If you’ve been told your anxiety is your primary issue, but treatment hasn’t helped much, undiagnosed or undertreated ADHD could be part of the reason. A comprehensive evaluation can help untangle the two.
Symptoms That Overlap — and How to Tell the Difference
Shared Symptoms That Create Confusion
Research on ADHD and anxiety comorbidity consistently identifies overlapping features that complicate diagnosis. Both conditions can cause:
- Difficulty concentrating — In ADHD, the mind wanders toward stimulating distractions. In anxiety, worrying thoughts consume attentional resources.
- Restlessness — ADHD restlessness is physical and driven by under-stimulation. Anxiety restlessness is tension-driven.
- Sleep problems — ADHD disrupts sleep onset (the racing, active mind at bedtime). Anxiety disrupts sleep through worry and hyperarousal.
- Forgetfulness — ADHD impairs working memory directly. Anxiety can impair memory via cognitive load (all mental resources consumed by worrying).
- Avoidance — ADHD avoidance tends to be about boredom or overwhelm. Anxiety avoidance is fear-driven.
A Useful Way to Distinguish Them
An inline definition worth knowing: Comorbidity — the simultaneous presence of two or more independent conditions in the same person — is the term clinicians use when ADHD and anxiety are both present as distinct diagnoses.
If your concentration difficulties happen mainly in situations that trigger worry (performance evaluations, social situations), anxiety may be the primary driver. If they happen across all tasks — interesting and boring, high-stakes and low-stakes — ADHD is more likely involved.
The tricky truth is that in many people, both things are true. See how ADHD and anxiety differ, overlap, and can be distinguished for a deeper dive.
> What This Means for You: Symptom overlap is precisely why self-diagnosis has limits. A licensed clinician uses structured assessment tools and developmental history — not just a symptom checklist — to identify what’s really going on.
How Having Both Affects Your Life
When ADHD and anxiety co-occur, the clinical picture tends to be more complex than either condition alone. A 2022 study in Psychiatry Research found that adults with ADHD and comorbid anxiety had:
- More severe overall presentations
- Higher rates of depression and suicidal ideation (important to discuss openly with a clinician)
- Lower educational attainment on average
- Greater functional impairment across multiple life domains
This isn’t meant to be alarming — it’s meant to validate why so many people with both conditions feel like they’re working harder than everyone else just to stay afloat. Both conditions together can create a reinforcing cycle: ADHD makes tasks harder → anxiety grows about failing → anxiety makes ADHD harder to manage → repeat.
Getting an accurate picture of both is the first step to breaking that cycle.
Treatment When You Have Both ADHD and Anxiety
Why Treating One Can Help (or Complicate) the Other
Treatment for comorbid ADHD and anxiety requires careful clinical judgment, because the two conditions interact.
Stimulant medications and anxiety: A common concern is whether ADHD stimulant medications will worsen anxiety. Research in Journal of Child and Adolescent Psychopharmacology found that stimulant treatment was “relatively safe regarding the risk of anxiety exacerbation” even in people with ADHD and comorbid anxiety. For many people with ADHD-induced anxiety, treating the ADHD effectively reduces the anxiety as a secondary benefit.
However, in some cases — particularly with independent anxiety disorders — stimulants may need to be introduced carefully, or combined with anxiety-specific treatment.
The role of CBT: A 2019 study comparing CBT alone versus CBT combined with medication confirmed that CBT is an effective treatment for adults with ADHD, particularly when anxiety is also present. CBT targets the thought patterns and behavioral cycles that sustain both ADHD-related dysregulation and anxious avoidance.
What an Integrated Treatment Approach Looks Like
For most adults with both ADHD and anxiety, the most effective approach involves:
- Accurate diagnosis first — establishing whether anxiety is primary, secondary, or both
- ADHD-focused medication if appropriate — often reduces ADHD-induced anxiety as a byproduct
- CBT or structured therapy targeting anxiety-specific thought patterns and ADHD behavioral strategies
- Ongoing monitoring — because the balance shifts as ADHD treatment takes effect
Therapy at Josi Health can be an important part of post-diagnosis support, especially when both ADHD and anxiety are in the picture.
> What This Means for You: There’s no one-size-fits-all protocol for treating ADHD and anxiety together. But there is a clear starting point: understanding exactly what you’re dealing with through a comprehensive evaluation.
Getting a Clear Picture: Why Evaluation Matters
If you’re reading this and recognizing yourself — the anxiety that won’t quiet, the difficulty concentrating, the exhaustion of trying to manage both — getting a formal evaluation isn’t about adding another label to your life. It’s about finally having an accurate map.
According to NIMH, effective treatments are available to manage ADHD symptoms — and when anxiety is also identified and treated, outcomes improve substantially.
An evaluation can answer whether what you’re experiencing is ADHD, anxiety, both as independent conditions, or ADHD with anxiety as a downstream consequence. That distinction shapes everything: which treatments you try, in which order, and what realistic improvement looks like.
If you’re looking for a diagnosis, you have options. Josi Health’s licensed psychologists conduct comprehensive ADHD evaluations via telehealth, and can assess for both ADHD and co-occurring conditions. Learn more about what happens after your evaluation — including how your report can support accommodations requests and ongoing care.
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Reviewed by the Josi Health Clinical Team, Licensed Psychologists.