ADHD and anxiety are two of the most common mental health conditions in adults. They also frequently appear together — research estimates that somewhere between 50 and 60 percent of adults with ADHD also have a diagnosable anxiety disorder. That overlap creates a specific diagnostic and treatment challenge: when both are present, it can be genuinely difficult to tell which condition is driving which symptoms.

Getting this right matters, because the wrong treatment can make things worse. Some medications that help anxiety can blunt the effectiveness of ADHD treatment. Some ADHD-focused approaches may increase anxiety if anxiety isn’t being addressed simultaneously. Understanding what you’re actually dealing with is the starting point for getting the right help.

How ADHD and Anxiety Can Look Alike

Both ADHD and anxiety can produce difficulty concentrating. Both can cause restlessness, irritability, and sleep problems. Both can lead to avoidance of tasks. Both can show up as chronic worry and rumination. From the outside — and sometimes from the inside — they can be hard to distinguish.

The key is looking at the mechanism. What’s driving the symptom?

Concentration Difficulties: ADHD vs. Anxiety

In ADHD, concentration difficulties stem from a regulatory problem — the brain struggles to direct and sustain attention due to differences in dopamine and norepinephrine systems. The mind wanders not because something is worrying you but because the executive function system isn’t holding focus in place. You might space out during a meeting not because you’re anxious about anything in particular — just because attention drifted.

In anxiety, concentration difficulties stem from intrusive worry. The mind isn’t wandering without direction — it’s being pulled toward feared outcomes, catastrophic scenarios, or unresolved concerns. The distraction has content. You know what you’re thinking about, and it’s something you’re worried about.

When both are present, you can have both mechanisms operating simultaneously — which is part of why the combination is so disorienting.

Avoidance: ADHD vs. Anxiety

Avoidance is a hallmark of anxiety — specifically, the behavioral tendency to avoid situations, tasks, or interactions that trigger anxious feelings. Over time, avoidance reinforces anxiety by preventing the brain from learning that the feared outcome is manageable.

ADHD also produces avoidance, but the mechanism is different. ADHD avoidance is driven primarily by task initiation difficulties — the neurological friction that makes it hard to start tasks that don’t generate sufficient dopamine reward, particularly tasks that are boring, complex, or aversive. It’s not that you expect catastrophe. It’s that starting just doesn’t happen.

In practice, both mechanisms can co-occur. An adult with ADHD and anxiety may avoid a task because starting it is neurologically difficult and because they’re also anxious about doing it imperfectly. Untangling these two drivers requires careful attention to what’s actually happening.

Worry: ADHD vs. Anxiety

Generalized anxiety produces chronic, pervasive worry — often about a range of things, often future-focused, often experienced as hard to control. The worry feels like a habit of mind that you can’t turn off.

ADHD can produce worry too, but it tends to be more reactive — triggered by specific situations like an approaching deadline, a perceived failure, or interpersonal conflict — and connected to the frustration and shame that accompany ADHD-related struggles rather than to free-floating anxious anticipation. ADHD-related worry is often about consequences that have already been set in motion by ADHD-driven behavior.

When Anxiety Is Secondary to ADHD

One of the most important clinical distinctions in this area is the concept of secondary anxiety — anxiety that develops as a direct result of living with unmanaged ADHD. When years of forgetting things, underperforming relative to potential, damaging relationships through impulsivity, and experiencing repeated failure and criticism accumulate, anxiety is a predictable response. The brain learns to be anxious about the contexts where ADHD-driven failures have happened before.

Secondary anxiety can look clinically identical to primary anxiety disorder. But if the ADHD is the root cause, treating the anxiety without treating the ADHD will have limited effect. The anxiety keeps getting replenished by ongoing ADHD-driven experiences.

This is why accurate diagnosis matters so much. A clinician who is treating your anxiety without evaluating for ADHD may be treating the symptom rather than the source.

What Treatment Looks Like When Both Are Present

The good news is that the treatments for ADHD and anxiety overlap meaningfully. CBT is effective for both. DBT‘s emotion regulation and distress tolerance skills address the reactivity that both conditions produce. Mindfulness-based approaches help both.

The sequence often matters. For many clients, addressing the ADHD first — building executive function skills, improving self-regulation, reducing the ongoing failures that fuel anxiety — produces significant anxiety relief as a downstream effect. For others, the anxiety is severe enough that it needs direct treatment before ADHD work can be effectively engaged.

At Kind Mind Psychology, our clinicians are trained to hold both conditions simultaneously and develop treatment plans that address the full picture. If you’re dealing with what looks like anxiety but also relate to the ADHD patterns described in this post, reach out — getting an accurate read on what’s driving what is the most important first step.

Frequently Asked Questions

How do I know if I have ADHD, anxiety, or both?

A comprehensive clinical evaluation is the most reliable way to answer this question. A good evaluator will look at symptom history across your lifespan, the contexts where symptoms appear, the mechanisms driving specific symptoms, and how conditions interact. At Kind Mind, we conduct clinical assessments for adults and can provide diagnostic clarity as the foundation for treatment planning.

Can ADHD cause anxiety?

Yes. Chronic ADHD-related difficulties — repeated failures, interpersonal friction, underperformance, shame — can produce significant anxiety over time. This secondary anxiety can look clinically similar to primary anxiety disorders but has a different origin. Treating the ADHD effectively often reduces secondary anxiety substantially.

Does medication help both ADHD and anxiety?

Stimulant medications that treat ADHD can sometimes worsen anxiety, particularly at higher doses. Non-stimulant ADHD medications may be better tolerated when anxiety is also present. Some anxiety medications can interact with ADHD treatment. Medication management for the comorbid presentation is best handled by a prescriber who understands both conditions. At Kind Mind, we focus on the therapy side and can coordinate with your prescriber.

Is CBT or DBT better for ADHD and anxiety together?

Both have application for this combination. CBT directly targets the thought patterns that drive anxiety and can address the negative beliefs about self-competence that ADHD and anxiety together often produce. DBT‘s emphasis on emotional regulation and distress tolerance is particularly valuable for the emotional intensity that characterizes both conditions. Many clients benefit from an integrated approach that draws from both.

About the Author

Dr. Monica Johnson, PsyD is a licensed clinical psychologist, AASECT Certified Sex Therapist, and founder of Kind Mind Psychology — a virtual group practice serving clients across New York, New Jersey, North Carolina, Delaware, and 40+ PSYPACT states. She is the host of ADHD& on Understood.org, the author of an Audible Original, and co-author of Addressing Race-Based Stress in Therapy with Black Clients (Routledge). Her work has been featured in The New York Times, NPR, British Vogue, SELF, and the Associated Press. Kind Mind specializes in evidence-based, culturally affirming care for BIPOC, LGBTQ+, and neurodivergent communities.