Anxiety and ADHD in Adults

Anxiety and ADHD are very different, but it isn't uncommon for people with ADHD to experience anxiety symptoms. Poorly accommodated ADHD can be stressful, which may explain why about half of all adults with ADHD also have a co-occurring anxiety disorder.

Because there can sometimes be overlap between anxiety and ADHD, distinguishing between them can sometimes be challenging. Both ADHD and anxiety can cause people to feel restless and unable to concentrate.

Understanding Anxiety and ADHD

In addition to the anxiety symptoms associated with ADHD described above, research does find a strong association between ADHD and anxiety disorders. Around 50% of adults with ADHD also have an anxiety disorder.

Characteristics of ADHD

Attention deficit hyperactivity disorder (ADHD) is a form of neurodivergence that first appears in childhood. ADHD brains differ in terms of structure and function, which can lead to challenges with hyperactivity, inattention, and impulsivity. 

People with ADHD brains may struggle to pay attention and put off doing things that don't hold their interest. They may have difficulty focusing, seem distracting, and struggle with planning. In some cases, such behaviors can look a lot like anxiety.

Symptoms of Anxiety

Anxiety disorders can manifest themselves in a variety of physical, mood, cognitive and behavioral symptom patterns. Common features of these disorders are excessive anxiety, worry, nervousness, and fear.

This is often accompanied by feelings of restlessness, being "keyed up" or constantly on edge, problems with concentration (or mind going blank), sleep disturbances, muscle tension, irritability, fatigue, and feeling overwhelmed. Such symptoms can make it very hard for a person to relax.

Anxiety also leads people to procrastinate or avoid making decisions. Or they might constantly ask others for reassurance to help manage their worries.

How Anxiety and ADHD Influence One Another

ADHD can make many aspects of daily living more stressful. Traits such as time blindness, restlessness, and trouble focusing can make everyday tasks and obligations challenging. People may have anxiety separate from their ADHD, but it isn't unusual for people to feel anxiety due to living with ADHD.

ADHD can cause people to miss deadlines or forget necessary appointments. It can cause people to procrastinate until the last minute or get distracted by interesting tasks while neglecting others. 

This can lead to problems at school and work. Relationships can also suffer. The frustrations that this brings can take a toll on self-esteem, contribute to stress, and result in feelings of anxiety. 

Distinguishing Between Anxiety and ADHD

Anxiety and ADHD can contribute to problems concentrating, insomnia, difficulty meeting deadlines, and restlessness. However, there are key differences between the two.

• ADHD is a form of neurodivergence that begins in childhood. People often exhibit patterns of inattention, hyperactivity, and impulsivity.
• Anxiety, on the other hand, is marked by feelings of worry and nervousness. It typically emerges during the teen and young adult years.

If you are having trouble differentiating between the two, you might start by asking yourself what's causing the underlying issue you notice. For example, if you are worrying because you find it hard to concentrate, then it's likely that your anxiety is being caused or worsened by your ADHD. 

On the other hand, if you find it hard to focus because you are so anxious, then the problem itself is the anxiety and not your ADHD.

Treating Anxiety and ADHD

Anxiety and ADHD can make daily living more challenging when they occur together. Both can contribute to problems with focus, increased procrastination, and poor time management. A combination of anxiety and ADHD can also make daily life seem more stressful and overwhelming. 

One of the first steps in planning treatment is to decipher whether these concerns are caused by a lack of appropriate accommodations or whether they are the result of a separate, co-existing anxiety disorder.

Whether or not a person meets the diagnostic criteria for an anxiety disorder, it is clear that symptoms of ADHD can result in chronic anxiety that can further impair a person’s functioning, happiness, and level of self-esteem. Getting the right kind of support and treatment can help.

Anxiety is typically treated with psychotherapy, although medications may also be prescribed. 

Therapy

Types of therapy that can be effective include:

• Cognitive-behavioral therapy (CBT): CBT helps people identify the negative thought patterns that contribute to feelings of anxiety. By challenging and replacing these thoughts, people are able to think in ways that are more realistic and less anxiety-provoking.
• Exposure therapy: This approach involves gradual, progressive exposure to the source of a person's fear. Over time, the anxiety-response begins to gradually fade. 

Therapy can also help people with ADHD learn more about how their brain works, challenges they might face, and strategies to help them cope more effectively.

Medication

Medications are often prescribed to treat ADHD. Stimulant medications are most commonly used, but non-stimulant options may also be prescribed.

Sometimes, people may experience increased anxiety symptoms when they first start taking stimulant ADHD medications. This effect often goes away over time as the body adjusts to medication, but you should talk to your doctor if the problems persists.

Anti-anxiety medications are also an option, depending on the individual and their needs. Anti-anxiety medications may include antidepressants, benzodiazepines, or monoamine oxidase inhibitors (MAOIs).

Lifestyle Modifications

If you have anxiety and ADHD, there are also a number of self-help strategies that may help you cope with feelings of anxiety.

Relaxation Techniques

There are a number of effective relaxation techniques that can help people manage symptoms of anxiety. These include deep breathing, meditation, mindfulness, visualization, and progressive muscle relaxation.

Sleep

Anxiety and ADHD can interfere with sleep, so finding ways to improve your rest may be beneficial. Strategies that can help include avoiding caffeine in the afternoon, going to bed at the same time each night, and creating a restful sleep environment.

Physical Activity

Studies have shown that exercise may help improve executive functioning in people with ADHD. Research has also shown that exercise can be very effective in reducing anxiety symptoms.

The key to staying active with ADHD is to choose activities that you enjoy. If something doesn't hold your interest, you're bound to get bored. Instead, try something fun like biking, rock climbing, swimming, dancing, or gymnastics.