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How do you tell if it’s ADHD or anxiety?

It can be challenging to tell the difference between ADHD and anxiety, since they share some similar symptoms like restlessness, difficulty concentrating, and feeling on edge. However, there are key differences that can help determine which one you may be dealing with.

Common Symptoms of ADHD

Some of the most common symptoms of ADHD include:

  • Difficulty paying attention and staying focused
  • Being easily distracted
  • Difficulty following instructions
  • Problems with organization and losing things
  • Fidgeting and restlessness
  • Difficulty waiting patiently
  • Interrupting conversations or being intrusive

Common Symptoms of Anxiety

Some typical symptoms of anxiety disorders like generalized anxiety disorder, social anxiety, panic disorder, and phobias include:

  • Feeling nervous, worried, or fearful much of the time
  • Racing thoughts and rumination
  • Feeling keyed up, on edge, or restless
  • Difficulty concentrating due to worry
  • Irritability
  • Muscle tension
  • Difficulty sleeping
  • Panic attacks

Differences Between ADHD and Anxiety

While ADHD and anxiety share some similar symptoms, there are key differences that can help distinguish between the two:

ADHD Anxiety
Inattention is more difficulty focusing, easy distractibility Inattention is more racing thoughts, worry
Restlessness feels aimless, fidgety Restlessness related to nervous energy, feeling on edge
Forgetfulness linked to inattention Forgetfulness linked to distraction from worrying
Disorganization, tardiness, task avoidance Punctual, can be perfectionist
Mainly problems focusing Mainly feelings of worry, fear, nervousness

ADHD tends to cause more aimless restlessness and difficulty staying on task. Anxiety restlessness has more of a nervous energy and is associated with excessive worry. ADHD forgetfulness stems from inattention, while anxiety forgetfulness is due to preoccupation with anxious thoughts.

Adult ADHD

Many people with ADHD do not receive an accurate diagnosis until adulthood. Adult ADHD symptoms may include:

  • Difficulty focusing during lengthy conversations
  • Restlessness and boredom with sedentary tasks
  • Extreme disorganization
  • Poor time management skills and chronic lateness
  • Impulsiveness around money or relationships
  • Mood swings
  • Problems remembering obligations, completing tasks, and following instructions

Adult Anxiety

In adults, anxiety disorder symptoms may include:

  • Chronic worrying about everyday challenges or activities
  • Social withdrawal and isolation
  • Perfectionist tendencies
  • Seeking excessive reassurance from others
  • Panic attacks
  • Distress in situations like public speaking, eating in front of others, crowds
  • Avoidance of places, events, objects that cause anxiety
  • Physical symptoms like muscle tension, fatigue, restlessness, trouble sleeping

Causes and Risk Factors

Causes of ADHD

ADHD is a neurodevelopmental disorder that is believed to be caused by differences in brain anatomy and chemistry that affect executive functions like impulse control, organization, and attention regulation. Causes may include:

  • Genetics – ADHD strongly runs in families.
  • Brain structure – Those with ADHD tend to have smaller volume in certain brain regions.
  • Neurotransmitter imbalances – Lower dopamine and norepinephrine are linked to ADHD.

Causes of Anxiety

Anxiety disorders are believed to arise from a combination of genetic, environmental, psychological and developmental factors, such as:

  • Genetics – Higher risk if a close relative has anxiety.
  • Stress – Chronic stress can alter brain chemistry.
  • Environmental toxins – Some toxins have been linked to anxiety.
  • Trauma – Events like abuse, neglect, loss can increase anxiety risk.
  • Substance abuse – Withdrawal from substances can cause anxiety.

Risk Factors

There are some shared risk factors for both ADHD and anxiety, like genetics, substance abuse, and environmental exposures. Unique risk factors may include:

ADHD Anxiety
– Brain injury – Trauma/abuse
– Low birth weight – Stressful upbringing
-Exposure to environmental toxins – Negative life events
– Family history of ADHD – Family history of anxiety

Getting an Accurate Diagnosis

Due to the overlapping symptoms, it is important to have a thorough evaluation by a licensed mental health professional or doctor to get an accurate diagnosis. The evaluation may include:

  • Symptom review – The professional will take a detailed history of all symptoms.
  • Medical exam – This can help rule out any underlying medical conditions.
  • Screening tools – You may be asked to complete a questionnaire to assess symptoms.
  • Family history – Your family mental health history can give clues to diagnosis.
  • Diagnostic criteria – The clinician will assess official diagnostic guidelines.

An accurate diagnosis is essential, as treatment can be quite different for ADHD vs. anxiety. While counseling may be effective for both, medication is usually indicated for ADHD but not necessarily anxiety. Working with a knowledgeable clinician can help determine if symptoms are better explained by ADHD, an anxiety disorder, or possibly both.

Treatment Options

ADHD Treatment

Common ADHD treatment options include:

  • Stimulant medications like methylphenidate, amphetamine-dextroamphetamine, etc. to increase dopamine and norepinephrine.
  • Non-stimulants like atomoxetine, guanfacine, clonidine for those who don’t tolerate stimulants well.
  • Behavioral therapies like cognitive behavioral therapy (CBT) to learn coping skills.
  • ADHD coaching to help manage time, organization, productivity.
  • School or workplace accommodations like additional time for tasks or minimized distractions.

Anxiety Treatment

Common anxiety treatments include:

  • Cognitive behavioral therapy (CBT) to face fears and change anxious thought patterns.
  • Exposure therapy to gradually face feared situations in a safe, controlled way.
  • Anti-anxiety medications like SSRIs, SNRIs, benzodiazepines in some cases.
  • Relaxation techniques like deep breathing, meditation, mindfulness, progressive muscle relaxation.
  • Exercise and improved sleep habits to reduce anxiety symptoms.

Coping Strategies

Those with ADHD, anxiety, or both can implement certain strategies to help cope with their symptoms:

  • Follow a routine to add structure to your day.
  • Use productivity tools like daily planners, calendars, and to-do lists.
  • Break up tasks into smaller, manageable steps.
  • Minimize distractions in your home and work environment.
  • Practice mindfulness and be aware of your thoughts, feelings, behaviors.
  • Get regular exercise to improve mood and reduce anxiety.
  • Don’t be too hard on yourself. Celebrate small successes!


Untangling symptoms of ADHD vs. anxiety can certainly be tricky. While there is overlap with restlessness, poor concentration, and feeling on edge, key differences exist related to the source of inattention and type of worries involved. A comprehensive evaluation is needed for accurate diagnosis, which can then guide appropriate treatment options. Being informed about the distinguishing symptoms and utilizing positive coping strategies can help manage ADHD, anxiety, or both.