You’re not alone if you’ve been surfing the net for hours wishing to learn more about what might be wrong with you if you have ADHD or anxiety problems, why you can’t focus, why your mind doesn’t slow down, or why things seem impossible? The adults would be brought to psychiatric evaluations once a week, telling the same complicated stories of racing thoughts, missed deadlines, restlessness and unceasing self-doubt, and asking in amazement – is this ADHD, is this anxiety, or is it both?
Honestly, there’s no clear cut way to know the difference between anxiety and the symptoms of ADHD, and even seasoned professionals find it hard to distinguish one from the other. This article is meant to elucidate how psychiatrists differentiate between the two, why they are often found together, and what it looks like to have a correct diagnosis procedure.
Why ADHD and Anxiety Symptoms Overlap
At first glance it might seem that ADHD anxiety symptoms are almost indistinguishable. Both these types can present with:
- Problem maintaining attention or focus
- If numbness or lack of concentration, restlessness and inability to sit still, occur
- Lack of sleep or an overactive or active mind at night-time
- Forgetting to do some tasks and responsibilities
- Forgetfulness and disorganization
- Low tolerance of frustration and irritability
Many adults are misdiagnosed with one disorder when the other – or both – is actually causing their symptoms as the visible behaviors are extremely alike. That’s why it’s one of the most prevalent misdiagnosis and confusing scenarios in the field of adult psychiatry – and why you should tailor your clinical assessment rather than take a quick online quiz.
Anxiety vs ADHD Symptoms: The Key Differences
The symptoms may appear similar, but psychiatrists consider what is causing the symptoms as well as the fact that the symptom is occurring. Let’s break down the differences between anxiety and ADHD symptoms in more detailed analysis when observed in the clinic:
Where attention goes. In ADHD the mind wanders towards anything new, stimulating or interesting, even when doing something one really wants to complete. When it comes to anxiety, there’s a type of fixation in the mind, a worry or feared event – it repeats itself over and over again.
Restlessness. Restlessness is a common symptom of ADHD that is a physical need for stimulation or physical activity. Restlessness commonly associated with anxiety is usually caused by nervousness stemming from a particular fear or stressor.
Why is the chore not getting done. Procrastination is a different issue in ADHD vs anxiety. The usual reason for ADHD procrastination is failure to get started: The “Start now” signal is not activated internally. Anxiety procrastination can be based on fears of doing it wrong, others judging and failure.
Onset and pattern. ADHD symptoms do not disappear over the course of one’s life and they can manifest in a variety of situations including in school, work and relationships at any time in life, even without stress. Anxiety symptoms may appear at any age and tend to get worse when people encounter a stressful situation and get better when they pass such a situation.
Physical symptoms. Physical symptoms of anxiety range from a beating heart, muscle tension, sweating, stomach discomfort, and others. Physical symptoms are not usually seen in children with ADHD alone, but are in those with ADHD and anxiety.
To truly appreciate these differences is at the heart of every adult ADHD evaluation Dr. Shershow performs: any symptom is never provided equal weight; the underlying cause is always examined.
Can Anxiety Cause ADHD Symptoms?
One of the most frequently asked questions is why can’t patients have more than one? The answer to that question is yes – up to a point. Longstanding, uncontrolled anxiety has the potential to definitely induce ADHD symptoms: problems paying attention, forgetfulness, restlessness, and inability to finish work. A person who is constantly worried struggles with his working memory & paying attention, does not pay attention to what is meant to think of.
When however, anxiety brings out symptoms of ADHD, these symptoms are situational. In stressful situations they increase and get better when the stress is dealt with. Here’s where psychiatrists get a clue in an evaluation: while the person is calm, in a low-stress situation, true ADHD is present throughout the person’s life.
Does ADHD Cause Anxiety?
A relationship can also be the other way around. Many adults suffer from anxiety because of ADHD, although typically indirectly. Forgotten deadlines and commitments, underperformance with distinction, and rifted relationships can build up over a number of years and result in a constant undercurrent of worry, self-criticism and worry. This is sometimes referred to as “secondary anxiety” or anxiety that occurs directly as a result of having untreated or undiagnosed ADHD.
Years of anticipatory anxiety come to mind for many adults going on to be diagnosed with ADHD: Anxieties like forgetting something important, being late, or losing focus in public. Unfortunately, when ADHD is diagnosed and managed, this kind of anxiety will typically go down dramatically, which is why diagnosis is extremely important.
Is Anxiety a Symptom of ADHD?
Anxiety cannot be considered a key element of the diagnostic criteria for ADHD, from a clinical perspective. The diagnostic criteria in the DSM-5 for ADHD concentrate on inattention, hyperactivity and impulsivity – not worry or fear. But rather an alternative question: Is anxiety a symptom of ADHD? Anxiety is one of the most common conditions associated with ADHD – but it doesn’t necessarily fit into the official diagnostic categories.
But the chronic worry over performing, time management, forgetfulness, etc. can become so part of their daily life, that people with ADHD can express that they feel anxiety as if it were part of their ADHD – when actually, it is a distinct condition that can be diagnosed separately.
When ADHD and Anxiety Occur Together
It is a very common comorbidity and is often found in adult psychiatric practice and ADHD and anxiety go hand-in-hand. Chronic worry, physical tension and avoidance behaviors are common traits in adults suffering with ADHD, and are particularly prevalent, with some being the direct result of years of unmanaged ADHD symptoms.
If both conditions are present, the treatment must be directed at treating both of them at the same time and not individually. Therapy alone for anxiety although sometimes helpful for ADHD does not necessarily work, and if it does, those issues remain unresolved. However, treating ADHD only without including anxiety, will result in a person feeling still being out of balance due to worry despite being better focused. This is the reason why a thorough psychiatric assessment should be made not just a process of ticking off symptoms off a checklist: the adult ADHD psychiatry page covers any associated conditions along with a full treatment plan.
ADHD Symptoms, Anxiety, and Depression: The Bigger Picture
Many adults are not only experiencing symptoms of ADHD and anxiety – for many, the picture is a three-way combination of ADHD symptoms, anxiety and depression. If ADHD symptoms are left untreated over extended periods of time, it can slowly take a toll on self-esteem. Constant self-criticism resulting from repeated experiences of failure despite feeling as smart and hardworking as one can is likely to escalate over time to become an anxiety and depressing condition.
Many adults are not only experiencing symptoms of ADHD and anxiety – for many, the picture is a three-way combination of ADHD symptoms, anxiety and depression. If ADHD symptoms are left untreated over extended periods of time, it can slowly take a toll on self-esteem. Constant self-criticism resulting from repeated experiences of failure despite feeling as smart and hardworking as one can is likely to escalate over time to become an anxiety and depressing condition.
How Psychiatrists Actually Tell the Difference
But how does a psychiatrist sort through ADHD or anxiety when examining in a real world evaluation? It usually takes the following steps:
1. A thorough developmental history. Because ADHD starts in childhood, psychiatrists ask their patients about their performance in school, feedback from teachers and patterns in behavior since early childhood, even if they were not treated for ADHD then.
2. Personalized timeline symptoms and triggers. Is concentrating on a task a problem at all times or prominently during stressful times? Persistent lifelong symptoms indicate ADHD; symptomology related to a particular stressor indicates anxiety.
3. Standardized rating scales. Validated tools can be used to quantify inattention, hyperactivity and anxious symptoms, providing objective data for comparison with clinical interviews for the psychiatrist.
4. Discovery of the underlying “why” of each symptom. Restlessness, procrastination and impaired concentration can be a consequence of a variety of very different causes – and the task of the psychiatrist to determine which mechanism underlies what symptom.
5. Excluding conditions that overlap. Some other diagnoses such as sleep disorder, thyroid problems, depression and other issues can simulate ADHD or anxiety symptoms so a complete clinical picture is important for diagnosis.
This is a structured, slow pace process that’s a key part of how ADHD is diagnosed – I’m not using a checklist, I am having a whole clinical interview, and trying to determine if they actually are suffering from a clinical symptomology of ADHD and not something that’s anxiety induced.
Getting an Accurate Diagnosis
However, if you’ve already had a change in focus, hyperactivity, or a persistent state of concern or nervousness for which there’s no obvious cause, you don’t have to guess if you may have ADHD or anxiety. A board certified psychiatrist can explain all your symptoms, past history, and how it affects your daily life to find out what the real underlying issues are – and then create a treatment plan around those true issues, not just the symptoms.
In-person visits and secure telehealth evaluation of ADHD for adults are welcome across New York and New Jersey with ongoing ADHD medication management as needed.
Frequently Asked Questions
Can anxiety cause ADHD symptoms?
Yes. Persistent worry can result in symptoms of ADHD, including attention deficits, impulsiveness and forgetfulness. In people with anxiety the symptoms can shift with their mood and stress, but in those with ADHD, the symptoms are consistent regardless of the situation and useful information is given.
Does ADHD cause anxiety?
Indirectly, but a lot of adults are suffering from anxiety due to ADHD. Slippage on deadlines, disorganization and under performance in primary activities can cause secondary anxiety and persistent concerns about forgetfulness and failure at assignments.
Is anxiety a symptom of ADHD?
Although anxiety is not a recognized diagnostic symptom for ADHD, it is one of the most prevalent associated disorders. Many adults do not get the symptoms of either kind alone, so that is why psychiatric evaluations check for symptoms of both.
What’s the main difference between ADHD vs anxiety?
ADHD is a life-long neurodevelopmental pattern of inattention and hyperactivity/impulsivity that begins in childhood. Anxiety is an excessive worry response that may begin at any age and increase during periods of stress, but not necessarily.
Can someone have both ADHD and anxiety at the same time?
Yes. ADHD is often co-occurring with anxiety and when treating for ADHD only, the anxiety symptoms may not be brought into balance. It is important to have a thorough examination carried out so that they can see the whole picture and treatment can be provided.
How do psychiatrists tell ADHD symptoms apart from anxiety symptoms?
Children’s history, symptom patterns in various contexts, rating tools, and the root of each symptom, due to the distinct and sometimes mutually exclusive causes of each symptom in ADHD vs anxiety.
Is it common for ADHD symptoms, anxiety, and depression to occur together?
Yes. By their nature, and over time, undiagnosed ADHD may also lead to anxiety and depression, if problems with concentration and organization become a chronic nature and impact an individual’s self-confidence and functional ability.
It can be very tiring to live with unexplained difficulties with concentration, hyperactivity, or worry – but you don’t have to know if it’s ADHD or anxiety symptoms alone. Check out DrJohnShershow.com for a complete psychiatric examination and insight into the root cause of your symptoms.