ADHD and Anxiety: How They Interact and Overlap

ADHD and anxiety have been well documented to overlap and co-occur. But what does that psychological jargon actually mean? Here is an extremely simplified breakdown.

It means that many adults who explore ADHD also realise they feel anxious, constantly overthinking, worrying about how others see them, or feeling on edge even when nothing is “wrong.” Others have lived with anxiety for years before discovering underlying ADHD traits they didn’t know were there.

ADHD and anxiety often exist together, but they are not the same thing. And often, they are not diagnosed together.

You can be diagnosed with ADHD and have features of anxiety, or receive a co-occurring diagnosis of ADHD and an Anxiety Disorder. (I highly suggest leaving this up to a qualified clinician to assess and decide with you.)

However, understanding how they overlap, and how they differ, can help you make sense of your experiences with more compassion and less self-blame. (It is also always an attempt at psycho-education, what we don’t know, we don’t know right?)

ADHD vs Anxiety - What’s the Difference?

ADHD Traits	Anxiety Patterns
Brain seeks stimulation	Brain seeks certainty and safety
Difficulty starting tasks, staying focused, managing time	Persistent worrying, “what if” thoughts, fear of future scenarios
Forgets things, loses items, jumps between tasks	Overprepares, avoids, freezes
Emotions appear quickly and intensely; rejection sensitivity	Emotions often centre around fear, control, and imagined danger
May underestimate own internal resources	May underestimate ability to cope with perceived threat

Both can make everyday life overwhelming, but they originate from different places.

• ADHD is about how the brain manages attention, motivation, impulse, time and energy.

• Anxiety is about how the brain scans for danger, tries to stay safe, and prepares for worst-case outcomes (rational or not).

Yet in both, anxiety can develop from feeling out of control, unsupported, overwhelmed, or not equipped to cope.

So how can they look so similar, and still be different? Because for many people, ADHD can lead to anxiety over time.Not because ADHD is anxiety, but because living with ADHD traits in a world that expects consistency, organisation, emotional control and punctuality can naturally create anxiety and self doubt.

You might recognise this:

• Always feeling behind → anxiety about failure

• Forgetting appointments or deadlines → anxiety about consequences

• Being called “too much”, “too sensitive”, “careless”, “lazy” → anxiety about being judged or rejected

• Working twice as hard to stay on top of things → exhaustion → anxiety about dropping any ball

  
  

This is often called secondary anxiety, anxiety that evolves over time due to unmanaged ADHD traits, masking, pressure, burnout, and shame.

ADHD and secondary anxiety and Anxiety Disorder can have the same appearance but different voice. Both ADHD and anxiety can show up as:

• Overthinking

• Trouble sleeping or switching off

• Restlessness (internal or physical)

• Avoiding certain tasks or situations

• Feeling overwhelmed by simple decisions

• Repetitive checking behaviours

But the inner dialogue is different, if we’re pulling on the deeper psychological theories, they would say that the why is different.

ADHD says:

“I want to do this. I just can’t get started.”

“I lost track of time… again.”

“My brain is loud, busy and everywhere.”

Anxiety says:

“What if I fail?”

“What if I forget and embarrass myself?”

“What if something goes wrong?”

“What if people think I’m lazy, rude, or not good enough?”

ADHD is often about initiation and attention. Anxiety is often about fear, control, and prediction. This is where my previous blog comes in. (If you haven’t read it yet, it might help everything below make more sense.[Read about emotional overwhelm here]

When someone experiences emotional overwhelm or rejection sensitivity, particularly with ADHD traits, the nervous system begins to anticipate emotional pain. It scans for it before it even happens. And that’s where anxiety steps in.

Not always anxiety about events - but anxiety about how it will feel if something goes wrong:

• Fear of embarrassment

• Fear of letting someone down

• Fear of feeling shame, guilt, rejection or disappointment

In ADHD, emotions tend to arrive quickly and intensely. In anxiety, the anticipation of future emotions keeps the mind alert, tense and on guard.

So What Helps When Both Show Up?

You don’t need to decide which one you “really” have before you can help yourself. Supporting your nervous system gently and consistently helps both. Help one, and you often help the other.

Here are a few things I like to work on with clients:

1. Name What’s Happening (Emotional Awareness)

What emotion is coming up?“I’m feeling overwhelmed.”“My brain is racing.”“My chest feels anxious.” Naming shifts you from being inside the experience to noticing it.

2. Support the Body First -Not the Thoughts

Try:

• Slow breathing (inhale 4, hold 2, exhale 6)

• Cold water on wrists or face

• Stretch, shake out tension, move your body

• Grounding: 5 things you can see, 4 you can touch, etc.

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3. Make Tasks Startable - Not Perfect

(Scaffolding instead of perfection)

• ADHD responds well to tiny steps, not giant plans.

• Anxiety calms when we allow “good enough” instead of perfect.

• Too much planning can trigger both. Getting started matters more than getting it right.

  
  

4. Write the Thought Down - and Leave It There

What I call “letting the bee out the window.” Write the thought, fear, or worry down. Tell your brain: “I’ve caught it. I’ll come back to it if needed.” Often, you won't need to.

Or  if writing isn’t your thing visualise it. You’re sitting on a station platform. Thoughts are trains. They arrive, pause, and leave again. You don’t have to board every one.

5. Practise Emotional Tolerance

Not suppressing or ignoring emotions,  but learning you can carry them without breaking.This is where therapy can help: building a bridge between your emotional brain and rational brain. (Although, this in itself deserves its own blog post.)

If you live with ADHD traits and anxiety, don’t worry – you’re human. You’re a human doing your best with a brain that feels, notices, and responds deeply.

You don’t have to choose one label to explain yourself. Understanding the overlap simply gives you language, permission, and new ways to care for your mind.

If you’re struggling with anxiety, wondering if you may have ADHD, or wondering how they overlap for you - you’re welcome to book a consultation, and we can talk about it.