Anxiety in ADHD: Managing Both Conditions as an Adult

If you’re an adult living with attention deficit hyperactivity disorder and feeling anxious much of the time, you’re far from alone. About half of people with ADHD also experience anxiety disorders, making this one of the most common comorbid conditions in mental health. When ADHD and anxiety occur together, they amplify each other—making it harder to focus at work, manage daily tasks, and maintain relationships.

Understanding how these conditions interact can make a real difference in how you feel day to day.

Can Anxiety Be a Symptom of ADHD?

Anxiety isn’t technically a symptom of ADHD, but the two conditions are closely connected. Anxiety disorders occur at much higher rates in people with adult ADHD compared to the general population. Research shows that anxiety disorders tend to be among the most common comorbid disorders in individuals with attention deficit hyperactivity disorder.

Why do they appear together so often? ADHD involves deficits in executive functioning—your brain’s ability to plan, organize, and regulate emotions. These challenges create real consequences: missed deadlines, forgotten commitments, social misunderstandings. Over time, chronic stress from managing ADHD challenges can increase vulnerability to anxiety as you worry about making mistakes or disappointing others.

Both conditions also share neurobiological features. Research shows that comorbid anxiety and ADHD involve dysregulation in similar brain systems controlling attention and emotional responses. Both ADHD and anxiety are associated with low levels of GABA, which is a primary inhibitory neurotransmitter in the central nervous system. This biological overlap explains why comorbid anxiety disorders occur so frequently alongside ADHD.

In our Dupont Circle practice, we often see clients who’ve spent years thinking they were “just anxious” or “just disorganized”—only to discover they’ve been managing both ADHD and anxiety without realizing it. Once we identify both conditions, treatment becomes much more targeted and effective. Many clients tell us this clarity alone brings relief.

What Does It Feel Like When ADHD and Anxiety Overlap?

When you have both conditions, symptoms blend together in confusing ways. The overlapping symptoms between ADHD and anxiety can make it difficult to identify which is causing what. You might experience:

Difficulty concentrating from both anxious thoughts and ADHD-related inattention
Restlessness and muscle tension that could be ADHD hyperactivity, anxiety-driven physical symptoms, or both
Trouble concentrating and sleep problems from racing thoughts or an overactive mind that won’t settle
Emotional dysregulation including irritability, mood swings, and disproportionate stress reactions

Anxiety symptoms can exacerbate the symptoms of ADHD. When you’re anxious, your working memory—already compromised by ADHD—becomes even less effective. Higher levels of anxiety are linked to greater impairment in working memory for individuals with ADHD. This creates a frustrating cycle where persistent anxiety interferes with the cognitive skills you need to manage ADHD challenges.

Those with both ADHD and anxiety tend to have more severe anxiety symptoms compared to those with anxiety alone. This means the clinical presentation often looks different than either condition in isolation.

How Anxiety Affects Working Memory

Working memory is your brain’s ability to hold and manipulate information in the moment—like remembering instructions while completing a task. People with ADHD already experience deficits in working memory tasks, but anxiety modulates these further.

Think of working memory as your brain’s whiteboard. ADHD makes the whiteboard smaller. Excessive worry from anxiety disorders then clutters that limited space with anxious thoughts, leaving even less room for the task at hand. Neuroimaging studies indicate that anxiety can modulate the brain activity related to working memory in individuals with ADHD. This explains why ADHD symptoms often become worse when an individual is anxious.

Ready to move forward?

How Do I Know If I Have Both ADHD and Anxiety?

Getting an accurate diagnosis requires a thorough clinical history from a mental health professional. Clinical assessments for ADHD should include screening for anxiety disorders. The overlapping symptoms between these conditions can cause diagnostic confusion, so working with someone who understands both mental disorders is essential.

During assessment, clinicians look for key differences:

ADHD-related difficulty concentrating happens across all situations, stressed or not
Anxiety-related trouble concentrating worsens in specific anxiety-inducing situations or during excessive worry
ADHD involves persistent mental chatter jumping between unrelated topics
Anxiety features specific, dominating fears circling around particular worries

A proper evaluation will also screen for other conditions that commonly occur with ADHD, including mood disorders, generalized anxiety disorder, panic disorder, or social anxiety. According to diagnostic and statistical manual criteria from the American Psychiatric Association, assessments examine symptoms in multiple settings over time.

The combination of ADHD and anxiety may lead to later diagnoses compared to ADHD without anxiety. This delay can mean years of struggling without understanding why things feel so hard.

We’ve learned that accurate diagnosis often requires looking beyond the most obvious symptoms. A client might come in describing anxiety, but when we explore further, we discover ADHD has been fueling that anxiety for decades. Taking time for a comprehensive assessment—rather than rushing to a single diagnosis—makes all the difference in treatment outcomes.

Can ADHD Meds Help With Anxiety?

For many adults, treating ADHD effectively reduces anxiety symptoms. When stimulant medications improve your ability to focus, organize, and follow through on tasks, they remove many real-life stressors that trigger secondary anxiety. Addressing ADHD symptoms first can often lead to a reduction in anxiety symptoms because you’re no longer constantly worried about forgetting commitments or underperforming at work.

Stimulant medications are the first-line pharmacological treatment for ADHD and remain effective even when comorbid anxiety disorders are present. However, individual responses vary—some stimulants can worsen anxiety in individuals with ADHD, increasing physical symptoms like muscle tension or restlessness.

If you have comorbid ADHD and anxiety, your treatment plan might include:

Starting with ADHD treatment first, since addressing attention deficit hyperactivity disorder symptoms often leads to natural anxiety reduction
Considering non-stimulant options like atomoxetine, guanfacine, or bupropion, which may be better tolerated for some individuals with ADHD and anxiety
Monitoring carefully, since medication for ADHD may worsen anxiety in some cases, requiring careful management by a psychiatrist

A combination of medication and therapy has been found to be most beneficial for individuals with both ADHD and anxiety. Monitoring ADHD and anxiety symptoms is crucial as treatment progresses.

How to Combat ADHD Anxiety: Practical Strategies That Work

Managing anxiety in adults with ADHD requires addressing both conditions simultaneously. A multimodal approach works best.

Therapy for Anxiety and ADHD

Does therapy help with anxiety when ADHD is also present? Yes—cognitive behavioral therapy can be a beneficial non-pharmacological intervention for both ADHD and anxiety. CBT helps you identify unhelpful thought patterns, develop coping strategies, and build skills for managing anxious thoughts while improving executive functioning.

When exploring different types of therapy for anxiety, CBT is often the starting point for people with comorbid conditions. A therapist can help distinguish between anxiety-driven and ADHD-driven challenges, then develop targeted interventions for each.

Executive Functioning Support

Since both conditions impair executive functioning, building external structure is crucial. Executive function deficits can lead to missed deadlines and general disorganization, which then feeds anxiety. Strategies that help:

Use detailed systems for calendars, reminders, and task management
Break large projects into smaller, manageable steps
Create visual cues and checklists for daily routines
Designate specific places for important items

Executive functioning coaching can support individuals with ADHD and anxiety in managing their symptoms. These strategies compensate for working memory limitations and reduce the anxiety that comes from feeling disorganized.

Building Emotional Regulation Skills

Both ADHD and anxiety can lead to poor emotional regulation, irritability, and mood swings. Learning skills for emotional regulation helps you respond to stress more effectively rather than reacting impulsively.

Mindfulness techniques like deep breathing, meditation, and yoga can help manage anxiety and improve emotional regulation. Start small—even five minutes of daily practice makes a difference in managing severe anxiety symptoms and improving focus.

A reminder we often give clients: building new coping skills takes time, especially when you’re working against both ADHD and anxiety. We encourage starting with one small change rather than overhauling everything at once. Consistent small steps tend to stick better than dramatic overhauls that become overwhelming.

Physical Activity and Routine

Regular physical activity can improve focus, mood, and restlessness in individuals with ADHD and anxiety. Establishing consistent daily routines provides structure and predictability, significantly reducing anxiety and helping with ADHD-related disorganization.

Building a support system can provide emotional reinforcement and practical assistance for those coping with ADHD and anxiety. Family members, friends, and mental health professionals all play a role.

When to Seek Professional Help

If symptoms of both attention disorders and anxiety interfere with work, relationships, or daily functioning, professional assessment is the next step. This is especially important if you’re experiencing:

Sleep disturbance affecting your ability to function
Difficulty meeting basic responsibilities at work or home
Social interactions that feel increasingly overwhelming
Work or school performance that’s significantly declined

Stressful life events can trigger anxiety in individuals managing ADHD, so reaching out during difficult transitions makes sense. Counseling for anxiety combined with ADHD-focused treatment leads to better outcomes than addressing either condition alone.

Managing both ADHD and anxiety takes work, but effective treatments exist. With the right combination of professional support, evidence-based treatment, and practical strategies, many people see significant improvement in their daily functioning and overall quality of life.

Get Support in Dupont Circle

If you’re looking for therapy for anxiety and ADHD, the therapists at Therapy Group of DC are here to help. Our clinicians in Dupont Circle understand the complexities of comorbid conditions and provide evidence-based treatment tailored to your needs. Contact us to schedule an appointment.