Reviewed by Whitney White, MS CMHC, NCC., LPC
Disorders on the DSM 5 manual hardly ever come as “single spies”; instead, they often show up in battalions. This means, if your doctor diagnoses you with Attention Deficit Hyperactivity Disorder (ADHD), there’s a chance another condition is coexisting with your ADHD.
It is common for symptoms of ADHD to mask the symptoms of other disorders, making it very difficult for them to be diagnosed. It is estimated that over 6 out of 10 people diagnosed with ADHD will also have a coexisting condition or comorbidity. As chance would have it, anxiety is among the most common disorders seen together with ADHD. Nearly 1 out of 2 adults and 1 out of 3 children diagnosed with ADHD also suffer from an anxiety disorder.
ADHD vs. Anxiety
It is important to understand that ADHD can onset very early in childhood, and there’s a strong probability you will carry it with you into adulthood. Many of the symptoms associated with ADHD overlap heavily with anxiety. So, if you are diagnosed with ADHD, it may be harder for your doctor to recognize that you may be dealing with an anxiety disorder as well.
Perhaps the biggest symptom common between ADHD and anxiety disorder patients is difficulty concentrating or paying attention. Meanwhile, another shared symptom is persistent restlessness, where you find yourself unable to fully relax. While these symptoms overlap, ADHD is often passed off as a disorder with milder symptoms, whereas anxiety disorders are far more serious.
The severity of symptoms of anxiety disorders may have a serious impact on work relationships, study performance, personal relationships, and day-to-day activities. The aspect of nervousness and fear is also missing in ADHD, but it can be quite prominent among anxiety symptoms. Likewise, the chronic nature of repetitive worry, the presence of fear without obvious reasons, being irritable, having trouble sleeping, and the physical symptoms that manifest themselves are all symptoms of anxiety.
On the other hand, with ADHD, common symptoms include forgetfulness, inability to finish tasks on time, feelings of restlessness, difficulty following instructions, etc. As you can see, some of the more serious symptoms are associated with anxiety disorders.
How to Tell the Difference Between ADHD and Anxiety
First and foremost, a professional's proper evaluation should be your number one objective in determining whether you are suffering from ADHD, anxiety, or both. However, there are some things you can watch out for and observe that can help you work with your healthcare provider to get the correct diagnosis.
Observing and keeping track of your symptoms can help tell the difference between ADHD and anxiety. The longer you observe and record, the more data you have to make a proper diagnosis. For instance, you may record that you have difficulty concentrating. But, if over time you recognize that your issues concentrating primarily start when you begin to feel anxious, you are likely dealing with anxiety. However, if you are noting that you are having difficulty concentrating at all times, no matter the occasion, it’s likely ADHD.
If you have both ADHD and social anxiety or another form of anxiety disorder, your symptoms will overlap and start to look more extreme. Anxiety is likely going to make it very difficult to pay attention to the will or finish tasks if you also have ADHD.
Explaining the Connection Between ADHD and Anxiety
It is well established that anxiety and ADHD are intrinsically connected. However, professionals don’t quite understand why the connection or what may be causing either of these conditions.
When we start to look at the possible reasons, genetics is one of the first to be suggested. While genetics may be behind these conditions, it may also be blamed for comorbidity. Many times, ADHD is accompanied by other conditions. These conditions often include:
- Sleep disorders
- Substance abuse
- Bipolar disorder
Besides genetics, it is also believed that environmental toxins and premature births could also be reasons behind ADHD.
What If You Are Diagnosed with Both?
The good news is that these conditions can be treated by working together with your healthcare professional. While the exact treatment will vary by individual, four different methods are commonly used with both ADHD and anxiety disorders. These methods include:
- CBT (cognitive and behavioral therapy)
- Relaxation methodologies
- Prescription medication
It’s important to realize that there isn’t a single treatment method that works for everyone. In fact, some of the commonly prescribed medications to treat one condition may actually end up exacerbating the symptoms of the other condition. If medications are part of the treatment plan suggested by your healthcare provider, they may give you a choice as to which medication you will take or to treat only one condition at a time. In such instances, it is often recommended to treat the more bothersome condition (and disrupting your quality of life to a greater extent).
To find the right treatment plan for you, it can be beneficial to carefully record your symptoms and share them with your healthcare provider. In these observations, you want to be forthright and frank with the description of your symptoms. This can help your provider really understand what is going on. In addition to recording your symptoms, it is important to make an effort to find a professional that you gel with (that you feel listens to you and believes what you are saying). This will give you peace of mind, and you’ll have greater belief in the entire process and treatment plan.
Even after you have started a treatment plan, it is important to continue observing and recording your symptoms. This feedback (over how bad the other condition is getting while you get treated for the more distressing condition) will help determine the direction in which your treatment will go. As a matter of rule, you must remember to inform your healthcare provider about every one of your symptoms, even if you think they are unrelated. Likewise, if you experience new symptoms, those could condition worsening or side effects from the treatment method. Just remember that a diagnosis for both conditions occurring simultaneously is the first step toward treatment.
How To Manage ADHD and Anxiety At the Same Time
While it is important to work with your healthcare provider to determine a formal treatment plan, you can take steps to manage your ADHD and anxiety at the same time. Many of these steps are commonly associated with getting your mental health back on track.
Stick to A Schedule
If you’re already suffering from ADHD, you will already know it’s challenging to complete tasks. Just the simple process can bring you more anxiety. One of the easiest ways to combat this is to create a schedule and find some way to stick to it. Remember that your schedule doesn’t have to be a layout of your ambition on paper. Instead, it needs to pragmatically involve the few things that will get you 70% of your happiness. You should also allow some extra time into your schedule when your goal exceeds its allotted time slot. Being realistic is of the utmost importance. Not being realistic in what you can achieve will only work to increase your anxiety levels.
Identifying Your Triggers
You’ll find certain things (triggers) that make you feel anxious or give you full-scale anxiety with careful observation. It is just the way anxiety works, and these triggers vary from person to person. Examples of common triggers include speaking in public or getting on the phone with someone you may not know. It may not be practical to not engage in these triggers, but you could work with your doctor to manage these difficult situations. For instance, before a phone call, you could create notes or draft a presentation well in advance and practice to get more comfortable with the material you’ll be sharing. Understanding what triggers you can help you avoid it or make a plan if the situation is unavoidable.
A Robust Sleep Habit
Your sleep can be the most important tool in the toolbox when tackling multiple conditions such as ADHD and anxiety. Simply being tired may cause you to be more anxious. Forget all you’ve been told about hustling, getting 4 hours of sleep, and pulling all-nighters to get more done.
You must prioritize sleep if you want to successfully deal with these conditions and get ahead. Aim for 7 to 9 hours of sleep each night. If you struggle to fall asleep, mentally preparing yourself for sleep, meditating, doing mindfulness exercises, or even taking a warm shower before bed may all help. It’s also helpful to try to get to bed and wake up at the same time. Over time this will make getting the right amount of sleep easier.
If you find that it is still hard to get to sleep, you may want to talk to your doctor. Some medications for ADHD and anxiety can interfere with sleep. If you need to take a sleeping aid (in the beginning), you must talk to your doctor about all medications or substances you engage in as they could interact with prescribed medications or could be affecting your overall treatment.
Mindfulness and Journaling
When you focus on your mind, every other process tends to streamline. Writing in a journal can help you clear your mind of clutter. If you’re worried about someone else reading it, you don’t even have to keep records; some people find writing and immediately destroying/deleting works for them. Essentially, the goal of journaling is to help you sort through your thoughts.
Being mindful will help you observe your heart and get familiarized with the working of your mind. This simply implies paying attention to whatever is happening at the moment. When you make that much conscious effort to go from situation to situation, you're putting up a strong front against anxiety and ADHD.
Exercising expresses your strong resolve to fight back against whatever is obstructing your life flow. A number of studies show that exercise can help fight anxiety. But you don’t have to keep the same regimen; mix it up if you want. It’s all about moving your body. Exercising helps you release endorphins and exercise control over your body. Most people benefit from exercising for about a half-hour daily.
Figuring Out Your Symptoms
If you’ve been struggling with your concentration or feeling especially anxious, know that you are not alone. Many people have successfully managed conditions such as ADHD and anxiety. Working with your health care professional or a licensed counselor can help you develop a treatment plan that enhances the quality of your life, despite these conditions. Take this free test to determine if it is time to see someone about the issues you’ve been facing regarding your concentration and anxiety.