ADHD or Anxiety? How to Tell the Difference

19.10.26

“What’s going on?” “Why am I feeling this way?”

These are some of the most common questions people bring to therapy. And it’s no wonder. Understanding what is contributing to a difficulty can be surprisingly complex, particularly when different experiences can look very similar on the surface.

ADHD and anxiety are a good example. Although they are distinct, they can overlap in ways that make them surprisingly easy to confuse.

Both can involve difficulties with concentration, forgetfulness, restlessness, procrastination, feeling overwhelmed, trouble sleeping, irritability, and decision-making. The same behaviour can look identical on the surface, but what is driving that behaviour can be quite different.

Someone may be struggling to concentrate because their attention is being pulled in multiple directions, because their mind is caught up in worry, or because both are happening at once. Procrastination might reflect difficulty getting started, fear of making a mistake, or a combination of the two.

So, when it comes to ADHD and anxiety, the important question is often not simply what is happening, but why.

Different Processes Can Sit Behind Similar Experiences

ADHD and anxiety can lead to similar experiences, but the processes contributing to them may differ.

ADHD: Differences in Attention and Executive Functioning

ADHD is a neurodevelopmental condition, meaning it involves differences in areas such as attention, planning, organisation, working memory, emotional regulation, and impulse control.

These differences are not a reflection of intelligence, motivation, or effort. People with ADHD often experience attention as more variable and context-dependent. It may be much easier to focus on something that is interesting, stimulating, novel, or urgent than on a task that feels repetitive or low in immediate reward.

This helps explain why someone with ADHD may struggle to begin an everyday task, yet become deeply absorbed in something they find engaging. The difficulty is not simply an inability to pay attention, but regulating, shifting, and sustaining attention across different situations.

Anxiety: A Brain Trying to Keep You Safe

Anxiety is more closely associated with the brain and body’s threat-detection systems.

These systems are designed to protect us. When something feels threatening, whether the threat is immediate, anticipated, or unclear, the nervous system can shift into a state of increased alertness and activate the body’s fight, flight, freeze, fawn, or flop responses.

During periods of anxiety, attention can become drawn towards worries, “what if” thoughts, possible mistakes, or signs that something may go wrong. This can make concentrating on other things much harder.

Of course, these patterns are not mutually exclusive. A person with ADHD can also experience worry, and someone with anxiety may have difficulty regulating their attention for a range of reasons. The differences become clearer when we look at the broader pattern rather than any single symptom.

What’s Driving the Symptoms in ADHD and Anxiety?

Looking at what tends to sit behind an experience can provide useful clues.

Difficulty Concentrating

With ADHD, attention may be more variable and more easily drawn towards what is interesting, novel, stimulating, or immediately rewarding. Sustaining focus on repetitive or less engaging tasks can therefore be harder.
With anxiety, concentration may be disrupted because attention is repeatedly pulled towards worry, analysing situations, or anticipating potential problems.

Procrastination

Procrastination with ADHD may reflect difficulties with task initiation and executive functioning. Even when someone genuinely wants to complete a task, getting started can feel disproportionately difficult.
With anxiety, procrastination may be more strongly influenced by fear, uncertainty, perfectionism, or concern about making a mistake.

Restlessness

Restlessness in ADHD can be linked to a need for movement or stimulation, which helps the brain maintain a comfortable level of baseline activation. A person may fidget, move around, or seek activity even when they otherwise feel calm.
Restlessness with anxiety may be more closely linked to physiological arousal or distress, and can occur alongside racing thoughts, muscle tension, or a sense that something is not quite right.

Forgetfulness

With ADHD, forgetfulness may be related to working memory and executive functioning. Information can be difficult to hold in mind long enough to act on, or attention may move on before a task is completed.
With anxiety, memory can also be affected when significant mental energy is being taken up by worry or threat-monitoring.

Feeling Overwhelmed

For someone with ADHD, overwhelm may arise when organising, prioritising, or managing several demands at once becomes difficult.
With anxiety, overwhelm may be more strongly linked to worry, anticipating problems, or trying to prepare for multiple possible outcomes.

Impulsivity

With ADHD, impulsive behaviour may be linked to immediate reward, stimulation, or acting before there has been time to pause and consider the consequences.
With anxiety, a person may also act quickly in an effort to reduce distress, such as seeking reassurance, making a rushed decision, or avoiding an uncertain situation.

These are general patterns, not hard-and-fast rules. The same person may recognise themselves in both descriptions, and context is very important. A single symptom rarely tells the whole story.

To Complicate Matters… You Can Absolutely Have Both ADHD and Anxiety

ADHD and anxiety can be difficult to untangle because they often occur together. In fact, 25% of people who meet the criteria for ADHD also have anxiety. When they do occur together, each condition can also make the other more challenging to manage.

Living with ADHD can create understandable anxiety. Forgetting appointments, missing deadlines, or struggling to stay on top of everyday responsibilities can lead to worrying about making mistakes or feeling as though you need to stay constantly “on alert”.

At the same time, anxiety can make ADHD-related difficulties harder to manage. When your mind is already occupied with worry, concentrating, organising your thoughts, making decisions, or getting started on tasks can become even more difficult.

This can create a cycle where ADHD-related challenges increase anxiety, while anxiety makes executive functioning more difficult.

How a Psychologist Can Help Untangle ADHD and Anxiety

Psychologists who work with ADHD draw on research and clinical knowledge, but they also look at the individual person in front of them. This means considering when certain patterns began, when they tend to appear, what makes them better or worse, and how they fit within the person’s broader history, relationships, environment, and current circumstances.

For example, difficulty concentrating can mean very different things depending on whether it has been present since childhood, appears mainly during periods of stress, occurs only in particular settings, or changes depending on how engaging a task feels.

This process is called formulation: building an individualised understanding of how different factors may be interacting to create or maintain a person’s difficulties.

That is one reason professional input can be so useful. Rather than asking whether someone simply “fits” ADHD or anxiety, a psychologist can help explore the unique pattern of their experiences and consider whether ADHD, anxiety, both, or something else provides the most helpful explanation.

That understanding can then guide treatment and support in a way that is better matched to the individual, rather than relying on a one-size-fits-all approach.

Clarity Around Your Experience

If you’ve been wondering whether your experiences reflect ADHD, anxiety, or both, you’re certainly not alone. The overlap between the two can make it difficult to know what is really going on.

Gaining a better understanding of what may be contributing to those experiences can be incredibly validating. Rather than wondering “What’s wrong with me?”, you can begin to better understand your own patterns, needs, and ways of responding to the world around you.

With that understanding comes the opportunity to find strategies and support that genuinely fit your needs.

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If this article has resonated with you but you’re still unsure which explanation best fits your experience, that’s completely understandable. If you’d like to explore your experiences further, you can reach out to our team today. Our friendly admin team will take the time to understand your needs and thoughtfully match you with a psychologist who may be a good fit for you.

Looking for more? We recommend reading The Year I Met My Brain by Matilda Boseley, which explores navigating life as an adult with ADHD.