Trouble concentrating, a restless body and a mind that will not switch off at night. Is it ADHD or anxiety? It can be either, or both.
ADHD and anxiety share several features, which makes them easy to confuse. This article explains the main differences clinicians look for, why the two often occur together, and how a careful assessment can sort out what is going on.
Key points
- ADHD and anxiety share symptoms such as poor concentration, restlessness and sleep problems.
- ADHD starts in childhood and affects most areas of life. Anxiety is often tied to worry and specific triggers.
- Many people have both, and anxiety can develop after years of undiagnosed ADHD.
- A careful assessment looks at your history from childhood, not only how you feel now.
- Treating one condition may not fully treat the other, so an accurate picture matters.
Why ADHD and anxiety are easy to confuse
ADHD (attention deficit hyperactivity disorder) is a neurodevelopmental condition that affects attention, activity and impulse control. Anxiety disorders involve worry or fear that is hard to control and gets in the way of daily life.
Both are common. Healthdirect estimates that around 1 in 20 people in Australia has ADHD. It also reports that anxiety disorders affect 1 in 4 Australians at some stage in their life.
A 2022 review by Koyuncu and colleagues notes that the two conditions have overlapping symptoms. These include:
- trouble concentrating
- restlessness
- sleep problems
- feeling overwhelmed by tasks
Because of this overlap, a checklist of current symptoms is rarely enough to tell them apart.
Differences clinicians look for
These are common patterns, not strict rules. A clinician weighs them together with your full history.
| Question | More typical of ADHD | More typical of anxiety |
|---|---|---|
| When did it start? | In childhood, with several symptoms before age 12 | Can start at any age, often during a stressful period |
| Where does attention go? | Drifts to whatever is more interesting, even when you are calm | Pulled towards worries, “what ifs” and possible threats |
| What does restlessness feel like? | A need to move or keep busy, often felt as fidgety or bored | Tension, feeling on edge, a racing heart or churning stomach |
| Is it there when life is calm? | Usually yes, including on holidays | Often eases when stress and worry settle |
| Where does it show up? | Across most settings, such as home, work and social life | Often in situations linked to the worry, such as social events |
For example, a person might say they cannot focus in meetings. If their mind wanders to weekend plans or a song in their head, that points one way. If their mind fills with fear about being asked a question, that points another way. Many people notice a mix of both.
In children
The same patterns apply to children, but they can look different. An anxious child may avoid situations, seek a lot of reassurance, or complain of tummy aches before school. A child with ADHD may be distracted, forgetful or restless at home, at school and at play, even when nothing is worrying them.
Children often cannot explain what is happening in their minds. That is why clinicians rely on parents, teachers and careful observation, as well as the child’s own view.
When it is both
ADHD and anxiety often occur together. In a 2017 paper, Reimherr and colleagues looked at four different groups of patients, including people in ADHD and anxiety studies. About 25% of patients in each group had both ADHD and anxiety.
The link can run in different directions:
- Anxiety that grows from ADHD. Years of missed deadlines, forgotten tasks and criticism can lead to constant worry about getting things wrong. The Koyuncu review describes research suggesting that social anxiety may develop after childhood ADHD.
- Anxiety that hides ADHD. Some people use worry to stay on track. They double-check, over-prepare and lie awake making lists. This can mask ADHD for years.
- Two separate conditions. Sometimes both are present and each needs its own attention.
The Australian ADHD Clinical Practice Guideline notes that ADHD commonly occurs with other mental health conditions. It says some of these may be a result of ADHD that has not been diagnosed or treated. It also warns that girls and women with ADHD may be more likely to receive an incorrect diagnosis, such as an anxiety disorder.
How clinicians tell them apart
A thorough assessment usually includes:
- A timeline. When did each difficulty start? Which came first? School reports and family memories help here.
- More than one point of view. The Koyuncu review stresses the value of standardised interviews and information from more than one person, such as a parent, partner or teacher.
- Rating scales for both conditions. These show the pattern and severity of symptoms. The Australian guideline says rating scales are useful but should not be used alone to diagnose ADHD.
- Checking other causes. Depression, trauma, sleep disorders, heavy caffeine use and some medical conditions can also affect concentration and restlessness. Your GP can help rule out physical causes.
- Looking at past treatment. If anxiety treatment helped with worry but focus and organisation problems remain, that can be a useful clue.
Why getting it right matters
Treatments overlap in some ways and differ in others. Healthdirect lists psychological therapy such as cognitive behaviour therapy (CBT), lifestyle changes and medicines as options for anxiety. The Australian ADHD guideline supports a mix of approaches for ADHD, including CBT-based strategies, education, coaching and, for some people, ADHD medication.
When both conditions are present, treating one may not be enough. In the Reimherr paper, ADHD medication improved ADHD symptoms in people with both conditions. Anxiety symptoms also went down, but not more than with a placebo (an inactive tablet). This suggests anxiety may need its own treatment plan.
An accurate picture helps you and your treating team choose what to try first, and what to add if progress stalls.
What you can do now
- Keep simple notes for two to four weeks about when focus, restlessness and worry are worst.
- Look for old school reports and ask family what you were like as a child.
- Talk with your GP about your sleep, general health and any medicines you take.
- If worry or low mood is affecting your daily life, seek support now. You do not need to wait for an assessment.
If you are in danger, call 000. For 24-hour crisis support call Lifeline on 13 11 14.
How Invictus Health can help
Our psychologists and neuropsychologists provide ADHD assessments that also consider anxiety and other conditions. If autism is part of your question too, see our ADHD and autism assessments page.
For help with worry and stress, our anxiety and stress counselling is available in person in Preston or by telehealth across Australia. You can self-refer for most services. See our fees and rebates page for costs.
This article is general information only. Please speak with a qualified health professional about your own situation.
Frequently asked questions
Can ADHD be mistaken for anxiety?
Yes. Both can cause poor concentration, restlessness and sleep problems. The Australian ADHD guideline notes that girls and women in particular may be diagnosed with an anxiety disorder when ADHD is the underlying issue, or when both are present. A detailed history that goes back to childhood helps clinicians tell the difference.
Can ADHD cause anxiety?
It can contribute to it. Living with ADHD that has not been recognised can mean years of forgetting things, missing deadlines and being criticised. Over time, this can lead to worry and fear of failure. Research also suggests social anxiety can develop after childhood ADHD. Treating both conditions often works better than treating one.
Can you have ADHD and anxiety at the same time?
Yes, and it is common. One study found that about a quarter of patients in several different clinical groups had both ADHD and anxiety. When both are present, each may need its own support. A careful assessment can clarify which difficulties relate to ADHD and which relate to anxiety.
How can I tell if my child has ADHD or anxiety?
Look at when and where the difficulties happen. ADHD signs usually appear in many settings, even when a child is relaxed. Anxiety often links to particular worries or situations, such as school or separation. Children can also have both. Talk with your GP or a psychologist, and collect teacher observations to share with them.
Should I be assessed for ADHD if anxiety treatment has not helped?
It may be worth asking about. If therapy or medicine has eased your worry but problems with focus, organisation or restlessness remain, ADHD could be part of the picture. It could also be another condition, such as depression or a sleep disorder. Discuss it with your GP, psychologist or treating doctor.
Get a clearer picture
An assessment can help work out whether ADHD, anxiety or both are affecting you. You can self-refer.
References
- Australasian ADHD Professionals Association. Australian Evidence-Based Clinical Practice Guideline for Attention Deficit Hyperactivity Disorder. AADPA; 2022. adhdguideline.aadpa.com.au/wp-content/uploads/2022/10/ADH…
- Koyuncu A, Ayan T, Ince Guliyev E, Erbilgin S, Deveci E. ADHD and anxiety disorder comorbidity in children and adults: diagnostic and therapeutic challenges. Current Psychiatry Reports; 2022;24(2):129-140. link.springer.com/article/10.1007/s11920-022-01324-5
- Reimherr FW, Marchant BK, Gift TE, Steans TA. ADHD and anxiety: clinical significance and treatment implications. Current Psychiatry Reports; 2017;19(12):109. link.springer.com/article/10.1007/s11920-017-0859-6
- Healthdirect Australia. Anxiety. Healthdirect; reviewed 2024. healthdirect.gov.au/anxiety
- Healthdirect Australia. Attention deficit hyperactivity disorder (ADHD). Healthdirect; reviewed 2025. healthdirect.gov.au/attention-deficit-disorder-add-or-adhd