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ADHD, Anxiety, or Both? Understanding Overlapping Symptoms
- Dr Titilayo Akinsola
- 4 hours ago
- 5 min read
You sit down to work, and your mind starts spinning. You forget appointments, lose track of conversations, or feel overwhelmed by the simplest task. You’re told it’s “just anxiety.” You try therapy, breathing, maybe even medication—but the fog doesn’t lift.
What if it’s not just anxiety? What if the real story is ADHD—hidden beneath the noise of worry and stress?
At Favor Mental Health, we help Maryland adults untangle one of the most common and costly diagnostic puzzles in psychiatry: the overlap between ADHD and anxiety disorders.
Because when you know which one (or both) you’re facing, you can finally treat the cause—not just the chaos.
The Overlap: Why ADHD and Anxiety Look So Similar
ADHD and anxiety share multiple overlapping symptoms:
Difficulty concentrating
Restlessness or fidgeting
Racing thoughts
Irritability
Sleep difficulties
Avoidance of demanding tasks
This overlap often leads to misdiagnosis, especially in adults and women.
Symptom | ADHD Interpretation | Anxiety Interpretation |
Racing thoughts | Fast, non-linear thinking | Worry and rumination |
Restlessness | Impulsivity or boredom | Nervous energy |
Trouble focusing | Distractibility, attention lapses | Overthinking or fear of mistakes |
Poor organization | Executive dysfunction | Perfectionism and avoidance |
Emotional sensitivity | Rejection sensitivity | Social worry or fear of judgment |
Both conditions can cause chaos in work, relationships, and self-esteem—but the “why” behind the symptom matters when creating a treatment plan.
The Key Difference: Internal vs. External Drivers
Anxiety is driven by fear: What if I fail? What if something bad happens?
ADHD is driven by inconsistency: I want to focus, but my brain won’t cooperate.
In ADHD, the attention problem exists even when you’re calm. In anxiety, attention problems happen because you’re worried.
🔍 Example:
A teacher in Columbia, MD, struggles with grading papers. She’s anxious about deadlines—but also constantly distracted by noise and her phone. After testing, we find both ADHD and generalized anxiety disorder. Once her ADHD is treated, her anxiety drops by 60%.
The lesson: sometimes anxiety is not the root problem—it’s the symptom of untreated ADHD.
The Hidden Patterns: How Each Feels Day-to-Day
If It’s Primarily ADHD
Your energy spikes and crashes unpredictably
You hyperfocus on things you enjoy but can’t start things you don’t
You often feel shame about “not living up to your potential”
Anxiety shows up after things go wrong (not before)
If It’s Primarily Anxiety
You feel constant “what if” thoughts about future scenarios
You overplan, overprepare, and overanalyze
You find it hard to relax, even when things are fine
Sleep is shallow or disrupted by tension and worry
If It’s Both
You’re exhausted from the combination of chaos and fear
You procrastinate because of anxiety, then panic because of deadlines
Your mind races from “too many thoughts” and “too much worry” simultaneously
Why This Matters: The Risk of Misdiagnosis
If ADHD is mistaken for anxiety, treatment may focus only on calming the nervous system (therapy, SSRIs, relaxation techniques).While this helps some symptoms, it can leave executive dysfunction—poor focus, disorganization, forgetfulness—completely unaddressed.
If anxiety is mistaken for ADHD, stimulant medications may increase restlessness and worsen panic symptoms.
Accurate diagnosis ensures:
✅ The right medication class (stimulant vs. non-stimulant vs. anxiolytic)
✅ The right therapy approach (CBT vs. executive function coaching)
✅ The right lifestyle supports (structure vs. relaxation emphasis)
At Favor Mental Health, we carefully assess both—because it’s not always one or the other.
The Science: What’s Happening in the Brain
ADHD
In ADHD, the dopamine and norepinephrine pathways are underactive, making it harder for the brain to regulate attention, motivation, and reward processing.This explains why people with ADHD crave novelty, stimulation, and urgency.
Anxiety
In anxiety, the amygdala and limbic system are overactive, producing excess cortisol and adrenaline even when there’s no threat.
When both conditions coexist, the nervous system swings between understimulation (ADHD) and overactivation (anxiety)—creating a constant feeling of burnout and internal noise.
Gender and Diagnostic Bias
Women in Maryland and beyond are often diagnosed with anxiety or depression years before ADHD is identified.Why? Because female ADHD tends to be inattentive, not hyperactive.
Instead of disruptive behavior, women internalize their symptoms—appearing “stressed,” “tired,” or “emotional.”
This leads to:
Years of untreated executive dysfunction
Repeated antidepressant trials with minimal improvement
Emotional exhaustion from “trying harder” without success
At Favor Mental Health, our providers are trained to recognize gender-specific ADHD presentations, ensuring women get the clarity and treatment they deserve.
How Favor Mental Health Diagnoses ADHD and Anxiety
We use a multi-step evaluation process to separate and identify overlapping conditions:
Comprehensive Clinical Interview
We explore medical history, childhood behavior, family background, and symptom patterns.
ADHD-Specific Screening Tools
Validated assessments like the Adult ADHD Self-Report Scale (ASRS) and Barkley Functional Impairment Scale are used to measure true executive dysfunction.
Anxiety Assessment
We use structured tools for GAD, panic disorder, social anxiety, and OCD, since anxiety disorders frequently coexist with ADHD.
Neurocognitive Testing (When Indicated)
For complex or ambiguous cases, computerized testing may be used to assess working memory, attention, and response time.
This integrated approach minimizes false positives and ensures treatment precision.
Treatment That Works for Both
Many patients have both ADHD and anxiety. The goal isn’t to “pick one”—it’s to sequence treatment correctly.
At Favor Mental Health, our Maryland-based providers may:
Start with non-stimulant ADHD medications (e.g., atomoxetine, guanfacine) when anxiety is high
Use CBT to target both anxious thought patterns and procrastination loops
Introduce mindfulness and nervous system regulation to calm overstimulation
Layer in executive function coaching once stability improves
Each plan is personalized—because no two brains operate the same way.
Local Access: Maryland-Based Care, National-Level Expertise
Favor Mental Health serves patients across:
Baltimore, Columbia, Silver Spring, Rockville, and Annapolis, both in-person and through secure telehealth.
We provide:
Comprehensive diagnostic evaluations
ADHD testing and anxiety assessment
Personalized medication management
Cognitive and behavioral therapy
Confidential, compassionate follow-up care
Your journey to clarity doesn’t have to be confusing—or lonely.
If you’ve wondered whether your “anxiety” is actually ADHD—or vice versa—now is the time to find out.
At Favor Mental Health, we help you identify the difference, manage both conditions effectively, and rebuild your confidence from the inside out.
Schedule your comprehensive ADHD and anxiety evaluation today. Because the right diagnosis doesn’t just change your treatment—it changes your life.
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