This article will demystify the complexities of anxiety and ADHD by elucidating their differences and similarities, guiding readers through the intricacies of diagnosis and treatment to foster better understanding and support for individuals facing these challenges.
Anxiety
The National Institute of Mental Health states that everyone experiences anxiety. Regular anxiety is what helps you wake up on time so that you’re not late for work, don’t get fired, and can earn money to pay your bills. It’s this same type of anxiety that helps you prepare and plan ahead, stay alert to other drivers on the roads so that you don’t get into an accident, and be a supportive partner within your relationships.
But anxiety can quickly become an anxiety disorder when those worries about family, health, money, or other daily tasks become so severe that they disrupt your daily function, impede your relationships, or have a negative impact on your health.
You can tell different anxieties apart based on the severity of the symptoms and what things trigger them.
Types of anxiety disorders
There are a few anxiety disorders, including the following:
- Generalized anxiety disorder
- Panic disorder
- Social anxiety disorder
- Phobia disorder
- Agoraphobia
- Separation anxiety disorder
Generalized Anxiety Disorder
The most common anxiety disorder is generalized anxiety disorder, and feelings might appear without any noticeable cause and remain for several months, characterized by General feelings of anxiety or hopelessness.
Panic Disorder
Panic disorder often accompanies other anxiety disorders, characterized by panic attacks.
Social Anxiety Disorder
Social anxiety disorder involves symptoms of fear that others might judge you when you are in social settings. Symptoms can be strong enough that they dissuade people from participating in any social event at all.
Phobia Disorders
Phobia disorders apply to individual phobias like a fear of heights or a fear of needles. Agoraphobia is the fear of being outdoors, which falls under the category of phobia disorders.
Symptoms
Symptoms differ depending on the anxiety. For example, panic attacks are characterized by uncontrollable and unexpected feelings of danger and fear, which can include things like:
- Dizziness
- Difficulty breathing
- Hyperventilation
- Sweating
- Trembling
- Confusion
Symptoms across other anxiety disorders can include:
- Feelings of impending danger
- Restlessness
- Nervousness
- Hyperventilation
- Sweating
- Feeling weak
- Problems concentrating
- Increased heart rate
- Trembling
Causes
There are several causes of anxiety disorders, which are very slightly contingent upon the type of anxiety disorder.
Generalized anxiety disorder, which is the most common anxiety disorder, can be caused by several factors with increased risk based on Behavioral inhibition, parenting practices like overprotective parents, early childhood adversities, as well as genetics.
For social anxiety disorder, personality traits can lead to the development of the disorder, but some evidence suggests that negative social experiences can also increase the risk of developing social anxiety disorder. In addition to this, there are predisposing genetic traits and the risk of having socially anxious behavior models by parents.
For panic disorder, neuroticism, environmental stresses, especially chronic life stress, as well as genetics can leave people vulnerable to the development of a panic disorder. Similarly, agoraphobia can be caused by neuroticism, negative events in childhood like being attacked, and genetics. Heritability is 61% for agoraphobia.
Presentation
Symptoms of anxiety disorders present differently depending on the circumstances and the individual. Let’s look at some examples:
Jose has generalized anxiety disorder. He experiences worry on a regular, daily basis, concerned about things like:
- His workplace responsibilities
- His financial future
- Getting household chores done
- Being late for his appointments
- The health of his family
- His kids are experiencing problems at school
Under normal circumstances without an anxiety disorder, Jose might think about these things and then go throughout the rest of his day, but with an anxiety disorder, he can’t control how much he worries about these things no matter how small they are, and they interfere with his ability to do his tasks or get through the day. Every day, stress builds, such as stress over his job performance or the safety of his children, and it leaves him feeling restless, fatigued, irritable, with problems sleeping, muscle tension, and difficulty concentrating.
Now let’s look at another example:
Amber struggles with panic attacks. She experiences panic attacks, whether she is in a calm state or an anxious state. Her panic attack happens within a matter of minutes, and it can quickly become severe. Her unexpected panic attacks have no obvious trigger, and they don’t take place around the same time frame during the day. When she struggles with her panic attacks, Amber feels like:
- She can’t breathe
- The world is closing in on her
- She is choking
- She is dizzy and can’t stand
- She is trembling
- She feels numbness in her extremities
- She thinks she is going crazy
Different anxiety symptoms can manifest based on triggers or unexpectedly, and this varies from one person to the next. In many cases, the symptoms can disrupt daily life and cause impediments in socialization, relationships, occupational performance, and daily function.
Attention-Deficit/Hyperactivity Disorder (ADHD)
ADHD, or attention deficit hyperactivity disorder, is a neurological disorder. It is more common in boys than in girls but is often diagnosed in childhood despite the fact that symptoms last through adulthood.
Types of ADHD
Symptoms may vary across different individuals, with some people, as mentioned, experiencing impulsivity and hyperactivity While others primarily experience inattentiveness.
Symptoms
ADHD symptoms will start to appear during childhood, and they are not isolated to one specific location but rather will appear both at home and in school. People who struggle with ADHD will often have symptoms that fall into one of two categories:
- Inattentiveness
- Hyperactivity
It’s not uncommon for people to have both. In fact, 2/3 of those with ADHD struggle with inattentiveness and hyperactivity concurrently.
Inattentiveness
Inattentiveness refers to symptoms where you are easily distracted. Some examples include:
- Misplacing things
- Being forgetful
- Not managing tasks
- failing to give close attention to detail and having inaccurate work
- having difficulty remaining focused with lengthy reading or lectures
- mind-wandering even when spoken to directly
- gets easily sidetracked
- has problems managing sequential tasks
- avoids engaging in tasks that require a lot of mental effort
The symptoms of inattentiveness can make it difficult to stick with long-term tasks or challenging tasks especially because of poor organizational or time management skills. These symptoms can also look like an inability to listen to long instructions or even follow them, changing activities or tasks without ever finishing the first one.
Hyperactivity
Hyperactivity refers to symptoms where you are unable to remain still, particularly in quiet environments. Some examples include:
- Being fidgety
- Always moving
- Talking excessively
- Engaging in constant physical movement
- being unable to engage in quiet leisure activities
- running or climbing where it’s inappropriate if a child
- leaving the seat regularly even though they are supposed to be seated
- problems waiting their turn or waiting in line
- blurting out an answer even before a question has been completed
The symptoms of hyperactivity can make it difficult to remain focused leading to impulsivity. that impulsivity might extend to acting without thinking about the consequences or, in social situations, interrupting other people when they are talking.
Causes
Scientists believe that the leading cause of ADHD is genetics. If you have a biological parent who struggles with ADHD, you are four times more likely to experience it yourself. Exposure to toxins during pregnancy or early childhood, like lead exposure or tobacco exposure, can also result in ADHD.
Presentation
The presentation of ADHD often begins in childhood, and it’s characterized by at least six symptoms of inattention or hyperactivity, which have persisted for a minimum of 6 months in such a way that they directly impact social, academic, or occupational function.
When receiving a diagnosis, a psychiatrist will help determine whether ADHD presents with predominantly inattentive symptoms, predominantly hyperactive symptoms, or both, and how severe those symptoms are.
In a child, ADHD can look like the following:
Thomas can never seem to sit still in church, at school, or at home. If he is forced to sit still, he is always moving in his seat, squirming and restless. When his teacher or parent asks a question, he blurts out what he thinks is the answer before they even finish asking the question. In class, Thomas likes to talk a lot, but he doesn’t have a lot of friends because he continually interrupts other kids, talks over them, and doesn’t listen to them. When he’s on the playground, he likes to do dangerous things instead of just playing the way everyone else does. He is constantly losing his homework and other items sent home for school and losing things at home.
Now let’s see what it looks like in an adult:
Christine can never seem to stay organized. She is always losing things for work and misplacing things around her office and at home. Whenever she has a big task for work, she procrastinates, putting it off over and over. At home, she likes to start big projects, but she never finishes any of them.
Christine likes to spend money impulsively, buying things no matter how tight her finances might be. Each time she looks at her bank account and tells herself that she really needs to save money, she finds that she has made an impulsive purchase online within a few hours.
Christine is unable to keep a lot of friends because she always says what’s on her mind, she has low self-esteem and gets distracted easily. She interrupts other people when they speak and doesn’t seem very interested in what they have to say.
The differences between anxiety and ADHD
The difference between ADHD and anxiety can include its presentation, development, and course. Panic disorder, for example, is very rare to see in childhood, and it usually manifests in your 30s. By comparison, ADHD manifests in childhood, and while it is something that affects you in your adulthood, symptoms usually appear at a young age.
Some key differences include the following:
- ADHD symptoms begin in childhood, but many anxiety symptoms can develop in adulthood.
- ADHD symptoms are related to neurological differences in the brain, whereas anxiety symptoms are related to anxiety and related triggers.
- Anxiety is categorized by feelings of hopelessness and fear, whereas ADHD is categorized by hyperactivity or inattentiveness.
- Anxiety disorders come in several forms, whereas ADHD is generally categorized by which of the main symptoms an individual has.
- Anxiety disorders are generally caused by a combination of things such as genetics, temperament, and environment, whereas ADHD is caused by exposure to toxins in utero or genetics.
- ADHD is more likely to be diagnosed in men versus women, whereas anxiety disorder is more likely in women.
ADHD or anxiety: diagnostic criteria
Is it anxiety or ADHD? If you are wondering about your symptoms and trying to figure out if things like impulsivity, inattentiveness, or restlessness are signs of anxiety or ADHD, it’s important that you reach out to a professional therapist or psychiatrist.
Trained psychiatrists can tell the difference between ADHD and anxiety, and even though you might have overlapping symptoms with anxiety vs. ADHD, they can help you distinguish between the symptoms that are related to an anxiety disorder versus the symptoms that are related to ADHD.
In order to get a proper diagnosis, healthcare professionals will use diagnostic criteria from the DSM-5. This diagnostic criteria has a series of categories as well as severities and durations for each of those categories.
During an initial consultation, a qualified psychiatrist will sit down with you and ask you questions about the following:
- Your symptoms,
- How long they have lasted,
- When they present,
- How long they stay,
- Any other factors that surround the presentation,
- How long you have had these issues
- What it feels like
- What behaviors do you see yourself using
- Your family history of any mental health disorders
- Your medical history
- Whether you have been diagnosed with anything in the past
- What medication, if any, you have taken in the past
The similarities between anxiety and ADHD
ADHD shares the inattention symptoms of anxiety disorders. The difference between anxiety and ADHD inattentiveness is that people with ADHD are inattentive because they would prefer to be doing something more pleasurable or stimulating, whereas people with anxiety are inattentive because they are ruminating or worrying.
Another crossover between anxiety and ADHD is restlessness. Some people with anxiety disorders show restlessness, the same as someone with ADHD. However, with ADHD, the symptom of restlessness is not associated with worry like it is with anxiety.
Can ADHD look like anxiety?
Yes, ADHD symptoms can mimic those of anxiety, particularly the inattentiveness and the restlessness. Individuals who struggle predominantly with inattentive specific symptoms from ADHD are more likely to have trouble differentiating between ADHD and anxiety.
It’s not uncommon for misinterpretations to occur during an assessment, especially if multiple symptoms look the same. That is why it’s so important to undergo a thorough assessment from a qualified psychiatrist who can differentiate between symptoms of ADHD and anxiety.
Seeking a proper diagnosis
Understanding the difference between ADHD and anxiety can be difficult, which is why it’s important that you seek a proper diagnosis. During the diagnostic process, you will meet with a qualified psychiatrist who can review your symptoms with you.
During the consultation, you can prepare a list of questions you might have but know that the psychiatrist will ask you about the different symptoms you have encountered and how they affect your daily life. they might have you describe the emotions around those symptoms as well.
If you have notes about how long you have experienced symptoms of ADHD or anxiety, especially symptoms that manifested during childhood for ADHD, and the ways that impeded your academic progress, that can be useful in helping your psychiatrist evaluate your situation.
Once you have a proper diagnosis, you can expect your psychiatrist to offer expertise on treatment strategies for your situation.
Treatment Strategies for ADHD vs. Anxiety
The treatment for ADHD or anxiety will look slightly different depending on your symptoms, but if you have co-occurring situations where you experience anxiety or ADHD at the same time, some of the suggestions for treatment might overlap.
Treatment for Anxiety
Treatment for anxiety centers around therapy and medication.
Medications
The most common anxiety medications include:
- Selective serotonin reuptake inhibitors (SSRIs)
- Selective norepinephrine reuptake inhibitors (SNRIs)
- Antidepressants
- Benzodiazepines
Medications can be prescribed by your primary care physician or a psychiatrist after an initial assessment. It can take several months for medication to become effective if it is used to treat long-term symptoms. For acute symptoms, medication can be used on an as-needed basis. It’s important to always follow any rules regarding how frequently you use your anxiety medication and how much you use each time.
Therapy
Medication has been shown to be statistically more significant in treating anxiety if it’s used in conjunction with therapy. There are several types of therapies used for anxiety disorders, but the most common is cognitive behavioral therapy. This treatment was introduced in 1966 and remains the most effective form of anxiety therapy. Cognitive behavioral therapy helps you identify automatic negative thoughts that influence your emotions and behaviors and replace them with positive ones.
For example, if your automatic thought is to catastrophize, anticipating the absolute worst outcome, this can lead to high anxiety levels and maladaptive behaviors. However, cognitive behavioral therapy can help you catch those thoughts and change them.
Another common type of therapy for things like phobias and similar anxiety disorders involves exposure therapy. Exposure therapy can expose you on a slow basis to the source of your anxiety until such time that you learn to become more familiar with it and inhibit the immediate stimulus response that it normally triggers.
Treatment for ADHD
Treatment for ADHD can involve medication, therapy, and long-term coping skills like mindfulness, meditation, healthy exercise routines, and a good diet.
Medication
Some of the most common medications used to treat ADHD are Adderall and Ritalin. Working with a professional can help you find the right medication to manage your symptoms. For some people, medication offers immediate improvement, but for others, it does nothing, or worse, it can make symptoms much more apparent. This is something to review with a psychiatrist or your doctor.
Therapy
With anxiety vs ADHD, you might have different therapies, but the concept that medication is more effective when used with therapy remains true. Therapy can help with many things like:
- Relationship issues
- Academic problems
- Job turnover
- Sense of failure
- Low self-esteem
- Feelings of shame or embarrassment
Cognitive behavioral therapy is a common therapy used for ADHD treatment, so if you are struggling with both, CBT might help you change your outlook and learn organizational skills as well as time management skills that apply to both your anxiety and ADHD symptoms.
Other therapies can be uniquely designed to tackle things like low self-esteem, feelings of failure, problems with underachievement, as well as identifying individual triggers.
Skills
Treatment for ADHD often involves some form of skill acquisition contingent upon your needs. For example, if you are struggling to manage your symptoms at work, occupational skills might be something that helps you identify ways in which you can complete tasks at work without your symptoms getting in the way. If instead, things like time management are impeding your productivity, classes on time management and organization can be very useful.
Summing Up
Can ADHD look like anxiety? Yes, it can, particularly where restlessness and inattention come into play. But when you are wondering, “Is it anxiety or addiction?” you have to consider the source of those feelings. Someone who is restless and inattentive, because they are worried, is more likely to struggle with anxiety vs. ADHD.
It is important that you learn to distinguish between anxiety and ADHD and seek professional guidance for a proper evaluation to ensure accurate diagnosis and appropriate care.