Anxiety or ADHD? How to Tell the Difference in Adults
Why difficulty concentrating, restlessness, and feeling overwhelmed aren't always what they seem.
Have you ever sat down to complete a task, only to find yourself distracted, overwhelmed, or unable to focus? Maybe your mind feels like it never shuts off. You forget appointments, struggle to finish projects, or feel mentally exhausted by the end of the day.
You might wonder: Is this anxiety? ADHD? Or could it be both?
Anxiety and attention-deficit/hyperactivity disorder (ADHD) can look surprisingly similar, particularly in adults. Both can affect concentration, sleep, productivity, relationships, and emotional well-being.
But while they share certain symptoms, they are different conditions. Understanding what's behind those symptoms is an important first step toward finding the right treatment.
What Does Anxiety Look Like in Adults?
Anxiety is more than occasionally feeling stressed or worried. Anxiety disorders involve persistent or excessive fear, worry, or nervousness that can interfere with everyday life.
Common symptoms include:
Excessive worry about work, finances, health, relationships, or family
Difficulty relaxing or quieting your thoughts
Feeling restless, tense, or constantly on edge
Trouble concentrating because your mind is occupied with worry
Physical symptoms such as a racing heart, muscle tension, or stomach discomfort
Difficulty falling or staying asleep
Irritability and mental exhaustion
One important clue: With anxiety, difficulty concentrating is often related to worry or fear.
For example, you might struggle to focus on a work project because you're replaying a conversation, worrying about an upcoming appointment, or thinking about everything that could go wrong.
When the anxiety decreases, your ability to concentrate may improve.
What Does ADHD Look Like in Adults?
ADHD is a neurodevelopmental condition that affects attention, organization, impulse control, and other aspects of executive functioning.
Although ADHD begins in childhood, many people are not diagnosed until adulthood.
In adults, ADHD doesn't always look like the hyperactive child who can't sit still. It may be much less obvious.
Common symptoms include:
Difficulty starting or completing tasks
Frequently losing items or forgetting appointments
Trouble organizing responsibilities and managing time
Becoming easily distracted
Procrastinating, even when tasks are important
Feeling internally restless or constantly needing stimulation
Interrupting others or acting impulsively
Difficulty following through on plans
Feeling overwhelmed by everyday responsibilities
Adults with ADHD may also notice that they can become deeply absorbed in activities they find interesting while struggling to maintain attention on less stimulating tasks.
One important clue: With ADHD, difficulty regulating attention can occur even when you're feeling calm and aren't particularly worried about anything.
ADHD symptoms also begin during childhood, although they may not have been recognized at the time.
Anxiety vs. ADHD: What's the Difference?
One of the most helpful questions to explore is:
Why am I having difficulty concentrating?
With anxiety, attention may be pulled away by worry, fear, or repetitive thoughts.
With ADHD, difficulty regulating attention may be related to distractibility, executive functioning challenges, or difficulty sustaining effort on certain tasks.
However, this distinction isn't always clear-cut. Anxiety can cause distractibility even without obvious worry, and people with ADHD may become anxious because of the challenges their symptoms create.
FeatureAnxietyADHDPrimary difficultyExcessive worry, fear, or nervousnessAttention regulation, organization, and impulse controlConcentrationOften disrupted by worryMay be disrupted by distractibility or executive functioning difficultiesWhen symptoms beginCan develop at different stages of lifeSeveral symptoms must have been present before age 12RestlessnessOften related to nervousness or tensionMay involve internal restlessness or a need for stimulationOther common symptomsMuscle tension, excessive worry, physical anxiety symptomsForgetfulness, procrastination, impulsivity, and disorganization
These patterns can offer clues, but none of them independently establishes a diagnosis.
Can You Have Both Anxiety and ADHD?
Absolutely.
Anxiety and ADHD frequently occur together, and the relationship between them can be complicated.
For example, someone with ADHD may repeatedly miss deadlines, forget important responsibilities, or struggle to keep up with daily demands. Over time, these difficulties may contribute to significant anxiety.
Conversely, someone with an anxiety disorder may become so overwhelmed by worry that they experience problems with attention, organization, and memory.
When both conditions are present, treatment should address the full picture rather than focusing on just one diagnosis.
Why ADHD Is Sometimes Missed Until Adulthood
Many adults have spent years developing ways to compensate for attention and organizational difficulties.
They may rely on detailed calendars, constant reminders, rigid routines, or working extra hours to keep up with responsibilities.
From the outside, they may appear successful and organized. Internally, however, maintaining that level of functioning can feel exhausting.
This can be especially relevant for women, whose ADHD symptoms may be less outwardly hyperactive and more related to inattention or internal restlessness.
Major life changes, increasing responsibilities, or hormonal transitions may make previously manageable difficulties more noticeable.
For some women, perimenopause and menopause may bring changes in sleep, mood, and concentration that complicate the picture.
This doesn't necessarily mean someone has ADHD. It means their symptoms deserve a thoughtful evaluation.
Why a Comprehensive Psychiatric Evaluation Matters
Difficulty concentrating doesn't automatically mean ADHD. And feeling restless or overwhelmed doesn't necessarily mean anxiety.
Other factors can contribute to similar symptoms, including:
Depression
Chronic stress or burnout
Poor sleep or sleep disorders
Thyroid conditions
Hormonal changes
Medication effects
Other medical or psychiatric conditions
A comprehensive psychiatric evaluation explores more than a checklist of symptoms.
It considers your medical history, mental health history, childhood experiences, current stressors, sleep patterns, lifestyle, and how symptoms affect different areas of your life.
ADHD rating scales and questionnaires can be helpful tools, but they are only one part of the diagnostic process.
There is no single blood test, brain scan, or online questionnaire that can independently diagnose ADHD or an anxiety disorder.
What About Treatment?
Treatment depends on the underlying diagnosis, symptom severity, medical history, and individual preferences.
For anxiety, treatment may include psychotherapy, medication, stress-management strategies, and attention to sleep and lifestyle factors.
For ADHD, treatment may involve medication, behavioral strategies, organizational supports, and therapy focused on executive functioning skills.
When anxiety and ADHD occur together, treatment is individualized. In some cases, improving ADHD symptoms can reduce anxiety associated with daily functioning. In others, anxiety may need more direct treatment.
The goal isn't simply to assign a diagnosis. It's to understand what's contributing to your symptoms and develop a treatment plan that makes sense for you.
When Should You Consider an Evaluation?
Consider speaking with a qualified mental health professional if:
Difficulty concentrating is affecting your work or relationships
You frequently feel overwhelmed by everyday responsibilities
You're struggling with persistent worry or restlessness
Organization, time management, or forgetfulness have become ongoing challenges
You've tried multiple strategies but continue to struggle
You're unsure whether your symptoms are related to anxiety, ADHD, or something else
You don't need to know which diagnosis fits before asking for help.
Understanding the cause of your symptoms is the first step toward finding an effective treatment approach.
A Whole-Person Approach at York Psychiatry
At York Psychiatry, we recognize that mental health is influenced by more than symptoms alone.
Our approach to psychiatric evaluation and medication management considers the connection between mental health, physical health, sleep, hormones, lifestyle, and individual experiences.
We provide personalized psychiatric care for adults experiencing anxiety, ADHD, depression, mood disorders, and related concerns.
York Psychiatry offers telehealth appointments throughout New Hampshire and Vermont, making it easier to access care from the comfort of your own home.
If you're struggling with concentration, anxiety, or feeling overwhelmed and aren't sure why, a comprehensive psychiatric evaluation can help clarify what may be contributing to your symptoms.
Learn more about York Psychiatry or request an appointment at www.yorkpsychiatry.com or Book an Appointment Directly
Written by Lisa C. Jenkins, Psychiatric Mental Health Nurse Practitioner
This article is intended for educational purposes only and is not a substitute for individualized medical advice, diagnosis, or treatment.
References:
Szuhany & Simon, "Anxiety Disorders: A Review" (JAMA, 2022): the core features of anxiety disorders (worry, fear, physical symptoms like palpitations and muscle tension). It also explains how normal anxiety differs from a disorder: the deciding factors are severity, persistence, and impairment. [1]
American Psychiatric Association, DSM-5-TR (2022): the generalized anxiety disorder criteria (6 months or more of hard-to-control worry, with symptoms such as difficulty concentrating, restlessness, and poor sleep). It is also the source for the ADHD diagnostic anchors used in the questions-to-ask section. [2]
Olagunju & Ghoddusi, "Attention-Deficit/Hyperactivity Disorder in Adults" (Am Fam Physician, 2024): the side-by-side comparison of shared symptoms (irritability, restlessness, emotional ups and downs) and distinguishing ones. The main distinction is that people with anxiety can usually focus when relaxed, and people with ADHD cannot. [3]
Faraone et al., "Attention-deficit/hyperactivity disorder" (Nat Rev Dis Primers, 2024): the adult ADHD criteria (5 or more symptoms, onset before age 12, problems in more than one setting). It also supports the statements that no lab or biological test can diagnose ADHD and that diagnosing ADHD alongside another condition is routine. [4]
Pagán et al., "Adult ADHD: a Narrative Review" (Curr Neurol Neurosci Rep, 2023): the explanation that inattention in anxiety comes from worry and rumination, while in ADHD it reflects being pulled toward new or rewarding things. It also supports the advice to involve family members or partners in the evaluation. [5]
Koyuncu et al., "ADHD and Anxiety Disorder Comorbidity in Children and Adults" (Curr Psychiatry Rep, 2022) and Hartman et al., overview of anxiety, mood, and substance use disorders in adults with ADHD (Neurosci Biobehav Rev, 2023): how often the two conditions co-occur, and why one diagnosis does not rule out the other.
Schweitzer, "As More Adults Seek ADHD Care, Primary Care Clinicians Are Tasked With Getting the Diagnosis Right" (JAMA, 2026): the caution that short self-screening questionnaires cannot confirm a diagnosis.
