Your big research paper is due on Friday. It was assigned weeks ago, but you haven’t started yet. You didn’t mean to procrastinate, but each time you try to sit down and work on it, you can’t focus. Plus, whenever you so much as think about tackling this project, it overwhelms you. Too big. Too many steps. And none of your ideas seem good enough anyway. Now, with the deadline looming, you’re starting to panic. This, of course, only makes things worse. As your anxiety ramps up, your ability to focus diminishes even further, and knowing that you can’t focus enough to get the work done makes your anxiety even worse.
This can be what it’s like to have anxiety and ADHD: Your ADHD makes your anxiety stronger, and your anxiety makes your ADHD symptoms worse.1
They feed off of each other in a vicious cycle:
Another common experience for students with ADHD and anxiety is to struggle taking tests, and here they feed off of each other too. If you have trouble staying focused during exams, then you know that you’re not going to do as well as you otherwise could. And thinking that you’re not going to do well is likely to trigger anxiety, which makes it even harder to focus because rather than thinking about what the questions are asking, you’re thinking about how poorly you’re doing. Whereas most test anxiety is simply about being unprepared, this is a case where clinical issues are relevant. (Though studying effectively in order to be well prepared would still help.)
A Common Comorbidity
Having both of these conditions is very common. About 30 percent of children with ADHD also experience anxiety, according to The National Resource Center on ADHD, and around half of adults with ADHD have an anxiety disorder, according to the Anxiety and Depression Association of America.1
Thus, any parent of a child with ADHD should be aware of the increased likelihood that their child will also struggle with anxiety.
What is Anxiety?
“A person with an anxiety disorder is likely to experience long-lasting feelings of nervousness, fear, and worry. … They may have difficulty identifying and controlling their specific fears and worries. These feelings tend to be out of proportion to the situation, and can interfere with people’s daily lives and relationships with others.”1
This is distinct from the normal fears, worries, and nervousness that most people experience from time to time. If you feel butterflies in your stomach before giving a presentation, it doesn’t mean you have an anxiety disorder.
This is also distinct from ADHD, which is characterized by difficulty paying attention, hyperactivity, and poor impulse control.1 However, anxiety can lead to increased mind wandering, which may look similar to difficulty focusing.2 And both anxiety and ADHD can lead to apparent difficulties with executive function, such as not getting things done on time, failing to keep appointments, and otherwise struggling to play the game of school.
Treating ADHD When You Have Anxiety
It’s important to know whether or not you have anxiety when you determine an ADHD treatment plan. Children with both ADHD and anxiety sometimes respond differently to ADHD medication than those without anxiety.3 And the stimulant medications that are often used to treat ADHD sometimes exacerbate anxiety symptoms.1
Treatment for Anxiety
As with ADHD, anxiety can be treated with medication, which is sometimes appropriate. However, there are also non-medication treatment options that can be very effective on their own or in addition to a medication plan. And since these are all good things to do even if you don’t have anxiety, they’re a great place to start while you’re sorting out diagnoses and professional treatment options.
Here are some helpful, non-medication interventions for anxiety:
- Foundational brain health practices like exercise,4 eating good food,5 and getting adequate sleep6
- Cognitive therapy, both with a professional counselor7 and self-administered
- Mindfulness practices like yoga and meditation8
- Strategic stress management
- Learning to overcome procrastination and perfectionism
- Developing executive function skills1
However, starting and sticking with these kinds of healthy habits is challenging, especially if you have ADHD. But you don’t have to use brute-force willpower, and you don’t have to go it alone. I offer strategic habit coaching for adults and older students, and I would love to help you install some of these behaviors to run on autopilot. (For parents of younger students, the best place to start might be adopting these habits yourself and modeling them for your children.)
All of the anxiety-reducing strategies listed above also help reduce ADHD symptoms, so if you’re struggling with both anxiety and ADHD, you stand to benefit greatly from using these techniques.
Just as worsening anxiety leads to worsening ADHD in a downward spiral, treating one often improves the other, leading to a virtuous cycle of improvement on both fronts.
So if you or your child has both of these conditions, there is a good reason to be optimistic. True, ADHD with comorbid anxiety can spiral out of control if left untreated. But if you address them both using a combination of professional help and at-home treatments, you can turn things around and create a great deal of positive momentum.
Chris Loper has been an academic coach for Northwest Educational Services since 2014.
Chris also offers habit coaching, helping busy adults with habit formation and productivity.
In 2021, he published a humorous memoir titled Wood Floats and Other Brilliant Observations, a book that blends crazy stories with practical life lessons, available on Amazon and through most local bookstores.
He lives in Issaquah, WA, where he is the owner of South Cove Tutoring.
1 Written by Jayne Leonard. Medically reviewed by Timothy J. Legg, Ph.D., CRNP. What is the link between anxiety and ADHD? Medical News Today. May 15, 2017
2 Tiago Figueiredo, Gabriel Lima, Pilar Erthal, Rafael Martins, Priscila Corção, Marcelo Leonel, Vanessa Ayrão, Dídia Fortes, Paulo Mattos. Mind-wandering, depression, anxiety and ADHD: Disentangling the relationship. Psychiatry Research. Volume 285, 2020, 112798, ISSN 0165-1781,
3 Pliszka, Steven R., M.D. Effect of Anxiety on Cognition, Behavior, and Stimulant Response in ADHD. From the Department of Psychiatry, The University of Texas Health Science Center at San Antonio. Accepted 31 May 1989, Available online 4 January 2010.
4 John J. Ratey, MD. Can exercise help treat anxiety? Harvard Health Publishing. October 24, 2019
5 Uma Naidoo, MD, Nutritional strategies to ease anxiety. Harvard Health Publishing. August 28, 2019
6 Tips for beating anxiety to get a better night’s sleep. Harvard Health Publishing. October 13, 2020
7 Kaczkurkin, Antonia N, and Edna B Foa. “Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence.” Dialogues in clinical neuroscience vol. 17,3 (2015): 337-46.
8 Julie Corliss. Mindfulness meditation may ease anxiety, mental stress. Harvard Health Publishing. January 08, 2014