Is It ADHD or Anxiety?

While ADHD and anxiety disorders have very different causes and treatments, it can be hard sometimes to tell them apart. Some students exhibit symptoms that, at first glance, could be either ADHD or anxiety:

  • Difficulty focusing, inattentiveness

  • Hyperactivity

  • Working slowly/poor time management

  • Impulsive behavior

  • Social challenges

While each of these symptoms may look the same in students who have either ADHD or an anxiety disorder, the cause will be very different. For example, when it comes to inattention, students who struggle with anxiety may be so preoccupied with worries and fears that they are unable to apply themselves. People with ADHD, however, struggle to focus due to low levels of neurotransmitters such as norepinephrine.

So how can educators tell the difference between ADHD and anxiety? There are some signs that a student’s struggles may be related to anxiety and not ADHD:

  • Exaggerated apprehension and worry. Children with anxiety are more likely to talk about feeling worried, even if they can’t articulate exactly what they are worried about.

  • Somatic symptoms of anxiety. Anxiety can create physical symptoms such as a racing heart, clamminess, tense muscles, tummy aches, headaches, nausea, or dizziness. This is the physiological basis of anxiety.

  • Kids with anxiety are generally more sensitive to social cues and to what other people are thinking and feeling.

  • Children with anxiety don’t tend to have as many problems with impulsivity. Their impulsive behavior generally happens in isolated bursts when they are anxious, and is less likely to happen when they are feeling calm and safe.

  • Children with anxiety will be unlikely to show problem behaviors when they are feeling calm, safe, and doing things they enjoy. Children with ADHD might struggle even when they are doing the things they want to be doing.


When it comes to treatment, the two research-validated interventions known to be most effective for ADHD are medication and behavioral therapy. ADHD medications work to increase the action of the neurotransmitters available in certain brain regions and circuits that are not working effectively in individuals with ADHD. Behavioral therapy provides specific techniques and interventions that adults can implement to help students recognize and adjust triggers to problem behaviors. Other psychological interventions include social skills training and parent counseling.

As for anxiety disorders, according to Jovanovic and colleagues, there are many evidence-based therapies such as counseling, psychotherapy, and cognitive behavioral therapy. Medications are sometimes used in conjunction with psychotherapy. The most commonly prescribed medications include antidepressants and beta blockers.

Most treatment providers for anxiety-related disorders can be found in hospitals, clinics, and private or group practices; students with ADHD need support from professionals at the school and home setting such as subject teachers, special ed teachers, educational therapists, and their parents.

Telling the difference between ADHD and anxiety becomes even more difficult due to the fact that some students actually struggle with both! However, ADHD and anxiety have different causes and treatments, making it important to correctly identify the problems a student faces.


This article was first published on SMARTS website.

Learn More:

Dodson, W. Why Anxiety Disorder Is So Often Misdiagnosed. Retrieved from https://www.additudemag.com/anxiety-disorder-diagnosis/

Jovanovic, T., et al. What is Anxiety? Retrieved from https://www.anxiety.org/what-is-anxiety#evidence-based-therapies

Rosen, P. ADHD and Anxiety: What You Need to Know. Retrieved from https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/add-adhd/adhd-and-anxiety-what-you-need-to-know

Young, K. Anxiety or ADHD? Why They Sometimes Look the Same and How to Tell the Difference. Retrieved from https://www.heysigmund.com/anxiety-and-adhd/