Certain anxiety disorders and ADHD can be difficult to distinguish and often overlap. However, you’re much more likely to have an anxiety disorder if you have ADHD. Reasons for the overlap include brain structure, stress, and underlying coping mechanisms.
As a therapist and coach who works with clients who often have both anxiety and ADHD, I see a lot of people who struggle with a lot of the same stresses and coping mechanisms. Specifically, if you have anxiety or ADHD, you’re more likely to struggle from chronic people-pleasing, perfectionism, and overachieving in order to cope with your symptoms and to prove your value to the world.
In order to break free of these negative patterns in your life, it’s helpful to understand where they’re coming from in the first place. So let’s talk about the anxiety and ADHD overlap, and why certain coping strategies form with both.
There’s no denying there’s an anxiety and ADHD overlap. People who have ADHD can have secondary anxiety, meaning anxiety caused by their ADHD. Or they can have co-occurring anxiety disorders (usually generalized anxiety disorder) that occur at the same time.
Reasons for the anxiety and ADHD overlap aren’t entirely clear. However, most mental health professionals believe that the close relationship between ADHD and anxiety is largely due to the ways we cope with symptoms and stress. Three important causes believed to impact the development of both include brain structure, stress, and underlying coping mechanisms.
The reasons for your ADHD-anxiety overlap vary depending on your personality, genetics, history, and more. Much of it can be boiled down to existing in a society that isn’t particularly compatible with your skills, strengths, and learning styles. You are neurodivergent in a world that doesn’t understand or celebrate you, and in which your needs are bypassed in favor of neurotypical needs. This likely adds stress and anxiety to your life, whether or not you’re consciously aware of it. This stress, in turn, can become chronic – and problematic.
Below are three factors that explain the relationship between anxiety and ADHD in many of my clients.
Scientists have found similarities in brain functioning and structure between people with ADHD and anxiety. For example, people with anxiety and ADHD tend to have serotonin deficits in their brains, or the brain may struggle to properly use the existing serotonin. Both ADHD and anxiety also exhibit deficits in the prefrontal cortex, which is where executive functions and emotion regulation are controlled.
The structural similarities between ADHD and anxiety point to brain structure and functioning as a major component in the development of either. This is one of the reasons why some studies estimate that you’re nearly 50% more likely to have an anxiety disorder if you have ADHD.
Another reason for the overlap between ADHD and anxiety is that living with ADHD can cause stress and anxiety in everyday interactions. If you have ADHD, for example, you’re more likely to be overwhelmed, struggle with organizing tasks, have difficulty focusing at work, and feel awkward in social situations due to impulsivity (e.g. interrupting or saying something you didn’t think through first.) All of these factors can lead to increased anxiety because of the pressure to keep up with everyone else around you or feel good enough in your own skin.
The additional stresses caused by symptoms of ADHD are no joke. They impact your internal dialogue, your relationships, your work and career life, your ability to create and stick to new habits, and more. When you struggle to navigate these areas of your life, you may become chronically stressed. And if you weren’t anxious already, chronic stress often leads to anxiety.
You may have grown up being scolded for your ADHD behaviors, such as being fidgety, not turning in assignments on time, losing your things, or daydreaming. You likely learned to mask such behaviors – hide or overcompensate for them – in order to fit in better with the world around you. Masking often helps you be more productive and feel more “normal”, but it can create a lot of internal tension. You may feel like you have to put on an act all the time, and if you let your guard down – if you show your true messy ADHD self – you’ll be rejected, humiliated, or scorned. This can lead you to feeling inauthentic and worried about being vulnerable in front of anyone.
Because you learned early on that your natural, authentic behaviors often lead to criticism or judgment, you may overcompensate for these behaviors by becoming a people-pleaser, a perfectionist, or an overachiever. These three coping mechanisms are incredibly common for people with both ADHD and anxiety, because they’re all attempts to control other people’s reactions to you. The subconscious belief is that if you do a perfect job, please everyone around you, and never leave anyone upset or questioning your abilities, nobody will ever judge you harshly or reject you again.
Unfortunately, this is not the reality. Coping mechanisms like perfectionism and people-pleasing may have helped you survive when you were younger, or even at a certain time during your adulthood. However, they ultimately lead to more stress, more anxiety, and reinforce the message that you’re not enough as you are.
If you want help understanding and managing your mental health – whether you’re dealing with anxiety, ADHD, or both – I can help. My work with clients focuses on real-time strategies for managing coping mechanisms like perfectionism, such as examining and challenging core beliefs and negative thoughts. You’ll learn powerful stress reduction techniques for anxiety or ADHD, healthy coping mechanisms for each that don’t leave you spinning on an endless hamster wheel of overachievement and people-pleasing, and how to prioritize the to-dos in your life to prevent resentment and burnout.
If you’re located in Idaho or Iowa, I offer online anxiety therapy and ADHD therapy for millennials. I use different therapeutic modalities, such as cognitive behavioral therapy, to help you find sustainable strategies and techniques to not only manage but prevent and overcome your biggest challenges.
My coaching program for anxiety is designed for overachieving perfectionists. If you want help overcoming the belief that you have to constantly achieve in order to be worthwhile – and this belief is making you suffer – coaching is for you. No matter where you live, I’m here to support you on your path to empowerment and peace.
Reach out today to schedule a complimentary consultation and see if we’re a good fit. Let’s start building a better future together.
Danielle is an anxiety therapist and perfectionism coach. She specializes in helping busy millennials dial down their anxiety and ADHD, so they can perform at their best. Danielle has been featured on Apartment Therapy, SparkPeople, Lifewire, and Now Art World. When Danielle isn't helping her clients, she's playing video games or spending time with her partner and step children.