The Overlap Between ADHD and Anxiety: Why Diagnosis Isn’t Always Clear
- Moe | Scarlet Plus
- 1 day ago
- 4 min read
At Optimal Mind Psychiatry in McDonough, GA, we often encounter patients who present with a confusing mix of symptoms—difficulty concentrating, constant restlessness, or overwhelming worry. Too often, these individuals receive a diagnosis of either ADHD or an anxiety disorder, but rarely both. In reality, ADHD and anxiety:
Share overlapping symptoms like distractibility and sleep disturbance
Frequently co-occur, with as many as half of adults with ADHD also meeting criteria for anxiety
Require nuanced assessment to distinguish and optimize treatment
A comprehensive evaluation can be life-changing—turning self‑doubt into self‑understanding and poorly managed symptoms into effective strategies.
On this page:
1. Understanding the Symptom Overlap
Case Example: Lauren’s Story
Lauren, a 28-year-old marketing executive, described her days as pendulums swinging between frantic bursts of productivity and overwhelming self-criticism. She’d often miss project deadlines—not from laziness, but because her mind jumped from one thought to another. She also struggled with insomnia caused by worry: “What if I forgot something crucial?”
Upon examination, Lauren met many ADHD criteria:
Trouble organizing tasks
Temporarily "zoning out" during meetings
Impulsive decision-making—like sending emails without proofreading
But she also exhibited classic anxiety features:
Racing thoughts at night
Perfectionism and fear of messing up
Physical tension, digestive upset under stress
In her case, treating either condition in isolation would likely have led to patchy results. With integrated care, she found focus and became the confident professional she intended to be.
Commonly Shared Symptoms
Difficulty concentrating
ADHD: Attention drifts regardless of environment (meetings, movies, reading)
Anxiety: Worry makes it hard to concentrate, especially when thoughts revolve around “what ifs”
Restlessness or fatigue
ADHD: Physical hyperactivity—tapping feet, pacing
Anxiety: Psychological nervous energy—inner tension, muscle tightness
Emotional dysregulation
ADHD: Impulsive reactions when frustrated or bored
Anxiety: Negative self-talk and ruminative worry
Many symptoms appear similar but stem from different causes—requiring different treatment approaches
2. Why Accurate Diagnosis Matters When It Comes To ADHD And Anxiety
The Dangers of Misdiagnosis
Prescribing stimulants alone to someone with anxiety may intensify panic, insomnia, and racing thoughts
Treating non-stimulant ADHD medications to someone whose issues stem solely from anxiety can leave underlying distress unaddressed
Overlooking the presence of both conditions may result in subpar outcomes
Benefits of a Structured Assessment
Optimal Mind Psychiatry uses a systematic approach:
Comprehensive intake: We evaluate detailed histories, coexisting medical conditions, developmental issues, and current coping strategies
Behavioral observation: We look for signs of ADHD like procrastination, forgetfulness, and emotion-driven decision-making, versus anxiety manifestations like avoidance and chest tightness
Diagnostic tools: We integrate validated tools such as:
Adult ADHD Self-Report Scale (ASRS)
Generalized Anxiety Disorder 7 (GAD-7)
Informant reports: Input from partners, parents, or supervisors often provides a more complete picture
This thorough evaluation enables us to differentiate:
ADHD that leads to stress, vs.
Anxiety that causes poor focus
Or uncover both, which is common in practice.
3. Treatment Pathways: Optimizing for Dual Diagnosis
A. Psychoeducation
Learning how your mind works is a vital first step. By understanding the neurochemical basis of ADHD (dopamine and norepinephrine deficits) versus anxiety (amygdala overactivation), patients stop blaming themselves and begin strategizing effectively.
B. Medication Strategies
ADHD-first: Adding stimulants (e.g., methylphenidate) or non-stimulants (e.g., atomoxetine) may improve focus and reduce overall stress
Anxiety-first: Selective serotonin reuptake inhibitors (SSRIs) may relieve worry but may not improve attention
Combination approaches: A carefully balanced regimen—low-dose stimulant with SSRI—can manage both conditions safely
Each plan is personalized, closely monitored, and adjusted for effectiveness and side effects.
C. Therapy & Coaching
With dual diagnoses, therapy expands beyond standard CBT:
Unified CBT: We integrate cognitive techniques targeting both ADHD (e.g., reframing “I can’t focus” into “I’ll break this into smaller steps”) and anxiety (challenging fearful predictions)
Behavioral Activation & Coaching: We help clients implement habits and tools—like reminder apps, to-do strategies, and intentional breaks—to reduce mental clutter
Stress Exposure: For anxious clients, gradual exposure and mindfulness help manage fear and recalibrate stress response
D. Lifestyle Optimization
Focus support extends beyond the office:
Routine structure: Day segmentation, nightly wind-down, consistent sleep schedule
Movement breaks: Even 5-minute walks between tasks help “reset” focus, as used in ADHD coaching
Mindful journaling: End-of-day practice to segment ADHD lists and destress anxiety
Environmental support: Noise-reducing headphones, organized workspace, minimizing digital interruptions
4. Why Optimal Mind Psychiatry in McDonough Stands Out
Rigorous Dual-Diagnostic Expertise
We treat both ADHD and anxiety—not just one
Integrated Care Teams
Psychiatrists, therapists, and coaches collaborate closely
Flexible and Accessible
Both in-person and telepsychiatry options with extended hours
Evidence-Based Tools
We track progress through clinical scales, mood diaries, and symptom check-ins
Holistic Lifestyle Support
From nutrition to sleep, our recommendations support thriving cognition
Conclusion
Distinguishing between ADHD and anxiety—or realizing you have both—is key to effective treatment. Using precise diagnosis, personalized medication, and targeted therapy, we transform confusion into clarity and disengagement into regained control.
At Optimal Mind Psychiatry, our mission is clear: to support neurodiverse minds with understanding, expertise, and respect.
Contact Optimal Mind Psychiatry
Reach out to Optimal Mind Psychiatry today, and let us be a part of your journey towards healing and empowerment. Your story is not defined by schizophrenia; it's enriched by the strength you show every day.
