Treating ADHD and Anxiety (With and Without Medication)

While having persistent anxiety certain can make dealing with ADHD more challenging, there are ways to manage both disorders at the same time effectively. In order to do that, however, it helps to have a more thorough understanding of how ADHD and anxiety affect one another.

Overlapping Symptoms

ADHD often goes undiagnosed in adults, especially in women. That’s often because the symptoms of ADHD are frequently confused with those of other conditions, such as anxiety. There’s actually quite a bit of overlap between symptoms of ADHD and symptoms of anxiety, such as:

Difficulty with focus, attention, and concentration
Struggles with planning and organizing
Sleep problems or insomnia
Challenges with relationships, work, and/or school
Trouble coping with stress
Feelings of restlessness or an inability to relax

If you’re dealing with these symptoms, it might be unclear if you have ADHD, anxiety, or both. This can make getting a correct diagnosis more difficult.

On top of that, there’s the fact that ADHD can exacerbate the symptoms of anxiety, and vice versa. For example, you might experience anxiety when your ADHD makes it difficult to complete important tasks for work on time. Or maybe you’re losing sleep due to anxiety, and the resulting fatigue makes your problems with focus and planning due to ADHD even more challenging.

Genetic Factors

If you approach your doctor about the possibility of having both anxiety and ADHD, be prepared to answer a lot of questions. Your doctor will need to gather a significant amount of information to make sure they provide you with the correct diagnosis.

In addition to asking you detailed questions about the symptoms you’re experiencing, they’ll likely inquire about family medical history as well. There may be genetic factors at play with both ADHD and anxiety, so information about blood relatives suffering from one or both conditions could help inform your diagnosis.

Your personal health history will be closely considered as well. That’s because many of the symptoms associated with ADHD and anxiety can be related to other conditions, such as developmental disorders, thyroid problems, sleep disorders, brain injuries, or even low blood sugar. This might cause some of your doctor’s questions to seem like they’re coming out of left field, but really, they just need to rule out other possibilities before diagnosing you.

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Getting a Diagnosis

The boundaries between which symptoms can be attributed to ADHD or to anxiety are often unclear. These two disorders interact in such a close way that it can be hard for even experienced medical professionals to make an accurate diagnosis.

If possible, try to work with a doctor who’s very familiar with ADHD in adults—and the many complicating factors which may influence it—to make sure you’re getting the best level of care. They’ll be better able to discern which symptoms are being caused by which disorder and how those two conditions may affect one another.

Some of the questions regarding your symptoms that you may be asked when pursuing a diagnosis include:

When did your symptoms first begin?
Do you have problems with attention and concentration?
Do you struggle to control your temper or regulate your mood?
How often do you feel restless or fidgety?
Do you have trouble relaxing?
What triggers your stress or causes you to worry?
Do you avoid certain tasks, activities, or situations?
Do you have trouble completing tasks?
Do you often feel afraid or expect bad things to happen?

Keep in mind that while you may have anxiety, that may not mean that you’ll get an official diagnosis of an anxiety disorder, such as generalized anxiety disorder (which is the most common type). Your doctor will consider your symptoms carefully to determine whether you qualify for a particular anxiety-related diagnosis.

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Comorbidities with ADHD ‍

If you’re diagnosed with both ADHD and anxiety, you’ll likely hear the word comorbidity. Although that term may sound ominous, it just means that you have two or more medical conditions at once. Anxiety is actually one of several disorders and conditions that are common comorbidities with ADHD, including:

Depression
Sleep disorders
Autism
Obsessive-compulsive disorder
Bipolar disorder
Learning disabilities
Substance abuse

Having a comorbidity with your ADHD is nothing to be ashamed of. Doctors who are familiar with ADHD in adults will be well-versed in treating coexisting conditions like these and can help get you on the right path in terms of treatment.

Comorbidities are generally chronic and pervasive. They’re so intertwined that it’s very difficult to pull them apart and look at them on an individual basis. This is often the case with ADHD and anxiety. However, there may be some situations in which anxiety is actually a secondary problem. This just means that the anxiety is unlikely to be caused by ADHD, a determination which may be based upon when the condition originated. For example, if you’ve had ADHD symptoms for years but only started to experience significant anxiety after the death of a loved one, it’s probably not a true comorbid disorder.

Treatment Complications

When you’re dealing with both ADHD and anxiety, it’s not just the diagnoses that you have to worry about. The link between anxiety and ADHD can also make getting the right treatment more complicated. That’s because the best way to manage each disorder may vary from one person to the next. For instance, one person may experience more severe symptoms related to their anxiety than their ADHD, while another experiences the opposite.

Adding to the complexity of creating a treatment plan is the fact that many of the same strategies are recommended for both disorders. Prescription medication and therapy top the list, with exercise, stress-relief activities, and certain nutritional choices often recommended as supplementary treatment options.

To make matters worse, less than 20% of adults with ADHD receive treatment. If no treatments are being applied, the two disorders may continue to exacerbate one another.

That’s not to say that it’s all gloom and doom if you have both ADHD and anxiety. But it’s important to recognize that getting the right treatment may be more challenging when symptoms overlap so closely.

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Should You Treat ADHD or Anxiety First?

There isn’t one clear-cut solution when it comes to treating someone who has both ADHD and anxiety. In most cases, your doctor will choose to focus first on the condition that is causing you the most impairment in your day-to-day life or having the greatest impact on your overall health.

For example, if your impulsive behaviors due to ADHD are causing a lot of problems at work and at home, finding the right ADHD medication and starting cognitive behavioral therapy may be the priority. On the other hand, if your anxiety-related stress is causing you to experience other health symptoms, like headaches, nausea, or insomnia, your doctor may want to develop a treatment for that first.

Prescription medications are typically the first line of defense for both ADHD and anxiety disorders. Your doctor may want to monitor you closely if you start taking medication for one of these conditions. It’s important to make sure the chosen prescription is not magnifying the symptoms of the other condition.

If you begin taking medication to treat ADHD, be sure to inform your doctor if you feel that it is causing any anxiety symptoms to worsen. The same goes for anxiety meds that may result in more severe symptoms of ADHD.

Fortunately, there are many instances in which a person begins treatment for one condition and actually finds relief for both. You might discover that getting on an ADHD medication plan actually helps to alleviate the symptoms of both ADHD and anxiety. This is often the case when the two conditions are very closely related. As the symptoms of your ADHD lessen, the anxiety that was once intensified by those very symptoms may start to lessen as well.

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Long-Term Management

Eventually, you may be treated for both your anxiety and your ADHD. By focusing on only one condition at first, doctors are able to evaluate the effectiveness of a particular treatment. But as symptoms stabilize, remaining symptoms may be addressed. Over time, the goal is to have a comprehensive treatment plan which reduces the severity of the symptoms for both ADHD and anxiety.

In addition to talking with your doctor to develop a treatment plan, it helps to learn a few tips and tricks for managing both of these disorders in your daily life. Some of the most effective strategies include:

Create a routine: Knowing what to expect each day can lessen anxiety, and structuring your day can assist with time management and planning issues related to ADHD.
Prioritize sleep: Your mind and body need adequate rest for concentration and memory, both of which are challenging for many people with ADHD. At the same time, a healthy sleep routine can help minimize anxiety.
Exercise regularly: Frequent movement can help to relieve both anxiety and ADHD, especially if you tend to feel quite restless.
Limit caffeine and alcohol: Both of these substances can exacerbate symptoms of ADHD and anxiety, so limiting your consumption can be very helpful in managing these disorders.

ADHD and anxiety can both make it feel harder to get through the day and experience the kind of satisfaction and success you want in life. Don’t let these conditions hold you back any longer. Partner with an experienced healthcare provider to get the right treatment plan for your specifics needs.

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