Spot the Difference: ADHD vs Anxiety

ADHD vs Anxiety

Children with ADHD and children with anxiety can exhibit some similar characteristics and behaviors making it more challenging to tell the difference. For instance, children with ADHD are more likely to have higher rates of co-occurring anxiety. It can be difficult to tease out if inattention is due to anxiety or if in fact, the anxiety is a result of deficits regarding attention regulation due to ADHD. This brings up the added complication of secondary anxiety. Secondary anxiety in children with ADHD usually involves being anxious about executive functioning difficulty (anxiety about assignments, time management, school demands, etc.).

As we delve deeper into the differences between ADHD and Anxiety disorders, let's briefly look at some of the main symptoms of each.


Anxiety disorders, such as Generalized Anxiety Disorder (GAD) could present symptoms that include:

  • Being easily fatigued
  • Racing thoughts
  • Difficulty concentrating
  • Restlessness
  • Trouble sleeping
  • Muscle tension
  • Palpitations
  • Trembling
  • Temper tantrums
  • Refusal to go to school
  • Clinginess to caregivers

Attention Deficit Hyperactivity Disorder ADHD could present symptoms that might be the following:

  • Display routine and surprising forgetfulness. May seem like complete disregard for consequences
  • Trouble following through on projects
  • Restlessness
  • Racing thoughts
  • Difficulty with time management
  • Irritability/short temper
  • Lack of sustained focus on non-preferred tasks

How to tell the difference

Inattentiveness Differences:

Children with anxiety may be inattentive, but that is often because they might be too focused on what is causing them anxiety. The child is likely preoccupied with the object of their anxiety that they might not be able to switch their attention to anything else for sustained periods of time. On the other hand, a child struggling with ADHD might not be attentive because of a general struggle with focus and attention due to being easily distracted or losing interest in the topic at hand.

Environmental Differences:

In a highly stimulating environment, a child with anxiety might face more potential triggers. A highly demanding event or an important event could bring on more feelings of anxiety and could be more likely to bring on physical and emotional symptoms. A child with ADHD might be less symptomatic in a highly stimulating and interesting environment. Kids with ADHD tend to prefer environments with more sensory stimulation.

Primary vs. Secondary Anxiety

Clinicians work to identify the purpose behind a child's anxiety and to determine if that anxiety is the core issue or a secondary issue that is a result of another deficit. If a child's worry and stress is strongly tied to executive functioning difficulties, then that could be a sign that the worry and stress is secondary anxiety associated with ADHD. A helpful way to investigate this would be to look at the proportion of risk to worry. If a child is worrying about something and the worry/anxiety is out of proportion considering the possible risk, then an anxiety disorder might be at play. With ADHD the experienced stress and worry is more likely to be proportional because the child is indeed facing significant difficulties when it may come to handing in assignments on time or completing daily tasks.

Useful resources.

What is Hyperlexia?
What is Dysgraphia?