ADHD or Anxiety?

By Ezra Fromowitz, LMSW  

Attention-deficit/hyperactivity disorder, also known as ADHD, is a well-known, and widely diagnosed, mental health condition. In fact, close to 10% of U.S. children between the ages of 2 and 17 years old have been diagnosed with it. Symptoms of ADHD may include: impulsivity; difficulty with concentration, organization, and completing tasks; and fidgeting.  

ADHD also affects adults. Although adults generally have more freedom than children to choose a career path and lifestyle which make their symptoms less of an issue, many adults still seek treatment to deal with the significant challenges that their symptoms present. 

In treating adults with ADHD, I have seen that it is often assumed that it is their ADHD (diagnosed in childhood) which is the sole cause of their distress and difficulty with daily functioning. In fact, this may very well not be the case. According to studies, around half of adults with ADHD have some form of anxiety disorder as well. And although many symptoms of the two conditions overlap, there are symptoms which are unique to each one which might not get properly addressed if overlooked. In addition, some of the treatments for ADHD will not be affective for symptoms of anxiety. 

So how does one differentiate between ADHD and anxiety? Here are some things to look for in recognizing each condition: 

  • Avoidance – Avoidance refers to procrastinating or getting distracted from doing a task. Although ADHD might contribute to general avoidance, if you find that you persistently avoid particular tasks or routines, anxiety might be playing a role. Often the underlying anxiety causing the avoidance is subtle so therapy might be helpful in getting to the bottom of it. 
  • Emotional Instability – Although ADHD is considered a mental health condition, it is primarily characterized by behavioral indicators: high levels of energy, fidgetiness, impulsivity, and difficulty with maintaining focus on tasks. Anxiety, on the other hand, is characterized by emotional distress: worry, fear, and irritability. Symptoms of ADHD can be addressed using behavioral techniques (e.g. visuals, timers, routines, and incentives), while treatment of anxiety focuses on modifying the unwanted emotional responses to situations. 
  • Physical Indicators –Your body’s own physiological responses can be very informative in determining what it is you are dealing with. With ADHD, the main physiological responses are impulsivity and hyperactivity. However, if you are experiencing increased heart rate and breathing, sweating, trembling, palpitations, headaches, or stomachaches, it might be anxiety which is the culprit.  

As with all mental health conditions, seeking the right kind of support and treatment is important. If you are struggling with daily functioning, then understanding your symptoms is a critical step in the process of treatment and seeking the guidance of a qualified therapist can be helpful in getting to the bottom of whatever the issue is. 

Ezra Fromowitz, LMSW is a JCS Psychiatric Rehabilitation Program Coordinator Therapist 

JCS provides a broad range of services that meet the diverse, multi-dimensional needs of individuals and families throughout Central Maryland.  We offer guidance and support when you are seeking solutions for emotional well-being, aging and caregiving, parenting, job seeking, employers and businesses, achieving financial stability, living with special needs, and preventing risky behaviors. To learn more, please visit our home page or call 410-466-9200. 

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