The Overlap Between ADHD and Anxiety in Children and Teens

When a child struggles to sit still, follow directions, or manage their emotions, it’s easy to assume they might have ADHD. On the other hand, when a teen avoids school, complains of stomach aches, or seems overly worried, anxiety might seem like the obvious explanation. But what happens when a young person is experiencing both — and the signs are not so easy to untangle?

Attention-Deficit/Hyperactivity Disorder (ADHD) and anxiety are two of the most common mental health conditions among children and adolescents. And while they are distinct in how they affect the brain and behavior, there is a significant overlap in their symptoms. This overlap can make it difficult to pinpoint exactly what a child is experiencing, especially when both conditions occur at the same time — which, as it turns out, is quite common.

What Is ADHD? What Is Anxiety?

ADHD is a neurodevelopmental disorder that affects a child’s ability to focus, sit still, and control impulses. Children with ADHD may seem like they're always “on the go,” interrupting others, losing things frequently, or zoning out during tasks that require attention. It’s not that they don’t want to pay attention — their brain simply processes and regulates information differently.

Anxiety, on the other hand, is more about the emotional and physiological response to perceived stress or danger. Children with anxiety may worry excessively, fear social situations, avoid unfamiliar activities, or experience physical symptoms like headaches and stomachaches. They may appear overly cautious, clingy, or reluctant to try new things.

At first glance, these conditions may seem very different. But the real challenge comes when their symptoms begin to overlap.

Why the Confusion?

Imagine a student who can’t finish their homework, appears distracted in class, and avoids participating in group activities. A parent or teacher might assume it's ADHD — but it could just as easily be anxiety that’s interfering with their concentration and willingness to engage.

In fact, both ADHD and anxiety can cause:

• Difficulty concentrating: A child with ADHD may get distracted by external stimuli, while a child with anxiety may be focused on internal worries.

• Restlessness or fidgeting: ADHD can lead to hyperactivity, but anxiety can cause physical tension or nervous energy that looks similar.

• Irritability and mood swings: Emotional regulation is often challenging in both conditions, although for different reasons.

• Sleep problems: Trouble falling asleep, staying asleep, or waking up feeling unrested is common in both ADHD and anxiety.

When children are dealing with both conditions simultaneously, these symptoms can intensify and affect nearly every part of their life — from academic performance to friendships to family dynamics.

How Common Is the Overlap Between ADHD and Anxiety?

It’s more common than many people think. Studies suggest that anywhere from 25% to 50% of children diagnosed with ADHD also have an anxiety disorder. In some cases, anxiety develops as a response to living with undiagnosed or untreated ADHD. Constantly being reprimanded, struggling to keep up with peers, or feeling misunderstood can all contribute to a child developing anxious thoughts or behaviors.

On the flip side, some children with anxiety may show behaviors that mimic ADHD — like seeming distracted, avoidant, or restless — when in reality they are preoccupied with worries or fears that interfere with their ability to function.

Getting the Right Diagnosis Matters

One of the biggest challenges with overlapping conditions is getting an accurate diagnosis. If a child is treated only for ADHD, their anxiety symptoms might be overlooked or even worsened, especially if stimulant medications increase their nervousness. If they're treated only for anxiety, their attention and impulse control issues may continue to interfere with their daily life.

This is why a comprehensive evaluation is essential. A qualified mental health professional will gather information from multiple sources — such as parents, teachers, and the child themselves — and take time to understand how symptoms appear across different settings (home, school, social situations).

Supporting a Child with ADHD and Anxiety

Parenting or teaching a child with one of these conditions can be challenging. Supporting a child with both requires even more understanding, patience, and a flexible approach.

Here are a few ways families and educators can help:

• Keep communication open. Let your child know you’re there to listen without judgment. Encourage them to talk about their worries and experiences, and validate their feelings.

• Establish routines. Predictability can help reduce anxiety and provide structure that supports children with ADHD.

• Use positive reinforcement. Celebrate small victories and highlight strengths. Children with coexisting conditions often face a lot of criticism, so encouragement goes a long way.

• Explore professional support. Cognitive Behavioral Therapy (CBT) is effective for anxiety, while behavior therapy and sometimes medication can help manage ADHD symptoms. Some children may benefit from a combination of both.

• Work with schools. Teachers can be powerful allies. Ask about accommodations like extended test time, seating arrangements, or breaks during the day.

Final Thoughts

Children and teens are complex — and so are the conditions that affect their mental health. ADHD and anxiety often coexist, and their symptoms can overlap in ways that make it hard to tell them apart. But with careful observation, professional evaluation, and a supportive environment, kids can learn to manage their symptoms and thrive in school, at home, and beyond.

If you suspect your child may be dealing with ADHD, anxiety, or both, don’t hesitate to reach out to a mental health professional. Understanding what’s happening is the first step to helping them feel better — and more confident — every day.