The ADHD–Anxiety Link: Why They Often Co-Occur and How to Treat Both

For many people who come to Neuromed Clinic, ADHD is only part of the story. Alongside inattention, restlessness, or emotional overwhelm, there is often another layer quietly shaping their daily life: anxiety. Whether it shows up as constant worry, a racing mind at night, fear of making mistakes, or difficulty coping with uncertainty, anxiety frequently walks hand-in-hand with ADHD.

In fact, research suggests that 30–50% of people with ADHD also meet criteria for an anxiety disorder. But even when the anxiety isn’t diagnosable, it often plays a significant role in functioning, relationships, and wellbeing. This overlap can feel confusing for patients and challenging for families and clinicians to untangle, but it is absolutely treatable.

This article unpacks why ADHD and anxiety commonly co-occur, what’s happening in the brain, how to tell the difference between the two, and most importantly, the multi-modal treatments that can help both children and adults regain calm, clarity, and confidence.

ADHD and Anxiety: Two Conditions That Amplify Each Other

ADHD and anxiety frequently interact in a way that intensifies both conditions, creating a looping cycle that can be difficult to break without proper support. When someone has ADHD, everyday tasks such as organising, planning, managing time, and regulating emotions, often feel unpredictable or overwhelming.

This sense of uncertainty naturally increases stress levels, which can activate the body’s anxiety response. As anxiety rises, it becomes even harder to focus, think clearly, or stay on task, leading to more frustration and more ADHD-related challenges. In other words, each condition acts as a fuel source for the other.

For many people, this cycle shows up as constant mental tension, irritability, difficulty relaxing, or a sense of always being “on alert.” Over time, the overlap can mask the true source of the problem, making it harder to identify what needs treatment. Understanding how these two conditions amplify one another is a crucial first step toward effective, targeted intervention. So, let’s dive a little deeper and look at what happens in the brain.

The Neuroscience Behind the ADHD–Anxiety Connection

Understanding why ADHD and anxiety so often appear together starts with looking at what’s happening in the brain. Both conditions involve networks responsible for attention, emotional processing, and stress regulation, and when these circuits become overloaded or under-supported, symptoms can easily spill into one another.

By exploring how key regions like the prefrontal cortex and the amygdala communicate, and how the ADHD brain responds to stimulation and stress, we can better understand why anxiety is such a common companion to ADHD. This insight also helps guide treatment, showing us, which interventions genuinely support regulation, and which approaches may fall short.

Shared Brain Circuits: Prefrontal Cortex + Amygdala

Both ADHD and anxiety involve dysregulation in circuits connecting the prefrontal cortex, which is responsible for planning, attention, and impulse control, and the amygdala, responsible for threat detection and emotional responses.

The ADHD Brain Processes Stimulation Differently

People with ADHD typically experience higher levels of emotional hyperarousal, sensitivity to criticism, sensory overwhelm, and difficulty filtering input, factors that contribute to anxiety.

Chronic Stress Reinforces Anxiety Pathways

Untreated ADHD often leads to repeated difficulties at school or work, social misunderstanding, and ongoing performance pressure, all of which activate the nervous system’s stress response, wiring the brain for hypervigilance.

How Untreated ADHD Increases Anxiety

Untreated ADHD increases anxiety in several interconnected ways. For many people, simply trying to keep up with daily demands requires enormous effort, which creates chronic mental strain. Frequent mistakes or missed deadlines often lead to repeated negative feedback, reinforcing a sense of failure or fear of disappointing others.

Emotional dysregulation can turn small setbacks into overwhelming experiences, while social misunderstandings contribute to embarrassment or avoidance. Added to this is the constant worry about forgetting important tasks or commitments. Over time, these pressures build into persistent tension and worry, making anxiety an almost inevitable companion to untreated ADHD.

Why Anxiety Is Often Misdiagnosed as Inattention

Anxiety and ADHD both affect concentration, but for very different reasons. When someone is anxious, their mind becomes crowded with worry, what-ifs, and mental rehearsing, leaving very little cognitive space for focus. In contrast, ADHD disrupts concentration because the brain struggles to regulate attention itself, it drifts, seeks stimulation, or becomes overwhelmed by competing inputs.

Although the outward behaviour may look similar, the internal experience is distinct, and so is the treatment approach. Understanding this difference is essential, as an accurate assessment ensures that patients receive the right interventions and are not treated for the wrong problem.

Emotional Hyperarousal: The Overlooked Link

Emotional hyperarousal, which is described as experiencing feelings quickly, intensely, and with a sense of urgency, is a core but often under-recognised aspect of ADHD. Many people with ADHD describe emotions “hitting all at once,” shifting rapidly, or feeling disproportionately strong compared to the situation.

Because these reactions can resemble panic, overwhelm, or heightened sensitivity, they are frequently misinterpreted as anxiety. However, the underlying mechanism is different: it stems from challenges in regulating emotional impulses rather than from fear-based worry.

Understanding this distinction helps you and your clinician to choose the right treatment approach and will help you make sense of your emotional world with greater clarity and compassion.

Treating ADHD and Anxiety Together: What Works

Treating ADHD and anxiety together works best when both conditions are understood as interconnected parts of the same experience. Because each one can intensify the other, focusing on only one area often leaves people feeling partially supported. A multi-modal approach is most effective. This might include all or a combination of the following:

1. Psychoeducation. Understanding why the brain behaves the way it does reduces fear, shame, and confusion, which are key contributors to anxiety.

2. Behavioural and Lifestyle Strategies. These include routines, task breakdown, emotional literacy skills, grounding techniques, sleep optimisation, and physical activity.

3. Medication Options. Medication for ADHD often improves anxiety indirectly. SSRIs or SNRIs may be used for moderate to severe anxiety. Treatment is personalised depending on symptoms.

4. TMS for Anxiety. Transcranial Magnetic Stimulation (TMS) helps regulate brain circuits involved in anxiety and emotional control. It is non-invasive, safe, and particularly helpful when medication is ineffective or poorly tolerated.

5. Parent Coaching and Family Support. For children and teens, parent coaching enhances predictability, emotional safety, and co-regulation, significantly reducing anxiety and behavioural difficulties.

6. Somatic and Nervous System Regulation Strategies. Somatic approaches help calm the body’s stress response, which is often heightened in both ADHD and anxiety. Techniques such as paced breathing, gentle movement, body scanning, grounding, and interoceptive awareness exercises support emotional regulation by stabilising the nervous system.

When to Seek Help

If persistent worry, emotional overwhelm, fear of making mistakes, shutdowns, irritability, or physical symptoms of anxiety such as a racing heart, tense muscles, or difficulty sleeping are becoming part of daily life, it may be time to seek a professional assessment. These signs often indicate that the nervous system is under sustained stress and needs targeted support.

Early intervention can prevent symptoms from escalating and helps individuals regain a sense of control and stability. At Neuromed Clinic, patients have access to comprehensive care, including diagnostic assessment, medication management, TMS treatment, psychoeducation, and integrative support.

Our team works collaboratively to identify underlying causes and create a personalised treatment plan that addresses both ADHD and anxiety effectively. Meet our professional team… Please reach out to us at: 01-9653294

A Take-Home Message

ADHD and anxiety commonly occur together, but the encouraging news is that both conditions are highly treatable with the right support. When individuals understand what’s happening in their brains and bodies, they can begin developing the skills needed to regulate emotions, reduce overwhelm, and move through daily life with greater ease.

With a tailored, comprehensive care plan, whether that includes behavioural strategies, medication, TMS, somatic tools, or family support, people of all ages can experience meaningful improvement. With the right guidance, it is entirely possible to feel calmer, think more clearly, and build a life that feels balanced, steady, and hopeful.

Dr. Susan McGarvie

Mindfulness-Based Therapeutic Coach

Dr. Susan McGarvie is a Mindfulness-Based Therapeutic Coach who works with adults to support personal change and growth. She uses mindfulness, positive psychology, and coaching in a gentle but powerful process. Her practice is evidence-based and shaped by both her own research and leading studies in the field. With 20 years of experience in healthcare, nonprofits, and academia, she brings deep knowledge and care to her coaching.