Are you ready for a nerdy deep dive into the link between anxiety and ADHD? There are several differences (and similarities) between ADHD and Anxiety, and the two share a ton of symptoms: racing thoughts, sleep problems, worry about forgetting something, and fidgety hands. And while they have a lot of the same symptoms, they do have some fundamental underlying differences in what’s going on in the brain—and a lot of it has to do with executive function…so let’s dive in and figure it out.
The Link Between Anxiety and ADHD: Same Leaves, Different Roots
Check out this tree. It’s a nice tree with nice leaves. Let’s say that this tree represents anxiety.
But surprise! Our “anxie-tree” is actually two trees with two different roots. The actual trees looks very similar, but one of these trees is a lemon tree and the other is a lime tree. For our metaphor, the lemon tree will be the tree that’s rooted in anxiety. The other tree is a lime tree, and though it looks practically the same up top, this tree is rooted in ADHD. When we think of it this way, we can see the link between anxiety and ADHD.
Up to 50% of people with ADHD have an anxiety disorder. The symptoms can look super similar, and they have a ton of overlap, from racing thoughts to difficulty sleeping, to memory problems. Today we’re going to talk about the overlap between anxiety and ADHD, the two separate root causes, and how brain differences might help explain why this is happening. If you wonder why this even matters, it’s because if we look at some forms of anxiety as being fueled by ADHD, that gives us some different options for treating it. When I learned the crucial role that executive function plays in processing emotions, it completely changed how I manage my own anxiety and how I help clients.
The ADHD Brain on Fast Forward: How Executive Function Challenges Fuel Anxiety
Do you know that feeling, where your thoughts bombard you and everything feels awful and frightening and overwhelming? We could describe that as anxiety. But that also sounds like ADHD.
Here’s how ADHD looks like anxiety for me sometimes: the best way I can describe it is that my thoughts are just flying by so fast! And there’s usually three of them at once. I’ll look at my messy kitchen and think, “I need to cook dinner, but I can’t cook dinner until I do the dishes. I’m such a bad mom! I can’t even think with this music on! Maybe if I were just more chill, that would solve everything. Where was I? Oh yeah, the dishes. What is that fan noise? Also, I need to order groceries. ‘Alexa, add almond milk to the shopping list.’ Why is this music so loud? What should I make for dinner? I hate cooking, and I can’t even start because this kitchen is so messy. I hate everything! Accck!”
It can be very loud in my ADHD brain. It seems like there’s always something important I’m forgetting, and it feels like something bad is just around the corner.
ADHD and Anxiety Symptoms Overlap
ADHD and Anxiety have a ton of symptom overlap, from worrying, to hyperactivity, to getting stuck in overwhelm, to overthinking, difficulty focusing, and trouble sleeping.
If you know me, you know that I like charts to explain this stuff, so I created a table for those who want to learn more. It shows more than one dozen overlapping symptoms of anxiety and ADHD and how the root causes come from different places. I’m including the chart as a free resource here on my website, and this link will take you there:
ADHD and Anxiety Overlap Guide
For now, let me highlight just a few of these overlapping symptoms for you.
Understanding Worry in ADHD vs. Anxiety
With anxiety, worry is a maladaptive habit of trying to prevent bad things from happening that is actually reinforcing to the brain: “As long as I worry about it, I can prevent it.” This leads to a cycle. Anxiety prompts worry to prevent the bad thing, and when the bad thing doesn’t happen, the brain thinks the worrying worked and continues to use anxiety and worry to prevent bad things.
Worry with ADHD starts with your default mode network. These are the activities the brain does in the background when you’re not actively engaged in a task or other external inputs. With ADHD, the brain often turns to worrying without you noticing it. And the hyperfocus that comes with ADHD can make it hard to switch thoughts away from something worrisome.
So the symptom is worrying. With anxiety disorder worrying is a maladaptive habit around avoidance. With ADHD, as we’ll discover, it’s about executive function.
Hyperactivity in ADHD vs. Anxiety
Fidgeting, jiggling legs, need to constantly move. With ADHD, this is often called “driven by a motor”. You have the gift of lots of physical energy (and poor inhibition). This is great if you’ve got physical problems to solve, but can be problematic if you have to sit still or try to relax.
From an Anxiety perspective, you’re stuck in the fight-flight-freeze response to perceived danger. Your body pumps out stress hormones so you’ve got energy to run away from a tiger, which is great unless there’s no tiger and it’s only your emails that are frightening.
So with both ADHD and Anxiety you might see hyperactivity, but it has two different things fueling it.
ADHD and Anxiety: Two Different Paths to Distracted
With ADHD there seems to be an inherent difficulty maintaining attention for tasks that aren’t the right level of stimulation.
With anxiety, your brain is constantly scanning for danger. For example, why would you pay attention to your homework when you’re being chased by a tiger?
How Anxiety and ADHD Disrupt Sleep in Different Ways
With ADHD your brain has difficulty with impulse control and behavior regulation. This leads to difficulty calming your mind and body. Your brain hates being bored, so while you’re laying in bed, your brain pulls up all sorts of random ideas and thinks about everything when you’re trying to sleep.
With anxiety, that worry cycle shows up again to keep the body’s sympathetic state active, that fight-flight-freeze response. Racing thoughts, that preventative worrying, keep you on high alert.
There are other overlapping behaviors, but you get the idea.
The Link Between Anxiety and ADHD Starts With Executive Function
ADHD and Anxiety can look very similar on the surface, but the symptoms are rooted in two different functions in the brain. So what’s the fundamental root difference between ADHD and Anxiety? It’s executive function.
Executive function (EF) is the brain’s ability to manage thoughts, emotions, and actions to reach a goal. It includes skills like planning, focusing attention, remembering instructions, and regulating impulses.
With ADHD, there appears to be a predisposed deficit in executive function. This makes it hard to process emotions like anxiety. For example, when you feel anxious about all the homework you need to do, poor EF makes it hard to choose which task is most important, and makes it hard to remember why school is important, which drains your motivation. You might have a hard time getting started. Eventually you look at your clock, realize it’s 1:00 AM, pull an all-nighter, and then have much worse EF in the morning because you didn’t sleep. Now you’re running late and can’t find your keys. When you finally show up late, you have a harder time paying attention in class. Now it feels like school is impossible and you’re worried about your grades. This all stems from difficulty organizing and initiating tasks the day before; it starts with poor executive function which generally happens in the prefrontal cortex of the brain.
On the other hand, with anxiety disorder there is perhaps an overactive amygdala (or HPA axis in the nervous system) that leads to a heightened fear response. So when you perceive that you’re in danger—like a tiger is chasing you—your brain doesn’t care about making a budget or planning out tomorrow’s task list. The brain channels that energy into running away, and it decreases big picture thinking, or value-based decision making. So you might make choices that avoid problems or situations. With the homework example, someone with anxiety disorder would avoid doing your homework, because you’re afraid you won’t do it perfectly. Or you might do your homework under another form of avoidance, which is to avoid “failure” by trying to do your homework perfectly. That avoidance fuels a cycle of increasing anxiety, increasing avoidance, increasing worry (which is another type of avoidance), which impacts ability to function. It makes it harder to choose to do difficult things, harder to think clearly, and harder to relax. That’s the anxiety cycle. And with an anxiety disorder we’ll often see heightened responses in the amygdala, which is located in the middle of the brain.
ADHD, Anxiety, and the Feedback Loop Between Executive Function and Fear
Executive Dysfunction often shows up as trouble regulating emotions. 30-70% of people with ADHD struggle to regulate their emotions.
Here’s where it gets messy. When we have poor EF, it fuels emotional dysregulation. And when you’re highly emotional, it’s hard to slow down and think clearly, and that’s because the FFF response is channeling resources like blood and oxygen away from the prefrontal cortex and into the more primitive survival parts of the brain. So poor EF can fuel anxiety, and anxiety can fuel poor EF. This is why ADHD and anxiety are often connected, but they stem from differences in how the brain processes information and responds to stimuli.
ADHD stems from poor Executive Function.
Anxiety stems from a habitual avoidance response. But anxiety can also decrease executive function. It’s hard to think clearly when you’re scared.
We can often treat the symptoms of ADHD-type anxiety by improving executive function.
And we’re going to get to that, but let’s first take a deep dive into what might be causing this poor Executive Function in the ADHD brain type?
ADHD and Cognitive Profile Scatter: Why Executive Function Skills Feel Uneven
One of the things we see with ADHD is something called a “Cognitive Profile Scatter”.
Are you ready for a deep dive? I promise we’re going to talk about some helpful strategies soon.
You’ve probably heard of IQ scores, which is one measure of intelligence. But most people think they’re just one number, like 140 is genius, 100 is pegged as average, below 70 is considered an intellectual disability. Most people score between 85 and 115. But most people don’t know that your IQ score is actually an average of subtests measuring 4 different skills: verbal reasoning, processing speed, working memory, and problem-solving. And here’s the thing with averages. A smart, average person without ADHD might score 110, 111, 107 and 112 in those four subcategories, and their overall score would be 110. The point is that the scores are tightly grouped around their average, which is their IQ number.
But one thing we often see with ADHD is someone might have the exact same average IQ score of 110, but their processing speed could be super fast at 130. And then their working memory might be just under average at 90
They have a bigger gap: 40 points between their processing speed and their working memory. As Russel Barkley says, that’s like a racecar engine with bicycle brakes. These gaps in mental skills are pretty typical with ADHD.
ADHD and Executive Function: Why Working Memory Is Often a Struggle
Specifically, a common pattern of Cognitive Profile Scatter with ADHD is high processing speed + low working memory.
Working memory helps you hold and sort through thoughts, like “I’m feeling anxious because I have a deadline—but I’ve done this before.” That’s two thoughts at once. Hold those in your head while trying to remember your system, pull out your calendar, and pretty soon the ADHD brain will just give up.
Working memory is also essential for holding emotional information, comparing it with past experiences, and choosing appropriate responses. In ADHD, working memory is often impaired, which makes it harder to pause and think before reacting emotionally. This can lead to impulsive emotional outbursts or difficulty calming down. A slower working memory also inhibits your overall executive function.
Imagine your brain races ahead, your fast processing cranks out a flood of ideas and emotions:
“What if I fail my test? What if my teacher gets mad at me? What if I never get a job? What if I …? All this catastrophizing.
That’s what many people with ADHD experience. And then your ability to slow down, organize, and self-soothe lags behind:
“You’re going to be okay.” “Remember to breathe.” “This is just your brain making words.” “There’s no evidence that you’re going to fail your test.”
With ADHD, thoughts and feelings move fast, but the tools to regulate those feelings—the metaphorical brakes like self-talk, reflection, or calming strategies—can’t keep up. So anxiety, overwhelm, and emotional outbursts take over.
These aren’t just behavioral issues, and they’re not a lack of willpower—they’re regulation issues. You might desperately want to stay calm or focused, but your cognitive systems aren’t working in sync. Over time, this can lead to chronic anxiety, low self-esteem, and fear of failure, especially when you’re misunderstood or punished for something you can’t yet control.
And not only that, but parents or teachers will incorrectly think, “This kid or adult is super smart, but unmotivated.” For example, a child with ADHD might think quickly and talk fluently (high verbal processing speed), but struggle to hold thoughts in mind or stay grounded in the present moment (low working memory or executive function).
So these kids are more likely to be punished or corrected, because they seem so smart, and “they should know better”, but the smart part of their brain is actually making it harder for them to process their emotions.
ADHD can make it much harder to process emotions like anxiety—and not because the person is “too sensitive” or dramatic, but because of how their brain works.
How Emotion Processing Supports Executive Function with ADHD
So let’s say your friend criticizes you. (OK, this example is about me.) If someone said, “You keep interrupting me Emma!”, in response, I might feel a flood of emotions:
- Defensiveness: “I do not!”
- Indignation: “You’re not so great yourself. You’re always talking about yourself!”
- Immense shame: “I’m such a bad friend. I suck at relationships!”
With a delayed prefrontal cortex, emotions hit fast and hard, and it’s hard to slow yourself down, soothe yourself, or think clearly in the moment. I might react quickly, storm off, get overwhelmed, shut down. Without knowing what to do with those emotions, I might feel anxious that I’ll lose her as a friend, or depressed that I can never maintain relationships. I might shut down, withdraw, or blow things up. And that might make me more anxious or depressed in the future.
But…if my prefrontal cortex were activated, instead of replying right away, executive function would help me. I’d pause, take a breath (impulse control), remember that my friend cares about me (working memory), acknowledge that it hurts that she said that while also asking myself, “Is it true?” (working memory). I would calm myself down enough to ask her what that looks like (self-soothing), and then check in with my values: “I do value being a better listener and I value my friendships” (prioritization). Then I’d create a plan to become a better listener, which might look like watching some videos, practicing being a better listener, and then asking for feedback (organization).
What I’m describing is emotion processing. It’s a multi-step process that requires you to slow down, soothe yourself, make some space, and then clarify and organize your thoughts and feelings into choosing valued action. The skills of emotion processing are essential, and with ADHD, poor executive functioning is basically tripping you up at each step if you don’t give it support and scaffolds to work through this.
And that’s the whole point. If you identify with ADHD, that’s not just some new excuse for why you can’t be happy and get stuff done. Knowing that ADHD limits your executive function gives you a roadmap to build up the scaffolds and tools that are going to help you solve problems and be super awesome.
Helping Anxiety from an ADHD Approach
You don’t need more pressure or discipline; you need tools for co-regulation, memory supports, and ways to build emotion processing.
So how do we do that? Let’s talk about 3 practical strategies that can help anxiety if we take an executive function approach. And since this is a post about ADHD, I’m going to introduce a new metaphor because the way I think about my ADHD is like a racecar with inadequate brakes. Let’s see how supporting executive function will 1) slow down the race car; 2) build up the brakes; 3) get a good pit crew.
Slowing the ADHD Brain: Why Pace Matters for Executive Function
- In a race car, you can slow down by taking your foot off the gas. Here’s how to similarly slow down our body and thoughts:
- Exercise is shown to directly support executive function (and it’s great for anxiety too).
- Meditation might feel terrible for many people with ADHD. But remember, it’s not a coping skill, it’s a training skill. You’re training your brain to slow down and improve attention
- Medication for ADHD stimulants. They stimulate the executive function parts of the brain to help you slow down. (Please talk with your doctor about this option.)
- Writing about your feelings can be one of the most effective ways to process them. This is my number one favorite way to sort through the clutter in my head. You don’t have to journal every night (though that’s not terrible), but when you’re feeling super emotional, sit down and write about it. It will help you slow down and clarify what’s going on.
So for example, if you’re freaking out about whether your friend hates you because of something you said, write it down. What are your thoughts? What are your fears?
She’ll never talk to me again.
I just suck at this, why even try?
No one would ever want to be my friend because I say stuff like that.
Now you can add some helpful thoughts. What would you say to someone who was thinking those things? Write those down.
It’s probably not as bad as I think.
Real friendships work through stuff like this all the time.
What steps could I take to check in with her and make it right?
There have been rough times like this in the past and I’ve always gotten through them ok. I can do this.
When we slow down the racecar and look around, we can often manage the anxiety better.
Sometimes the race car zooms ahead with impulsivity. My friend Sean, who is an Executive Function coach, also has ADHD and anxiety. I love how he manages task overwhelm by writing only one thing at the beginning of each day that he will accomplish to be successful that day. (Sean shares this at minute 21:00 in the video embedded above that corresponds to this post, or you can see a longer interview I did with him here.)
- Pausing will counteract impulsivity, which is a strong fuel for ADHD and anxiety. Does this sound familiar? You get upset at work, impulsively quit your job, and now you’re very anxious about paying rent. To support impulsivity we need to train ourselves to pause. Take a breath or take a walk instead of reacting right away. Bite your tongue. Put your hands behind your back. Sometimes it’s good to sleep on a problem, or force yourself to take 48 hours before making a decision. Want to break up with your girlfriend? Buy something expensive? Set a timer and wait 48 hours before taking that action. These helps for pausing are behavioral strategies that you can practice until you make a habit of them.
- Do less stuff. One of the best ways to make yourself anxious and disorganized is to overbook yourself and run around like a chicken with its head cut off. Schedule in time every day to slow down and work through feelings, plan, organize, rest and do self-care.
Building Stronger Brakes for ADHD: Stopping Before Anxiety Takes Over
2. The second way we improve our ability to work through anxiety from an ADHD lens is we strengthen the weak parts of our car, the bicycle brakes that need extra support. Or in the case of ADHD, it’s often working memory and impulse control that need extra support. This post can’t cover all the different skills to support EF, but let me list a few. And I encourage you to do your own research to figure out how to build systems that work for you.
a. Keep visual reminders around you. For people with ADHD, out-of-sight is literally out-of-mind. If my ADHD-induced anxiety makes me feel panicky, then it seems impossible to remember that I’ve gotten through this before and that I’ll feel better after going for a walk. So notes and other visual reminders can be really helpful to interrupt this anxiety. You might do the following:
Make a list of your routines and put it on your wall, by your bed, etc.
Write your coping skills and post them in an obvious place.
Put a note about your warning signs that you need support somewhere that you’ll see it regularly.
b. With ADHD, planning and organization skills might be more helpful than mindfulness or CBT. You could work with an Executive Function coach to create a calendar system that works for you. Maybe your calendars need to be posted on the wall where you’ll see them often. And whenever possible, use routines and systems with checklists. The YouTube channel “How to ADHD” has some great examples of this.
c. Set reminders on your phone for the important things, like scheduled worry, journaling, breathing slowly, or even a reminder to hug your spouse.
d. Process emotions physically, not just mentally. You could get them physically on paper, do a brain dump, or make a mindmap.
Or consider working through the steps of my Emotion Processing course.
I created the Emotion Processing course, not because I’m the best at processing emotions, but because I needed a 30-step system to work through my own huge and overwhelming feelings with my mediocre working memory. You can buy the course on its own, or get it (along with 9 other courses) in the monthly membership.
Executive Function Boost: How Relationships Help ADHD Brains Thrive
3. The third way to decrease your anxiety by addressing ADHD deficits is to get support. In other words, help your racecar brain with a good pit crew.
a. A therapist or Executive Function coach can help you slow down, be less impulsive, and reinforce good strategies. They can help you process your emotions and build healthier habits.
b. Body doubling. Getting someone to do the overwhelming things with you can be super helpful. For example, a friend can help you clean out your over-packed garage, or face your fears. It might sound scary to impose on someone like this, but a friend will actually enjoy spending time with you and helping you be a better version of yourself. In fact, imposing on each other in a give-and-take relationship where you both practice reciprocity will serve to strengthen your friendship.
c. Say it out loud. Racing thoughts can go in circles in your head, but when you say them out loud it’s easier to make sense of them. You can talk to a friend, or at work you can meet with an assistant to listen and help you organize your tasks. You could even just talk into your phone’s voice memos or notes, or talk to your favorite AI.
Supporting Executive Function: The Key to Managing ADHD and Anxiety
In the end, the goal is to support your executive function so that you can make choices that line up with the life you want to be living.
With ADHD, that’s usually about supporting executive function first, which will help you solve problems and soothe your emotions. With anxiety disorder it’s often about reversing behaviors and thought patterns that keep fueling avoidance and fear, and then that’s going to help your executive function kick into gear.
Either way, when you support your executive function, you’ll be better at thinking clearly and solving problems, and ADHD anxiety will be easier to live with.
If your anxiety doesn’t seem to be based in ADHD, my course called Grounding Skills for Anxiety might be just what you need. It’s free—just follow the link.
