If you have been struggling with racing thoughts, difficulty concentrating, restlessness, or a constant feeling that your brain will not slow down, you have probably wondered what exactly is going on. Is it anxiety? Is it ADHD? Could it be both? You are not alone in asking this question — it is one of the most searched mental health queries in the country and for good reason. ADHD and anxiety share a surprising number of overlapping symptoms which makes it genuinely difficult to tell them apart without professional help. This post explains the key differences, the areas of overlap, and how a therapist can help you figure out what you are actually dealing with.
What Is ADHD?
Attention Deficit Hyperactivity Disorder is a neurodevelopmental condition that affects the brain’s ability to regulate attention, impulse control, and executive function. It is not a lack of intelligence or willpower — it is a difference in how the brain processes information, prioritizes tasks, and manages focus.
ADHD is typically categorized into three presentations. Predominantly inattentive presentation — difficulty sustaining attention, following through on tasks, organizing, and managing time. This is the presentation most commonly missed especially in women and girls because it does not involve the hyperactive behavior most people associate with ADHD. Predominantly hyperactive-impulsive presentation — fidgeting, restlessness, difficulty sitting still, talking excessively, and acting impulsively without thinking through consequences. Combined presentation — a mix of both inattentive and hyperactive-impulsive symptoms.
ADHD is present from childhood though it is frequently not diagnosed until adulthood — particularly in women who were socialized to mask their symptoms. Many adults who are diagnosed with ADHD later in life describe a lifelong feeling of being different or having to work twice as hard as everyone else to accomplish the same things.
What Is Anxiety?
Anxiety is an emotional and physiological response to perceived threat or danger. Unlike ADHD which is a neurodevelopmental condition, anxiety is a mood-based condition characterized by persistent excessive worry, fear, and physical tension. Everyone experiences anxiety occasionally but an anxiety disorder involves anxiety that is disproportionate to the situation, difficult to control, and significantly interferes with daily functioning.
Common anxiety disorders include generalized anxiety disorder characterized by chronic pervasive worry about many different things, social anxiety disorder involving intense fear of social situations and judgment, panic disorder involving recurrent unexpected panic attacks, and specific phobias involving intense fear of particular situations or objects.
How Do ADHD and Anxiety Overlap?
This is where the confusion gets real. ADHD and anxiety share a remarkable number of surface-level symptoms that can look almost identical from the outside:
Difficulty Concentrating
Both ADHD and anxiety can make it extremely hard to focus. In ADHD the difficulty comes from the brain’s inability to regulate attention — it drifts, gets pulled toward more stimulating inputs, and struggles to stay on task. In anxiety the difficulty comes from the mind being consumed by worry — the brain is focused, but on the wrong things.
Restlessness and Fidgeting
Both conditions can produce physical restlessness. In ADHD this is driven by the brain’s need for stimulation. In anxiety it is driven by the body’s fight-or-flight response being activated by perceived threat.
Sleep Problems
Both ADHD and anxiety frequently disrupt sleep. ADHD can make it difficult to quiet the mind enough to fall asleep. Anxiety can keep a person awake with racing worried thoughts about the future.
Irritability
Both conditions can produce irritability. In ADHD it often comes from frustration with oneself — the gap between what you want to do and what your brain lets you do. In anxiety it often comes from being emotionally overwhelmed by constant worry and tension.
Difficulty With Decision Making
Both ADHD and anxiety can make decisions feel paralyzing. In ADHD this is often because the brain struggles to prioritize and organize options. In anxiety this is often because every option feels like it could lead to a catastrophic outcome.
How Do I Tell the Difference Between ADHD and Anxiety?
While the symptoms can look similar on the surface there are key differences that a trained therapist can help you identify:
When Did It Start?
ADHD is present from childhood even if it was not recognized or diagnosed. If your concentration difficulties, restlessness, and impulsivity have been with you as long as you can remember, ADHD is more likely. Anxiety can develop at any point in life and is often triggered by specific circumstances, life events, or periods of stress.
What Is Driving the Difficulty?
In ADHD the difficulty with focus comes from the brain being understimulated and seeking more engaging input. In anxiety the difficulty comes from the brain being overstimulated by worry and threat detection. A person with ADHD might say my brain just drifts away. A person with anxiety might say my brain won’t stop thinking about everything that could go wrong.
How Does Rest Feel?
People with ADHD often feel bored or restless during downtime and crave stimulation. People with anxiety often feel unable to relax because their mind keeps generating worries even when nothing is objectively wrong.
What Happens Under Pressure?
Many people with ADHD actually perform better under pressure — the urgency provides the stimulation their brain needs to focus. People with anxiety typically perform worse under pressure because the added stress amplifies their worry and overwhelm.
Can You Have Both ADHD and Anxiety at the Same Time?
Yes — and this is extremely common. Research suggests that approximately 50 percent of people with ADHD also have an anxiety disorder. Living with undiagnosed ADHD can actually cause anxiety over time because the chronic experience of underperforming, forgetting things, missing deadlines, and feeling like you are constantly falling short creates genuine anxiety about your ability to function in the world.
This is why accurate diagnosis matters so much. If you have both ADHD and anxiety and only the anxiety is treated, the ADHD will continue to generate the very experiences that fuel your anxiety. A comprehensive assessment that considers both conditions is essential for effective treatment.
How Can Therapy Help With ADHD and Anxiety?
Therapy is highly effective for both ADHD and anxiety — though the approaches may differ depending on what you are dealing with:
For anxiety, Cognitive Behavioral Therapy is the gold standard treatment. CBT helps you identify and challenge the thought patterns that fuel your anxiety and develop practical coping strategies for managing worry and physical tension.
For ADHD, therapy focuses on building executive function skills — organization, time management, prioritization, and emotional regulation. CBT adapted for ADHD helps clients develop practical systems and strategies for managing the challenges of daily life with a brain that processes information differently.
For both conditions together, an integrated approach that addresses the ADHD and the anxiety simultaneously produces the best outcomes. Your therapist at Sunflower Counseling Montana will work with you to develop a treatment plan that fits your specific presentation rather than applying a one-size-fits-all approach.
Should I Get a Formal Assessment?
If you have been wondering whether you have ADHD or anxiety — or both — a formal assessment with a qualified professional is the most reliable way to get clarity. A comprehensive assessment typically involves a detailed clinical interview, a review of your developmental and educational history, symptom questionnaires, and sometimes cognitive testing.
At Sunflower Counseling Montana our therapists are experienced in assessing and differentiating between ADHD and anxiety in both children and adults. We can help you understand what is actually driving your symptoms and develop a treatment plan that addresses the root cause rather than just the surface-level presentation.
Do You Offer ADHD and Anxiety Therapy in Montana?
Yes. Sunflower Counseling Montana offers therapy for both ADHD and anxiety at our in-person locations in Missoula, Kalispell, and Butte, as well as online therapy for clients throughout Montana. Whether you are an adult who has been wondering about ADHD for years, a parent concerned about your child, or someone struggling with anxiety that will not quit — we are here to help you get the clarity and support you deserve.
You do not have to keep guessing. The answer is available and it starts with a single conversation.
Frequently Asked Questions About ADHD and Anxiety
Q: What is the difference between ADHD and anxiety?
A: ADHD is a neurodevelopmental condition affecting attention, impulse control, and executive function that is present from childhood. Anxiety is a mood-based condition characterized by persistent excessive worry and fear that can develop at any point in life. Both can cause difficulty concentrating, restlessness, and sleep problems but the underlying causes are different.
Q: Can you have both ADHD and anxiety at the same time?
A: Yes. Research suggests approximately 50 percent of people with ADHD also have an anxiety disorder. The two conditions frequently co-occur and living with undiagnosed ADHD can actually cause anxiety over time.
Q: How do I know if I have ADHD or anxiety?
A: The most reliable way to tell the difference is through a comprehensive assessment with a qualified mental health professional. Key differences include when symptoms started, what is driving the difficulty with focus, how you respond to pressure, and how rest feels. A trained therapist can help you identify which condition or conditions are present.
Q: Can ADHD be diagnosed in adults?
A: Yes. Many adults are not diagnosed with ADHD until later in life particularly women who were socialized to mask their symptoms. ADHD is present from childhood but is frequently missed or misdiagnosed as anxiety or depression.
Q: What therapy approaches are used for ADHD?
A: Therapy for ADHD focuses on building executive function skills including organization, time management, and emotional regulation. CBT adapted for ADHD helps clients develop practical systems for managing daily life. When anxiety is also present an integrated approach addressing both conditions simultaneously produces the best outcomes.
Q: Do you offer ADHD therapy in Montana?
A: Yes. Sunflower Counseling Montana offers ADHD therapy for children and adults at our locations in Missoula, Kalispell, and Butte, as well as online therapy throughout Montana.
Q: Is ADHD therapy covered by insurance in Montana?
A: Yes. Most major insurance plans cover ADHD therapy when provided by a licensed mental health professional. Contact Sunflower Counseling Montana and we will verify your benefits before your first appointment.
Q: Can children be assessed for ADHD at Sunflower Counseling Montana?
A: Yes. Our therapists are experienced in assessing and treating ADHD in both children and adults. We use age-appropriate, evidence-based approaches to help young people with ADHD develop the skills they need to thrive at home, at school, and in their relationships.
Call or text Sunflower Counseling Montana today to get started: (406) 214-3810 or email hello@sunflowercounseling.com.
Serving clients in person in Missoula, Kalispell, and Butte — and online throughout Montana.
About the Author: Marie is a Licensed Clinical Professional Counselor (LCPC) and Clinical Director at Sunflower Counseling Montana, specializing in children, teens, families, and trauma-informed care across Montana.
