Is it anxiety, ADHD, or BOTH?? The overlap and co-occurrence between these two diagnoses is quite common. While ADHD may not necessarily cause anxiety, it can fuel it. In reverse, high anxiety can make it even harder to manage some of the challenges that people face with ADHD. Both diagnoses can cause racing thoughts, restlessness, perfectionism, and other emotions leading to feelings of overwhelm.
Many people with co-occurring ADHD and anxiety often seek treatment for and are diagnosed with anxiety first, missing their ADHD diagnosis until later in life. While ADHD-specific treatment targets many of the challenges of executive functioning (i.e., focus, time management, procrastination, etc.), therapy for anxiety can also address some of the other overlapping symptoms contributing to an “overactive” brain (i.e., feelings of overwhelm, excessive worrying, perfectionism, etc.).
ADHD-informed Therapy for Anxiety
You may have heard the term “there is no one size fits all” in therapy with ADHD. Well, it’s true. The best ADHD-informed therapy merges science with the uniqueness of the ADHD brain. This means a treatment plan will be customized around how ADHD impacts your life.
Traditional approaches to therapy are modified to address the unique parts of life with ADHD, like time-blindness, Rejection Sensitive Dysphoria, and ADHD burnout.
“My brain never shuts off.”
While ADHD and anxiety both involve racing thoughts, the content of each tends to differ. ADHD thoughts are generally focused on, well…anything! Anxiety-related thoughts tend to involve worry, anticipation, or catastrophic thinking. It’s not uncommon for someone to report a hard time falling asleep due to general racing thoughts about their day, which sometimes trigger an anxious response about something they forgot to do, leading to more anxiety around a particular topic, or simply around the inability to fall asleep (ahh!), and the cycle continues.
Cognitive Behavioral Therapy (CBT) is one evidence-based treatment targeting unhelpful thinking patterns leading to feelings of distress, including anxiety. By working to address some of the racing thoughts occurring with anxiety, someone can “declutter” the mind a bit, sometimes even increasing the ability to focus.
“I can’t relax!”
As described above, restlessness (including difficulty falling asleep) can be present with both ADHD and anxiety. Individuals with ADHD often report that it’s quite hard to sit down and relax, often needing to “do something else” during sedentary activities, like watching TV.
Additionally, we know ADHD creates several barriers with things like organization, time management, and memory. These difficulties often lead to feelings of overwhelm or a sense of being “on edge”. Many people report anxiety about things like missing deadlines, forgetting important tasks, losing essential items, or being late. Naturally, one may develop increased anxiety over
time and find it VERY hard to relax when it always feels like something needs to be done! People often report things like increased heart rate, high blood pressure, headaches, muscle tension, and other physiological responses outside of the mental load. Not only does ADHD-informed CBT target thinking patterns leading to overwhelm and anxiety, but it also focuses on coping skills to manage physical reactions to stress and anxiety. Strategies like mindfulness, deep breathing, progressive muscle relaxation, and other grounding skills help restore the mind-body connection and improve the body’s nervous system response, providing some sense of relaxation.
“I’m always disappointing people.”
Individuals with ADHD often receive criticism or negative feedback throughout their lives in response to executive functioning challenges (i.e., forgetfulness, disorganization, procrastination, etc.). Many people report experiencing Rejection Sensitivity Dysphoria, often involving strong emotional reactions to feedback or thoughts of disappointing others. This can lead to behaviors such as people-pleasing or looming thoughts around never being “good enough.” It is not surprising that these thoughts and emotions also contribute to feelings of overwhelm, burnout, or low self-esteem. While CBT cannot change the neurological predisposition to increased emotional reactivity, it can address unhelpful thinking patterns that lead to negative emotions and improve your self-worth, confidence, and overall quality of life.
“Let me proofread that again…and again…and again.”
It’s not uncommon to hear someone say, “I’m just a perfectionist.” However, with ADHD, perfectionism can develop as an
initial coping strategy to catch missed details, avoid mistakes, and prevent negative feedback. Over time, the need to be “perfect” can become an impairment, sometimes requiring extra time to complete tasks, try around potential mistakes, and, in some cases, excessive anxiety, “analysis paralysis” that prevents someone from starting anything at all. CBT helps challenge the thought patterns behind these behaviors and often includes gentle exposure work to build tolerance for mistakes and uncertainty.
Given the overlap between ADHD and anxiety, it is not surprising that CBT provides help for both diagnoses. We want to help with both.
Take the First Step Toward ADHD Therapy in Columbus, OH
If you’ve been researching online ADHD therapy in Cleveland, OH, you likely want a clear, professional explanation of how to manage life with ADHD. Virtual ADHD therapy allows you to get expert insight and personalized therapy without the stress of in-person appointments.
Our ADHD therapy and assessment practice offers online evaluations guided by licensed clinicians who specialize in adult ADHD. We focus on making the process transparent, supportive, and easy to follow, so you know exactly what to expect at every stage.
Here’s how to get started:
- Submit our contact form to request ADHD Counseling. A member of our intake team will reach out to schedule a complimentary 15-minute.
- Meet in person (or virtually) with an ADHD therapist in Columbus, Ohio, who will walk you through the assessment, discuss your concerns, and gather the necessary clinical information.
- Receive professional feedback and next-step guidance, helping you understand whether ADHD may be affecting your life and what support options are available.
With the right assessment, clarity replaces uncertainty—and meaningful change can begin.
Other Counseling Services at Focused Mind ADHD Counseling in Columbus, Ohio
Besides ADHD counseling, Focused Mind offers comprehensive mental health services for adults with ADHD. These include ADHD testing, anxiety treatment for ADHD, depression counseling for ADHD, ADHD-informed couples therapy, therapy for men with ADHD, and therapy for women with ADHD.
We also provide an ADHD and women’s skill and support group. For continued learning, our blog offers therapist-written resources to help you better understand ADHD and its impact on daily life.
About the Author
Gina McDowell, LPCC-S, ADHD therapist and Director of Community Engagement at Focused Mind ADHD Counseling. Gina has over a decade of experience with people with ADHD and their families. She has created entire therapy curricula implemented across statewide mental health care systems. Read her full bio.
