Key takeaways
- ADHD and anxiety disorders commonly co-occur in adults, and each condition can make the other harder to manage.
- A proper evaluation is essential because ADHD and anxiety share overlapping symptoms, including restlessness, difficulty concentrating, and sleep problems.
- Adults with both conditions can be treated at the same time, using a combination of therapy, medication, and lifestyle strategies.
- Non-stimulant medications and behavioral therapy are effective options for adults who don’t want to use stimulants.
- Transcranial magnetic stimulation (TMS) is an emerging, non-medication option that may benefit adults with ADHD and co-occurring anxiety or depression.
ADHD and anxiety disorders frequently co-occur in adults, affecting up to half of people diagnosed with ADHD. When both are present, symptoms can feel more intense and harder to separate from each other. Both conditions can be treated at the same time using a combination of therapy, non-stimulant medication, and behavioral strategies. For adults who want to avoid stimulants, effective alternatives exist, including cognitive behavioral therapy, SNRIs, and non-stimulant ADHD medications.
If you’re an adult living with attention deficit-hyperactivity disorder (ADHD) and anxiety, you may have wondered which one is driving your restlessness, your racing thoughts, or your trouble sleeping. The truth is, it can be both, and treating them together is not only possible, it’s often the most effective approach.
How are ADHD and anxiety related in adults?
Research estimates that up to 50% of adults with ADHD also have an anxiety disorder. ADHD and anxiety disorders are distinct conditions, but they share a significant overlap in how they show up day to day. Both can cause difficulty concentrating, irritability, sleep disruption, and a general sense of being overwhelmed. This overlap is one reason the combination is so often misdiagnosed or missed entirely.
“ADHD and anxiety can look remarkably similar on the surface, which makes a thorough evaluation so important,” said Joshua Flatow, MD, medical director and chief psychiatrist at Pacific Mind Health. “When both are present, treating only one of them often leaves the other unaddressed, and patients continue to struggle without understanding why.”
The relationship between the two conditions runs deeper than shared symptoms. ADHD can directly contribute to anxiety. When someone with ADHD consistently struggles to meet deadlines, remember commitments, or stay organized, the accumulated stress and self-doubt can trigger or worsen anxiety over time.
According to a 2019 study published in the Journal of Attention Disorders, adults with ADHD who also had anxiety reported significantly lower quality of life than those with ADHD alone.
What does it mean to have both ADHD and anxiety?
Having both ADHD and an anxiety disorder is called a comorbidity, meaning two conditions present at the same time. This is common, not rare. According to the National Institute of Mental Health, anxiety disorders affect nearly 20% of U.S. adults in a given year, and among those with ADHD, that rate is considerably higher.
For adults with both conditions, the day-to-day experience can be especially draining. ADHD may make it hard to get started on tasks, while anxiety adds a layer of worry about what happens if you don’t. ADHD may cause forgetfulness, while anxiety amplifies guilt about it. The two conditions don’t just add together, they interact with each other in ways that can feel relentless.
This is why an accurate evaluation matters. Without it, treatment may target only the more visible symptoms, leaving the underlying picture incomplete.
Can ADHD and anxiety be treated at the same time?
Yes, ADHD and anxiety can and often should be treated simultaneously. The right approach depends on which symptoms are more disabling, what treatments the person has already tried, and individual factors like health history and medication sensitivity.
Treatment typically involves a combination of approaches:
- Therapy. Cognitive behavioral therapy (CBT) is one of the most well-studied treatments for both ADHD and anxiety in adults. It helps with time management, emotional regulation, and restructuring the anxious thought patterns that often accompany ADHD. Research supports CBT as an effective intervention for adults with ADHD, including those with co-occurring anxiety.
- Medication. Some medications can address both conditions. Certain antidepressants, particularly SNRIs like venlafaxine, have evidence for reducing both ADHD symptoms and anxiety. A psychiatrist can help determine whether a single medication or a combination is appropriate based on a patient’s full clinical picture.
- Lifestyle and behavioral strategies. Regular physical activity, consistent sleep schedules, and mindfulness-based approaches have support in the research for both conditions. These aren’t replacements for clinical care, but they can meaningfully support treatment outcomes.
What ADHD treatment options exist for adults who don’t want stimulants?
Stimulant medications like amphetamines and methylphenidate are among the most studied treatments for ADHD, but they’re not the right fit for everyone. For adults who have anxiety, stimulants can sometimes worsen anxious symptoms, which is one reason non-stimulant options are often considered first when both conditions are present.
Non-stimulant options for ADHD include:
- Atomoxetine (Strattera). A non-stimulant medication approved specifically for ADHD that works on norepinephrine rather than dopamine. It tends to have a slower onset than stimulants but is less likely to worsen anxiety.
- Viloxazine (Qelbree). A newer non-stimulant option approved for adults with ADHD. It has shown effectiveness in clinical trials and may also have some benefit for mood symptoms.
- SNRIs. Medications like venlafaxine are used off-label for ADHD and may be especially useful when anxiety is also present, since they target both conditions through the same mechanism.
- Therapy-only approaches. Some adults, especially those with milder ADHD or strong concerns about medication, choose to pursue structured behavioral therapy without medication. CBT for adult ADHD focuses on building systems and routines to compensate for executive function challenges.
For adults exploring non-medication options, the University of Washington Department of Psychiatry notes that non-stimulant treatment can be effective for many patients, particularly when ADHD co-occurs with other conditions that may be sensitive to stimulant side effects
What role can TMS play in treating ADHD and anxiety?
Transcranial magnetic stimulation (TMS) is a non-invasive, FDA-cleared treatment that uses magnetic pulses to stimulate specific areas of the brain. It is best known as a treatment for depression, but it is also used off-label for ADHD and anxiety.
For adults dealing with both ADHD and anxiety, particularly those who haven’t responded well to medication, TMS offers a non-medication option that can be used alongside therapy. At Pacific Mind Health, TMS is used to treat a range of conditions including ADHD, anxiety, depression, and post-traumatic stress disorder (PTSD).
TMS does not involve anesthesia or recovery time, and patients can drive themselves to and from appointments. Sessions are available in standard (20–40 minutes), Express (3 minutes), and One-Day formats. It’s covered by most major insurance plans, though some may require pre-authorization.
Looking for ADHD services near you?
Pacific Mind Health treats a wide range of mental health conditions, including ADHD. We offer ADHD assessments, medication management, therapy, and interventional treatments like transcranial magnetic stimulation (TMS) and ketamine and Spravato (esketamine).
Located in Southern California and serving patients across the state, Pacific Mind Health was founded by Joshua Flatow, MD, a board-certified psychiatrist and published research author.
Ready to take the next step? Schedule a free consultation and start your mental health journey today.
Frequently asked questions
Can ADHD cause anxiety in adults?
ADHD doesn’t directly cause anxiety, but the two conditions are closely linked. The ongoing challenges of living with unmanaged ADHD (missed deadlines, forgetfulness, difficulty organizing) can create chronic stress that contributes to anxiety over time. Many adults with ADHD develop anxiety as a secondary effect. Treating ADHD effectively can sometimes reduce anxiety symptoms as well.
How do doctors tell ADHD and anxiety apart?
ADHD and anxiety share several overlapping symptoms, including trouble concentrating, restlessness, and sleep problems. A thorough psychiatric evaluation looks at when symptoms started, how they show up across different settings, and which symptoms came first. Standardized rating scales, clinical interviews, and sometimes neuropsychological testing help providers distinguish between the two and identify when both are present.
What is the best medication for adults with both ADHD and anxiety?
There’s no single “best” medication for both conditions, and the right choice depends on individual factors. SNRIs like venlafaxine have evidence for both ADHD and anxiety. Non-stimulant ADHD medications like atomoxetine are often preferred when anxiety is a concern, since stimulants can sometimes worsen anxious symptoms. A psychiatrist can evaluate your full clinical picture and recommend the most appropriate option.
What ADHD treatment options exist for adults who don’t want stimulant medication?
Adults who prefer to avoid stimulants have several options. Non-stimulant medications like atomoxetine (Strattera) and viloxazine (Qelbree) are approved for ADHD and generally less likely to affect anxiety. SNRIs may address both conditions. Cognitive behavioral therapy (CBT) tailored for adult ADHD is also effective and can be used with or without medication. TMS is another non-medication option being explored for ADHD and related conditions.
Is TMS effective for ADHD and anxiety?
TMS is FDA-cleared for depression and OCD, and used off-label for ADHD and anxiety. It works by delivering magnetic pulses to brain regions involved in attention, mood, and emotional regulation. For adults who haven’t responded well to medication or prefer a non-medication approach, TMS may be worth discussing with a psychiatrist as part of a broader treatment plan.
