Understanding the Complex Relationship Between ADHD and Anxiety in Children
Attention-deficit/hyperactivity disorder (ADHD) and anxiety are two of the most common mental health conditions affecting children today. Each comes with its own challenges, but what happens when a child has both? Research suggests that up to 50% of children with ADHD also meet criteria for an anxiety disorder. Understanding how ADHD and anxiety interact is essential for parents, educators, and mental health professionals to provide the best support to kids.
Distinguishing ADHD and Anxiety
ADHD is a neurodevelopmental disorder whose main signs are inattention, hyperactivity, and impulsivity. Kids with ADHD might struggle to sit still, complete tasks, follow directions, or stay organized.
On the other hand, anxiety disorders include conditions like generalized anxiety, panic disorder, and phobias. Their overarching symptoms include excessive worrying, nervousness, and irrational fears. Children with anxiety typically avoid certain activities, ask for constant reassurance, or show physical symptoms like stomachaches or headaches.
While ADHD and anxiety may look very different on the surface, they do have overlapping symptoms. For example, a child who has trouble focusing could be distracted by racing thoughts due to anxiety, or they could be inattentive because of ADHD. This makes it hard to determine exactly which condition is at play or whether a child has both.
How ADHD and Anxiety Interact
When ADHD and anxiety co-occur, they don’t just exist side by side—they interact in complex ways. One common pattern is that the symptoms of ADHD contribute to the development of anxiety. A child with ADHD might get in trouble at school due to missed assignments or impulsive outbursts. Over time, these repeated negative experiences can lead to feelings of inadequacy, worry, and fear of failure. They might even want to avoid school. These issues lay the groundwork for an anxiety disorder.
Anxiety can also mask ADHD symptoms or make them worse. A highly anxious child may appear hyper-focused in certain situations, such as during tests or in social settings. This isn’t because they’re managing their attention well, but because they are driven by the fear of making a mistake. On the other hand, their worries might lead to avoidance behaviors that look like inattention or procrastination.
Difficulties With Diagnosis
Because of how similar their symptoms can be, it’s easy for one condition to be overlooked. A child may be diagnosed with anxiety and not ADHD, especially if they are more inwardly anxious rather than outwardly hyperactive. Others may be diagnosed with ADHD and their anxiety may go unnoticed, particularly if their anxiety presents subtly. A thorough assessment should involve gathering information about their behavior from parents, teachers, and the child themselves.
Supporting Kids at Home and in School
Whether you’re a parent or educator, there are several ways to support a child struggling with these mental health issues:
Provide structure and predictability. Routines help reduce anxiety and encourage them to pay attention.
Focus on what the child does well to build confidence.
Encourage open communication by letting children know it’s okay to talk about their worries.
Collaborate with other adults in the child’s life. Teachers, counselors, and therapists can work together to create a consistent support system.
Does Your Child Have ADHD or Anxiety?
When a child has both ADHD and anxiety, their treatment should be tailored to their situation. Children typically thrive best with some combination of therapy, behavioral interventions, school support, and sometimes medication. Reach out to us today to discuss which therapeutic options are best for your child. Through child therapy, they’ll learn to challenge negative thought patterns, manage tasks, develop coping strategies for difficult emotions, and practice mindfulness. With the right support, your child can learn to thrive and manage their mental health.
