ADHD and Anxiety in Teens: Understanding The Link

ADHD and Anxiety Disorders are two of the most common mental health challenges affecting teens. ADHD is a neurodevelopmental disorder that develops in childhood, primarily influenced by genetics and structural differences in the brain. Anxiety is influenced by a combination of factors, both genetics and external triggers, and can develop at any age. 

Some studies estimate that around 50% of teens with ADHD struggle with co-occurring anxiety, and many teens report that anxiety worsens symptoms of their ADHD, creating a distressing cycle that can be hard to break without professional intervention [1]. 

Effective treatment involves integrated care to address both the biological component of ADHD and help teens develop coping skills for anxiety relief. 

Overview of ADHD in Teens

Attention Deficit Hyperactivity Disorder (ADHD) is considered a neurodevelopmental disorder that typically occurs during early childhood. Regions of the brain that regulate emotions, attention, memory, and focus have differences in key structures influenced primarily by genetics. 

ADHD is characterized by inattention, hyperactivity, and impulsivity, and affects approximately 9% to 13.6% of teens [2]. 

Common ADHD symptoms include: 

• Inability to focus 
• Difficulty organizing tasks 
• Fidgeting or restlessness 
• Impulsivity, risk-taking behaviors, 
• Increased anxiety or depression  

Overview of Anxiety in Teens 

There are several kinds of anxiety disorders, and one of the most commonly co-occurring with ADHD is Generalized Anxiety Disorder (GAD). GAD is characterized by excessive, pervasive, and uncontrollable worry about many things.

It must occur more days than not for at least six months and impair daily functioning. Anxiety disorders are thought to affect nearly 30% to 32% of teens, and many teens with anxiety also struggle with co-occurring conditions such as ADHD, depression, or trauma [3]. 

Common symptoms of anxiety in teens include: 

• Worry, fear, or nervousness about everyday things 
• Physical symptoms such as muscle aches, nausea, dizziness, headaches, and migraines
• Irritability, restlessness, aggression
• Social withdrawal, isolation, reduced self-esteem 
• Intrusive thoughts, difficulty handling pressure or criticism, panic attacks   

How Common Is It To Have Co-Occurring ADHD and Anxiety?

ADHD and anxiety are common co-occurring conditions, with approximately half of individuals with ADHD also struggling with symptoms of anxiety. 

Below are a few stats to highlight the common co-occurrence of ADHD and anxiety [4]: 

• 31% of those with ADHD meet the criteria for Generalized Anxiety Disorder (GAD). 
• 27% of ADHD children struggled with more than one anxiety disorder (e.g, social anxiety, phobia, or GAD and OCD). 

ADHD and Anxiety: Overlap of Symptoms 

Sometimes, diagnosing anxiety or ADHD based purely on symptoms is not possible, as these conditions can often mimic each other, leading to a diagnosis being missed. Some of the most common overlapping symptoms of ADHD and anxiety include: 

• Inattention: Worrying makes it hard to focus, and trouble focusing is a key feature of ADHD. ‍
• Sleep Issues: Disrupted sleep is a common problem reported in those with anxiety. And approximately 35-50% of ADHD patients struggle with sleep disorders such as insomnia, narcolepsy, restless leg syndrome, and nightmares [5].  ‍
• Intrusive Thoughts: Racy, flighty thoughts are a common occurrence in teens with ADHD and generalized anxiety. ‍
• Gastrointestinal Issues: Stomachaches, nausea, and other digestive tract issues are common in kids with ADHD, especially if taking medication, and are a physical symptom of anxiety.  

Can ADHD Cause Anxiety?

Yes, ADHD can certainly increase the risk of developing an anxiety disorder. Especially if ADHD goes untreated, many adults (especially women) with ADHD are often misdiagnosed with anxiety or depression. ADHD can contribute to anxiety in several ways. 

ADHD symptoms such as impulsivity, focusing, and trouble staying organized or managing deadlines can increase anxiety and reduce self-esteem or self-worth. The emotional dysregulation component of ADHD can also make it harder for individuals to manage feelings such as fear, boredom, and frustration. People with ADHD tend to overthink or catastrophize situations, which can increase anxious thoughts and emotions [4]. 

Lastly, ADHD brains are naturally structured differently, and regions responsible for filtering information, regulating emotions, and processing stress are impacted. 

Can Anxiety Cause ADHD?

ADHD is considered a neurodevelopmental disorder, primarily influenced by genetics and neurobiology. So anxiety or other external factors can’t just “cause” ADHD. However, anxiety or just feeling under stress can greatly exacerbate ADHD symptoms.  

ADHD teens with anxiety tend to have more intense symptoms, an earlier age of onset of anxiety, and a higher risk of other co-occurring mental health diagnoses. 

Some of the symptoms that are especially exacerbated by co-occurring ADHD and anxiety include:

• Worry, tension, feeling on edge 
• Trouble falling asleep, staying asleep, or daytime fatigue 
• Greater impairment in working memory 
• One study found that anxiety can reduce symptoms of impulsivity in those with ADHD, but it makes symptoms like emotional regulation and impulse control worse.  

Treatment Options for ADHD and Anxiety

Treatment should focus on supporting executive functioning difficulties and reducing anxiety through a combination of medication management, individual therapy, group counseling, and family therapy. 

• Medications such as stimulants like Adderall, Ritalin, and Concerta are first-line treatments used for ADHD. Antidepressants and anti-anxiety meds can be used to reduce symptoms of GAD.‍
• Behavioral Therapies: Cognitive Behavioral Therapy, family-based therapy, Acceptance and Commitment Therapy, and parent coaching can help teens with ADHD and anxiety reframe negative thoughts and build positive coping skills to manage symptoms. 
• ‍School-Based Support: Individualized education plans, peer support, and executive functioning coaching can help academic and social functioning. 

Family-Centered Mental Health Treatment for Teens in Florida 

Lotus Behavioral Health is a residential treatment facility for teens located in Florida. Our structured inpatient and outpatient programs are designed to support teens and their families with the tools they need to recover from substance abuse and co-occurring mental health disorders.

Contact our admissions team today to connect your teen with the mental health support they deserve. 

Sources 

[1] Bishop, C. et al. 2019. An examination of the association between anxiety and social functioning in youth with ADHD: A systematic review. Science Direct. 

[2] Ghandour, R. (2024). ADHD Prevalence Among U.S. Children and Adolescents in 2022: Diagnosis, Severity, Co-Occurring Disorders, and Treatment. Journal of clinical child and adolescent psychology: the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53, 53(3), 343–360.

[3] National Institute of Mental Health. 2017. Any Anxiety Disorder.

[4] Neff, M. et al. 2021. ADHD vs. Anxiety: How They Overlap, Differ, and Co-Exist. Neurodivergent Insights. 

[5] Hvolby A. (2015). Associations of sleep disturbance with ADHD: implications for treatment. Attention deficit and hyperactivity disorders, 7(1), 1–18.