The Double Struggle of ADHD and Anxiety

It often begins with something small, like paying a bill. But on the way to your desk you remember there is a work email you meant to answer.  As you start logging in you notice the laundry is still in the dryer. On your way to take care of that a notification flashes on your phone and before you know it you're scrolling through social media. Thirty minutes later the bill is unpaid, the email is unwritten, the laundry hasn’t been put away, and you're left wondering how something so small can seem so challenging.  That’s when familiar self-critical and negative thoughts emerge, repeating messages such as “I’m always messing up” or “Why can’t I do what others seem to manage?” The tasks remain unfinished, and you’re left feeling anxious and inadequate.

As a psychologist who works closely with adults diagnosed with ADHD, I regularly encounter a frequent and under-discussed pattern: the connection between ADHD symptoms and chronic anxiety. Understanding this link can be transformative for individuals who constantly feel like they’re failing at daily responsibilities others seem to manage with ease.

Adult ADHD: More Than Lack of Attention

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition diagnosed in approximately 6 percent of adults in the United States. While the more classic childhood presentation focuses on hyperactivity or distractibility, adult ADHD often manifests more subtly, with disorganization, difficulty starting or completing tasks, and chronic time mismanagement challenges as the more obvious symptoms.  What is often overlooked is how emotionally draining these symptoms can be. The result is a perfect storm: executive dysfunction meets emotional burnout.

Where the Anxiety Loop First Begins

The symptoms of ADHD begin in childhood, even if they have been overlooked or went undiagnosed. During those early years many children with ADHD receive constant feedback that they are “too much,” “not enough,” or just “not trying hard enough.” Over time, this leads to internalized feelings of failure and persistent worry about underperforming. It makes sense that for many children with ADHD anxiety may not simply be a separate and co-occurring condition. Instead, it can be a learned response to years of feeling out of sync with the world around them.

How This Plays Out in Adulthood

Fast forward to adulthood and that anxious child is now an adult navigating professional and personal responsibilities with the same neurocognitive challenges and the same fears of falling short. When someone with ADHD faces an open-ended or multi-step task, they aren’t just tackling a practical problem; they’re confronting a well-worn emotional script The pressure to “do it right” triggers the same stress response that’s been experienced since childhood. Only now these hyper-critical thoughts have been practiced for years:  

• “You always screw things up.”

• “You are never good enough.”

• “Why do you even bother trying.”

It doesn’t matter that these thoughts may be far from accurate. After years of having them play on repeat they are accepted as facts. And they can make every ambiguous or complex task feel more like a threat than a challenge.

From Awareness to Action

Recognizing the link between ADHD and anxiety is a powerful first step toward healing. There are practical approaches that can help alleviate symptoms and support long-term management:

1. Normalize the struggle: Knowing that anxiety may be a conditioned response rather than a character flaw can reduce shame. It does not indicate laziness or lack of motivation. Instead, it reflects the burden of years of accumulated stress.

2. Break tasks into small, defined steps: Ambiguity is kryptonite for ADHD brains. Define the end goal, outline micro-steps, and remove decision fatigue wherever possible. Using checklists, timers, or visual planners can help anchor you in the task.

3. Treat both ADHD and anxiety: Treating both anxiety and ADHD simultaneously in therapy can be highly effective, as addressing the symptoms of one often supports improvement in the other. Cognitive-behavioral therapy (CBT) and mindfulness techniques can help individuals develop coping skills and improve focus and emotional regulation. In many cases, considering medication for ADHD is a helpful option as it can significantly improve attention, impulse control, and overall functioning.

4. Reframe the inner dialogue: Individuals with ADHD are likely to engage in self-critical thinking patterns, especially during task failure. Learning to catch and reframe these thoughts can shift your emotional response over time.

Moving Forward

If you’re someone who has struggled with symptoms of ADHD and anxiety you’re not alone. And you’re not broken. With the right tools and support you can learn to navigate challenges with more clarity, confidence, and a renewed belief in your own capabilities.