ADHD or Anxiety? Why Do Their Symptoms Sometimes Seem So Similar?

When a child cannot sit still, cannot focus, hates going to school, and is often easily distracted, it might seem to be ADHD. But these same symptoms can show up in children that are stressed and anxious.

That’s why the common question of whether it is ADHD or anxiety can be confusing to parents.

ADHD and anxiety are distinct disorders. However, at the same time, they share certain characteristics. They both can influence attention, school life, sleeping, mood, and behavior. Anxiety makes it hard to focus, while ADHD causes frustration and stress related to schooling, friends, and obligations.

What matters is that parents shouldn’t try to diagnose the problem on their own. An assessment will give an opportunity to understand the causes of the problems.

ADHD in Children: What Symptoms Does It Have?

ADHD may present itself through persistent inattentive, hyperactive, and impulsive behavior.

A child who has ADHD often:

• Loses things required for schooling;

• Has problems completing tasks;

• Is easily distracted;

• Finds it hard to stay organized;

• Interrups people and speaks without waiting for permission;

• Fidgets;

• Acts impulsively;

• Has problems obeying instructions.

But it doesn't mean that occasional distractibility or high energy means that the child has ADHD.

The National Institute of Mental Health states that symptoms of ADHD should persist and create significant impairments in everyday functioning. The symptoms should happen across multiple settings, for instance, at home and at school.

And that's a key point to keep in mind during a Comprehensive ADHD Evaluation.

What Could Be Signs of Anxiety?

Symptoms of anxiety in children are quite discreet.

Some children can voice their concerns and worries out loud. Others may claim they feel sick, complain about headaches, stomachaches, sleep problems, or feel scared of going to school.

A child with anxiety may:

• Feel excessive worry about school or friendship issues;

• Ask for reassurance;

• Be afraid of new situations;

• Be scared of making a mistake;

• Face sleep problems;

• Feel irritable and restless;

• Have problems concentrating;

• Avoid school or activities;

• Show signs of being unusually quiet and withdrawn.

The American Academy of Child & Adolescent Psychiatry says that sometimes anxious children may be quiet, well-behaved, or always agree to what they're told. It makes their anxiety easy to overlook.

That's why parents often wonder if the child has attention issues first.

Why Are ADHD and Anxiety So Similar?

Let's imagine a child sits in a classroom.

In case the child has ADHD, they will lose focus because their attention is hard to control. They may miss the instructions, be distracted by something that happens around, and switch from one activity to another.

The child with anxiety will also look distracted because his/her attention is focused on his/her fear.

• This child will think things like:

• "What if I make a mistake?"

• "What if people laugh at me?"

• "What if something happens to my parents?"

• From outside, both children may seem not to pay attention to anything.

The cause of such behavior may be very different.

According to NIMH, anxiety, stress, sleep disorders, depression, and other conditions may show similar symptoms of ADHD.

A child suffering from anxiety may:

• Show extreme worries about school or social life

• Seek frequent reassurance

• Avoid novel situations

• Feel afraid to make a mistake

• Experience trouble sleeping

• Become irritable and restless

• Have trouble focusing

• Refuse to attend school or other activities

• Be unusually silent or withdrawn

The American Academy of Child and Adolescent Psychiatry points out that anxious children may sometimes be quiet, compliant, and eager to please, so that their anxiety may go unnoticed.

This is one of the reasons why parents first think their child is suffering from some attention problems.

Why Do ADHD and Anxiety Often Have Common Symptoms?

Let us imagine a child in a classroom.

The child with ADHD may be losing concentration, as his attention is not easy to control. He may ignore instructions, get distracted by something going on around him, and switch tasks.

The child with anxiety may also look distracted – but it is anxiety that distracts his attention.

He may be having thoughts like:

• “What if I give the wrong answer?”

• “What if everybody makes fun of me?”

• “What if something happens to my parents?”

From the outside, the child's behavior looks similar in both cases. But the reasons for this behavior are quite different.

NIMH mentions in particular that anxiety, stress, sleep difficulties, depression, and many other diseases may present symptoms similar to ADHD.

However, ADHD and Anxiety May Be Coexisting Conditions

It does not have to be either or.

Sometimes a child is diagnosed with both ADHD and anxiety.

For instance, a child with ADHD can forget homework and find organization difficult. As a result of experiencing numerous issues in school, a child will start fearing trouble, let-downs of teachers, and even falling behind others.

In the same way, when a child has a serious problem with anxiety, it is possible to observe difficulty with concentrating since so much energy is focused on worrying.

According to current clinical recommendations regarding the diagnosis of ADHD, it is recommended to evaluate children who are suspected to have ADHD for any other conditions that co-exist or present like ADHD, such as anxiety disorders, depression, learning disabilities, language disorders, autism, sleep disorders and others.

That is the reason why it is essential to consider the whole child.

So How Can a Parent Figure It Out?

There is no magic checklist which would give an answer about the condition to the parents of a child with problems.

The following factors should be considered:

Where does it occur?

Is it difficult for the child to focus anywhere or mostly under stressful circumstances?

What seems to provoke this problem?

Does it increase around testing, social interactions, separation, or any other unusual activity

How long does it last?

Temporary reaction to stress will show itself differently than chronic issue.

Where does it occur?

It is helpful to have information from various sources to be able to make the bigger picture.

What does the child say?

Child's description of his problem is also essential clue.

Teachers and other care providers could be good sources of observations because they interact with the child in other environments.

When Should Parents Seek an ADHD Evaluation?

Consider consulting a professional about an evaluation if the symptoms of attention, impulsiveness, hyperactivity, or organization persist and start having an effect on academic performance, relationships, or functioning at home.

Comprehensive ADHD Evaluation can take into account not just some sporadic problems but also a whole list of factors that include developmental history, experience in school, behavior in different settings, as well as other reasons for the problems.

The CDC suggests using the information from parents or guardians, teachers, or other people working with the child during the ADHD evaluation process and use rating scales and other tools.

Such approach prevents from the assumption that any attention problems are related to ADHD.

When Should Parents Suspect That Anxiety Is the Problem?

If the child's problems are associated with fear, constant worries, avoidance, bodily complaints, perfectionism, or difficulties in certain situations, anxiety needs further consideration.

For instance, a child refusing to go to school because of his/her excessive worries requires different intervention than a child showing attention difficulties all day long.

According to AACAP, professional evaluation should be sought in case of anxiety that is severe enough to affect the ability of the child to function in daily activities including school attendance, maintaining friendships, or separation from parents.

Qualified Anxiety Psychologist NYC can help in determining whether anxiety contributes to the child's problems.

What Is Included in Comprehensive ADHD Evaluation?

Evaluation is not just about asking the child whether he or she has difficulties with attention.

Depending upon the needs of the child, a professional may conduct a review of:

• Developmental history

• Medical and psychological history

• School performance

• Home and school behaviors

• Attention/Executive Functioning

• Emotional issues

• Learning issues

• Sleep issues and other considerations

• Parent/Teacher observations

• Psychological testing and standardized rating scales

The aim is to get to know more about the child’s individual characteristics and determine what is causing the difficulties.

Sometimes this is very important, especially in cases of co-occurring ADHD and anxiety.

A Note for Parents in NYC

If your child is having difficulties in terms of attention, worrying, school performance, or regulating emotions, you do not need to decide whether the issue is ADHD or anxiety.

An evaluation could help figure out what causes the behaviors.

Dr. Andrew Lima sees children, adolescents, and families dealing with emotions, behaviors, development, and learning issues. His method is based on getting to know the child and considering various aspects influencing a child’s functioning at home, school, and socially.

If you are looking for Pediatric Psychologist NYC, a complete evaluation might be the starting point for figuring out how to help your child.

FAQ

Can a child's anxiety look like ADHD?

Absolutely. Anxiety may manifest in restlessness, difficulty concentrating, irritability, sleep difficulties, and avoidance. These behaviors may be mistaken for ADHD.

Can my child have both ADHD and anxiety?

Yes. Both ADHD and anxiety disorders co-occur. It's important to evaluate a child for both disorders because each of them could explain some symptoms.

How do I know if my child's attention problems stem from anxiety?

Be attentive to the patterns. If there is a clear link between attention problems and stressors or fear-producing situations, then anxiety could be part of the problem. On the other hand, attention problems can be persistent in various settings which is characteristic of ADHD.

What is a Comprehensive ADHD Evaluation?

Comprehensive ADHD assessment involves evaluating a child's attention and behavior in addition to their development, functioning at school, emotional issues, other medical diagnoses and input from those who know the child.

Do I have to go to an ADHD specialist or an anxiety psychologist first?

Depending on the child's symptoms, a consultation with either a pediatrician/psychiatrist or a clinical psychologist is necessary. When the parents suspect that the issue might have something to do with anxiety, ADHD, learning difficulties or something else, it could be a good idea to consult a child psychologist first.

Getting to the Bottom of the Reason for Behavior

When a child is having trouble paying attention, being restless, avoiding school or feeling overwhelmed – behavior is just one piece of the puzzle.

Often, a more helpful approach would be not just "Is it ADHD or anxiety?" but "What is making this difficult for my child?"

Such understanding helps parents make guesses unnecessary.

If the child's attention, anxiety, functioning at school or behavior interferes with everyday living, consider talking to a qualified professional to determine whether Comprehensive ADHD Evaluation or psychological assessment is needed.