ADHD vs. Anxiety: What’s The Difference?

When it comes to ADHD vs. anxiety, it can be difficult to distinguish between them. Both disorders have unique characteristics, but they also share some significant symptoms that can make diagnosis a challenge.

Anxiety symptoms that lead to poor concentration can be misdiagnosed as ADHD. [i] [ii]

Diagnosis can be made even more difficult due to anxiety being ADHD’s most common comorbidity. When the disorders occur together, sometimes only one diagnosis is made to account for all symptoms, and the other disorder is missed entirely. [iii]

For four decades, the Drake Institute has used advanced treatment technologies to diagnose and create customized treatment protocols for patients with ADHD and anxiety disorders. We use a unique combination of brain map-guided neurofeedback and neurostimulation to help our patients reduce symptoms and improve their lives.

For more information about how the Drake Institute treats anxiety, ADHD, and other brain-based conditions, please fill out the consultation form or call us at 800-700-4233.

What is ADHD?

ADHD is a neurodevelopmental disorder that impacts an individual’s daily life. It occurs due to atypical brain development that leads to difficulties with focus, attention, and in some patients, controlling impulsive behaviors.

While it might appear that individuals with ADHD aren’t “trying hard enough” to maintain focus or sit still, it’s important to remember that these difficulties arise from brain dysregulation. In other words, they simply don’t have the stable neurophysiologic mechanisms functioning necessary for self-regulation.

ADHD is likely caused by a combination of genetic and environmental factors. Like other brain-based conditions, ADHD cannot be diagnosed with a blood test or laboratory test. It is diagnosed by a comprehensive history and evaluation, looking at symptoms over extended periods of time. In addition, the Drake Institute analyzes the patient’s brain functioning through qEEG brain mapping that identifies where the brain dysregulation is occurring that is linked to symptoms. We use the results of qEEG brain mapping and clinical assessment to develop a customized treatment program using qEEG-guided neurofeedback and neurostimulation. [iv]

ADHD Symptoms

ADHD is a neurophysiologic disorder that leads to diminished cognitive functioning. According to DSM-V, there are 4 subtypes of ADHD, including:

ADHD (Inattentive presentation):

  • Inattention
  • Easily Distracted
  • Lack of sustained focus on non-preferred tasks
  • Difficulty finishing tasks such as homework without supervision
  • Poor short-term memory (i.e. difficulty following a series of instructions)
  • Often forgetful such as forgetting homework or turning it in
  • Poor listening skills

ADHD (Hyperactive-impulsive presentation):

  • Impulsive (acting without thinking of the consequences, blurting out answers, interrupting, experiencing difficulty waiting one's turn)
  • Hyperactive (fidgety and/or difficulty sitting still)

ADHD (Combined presentation):

  • Inattentive symptoms along with hyperactivity/impulsivity

ADHD: (Unspecified ADHD):

  • Significant clinical impairment but does not meet full criteria of ADHD symptom

What is Anxiety?

Anxiety is a common and natural response to stressful situations, such as work deadlines, relationship conflicts, and other day-to-day living pressures. It is characterized by feelings of nervousness, fear, restlessness, worry, rapid breathing, body tension, and more.

Although anxiety is something most people experience, it can become a disorder when it’s severe, out of proportion to the situation, and/or becomes chronic.

Of the different types of anxiety disorders, Generalized Anxiety Disorder is the most common, and according to the DSM-V, is described as “excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of activities (such as work or school performance”. [v]

In some cases, ADHD is misdiagnosed as anxiety, which is why understanding the link between ADHD and anxiety is crucial to ensuring proper diagnosis and treatment.

Anxiety Symptoms

Anxiety can cause a whole host of debilitating physical and psychological symptoms, some of which are listed below:

  • Digestive dysfunction
  • Easily fatigued
  • Restlessness
  • Muscle tension in the neck and shoulders
  • Somatic symptoms (sweating, nausea, diarrhea)
  • Frequent urination
  • Bruxism (teeth grinding or clenching)
  • Headaches
  • Cold or sweaty hands
  • Palpitations (heart pounding)
  • Trembling
  • Clinging Behavior
  • Fear of separation from parents
  • Refusal to go to school
  • Difficulty concentrating
  • Temper Tantrums
  • Avoidance of social situations
  • Nightmares
  • Irritability
  • Feeling on edge
  • Racing thoughts

In addition to these symptoms of anxiety, a previous study from Harvard Medical School (Internal Medical News, May 1, 2016), found an association in adults between an over-activated amygdala (limbic system) and an increased risk of cardiovascular events like a heart attack or a myocardial infarction. [vi]

The amygdala is part of the limbic system, and the emotionally reactive part of the brain, strongly associated with fear. Its over-reactivity triggers the fight or flight response.

Studies have shown that a dysregulated amygdala can negatively impact the brain’s ability to moderate the fear response system, leaving the individual in an increased state of “fight or flight”. They can be in an abnormal state of heightened psychophysiological arousal that sustains their anxiety. [vii]

How do ADHD & anxiety compare?

The difference between ADHD and anxiety causing inattention ultimately comes down to whether the individual is not focused because of fearful, apprehensive thoughts or is not focused because of being easily distracted even though their mind is calm.

In sum, children with generalized anxiety disorders will have poor focus because their minds are dominated by anxious, worrisome thoughts. Their anxiety can permeate all academic assignments.

In contrast, an inattentive ADHD child’s mind can be quiet but easily distracted, which results in their inattention. The ADHD child is unable to inhibit focusing on distracting or irrelevant stimuli. They may only show anxiety sometimes about a specific academic task or challenge.

A thorough clinical history is important in helping differentiate the cause of the inattention and evaluating if it may be primarily an anxiety disorder. QEEG brain mapping can further differentiate if regions or networks of the brain involved with attention or anxiety are dysregulated.

Can anxiety & ADHD occur together?

ADHD and anxiety often coexist, leading to unique challenges.

Children or adults with ADHD may be at a higher risk of developing anxiety disorders due to the constant challenges they face, such as difficulty focusing, impulsivity, and academic or workplace struggles, which can trigger feelings of anxiety.

For example, a child with ADHD might have trouble focusing on and completing their schoolwork, and then become overly anxious about their incomplete homework and the repercussions they’ll face.

Individuals with anxiety disorders may also exhibit some of the symptoms associated with ADHD, such as restlessness, difficulty concentrating, and impulsivity. Anxiety also can interfere with one's ability to focus and complete tasks.

In such cases, it's essential to consider the possibility of comorbidity (ADHD and anxiety running together) and to address both disorders if present. [viii] [ix]

ADHD vs. anxiety in kids

Differentiating between ADHD and anxiety in children can be challenging, as the symptoms of these conditions can look similar.

When it might be ADHD

ADHD is often characterized by symptoms such as inattention and in some children, hyperactivity, and impulsivity. Children with ADHD may struggle to focus on non-preferred tasks, even if they are not anxious. They may also be forgetful and frequently interrupt others during conversations. [x]

When it might be anxiety

Anxiety symptoms in children often include excessive worry, fear, and avoidance of certain situations. Children with anxiety may experience physical symptoms like restlessness, muscle tensions, and trouble sleeping. They may be generally apprehensive, have a fear of specific situations or objects, and may express their fears repeatedly. [xi]

So, is it ADHD or anxiety that your child is experiencing?

The following questions may help you determine if your child’s symptoms are related to ADHD, anxiety, or both.

  • Is your child a worrier? Ask your child if he/she has worries that will not go away regardless of what they do. Ask your child if worries make it hard for him/her to do things they want to do.
  • Is your child shy?
  • Ask your child if there are things that make them very scared when they think about them.
  • Is your child anxious about going to school or do they even feel homesick at school?
  • Does your child become anxious or irritated when they leave the house?
  • Is there a family history of anxiety?
  • Does either parent suffer from anxiety?

ADHD vs. anxiety in adults

The coexistence of ADHD and anxiety in adults is not uncommon, and individuals may experience symptoms of both conditions simultaneously. According to ADDA, “research shows that up to 80% of adults diagnosed with ADHD have at least one other disorder affecting their mental health, including mood and anxiety disorders”. [xii]

To differentiate between ADHD and anxiety, it’s necessary to understand the context in which inattention and anxiety occur. At the Drake Institute, we also use qEEG brain mapping to improve the specificity of the diagnosis and treatment plan. It can be complicated because sometimes the same area of the brain can be dysregulated in both anxiety and inattention, but improving the functioning of that area can help both symptoms.

When it might be ADHD

Adults with ADHD often struggle with focusing on tasks, leading to difficulties at work, in school, and in personal relationships. They may frequently forget important dates or instructions and not meet deadlines, which can result in unfinished projects. Due to weakness in executive functioning, the organization and prioritization of tasks become challenging for those with ADHD, as they may become easily overwhelmed when managing multiple responsibilities. Restlessness and fidgeting may occur, with individuals having a hard time sitting still, which further affects their ability to complete tasks that require extended concentration.

In conversations, ADHD can lead to frequent interruptions, impulsive remarks, and difficulty staying on topic. Impulsivity, both in speech and actions, may lead to decisions that haven't been fully thought through. Emotional dysregulation can cause mood swings, irritability, and difficulty maintaining stable emotional states.

When it might be anxiety

Anxiety disorders can profoundly impact daily life by causing a constant state of worry and fear. Difficulty focusing can certainly be a symptom of anxiety, and individuals may struggle to concentrate on tasks, with their minds often consumed by anxious thoughts. Problems with sleep, such as difficulty falling asleep or staying asleep, can lead to sleep deprivation, fatigue, and decreased productivity during the day. Anxious individuals may experience excessive fear, worry, and stress, which can result in physical symptoms like increased heart rate, tension in neck and shoulder muscles, headaches, chest tightness, sweating, and rapid breathing.

Irritability is another common consequence of anxiety, making it challenging to maintain stable and harmonious relationships with family and friends. Avoidance behaviors are typical in those with anxiety, as they may try to evade situations or environments that trigger their fears. These behaviors can hinder social and professional life.

How are ADHD & anxiety diagnosed?

Diagnosing ADHD and anxiety requires a comprehensive assessment. It typically involves a combination of clinical interviews, medical history, and observations. The Drake Institute also includes qEEG brain mapping to identify dysregulated brain regions that are linked to ADHD and anxiety. This is important for not only diagnosis but also for optimal treatment.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lays out criteria to ensure correct diagnosis for ADHD and anxiety. If the criteria are met for either condition, a diagnosis will be given. Here is how each of them are diagnosed according to best practices.


ADHD diagnosis involves an evaluation of the individual's symptoms and their impact on daily life. The process may include gathering information from multiple sources, such as parents, teachers, and the individual themselves. Clinicians look for symptoms such as inattention, hyperactivity, and impulsivity, considering the duration and severity.[xiii]


Diagnosing anxiety entails a careful evaluation of the individual's emotional and physical symptoms. Clinicians interview to assess the duration and severity of anxiety symptoms and how they impact the patient’s life. They consider the specific type of anxiety disorder and any potential triggers. In addition to the clinical assessment, standardized self-report questionnaires may be used.[xiv]

Anxiety disorders, including Generalized Anxiety Disorder (GAD), Social Anxiety Disorder, Panic Disorder, and others, each have their specific diagnostic criteria. Generally, an anxiety disorder diagnosis requires: [xv]

  • Excessive anxiety or worry about a range of events or activities that lasts for at least six months (in the case of GAD).
  • The anxiety or worry is associated with specific symptoms such as restlessness, fatigue, difficulty concentrating, muscle tension, and sleep disturbances.
  • The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
  • The symptoms are not better explained by another mental disorder, medical condition, or substance use.

How the Drake Institute treats ADHD & anxiety

Over the last 40 years, the Drake Institute has clinically pioneered the use of advanced treatment technologies to treat a variety of brain-based medical disorders such as ADHD, Autism Spectrum Disorder, PTSD, anxiety, panic disorder, depression, insomnia, and more. Using a combination of brain map-guided neurofeedback and sometimes neurostimulation, our Medical Director creates customized treatment protocols to address each patient's needs.

Brain Mapping

To develop our individualized treatment plans, we first complete a qEEG brain map analysis for each patient. Brain mapping helps us identify which specific regions or networks of the brain are dysregulated linked to symptoms.

To collect this data, 19 sensors are placed around the scalp in areas of the brain responsible for language, focus, memory, executive functioning, social/emotional understanding and behavioral/emotional regulation. The 19 sensors measure and record brainwave activity that is processed through a normative database of neurotypical individuals.

When we compare the patient's results with those of neurotypical individuals, we can identify regions or networks of the brain that are dysregulated and causing symptoms. This information also allows us to determine how these areas are dysregulated so that we can develop specific treatment protocols that help improve brain functioning and reduce symptoms.


During neurofeedback training/treatment, sensors are once again placed on the scalp. The sensors record and display instantaneous brainwave activity visually in real time on a computer screen with simultaneous auditory feedback as well.

During neurofeedback sessions, the patient sees the results of how their brain is working. With this information, they learn to improve their brainwave activity by guiding it toward healthier, more appropriately functional brainwave patterns.

We do not administer any drugs or perform invasive procedures during this process. Instead, the patient is improving their own brain functioning, guided by visual and auditory feedback.


As an adjunct to neurofeedback, we may also use neurostimulation guided by qEEG brain map findings to gently stimulate the brain into healthier functional patterns. In our experience, some patients may benefit even more from neurofeedback if we also use neurostimulation. We have found this particularly helpful for lower-functioning children on the Autism Spectrum.

Contact The Drake Institute Today!

In the last forty years, Drake has helped thousands of patients with various disorders such as autism, ADHD, PTSD, anxiety, panic disorder, depression, insomnia, migraine headaches, irritable bowel syndrome, and hypertension reduce or resolve their symptoms and thereby achieve a better quality of life. Call us at 1-800-700-4233 or fill out the free consultation form to get started.

FAQs about ADHD & Anxiety

Understanding the difference between ADHD and anxiety can be a challenge. Below, we’ve gathered several common questions about these two conditions. Keep reading to learn more about ADHD vs anxiety.

How do ADHD symptoms differ in boys vs. girls?

ADHD symptoms can show up differently in boys and girls. Boys are more likely to display hyperactivity and impulsivity, in addition to inattention, while girls may be more likely to exhibit only inattentiveness. Girls are also more likely to mask their symptoms, which can lead to underdiagnosis.

Can children outgrow ADHD?

While some children may see a reduction in ADHD symptoms as they mature, it’s not common for children to completely outgrow it. However, the presentation and severity of symptoms can change over time, especially with hyperactivity lessening.

Is ADHD a genetic disorder?

Evidence suggests that ADHD is certainly influenced by genetics. However, further studies show that various environmental factors can influence it.

Is ADHD considered a learning disability?

No, ADHD is not considered a learning disability, but they can run together. However, it can present challenges that severely impact learning and academic performance. Children with ADHD may struggle to pay attention, stay organized, and complete tasks, which can lead to underachievement.

Can you have ADHD & autism?

Yes, it is possible to have both ADHD and autism, along with anxiety. These conditions often coexist.

How common is ADHD?

ADHD is one of the most common neurodevelopmental disorders around the world. It affects all genders, ages, and races.

What’s the difference between being nervous and being anxious?

Anxiety is a more continuous state of worry with psychophysiological symptoms. Nervousness tends to be more short-lived, and symptoms tend to be milder.

How do fear and anxiety compare?

Fear is a response to a perceived threat, while anxiety is a more general sense of worry or apprehension that may or may not be connected to a specific threat. Both fear and anxiety trigger the body's stress response, but their triggers and durations differ.

Can anxiety and depression occur together?

Anxiety and depression often co-occur, a condition known as comorbidity. According to WebMD[xvi], these two conditions share some symptoms such as restlessness and agitation, and can exacerbate each other.

Are stress & anxiety the same thing?

Stress and anxiety are related, but different emotional responses. According to the APA[xvii], stress is typically a reaction caused by an external trigger, while anxiety is “defined by persistent, excessive worries that don’t go away even in the absence of a stressor.” They can share identical symptoms, and chronic stress can lead to an anxiety disorder.

How do panic attacks compare to anxiety attacks?

Panic attacks and anxiety attacks share some similarities, but they have distinctive features. According to the Cleveland Clinic[xviii], panic attacks often come suddenly and unexpectedly, while anxiety attacks may build up gradually. Anxiety attacks are also typically less intense and last longer than panic attacks, with similar symptoms.

Are there different types of anxiety disorders?

Yes, there are various types of anxiety disorders, including Generalized Anxiety Disorder (GAD), Social Anxiety Disorder, Panic Disorder, and more. Each type has its own set of symptoms and characteristics. The Drake Institute, along with clinical history and symptoms, conducts a qEEG brain map and stress biofeedback testing for optimal treatment.




















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dr david velkoff headshot

“David F. Velkoff, M.D., our Medical Director and co-founder, supervises all evaluation procedures and treatment programs. He is recognized as a physician pioneer in using biofeedback, qEEG brain mapping, neurofeedback, and neuromodulation in the treatment of ADHD, Autism Spectrum Disorders, and stress related illnesses including anxiety, depression, insomnia, and high blood pressure. Dr. David Velkoff earned his Master’s degree in Psychology from the California State University at Los Angeles in 1975, and his Doctor of Medicine degree from Emory University School of Medicine in Atlanta in 1976. This was followed by Dr. Velkoff completing his internship in Obstetrics and Gynecology with an elective in Neurology at the University of California Medical Center in Irvine. He then shifted his specialty to Neurophysical Medicine and received his initial training in biofeedback/neurofeedback in Neurophysical Medicine from the leading doctors in the world in biofeedback at the renown Menninger Clinic in Topeka, Kansas. In 1980, he co-founded the Drake Institute of Neurophysical Medicine. Seeking to better understand the link between illness and the mind, Dr. Velkoff served as the clinical director of an international research study on psychoneuroimmunology with the UCLA School of Medicine, Department of Microbiology and Immunology, and the Pasteur Institute in Paris. This was a follow-up study to an earlier clinical collaborative effort with UCLA School of Medicine demonstrating how the Drake Institute's stress treatment resulted in improved immune functioning of natural killer cell activity. Dr. Velkoff served as one of the founding associate editors of the scientific publication, Journal of Neurotherapy. He has been an invited guest lecturer at Los Angeles Children's Hospital, UCLA, Cedars Sinai Medical Center-Thalians Mental Health Center, St. John's Hospital in Santa Monica, California, and CHADD. He has been a medical consultant in Neurophysical Medicine to CNN, National Geographic Channel, Discovery Channel, Univision, and PBS.”

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