Attention deficit hyperactivity disorder (ADHD) and generalized anxiety disorder (GAD) are two common mental health conditions that frequently co-occur and may be misdiagnosed due to their shared symptoms. While both disorders share similar symptoms, such as restlessness, difficulty concentrating, and irritability, it is important to distinguish ADHD from GAD to ensure accurate diagnosis and effective treatment.
Understanding Comorbid Anxiety and ADHD
It is common for individuals to have both ADHD and GAD, which can create a more complex clinical picture. Symptoms of ADHD include inattention, hyperactivity, and impulsivity, which can lead to difficulties managing emotions, managing behavior, and completing tasks, which can contribute to anxiety symptoms.
A person with ADHD may feel overwhelmed and restless due to difficulty focusing. Impulsivity in ADHD can lead to risky behavior, which can increase anxiety levels. Additionally, ADHD-associated hyperactivity can hinder emotional regulation, and exacerbate anxiety symptoms.
Differences between ADHD and GAD
Despite their symptoms overlap, ADHD and GAD are distinct disorders with unique diagnostic criteria and treatment approaches. Both disorders significantly impact daily functioning, but their differences are essential for accurate diagnosis and tailored treatment plans [2].
ADHD: A Closer Look
Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder primarily affecting children but persisting into adulthood [8,10]. Its hallmark features include inattention, hyperactivity, and impulsivity, significantly impeding daily functioning and interpersonal relationships [8].
ADHD symptoms encompass difficulty focusing, distractibility, forgetfulness, and disorganization. Hyperactivity and impulsivity manifest in physical symptoms such as fidgeting, restlessness, interrupting others, and impatience.
Diagnosis entails comprehensive evaluations by healthcare professionals, such as psychiatrists or psychologists. Treatment typically combines behavioral therapies, counseling, and, in some cases, medication or alternative treatments such as transcranial magnetic stimulation (TMS) therapy, to manage ADHD symptoms and enhance daily functioning. ADHD’s severity varies, and early intervention and ongoing support can significantly improve quality of life.
General Anxiety Disorder (GAD)
GAD is a common mental health condition characterized by excessive worry or anxiety about various aspects of daily life, such as finances, health, relationships, and future events [9].
Individuals with GAD struggle to control their worry, often accompanied by physical anxiety symptoms like restlessness, muscle tension, irritability, and difficulty concentrating [9]. GAD significantly affects a person’s quality of life, relationships, and overall well-being, necessitating therapy and, in some cases, medication for effective management [9].
Similarities between ADHD and GAD
Though ADHD and anxiety symptoms like restlessness and trouble concentrating are common in both conditions, they manifest differently in each disorder and are accompanied by other specific symptoms that help differentiate them [6]. For example, ADHD symptoms revolve around attention and hyperactivity, whereas GAD symptoms are more rooted in excessive worrying and fear [6].
Individuals with ADHD often experience heightened anxiety due to factors such as time blindness, impulsivity, and executive functioning challenges [7]. Approximately 70% of ADHD patients experience at least one additional co-occurring condition, with roughly 20% suffering from anxiety [1]. This high comorbidity rate between ADHD and anxiety disorders, including GAD, further contributes to the diagnostic complexity [2].
Commonalities and distinctions between ADHD and Anxiety
Commonalities:
- Both anxiety and ADHD can cause restlessness and difficulty concentrating [3].
- Individuals with ADHD are more likely to have anxiety disorders [3].
- Co-occurring ADHD and anxiety disorders, like GAD, often result in more severe anxiety symptoms, earlier onset, and increased comorbidity with other psychiatric diagnoses and substance use [5].
Distinctions:
- ADHD is a neurodevelopmental disorder characterized by inattention, impulsivity, and hyperactivity, while GAD is an anxiety disorder characterized by constant fear and uneasiness [4].
- ADHD may be underdiagnosed due to physician familiarity with mood and anxiety disorders, potentially leading to a delayed ADHD diagnosis in adults [5].
Challenges in Diagnosing ADHD and Anxiety
Diagnosing anxiety in individuals with ADHD can be challenging due to overlapping symptoms, including restlessness, distractibility, excessive worry, and sleep difficulties [3]. An accurate diagnosis often requires a comprehensive evaluation, incorporating checklists and scales [3].
Some individuals with ADHD and anxiety may not receive a formal anxiety disorder diagnosis due to symptom variations, potentially leading to underdiagnosis and inadequate treatment [3].
Challenges in Treating ADHD and Anxiety
Treatment for both anxiety and ADHD can be complex. Addressing one condition can sometimes worsen the other, posing treatment challenges [3]. Clinicians often recommend initially addressing ADHD with stimulant medications, followed by managing anxiety through behavioral therapies and additional medications [3]. Due to the absence of clear guidelines for treating coexisting ADHD and anxiety disorders in children, clinicians may combine treatment strategies [3].
Optimal treatment for anxiety often involves a combination of medication and cognitive-behavioral therapy (CBT), yielding better outcomes than monotherapy [3].
Additionally, given the high rate of self-medication with substances like alcohol and marijuana in individuals with untreated ADHD and anxiety, drug screening may be necessary, especially for those over 12 years old[3].
As opposed to medication, alternative treatments such as transcranial magnetic stimulation (TMS) therapy have proven to be very effective in the treatment of anxiety and ADHD. TMS therapy works by sending small electric currents to targeted areas of the brain which may be underactive or overactive in certain psychiatric disorders. When TMS is used to treat anxiety, patients in one study had improved brain activity in their dorsolateral prefrontal cortex which is associated with symptom improvement. TMS as an ADHD treatment also focuses on the dorsolateral prefrontal cortex and a recent study showed significant improvement in regard to attention, focus, and impulse control in adults with ADHD.
Get Started with Anxiety and ADHD Treatment Today
In conclusion, distinguishing between ADHD and anxiety is vital to ensure an accurate diagnosis and effective treatment. While these disorders share commonalities, such as restlessness and concentration difficulties, their unique features and diagnostic criteria set them apart. Individuals with ADHD are at higher risk of developing anxiety disorders, which can result in more severe symptoms and complex comorbidities. Seeking professional medical guidance is essential for obtaining a precise diagnosis and receiving appropriate treatment.
If you or someone you know is experiencing symptoms of ADHD or anxiety, please consider contacting Neuro Wellness Spa for a consultation. Our team of experts specializes in ADHD and anxiety treatment and can provide personalized treatment plans to improve quality of life, overall well-being, and find the right treatment for you.
References
1. (n.d.). ADHD and Coexisting Conditions. CHADD. https://chadd.org/about-adhd/adhd-and-co-occurring-conditions-infographic/
2. D’Agati, E., Curatolo, P., & Mazzone, L. (2019). Comorbidity between ADHD and anxiety disorders across the lifespan. International journal of psychiatry in clinical practice, 23(4), 238–244. https://doi.org/10.1080/13651501.2019.1628277
3. Dodson, W. (2021, July 2). Why Anxiety Disorder Is So Often Misdiagnosed. ADDITUDE. https://www.additudemag.com/anxiety-disorder-diagnosis/
4. Fuller-Thomson, E., Carrique, L., & MacNeil, A. (2022). Generalized anxiety disorder among adults with attention deficit hyperactivity disorder. Journal of affective disorders, 299, 707–714. https://doi.org/10.1016/j.jad.2021.10.020
5. Katzman, M. A., Bilkey, T. S., Chokka, P. R., Fallu, A., & Klassen, L. J. (2017). Adult ADHD and comorbid disorders: clinical implications of a dimensional approach. BMC psychiatry, 17(1), 302. https://doi.org/10.1186/s12888-017-1463-3
6. Keen, D., & Hadjikoumi, I. (2015). Attention deficit hyperactivity disorder in children and adolescents. BMJ Clinical Evidence, 2015, 0312.
7. Lopez, P. L., Torrente, F. M., Ciapponi, A., Lischinsky, A. G., Cetkovich-Bakmas, M., Rojas, J. I., Romano, M., & Manes, F. F. (2018). Cognitive-behavioural interventions for attention deficit hyperactivity disorder (ADHD) in adults. The Cochrane database of systematic reviews, 3(3), CD010840. https://doi.org/10.1002/14651858.CD010840.pub2
8. Magnus W, Nazir S, Anilkumar AC, et al. Attention Deficit Hyperactivity Disorder. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441838/
9. Munir, S., & Takov, V. (2022). Generalized Anxiety Disorder. In StatPearls. StatPearls Publishing.
10. Wolraich, M. L., Hagan, J. F., Jr, Allan, C., Chan, E., Davison, D., Earls, M., Evans, S. W., Flinn, S. K., Froehlich, T., Frost, J., Holbrook, J. R., Lehmann, C. U., Lessin, H. R., Okechukwu, K., Pierce, K. L., Winner, J. D., Zurhellen, W., & SUBCOMMITTEE ON CHILDREN AND ADOLESCENTS WITH ATTENTION-DEFICIT/HYPERACTIVE DISORDER (2019). Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. Pediatrics, 144(4), e20192528. https://doi.org/10.1542/peds.2019-2528
