What is the link between ADHD and anxiety?

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If you’re parenting a child with ADHD and you’ve found yourself thinking, “They seem anxious… but is that part of ADHD, or something else entirely?” — you’re very much not alone.

ADHD and anxiety are frequent travelling companions. They don’t always arrive together, but when they do, they can interact in ways that make daily life feel more complicated (and more exhausting) for children and parents alike. The reassuring news is that once we understand why they’re linked, things often start to make a lot more sense.

Let’s gently untangle what’s going on.

How common is anxiety in children with ADHD?

Anxiety is very common in children and young people with ADHD. Research suggests that around 25–40% of children with ADHD also meet criteria for an anxiety disorder — far higher than in the general population.

This doesn’t mean ADHD causes anxiety in every case, but it does mean that the two frequently overlap. In clinical work, it’s often less a question of “Is it ADHD or anxiety?” and more “How are these two influencing each other?”

You can find an overview of ADHD and associated mental health difficulties on the NHS website.

Why are ADHD and anxiety so closely linked?

1. ADHD brains are busy, fast, and easily overwhelmed

Children with ADHD often experience the world at full volume. Their brains are juggling attention, impulses, emotions, noise, expectations, and sensory input — all at once.

When a brain is working this hard, it’s not surprising that worry and anxiety can creep in, especially in busy or unpredictable environments like school.

​2. Executive function difficulties can create constant stress

ADHD is fundamentally a condition of misfiring executive function - the skills that help us plan, organise, remember, regulate emotions, and manage time.

When these skills are shaky, children may:

• Forget things despite trying hard

• Struggle to start or finish tasks

• Feel constantly “behind”

• Get into trouble they didn’t see coming

Over time, this can lead to a very understandable pattern: “I’m always getting things wrong — I’d better stay on high alert.” Anxiety often grows from this repeated experience of failure or unpredictability.

NICE provides clear guidance on ADHD and co-existing conditions here.

3. Social experiences can fuel anxiety

Many children with ADHD desperately want to do well socially but struggle with:

• Interrupting

• Missing social cues

• Reacting quickly and emotionally

• Feeling rejected more often than peers

Repeated social knock-backs can quietly and quickly erode confidence. Anxiety may develop as children become more cautious, self-conscious, or fearful of “getting it wrong again”.

Can anxiety sometimes look like ADHD (or vice versa)?

Yes — and this is where things can get confusing.

Anxious children may appear:

• Distractible

• Fidgety

• Restless

• Avoidant of tasks

• Emotionally reactive

Meanwhile, children with ADHD may appear anxious because they’re:

• Constantly anticipating problems

• Overthinking past mistakes

• Feeling overwhelmed by demands

This overlap is one reason why careful, holistic assessment is so important — particularly in neurodevelopmental clinics where we look at the whole child, not just a checklist.

The CDC offers a helpful overview of ADHD and co-existing conditions here.

How does anxiety affect ADHD day-to-day?

When anxiety and ADHD interact, you might notice:

• Increased emotional outbursts

• School refusal or avoidance

• Sleep difficulties

• Perfectionism masking ADHD traits

• “Meltdowns” after holding things together all day

Importantly, anxiety can reduce a child’s capacity to use their ADHD coping strategies. A child who can focus under calm conditions may struggle hugely when anxiety is high.

This isn’t lack of effort — it’s nervous system overload.

What helps children with both ADHD and anxiety?

While every child is different, support usually works best when it focuses on reducing pressure and increasing predictability, rather than simply trying to “fix” behaviours.

Helpful approaches often include:

• Clear routines and expectations

• Emotion coaching and validation

• Reducing shame around mistakes

• Supporting executive function rather than punishing it

• School strategies that lower cognitive load

• Helping children understand their own brains

The charity YoungMinds has an excellent, parent-friendly guide to childhood anxiety here.

A reassuring final thought for parents

If your child has ADHD and anxiety, it doesn’t mean things are “worse” — it means they need understanding, joined-up support.

When we recognise how ADHD and anxiety interact, we stop asking “Why can’t they just…?” and start asking “What’s making this hard right now?”

That shift alone can be profoundly calming — for children and parents alike.

​Book an assessment or discuss treatment.