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Can anxiety symptoms mimic those of ADHD in children? 

Posted
Updated
ByMy Patient Advice
Author: Avery Lombardi, MSc | Reviewed by: Dr. Rebecca Fernandez, MBBS

Childhood anxiety and ADHD symptoms are common in comparison when looking for a differential diagnosis. The symptoms of anxiety can often resemble those of ADHD, especially when it comes to difficulty concentrating, restlessness, and irritability. Understanding how these symptoms overlap is crucial for clinicians to accurately diagnose and treat the child. 

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Anxiety and ADHD Symptom Overlap 

Both childhood anxiety and ADHD can lead to issues with attention, focus, and impulse control, making it challenging to distinguish between the two. However, the root causes of these symptoms differ, which can help guide the diagnostic process. 

Anxiety Symptoms Mimicking ADHD 

Children with anxiety often experience heightened worry, fear, and stress, which can manifest in physical symptoms like restlessness, fidgeting, and difficulty concentrating. The fear and nervousness that come with anxiety can cause children to appear distracted or unable to focus on tasks, which can mimic the inattention seen in ADHD. Anxiety-induced avoidance behaviors, such as avoiding certain activities due to fear or discomfort, can further make it hard to differentiate from ADHD symptoms. 

ADHD Symptoms in Children 

ADHD is primarily marked by inattention, impulsivity, and hyperactivity that are not driven by fear or worry. Children with ADHD may struggle to focus due to external distractions or an inability to regulate their attention, often jumping from task to task without completing them. Unlike anxiety, ADHD symptoms do not typically involve excessive worry, but rather a general difficulty with concentration and self-control. 

Pediatric Differential Diagnosis 

The pediatric differential diagnosis process involves thorough assessments, including clinical interviews, behavioural questionnaires, and gathering input from multiple sources, such as parents and teachers. By comparing the nature of symptoms, clinicians can determine whether anxiety or ADHD is the primary condition, or if both might be present. 

In conclusion, childhood anxiety vs ADHD can be difficult to distinguish due to symptom overlap. However, understanding the underlying causes of the symptoms whether they stem from worry in anxiety or impulsivity in ADHD can help clinicians provide an accurate diagnosis and appropriate treatment plan. 

Visit providers like ADHD Certify for personal consultations and expert guidance tailored to your unique situation. 

For a deeper dive into the science, diagnosis, and full treatment landscape, read our complete guide to Differential Diagnosis of ADHD. 

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Avery Lombardi, MSc
Author

Avery Lombardi is a clinical psychologist with a Master’s in Clinical Psychology and a Bachelor’s in Psychology. She has professional experience in psychological assessment, evidence-based therapy, and research, working with both child and adult populations. Avery has provided clinical services in hospital, educational, and community settings, delivering interventions such as CBT, DBT, and tailored treatment plans for conditions including anxiety, depression, and developmental disorders. She has also contributed to research on self-stigma, self-esteem, and medication adherence in psychotic patients, and has created educational content on ADHD, treatment options, and daily coping strategies.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the author's privacy. 

Dr. Rebecca Fernandez, MBBS
Reviewer

Dr. Rebecca Fernandez is a UK-trained physician with an MBBS and experience in general surgery, cardiology, internal medicine, gynecology, intensive care, and emergency medicine. She has managed critically ill patients, stabilised acute trauma cases, and provided comprehensive inpatient and outpatient care. In psychiatry, Dr. Fernandez has worked with psychotic, mood, anxiety, and substance use disorders, applying evidence-based approaches such as CBT, ACT, and mindfulness-based therapies. Her skills span patient assessment, treatment planning, and the integration of digital health solutions to support mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the reviewer's privacy. 

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