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How Does Comorbid Anxiety Affect Peer Relationships in Children with ADHD? 

Anxiety impact on peer relationships in ADHD is an important consideration when supporting children who face both conditions. ADHD can cause challenges with attention, impulsivity, and following social cues, while anxiety can bring excessive worry, fear of judgement, and avoidance behaviours. When these conditions occur together, they can significantly affect a child’s ability to form and maintain healthy friendships. 

Children with both ADHD and anxiety may struggle socially because their symptoms can influence how they communicate, respond to peers, and regulate their emotions. This can lead to difficulties in building trust, sustaining conversations, and participating in group activities. 

How ADHD and Anxiety Affect Social Skills and Friendships 

Here are some of the key ways anxiety impact on peer relationships in ADHD can be seen in daily life: 

Difficulty Reading Social Cues  

ADHD can make it challenging for children to pick up on non-verbal signals like tone of voice or body language. When anxiety is present, they may misinterpret these cues negatively, assuming others are upset or disapproving, which can lead to withdrawal. 

Fear of Rejection  

Children with anxiety may become overly focused on being accepted by their peers. Combined with ADHD-related impulsivity or forgetfulness, this fear can cause them to overcompensate, avoid social situations, or become overly dependent on certain friendships. 

Struggles with Emotional Regulation  

Both conditions can make it harder to manage emotions. Outbursts, mood swings, or shutting down emotionally can affect how peers perceive and respond to them, potentially leading to social isolation. 

Challenges in Group Settings  

Classroom activities, team sports, or playground games can be overwhelming due to distractions from ADHD and performance anxiety. This can cause avoidance or inconsistent participation, affecting relationship-building opportunities. 

Conclusion 

Anxiety impact on peer relationships in ADHD can limit a child’s ability to connect with others and maintain friendships. With targeted support in social skills training, emotional regulation strategies, and confidence-building activities, children can improve their peer interactions. 

For tailored guidance on helping children with ADHD and anxiety develop better friendships, visit ADHD Certify. For more on emotional regulation and social skills, read our complete guide to Anxiety disorders.

Dr. Rebecca Fernandez, MBBS, author and a reviewer for my patient advice - mypatientadvice.co.uk

Dr. Rebecca Fernandez, MBBS

Author

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 author's privacy.