How do ADHD and anxiety commonly co-occur?

PostedNovember 19, 2025

UpdatedNovember 21, 2025

ByMy Patient Advice

Author: Harriet Winslow, BSc | Reviewed by: Dr. Rebecca Fernandez, MBBS

Attention deficit hyperactivity disorder (ADHD) and anxiety often appear together, affecting both children and adults in ways that can make diagnosis and treatment more complex. When anxiety occurs alongside ADHD, it can increase restlessness, sleep problems, and difficulty focusing, which may lead to a cycle of stress and frustration. According to NICE and NHS guidance, early identification of coexisting anxiety is important because it can influence how ADHD is managed and how well people respond to treatment. Understanding how these conditions overlap helps clinicians and families create more effective, balanced care plans.

Understanding the link between ADHD and anxiety

ADHD and anxiety frequently occur together in children and adults. According to recent NHS and international research, between 18% and 47% of people diagnosed with ADHD also experience an anxiety disorder, depending on factors such as age and clinical setting (NHS England, 2025; PubMed, 2025). This overlap can complicate diagnosis and influence how treatment is planned. NICE guidance (NICE NG87) highlights the need for a holistic approach, ensuring both ADHD and anxiety symptoms are recognised and treated together.

Prevalence of co-occurrence

Recent studies show that around one in five children and nearly half of adults with ADHD also experience an anxiety disorder (RCPsych, 2025). The NHS reports that anxiety, depression, and emotional difficulties are common among people with ADHD. When both conditions are present, individuals often report more severe symptoms, including restlessness and trouble concentrating, which can affect education, work, and relationships.

Shared mechanisms

Experts believe ADHD and anxiety share overlapping brain mechanisms that affect attention, emotional control, and impulse regulation. Both conditions involve changes in the prefrontal cortex and related neural pathways (EPUT NHS, 2025). Emotional dysregulation, difficulty managing stress, and increased sensitivity to negative feedback are common features. These shared biological and behavioural factors may help explain why treating one condition often improves the other.

Diagnosis and treatment considerations

NICE guidance recommends that clinicians assess for anxiety when diagnosing ADHD and avoid treating the two conditions separately. Psychological therapies such as cognitive behavioural therapy (CBT) are recommended by the NHS for managing both ADHD and anxiety (NHS UK). Medication options may include stimulants or atomoxetine for ADHD and selective serotonin reuptake inhibitors (SSRIs) for anxiety. Shared care between general practitioners, psychiatrists, and specialist services helps ensure safe and coordinated treatment.

Key takeaway

ADHD and anxiety often occur together and require integrated management rather than separate treatment plans. Recognising this overlap allows healthcare professionals to design more effective, person-centred care that supports attention, mood, and emotional wellbeing in line with current NICE and NHS standards.

Harriet Winslow, BSc

Author

Harriet Winslow is a clinical psychologist with a Bachelor’s in Clinical Psychology and extensive experience in behaviour therapy and developmental disorders. She has worked with children and adolescents with ADHD, autism spectrum disorder (ASD), learning disabilities, and behavioural challenges, providing individual and group therapy using evidence-based approaches such as CBT and DBT. Dr. Winslow has developed and implemented personalised treatment plans, conducted formal and informal assessments, and delivered crisis intervention for clients in need of urgent mental health care. Her expertise spans assessment, treatment planning, and behavioural intervention for both neurodevelopmental and mental health conditions.

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.