For years, I believed I was
just an anxious person.
Before my ADHD diagnosis, my label was anxiety. A generalized anxiety disorder, identified by a therapist at 22. I was prescribed Lexomil. I took it when things got too intense, when the knot in my stomach made it impossible to eat. It dulled the dread. But nothing changed underneath. The forgetting continued. The startup paralysis stayed. And the anxiety kept coming back, every time, because the causes had not moved.
Six years later, the ADHD diagnosis landed. And suddenly, half of my anxiety made sense. Not all of it. But a good half. The anxiety was not the cause. It was the consequence. The consequence of living for years with an unidentified condition that made me fail repeatedly without understanding why.
What was my anxiety like before the diagnosis?
Yes, ADHD and anxiety coexist very often. According to Kessler (2006), about 50% of adults with ADHD have a comorbid anxiety disorder. The two mask each other: ADHD produces failures that generate anxiety, and anxiety is often diagnosed first, which delays the discovery of the ADHD underneath.
I was afraid of forgetting everything. Not a vague fear. A concrete, daily fear, based on experience. Because I did forget. Appointments. Deadlines. Birthdays. Conversations. I forgot things that the people around me remembered effortlessly, and every forgotten thing cost me: a damaged relationship, a lost client, an offended friend.
So I built a permanent surveillance system. Check my calendar three times. Reread my messages at night to make sure I had not missed anything. Anticipate everything that could go wrong. Go to bed with a mental list of everything I must not forget tomorrow. It was anxiety, yes. But it was also the only strategy I had found to keep from sinking.
The problem is that the anxiety became its own problem. The surveillance system worked, partly, but it cost me decent sleep, a stable mental state, and the ability to relax. I was always on alert. Always checking something. Always convinced I had forgotten something, even when I had not.
How does ADHD manufacture anxiety?
Untreated ADHD is an anxiety-producing machine. Here is how it works, at least how it worked for me.
Anticipating failure. When you have accumulated enough failures caused by your forgetting, your lateness, your disorganization, you start anticipating the next one. Every new situation becomes an opportunity to mess up. You walk into a meeting wondering what you forgot to prepare. You take on a new project already thinking about the moment you will fall behind. Anticipatory anxiety is the brain trying to protect you from the consequences of your ADHD.
Overcompensation. To avoid failures, you overdo it. You arrive 45 minutes early for a 10am appointment and sit in your car staring at the ceiling. You prepare a presentation three times more than necessary because you are afraid of losing your thread. You say yes to everything to avoid disappointing anyone, and then panic because you cannot do it all. Always in maximum-effort mode. Never relaxed. It is exhausting and invisible.
Accumulated shame. Every social failure leaves a trace. The dinner where you forgot an ingredient. The time you showed up late to a job interview. Your mother's birthday that you missed. These memories pile up and feed a diffuse social anxiety. You end up dreading interactions because each one is a chance to show that you are not managing.
How does anxiety hide ADHD?
This is the trap I stayed in for six years. You go see a doctor. You describe your symptoms: you cannot focus, you are restless, you sleep badly, you are always tense. The doctor hears "anxiety." He prescribes something for anxiety. End of story.
The problem is that anxiety and ADHD share symptoms. Both cause concentration difficulties. Both cause restlessness. Both disrupt sleep. A doctor who does not think of ADHD will see anxiety. And he will not be wrong. He just will not have the full picture.
In my case, the anxiety diagnosis was correct. I did have an anxiety disorder. But it coexisted with an ADHD that nobody looked for because the anxiety was enough to explain the visible symptoms. Treating the anxiety alone was putting a bandage on half the problem. The other half kept bleeding.
Kessler, in his 2006 study on adult ADHD prevalence in the United States, found that nearly 50% of adults with ADHD had a comorbid anxiety disorder. One in two. That is not a rare coincidence. It is the norm. And yet, in clinical practice, ADHD is rarely looked for in a patient presenting with anxiety.
How do you tell ADHD and anxiety apart?
Here is how my psychiatrist helped me see the difference. This is not a diagnostic tool. It is what helped me understand what came from where in my own head.
The source of inattention. When ADHD is the cause, inattention comes from a lack of stimulation. The brain disconnects because what is in front of you is not interesting enough to hold it. When anxiety is the cause, inattention comes from overload. The brain is so busy worrying that it has no room to focus on anything else.
The response to stress. My psychiatrist asked me: "When you have a deadline in two hours, what happens?" Answer: I finally get to work and I am hyper-efficient. That is pure ADHD. The stress creates the stimulation the brain needs. A person with anxiety alone, facing the same deadline, would be paralyzed by panic.
The history. ADHD has been there forever. Since childhood. Even if nobody saw it. Anxiety can appear later, often as a consequence of untreated ADHD. In my case, concentration difficulties existed since first grade. The anxiety appeared around 18-19, when the social consequences had accumulated.
The effect of treatment. When you treat ADHD in someone who has both, the anxiety often decreases without specific treatment. Because part of the anxiety was reactive. When forgetting decreases, when concentration improves, when you fail less often, there is less reason to be anxious.
How do you treat both at once?
This is the question I asked my psychiatrist when the dual diagnosis came in. "Where do we start?" His answer: "We start with ADHD. Because if the anxiety is largely reactive to the ADHD, treating the ADHD will reduce it."
That is partly what happened. When I started managing my ADHD symptoms better, when the forgetting decreased, when my days became less chaotic, the anxiety dropped a notch. Not completely. But I noticed after about six weeks that I was no longer checking my calendar at night before going to sleep. It is a small detail, but it meant something had shifted.
The background anxiety, the one that possibly exists independently of the ADHD, stayed. For that, CBT helps me. Not psychoanalysis, not guided meditations from YouTube. CBT with a therapist who understands ADHD and does not tell me to "breathe deeply" when I am in the middle of startup paralysis.
My psychiatrist also explained that some ADHD medications (stimulants, like Ritalin) can temporarily increase anxiety in people who have both. It is a delicate adjustment. It requires regular follow-up and a doctor who is comfortable with comorbidity. Not all are. That is a reality you should know about so you do not get discouraged if the first try is not the right one.
What have I learned to do?
These are not tips. This is what I, personally, have found helps me live with a brain that is both ADHD and anxious. It might not work for you. It works for me, most of the time.
Naming what comes from where. When I feel the restlessness rising, I ask myself: "Is this the ADHD or the anxiety?" If it is ADHD (I am bored, my brain is looking for stimulation), I change activities or add movement. If it is anxiety (I am anticipating failure, I am ruminating), I stop and write down what is bothering me. Just sorting it out reduces the intensity.
Radical externalization. Everything that is in my head needs to come out of my head. Tasks go in Notion. Worries go in a notebook. Appointments go in the calendar. My brain is not reliable for storage. And what it stores badly, it turns into anxiety. Externalizing is clearing the RAM to reduce the noise.
Physical movement. Exercise is the only thing I have found that calms both ADHD and anxiety simultaneously. Not yoga (my brain checks out after two minutes). Fast walking. Running. Cycling. Something that requires enough physical effort to occupy the brain and reduce the energy overflow.
Accepting the bad days. There are days when both hit at the same time. The ADHD preventing you from starting and the anxiety panicking because you are not starting. The knotted stomach and the empty brain. On those days, I have learned (well, I am trying to learn) that fighting is pointless. I lower expectations to the bare minimum. One thing in the day. If I do it, that is enough. If I do not, tomorrow exists.