At RMPS, many parents and adults come to us with a similar concern:
“I’ve tried anxiety therapy, coping tools, even medication… so why do I still feel overwhelmed all the time?”
For some, anxiety truly is the primary issue. But for many others, anxiety is not the whole story, it’s a signal. Beneath the constant worry, racing thoughts, and emotional exhaustion, there is often an underlying neurodevelopmental driver that has gone unrecognized: ADHD.
This blog is written for parents who are trying to understand their child’s ongoing anxiety, and for adults who have spent years feeling chronically stressed, scattered, or on edge despite doing “all the right things.” We believe that recognizing how ADHD fuels anxiety is often the missing piece that finally allows treatment to work.
Understanding the ADHD–Anxiety Connection
ADHD is commonly misunderstood as a condition of distraction or hyperactivity. In reality, it is a disorder of self-regulation, affecting attention, emotional control, executive functioning, and stress management. These challenges don’t occur in isolation, they interact constantly with the world’s demands.
Research shows that anxiety disorders co-occur in up to 50% of individuals with ADHD, across both children and adults (Kessler et al., 2006). However, what we see clinically at RMPS is that anxiety is often secondary, a response to living in a brain that struggles to keep up with expectations.
Research and clinical guidance from the Canadian Psychological Association emphasize that ADHD frequently co-occurs with anxiety and other emotional difficulties and should be understood within a broader developmental and psychosocial context (CPA, 2019).
In other words, anxiety often develops because of ADHD, not alongside it by coincidence.
How ADHD Creates the Conditions for Chronic Anxiety
Executive Dysfunction and Constant Mental Load
Executive functioning skills help us plan, prioritize, start tasks, manage time, and regulate effort. When ADHD disrupts these skills, everyday life requires significantly more cognitive energy than it does for others.
For children, this often shows up as forgetting homework or instructions, struggling to organize materials, and falling behind academically despite genuine effort. Adults may experience similar challenges in different forms; missing deadlines, feeling overwhelmed by tasks that seem simple to others, and living in a constant state of catching up. Over time, this ongoing strain can contribute to chronic stress and anxiety, even when motivation and ability are not the issue.
Over time, this creates a state of anticipatory anxiety; a persistent worry about forgetting, failing, or falling short. Research supports that executive dysfunction is strongly associated with internalizing symptoms like anxiety, particularly in individuals with ADHD (Barkley, 2015).
At RMPS, many clients describe anxiety not as fear, but as mental exhaustion from holding everything together.
Emotional Dysregulation and Heightened Stress Responses
ADHD affects emotional regulation, making reactions more intense and recovery slower. Small stressors can feel enormous, and frustration can quickly turn into panic or shutdown.
Neurobiological studies suggest that individuals with ADHD have differences in brain networks responsible for emotion regulation and stress response (Shaw et al., 2014). This means anxiety may appear “disproportionate” from the outside, even though it feels completely justified internally.
When emotional regulation challenges are mistaken for anxiety alone, treatment often focuses on calming strategies, without addressing why emotions escalate so quickly in the first place.
Why Anxiety Treatment Alone Often Doesn’t Work
Parents and adults often tell us:
- “CBT helped a bit, but the anxiety keeps coming back.”
- “I understand my anxious thoughts, but I still feel overwhelmed.”
- “My child knows the coping skills but melts down anyway.”
This makes sense when ADHD is unrecognized. Traditional anxiety treatment assumes that worry is driven primarily by cognitive distortions or fear-based thinking. But ADHD-related anxiety is often driven by environmental overload, poor task initiation, and emotional fatigue.
Research indicates that treating anxiety without addressing ADHD leads to poorer outcomes, especially in children (Jarrett & Ollendick, 2008). At RMPS, we emphasize that therapy must match the brain it’s supporting.
ADHD-Driven Anxiety in Children
“They’re Always Anxious About School”
Children with ADHD frequently develop anxiety around school due to repeated experiences of:
- Being corrected or reprimanded
- Falling behind despite effort
- Feeling different from peers
Over time, school becomes a place of threat rather than learning. Anxiety may show up as:
- School refusal
- Somatic complaints (headaches, stomachaches)
- Perfectionism or avoidance
Importantly, anxiety is not irrational but it is learned through experience. Research shows that academic stress and negative feedback significantly increase anxiety symptoms in children with ADHD (Langberg et al., 2011).
At RMPS, supporting these children means addressing both skill gaps and emotional safety, not simply teaching relaxation techniques.
ADHD-Driven Anxiety in Adults
The Invisible Struggle
Adults with ADHD are often described as “high functioning,” particularly when they are intelligent, driven, or creative. On the surface, they may appear successful or capable, but behind the scenes many live with persistent, exhausting anxiety tied to everyday challenges such as forgetting important tasks, struggling with consistency, and feeling chronically behind no matter how hard they try.
Because so much effort goes into compensating, this anxiety is often invisible to others. Many adults with ADHD develop elaborate systems, overwork themselves, or rely on constant self-pressure to keep things from falling apart. Over time, this can lead to burnout and a deep sense of self-doubt.
Large-scale studies show that adults with ADHD have significantly higher rates of generalized anxiety disorder than the general population (Kessler et al., 2006). Yet many reach adulthood without diagnosis, internalizing the belief that they are lazy, disorganized, or simply not trying hard enough.
At RMPS, adult clients often express both grief and relief when ADHD is finally identified:
“I thought my anxiety meant something was wrong with me. I didn’t realize I was overwhelmed because my brain works differently.”
That shift in understanding is often the first step toward meaningful and lasting change.
The Role of ADHD Assessment
A comprehensive ADHD assessment looks beyond surface symptoms. At RMPS, assessment includes:
- Developmental and academic history
- Executive functioning patterns
- Emotional regulation and stress response
- Co-occurring anxiety or mood symptoms
This depth matters. Research shows that accurate diagnosis significantly improves treatment outcomes, especially when ADHD and anxiety coexist (Pliszka, 2019).
Assessment helps answer the critical question:
Is anxiety the cause or the consequence?
Integrated Treatment: What Actually Helps
When ADHD is properly identified, treatment begins to shift in important and practical ways. Anxiety is no longer viewed as a standalone problem to be managed in isolation, but as part of a broader neurodevelopmental picture that shapes how a person thinks, feels, and copes with daily demands.
Effective treatment tends to be integrated, addressing both the emotional experience of anxiety and the underlying ADHD-related challenges that fuel overwhelm. This often includes ADHD-informed therapy that takes executive functioning limits into account, rather than relying solely on insight-based or cognitively demanding strategies. Therapy becomes more concrete, flexible, and aligned with how the brain actually works.
For children and teens, parent coaching plays a key role. The focus shifts away from increasing pressure or expectations and toward reducing overwhelm, adjusting demands, and building skills in a developmentally appropriate way. Environmental and academic accommodations are also essential, helping to lower unnecessary stress and create conditions where regulation and learning are more possible.
Across ages, skill-building for organization, planning, emotional regulation, and task initiation helps reduce the daily chaos that often drives anxiety. As these supports are put in place, many individuals notice that anxiety begins to soften, not because stress disappears, but because it becomes more manageable.
Research supports that combined treatment, addressing both ADHD and anxiety, leads to better long-term functioning than anxiety-focused treatment alone (MTA Cooperative Group, 2009).
Reframing Anxiety Through an RMPS Lens
At RMPS, we often help families and adults reframe anxiety not as a personal weakness, but as adaptation. Chronic worry is frequently a sign of a nervous system that has been working overtime, compensating for unmet neurodevelopmental needs, constant self-monitoring, and repeated experiences of falling behind or feeling misunderstood.
- When ADHD is acknowledged and properly understood, the emotional narrative often begins to shift.
- Children feel less “bad” or “broken” and more accurately seen for how their brains work.
- Parents move away from discipline rooted in frustration and toward support that reduces overwhelm and builds skills.
- Adults begin to rebuild self-trust, recognizing that many of their struggles were not due to lack of effort, but to unrecognized challenges with regulation and executive functioning.
This reframing alone can significantly reduce emotional distress, creating space for more effective support, healthier expectations, and long-term emotional relief.
When to Consider an ADHD Assessment
You might consider an ADHD assessment if anxiety treatment hasn’t fully helped, even when insight, coping strategies, or therapy have been in place. When worry improves only slightly or keeps returning, it may be a sign that anxiety is being driven by ongoing executive functioning challenges rather than fear alone.
An assessment can also be helpful when overwhelm persists despite effort. Many children and adults with ADHD are trying hard to stay organized, regulated, and on top of responsibilities, yet still feel mentally exhausted or constantly behind.
Another key indicator is when symptoms have been present since childhood, even if they were subtle or misunderstood at the time. Lifelong patterns of disorganization, emotional reactivity, or difficulty sustaining attention often point to neurodevelopmental roots rather than situational stress.
Finally, a family history of ADHD matters. ADHD is highly heritable, and it is common for one person’s assessment to raise important questions across generations.
Research consistently shows that untreated ADHD increases the risk of anxiety, depression, and burnout across the lifespan (Barkley, 2015). Early identification, or even later clarity, can significantly change the direction of treatment and long-term well-being.
Final Thoughts: Treat the Source, Not Just the Symptoms
Anxiety is real, painful, and deserving of care. But when ADHD is driving chronic overwhelm, anxiety-focused treatment alone often leaves people feeling stuck and discouraged.
At RMPS, we believe understanding comes first. When ADHD is recognized and supported, anxiety often softens, not because life becomes easy, but because it becomes manageable.
If you or your child have been living with persistent anxiety that never quite makes sense, an ADHD assessment may provide the clarity that years of coping strategies could not.
References
Barkley, R. A. (2015). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment (4th ed.). Guilford Press.
Canadian Psychological Association. (2019). Attention-deficit/hyperactivity disorder (ADHD) across the lifespan. https://cpa.ca
Jarrett, M. A., & Ollendick, T. H. (2008). A conceptual review of the comorbidity of attention-deficit/hyperactivity disorder and anxiety. Journal of Clinical Child & Adolescent Psychology, 37(2), 405–421.
Kessler, R. C., Adler, L., Barkley, R., et al. (2006). The prevalence and correlates of adult ADHD in the United States. American Journal of Psychiatry, 163(4), 716–723.
Langberg, J. M., Epstein, J. N., Altaye, M., Molina, B. S. G., Arnold, L. E., & Vitiello, B. (2011). The transition to middle school is associated with changes in the developmental trajectory of ADHD symptomatology. Journal of Clinical Child & Adolescent Psychology, 40(3), 356–367.
MTA Cooperative Group. (2009). A 14-month randomized clinical trial of treatment strategies for ADHD. Archives of General Psychiatry, 56(12), 1073–1086.
Pliszka, S. R. (2019). ADHD and anxiety: Clinical implications. Journal of Attention Disorders, 23(3), 203–205.
