ADHD and Anxiety in Children: Managing Both
If your child has ADHD and you've noticed they also struggle with worry, fear, or what seems like constant stress, you're not imagining things. The reality is that ADHD and anxiety often go hand in hand, affecting up to 50% of children with ADHD. And honestly, it makes perfect sense when you understand how these two conditions interact and feed off each other.
As a parent, watching your child navigate both ADHD and anxiety can feel overwhelming. You might be wondering: Is this just part of ADHD, or is it something separate? How do I help them when they're both hyperactive and worried? What strategies work when your child's brain is dealing with multiple challenges at once?
Here's what I want you to know: you can absolutely help your child manage both conditions effectively. It takes understanding, patience, and the right strategies, but children with ADHD and anxiety can thrive when they get the support they need.
Why ADHD and Anxiety Often Occur Together
Understanding the connection between ADHD and anxiety helps you respond to your child with more compassion and better strategies.
The Neurological Connection
Both ADHD and anxiety involve similar brain regions and neurotransmitter systems. The areas responsible for executive functioning, emotional regulation, and attention are affected in both conditions, which is why they often co-occur.
The Daily Stress Cycle
Think about what daily life is like for a child with ADHD:
They struggle to focus and complete tasks
They face criticism or correction frequently
They have difficulty managing their emotions
They may feel different from their peers
This chronic stress can naturally lead to anxiety. When your child consistently feels like they're failing or disappointing others, worry and fear start to creep in.
Anxiety Can Worsen ADHD Symptoms
Here's where it gets tricky: anxiety can actually make ADHD symptoms worse. When your child is anxious, their ability to focus decreases even more. They become more distractible, more impulsive, and have an even harder time with emotional regulation. According to an article, up to 50% of children with ADHD also experience anxiety, which can create a cycle where each condition worsens the other. This overlap stems from shared brain regions that affect attention, emotional regulation, and executive functioning, while daily struggles like criticism at school or difficulty managing tasks fuel chronic stress that develops into anxiety. The encouraging news is that evidence-based approaches such as structured routines, cognitive-behavioral therapy, and physical activity can ease both conditions, helping children build resilience and thrive.
ADHD Can Increase Anxiety
The flip side is also true. ADHD symptoms can fuel anxiety:
Forgetting homework creates worry about getting in trouble
Difficulty sitting still in class leads to anxiety about being "in trouble" again
Challenges with social situations create fear around friendships
Impulsive decisions lead to regret and worry about consequences
Recognizing Anxiety in Children with ADHD
Anxiety in children with ADHD doesn't always look like what you might expect. Sometimes it's obvious, but often it's hidden or mistaken for ADHD symptoms.
Obvious Signs of Anxiety
Excessive worry about school, friends, or family
Physical complaints like stomachaches or headaches with no medical cause
Avoidance of certain activities, places, or situations
Sleep problems - difficulty falling asleep due to racing thoughts
Panic attacks or intense fear episodes
Hidden Anxiety Symptoms
Sometimes anxiety in ADHD children shows up as:
Increased hyperactivity or restlessness when worried
More frequent meltdowns in situations that feel overwhelming
Perfectionism or refusal to try new things
Increased impulsivity as a way to escape anxious feelings
Opposition or defiance when faced with anxiety-provoking situations
The "Masking" Effect
Many children with ADHD become experts at hiding their anxiety, especially at school. They might appear fine during the day, but fall apart at home, where they feel safe to show their real emotions.
Common Anxiety Triggers for Children with ADHD
Understanding what specifically triggers your child's anxiety helps you provide better support and develop coping strategies.
School-Related Anxiety
Academic performance - worry about grades, tests, or completing assignments
Social situations - fear of being rejected or not fitting in
Teacher interactions - anxiety about getting in trouble or disappointing adults
Transitions - worry about schedule changes or new routines
Home and Family Triggers
Time pressure - anxiety about being late or not finishing tasks on time
Decision making - feeling overwhelmed by too many choices
Family conflict - heightened sensitivity to tension or arguments
Changes in routine - worry about disruptions to familiar patterns
Internal Triggers
Self-criticism - harsh internal dialogue about mistakes or failures
Physical sensations - mistaking ADHD symptoms (like restlessness) for anxiety
Racing thoughts - difficulty turning off the mental chatter
Fear of losing control - worry about emotional outbursts or impulsive behavior
Strategies That Work for Both ADHD and Anxiety
The good news is that many strategies can help address both conditions simultaneously.
Create Predictable Structure
Children with ADHD and anxiety thrive with predictable routines that reduce both hyperactivity and worry:
Visual schedules that show what's coming next
Consistent daily routines for morning, after school, and bedtime
Clear expectations about rules and consequences
Advance notice about changes or new situations
Teach Emotional Regulation Skills
Both conditions affect emotional regulation, so teaching these skills is crucial:
Deep breathing techniques - simple strategies they can use anywhere
Progressive muscle relaxation - helps with both hyperactivity and anxiety
Mindfulness activities - age-appropriate ways to stay present
Emotional labeling - helping them identify and name their feelings
Build in Movement and Sensory Breaks
Physical activity helps both ADHD and anxiety symptoms:
Regular exercise to burn energy and reduce stress hormones
Sensory breaks throughout the day - jumping jacks, stretching, fidget tools
Outdoor time whenever possible - nature has calming effects
Dance or music as emotional outlets
Develop Problem-Solving Skills
Help your child feel more in control by teaching them to:
Break big problems into smaller steps
Brainstorm solutions together rather than feeling stuck
Practice "what if" scenarios to reduce anxiety about unknowns
Celebrate problem-solving attempts, even if the solution doesn't work perfectly
Supporting Your Child Through Anxious Moments
When your child is having an anxious moment, your response can make all the difference.
Stay Calm Yourself
Your child will pick up on your energy. Take a deep breath and speak slowly and calmly, even if you're feeling frustrated or worried.
Validate Their Feelings
Instead of saying "Don't worry" or "You're fine," try:
"I can see you're feeling really worried about this."
"That sounds scary. Tell me more about what you're thinking."
"It makes sense that you'd feel anxious about that."
Help Them Through It
Guide them through calming techniques you've practiced when they weren't upset
Stay with them until the intensity passes
Problem-solve together once they're calmer
Remind them of past successes in handling difficult situations
Avoid Common Mistakes
Don't dismiss their fears even if they seem irrational to you
Don't rush them through the anxiety - give them time to work through it
Don't make promises you can't keep just to reduce their worry
Don't punish anxious behavior - they can't help feeling anxious
School Collaboration Strategies
Working with your child's school is essential when they have both ADHD and anxiety.
Share Information
Communicate with teachers about how anxiety shows up for your child:
Does anxiety look like increased hyperactivity?
Do they shut down when overwhelmed?
What calming strategies work at home?
Are there specific triggers to be aware of?
Request Appropriate Accommodations
Consider accommodations that address both conditions:
Extended time on tests to reduce time pressure anxiety
Breaks during long tasks to manage both attention and worry
Alternative testing locations if your child gets anxious in groups
Movement breaks built into the day
Regular Check-Ins
Ask teachers to let you know how things are going rather than waiting for problems to escalate. Early intervention prevents both ADHD and anxiety from spiraling.
When Professional Help is Needed
Sometimes parental support and school accommodations aren't enough, and that's completely normal.
Consider Professional Help If:
Anxiety is interfering with school, friendships, or family life
Your child expresses hopelessness or talks about not wanting to be alive
Panic attacks are frequent or severe
Avoidance behaviors are increasing over time
Your family is feeling overwhelmed and needs additional support
Types of Professional Support
Therapy - Cognitive Behavioral Therapy (CBT) is particularly effective for anxiety in children with ADHD
Medication evaluation - Sometimes medication can help with both conditions
Family therapy - Helps the whole family develop better coping strategies
Support groups - Connecting with other families facing similar challenges
Medication Considerations
Managing both ADHD and anxiety with medication can be complex and requires careful professional guidance.
The Balancing Act
Some ADHD medications can increase anxiety in certain children
Anti-anxiety medications might affect attention or motivation
Finding the right combination often takes time and patience
Regular monitoring is essential to adjust as your child grows
Working with Your Healthcare Provider
Be honest about all symptoms - both ADHD and anxiety related
Keep detailed notes about medication effects on behavior, mood, and anxiety
Ask questions about side effects and interactions
Don't make medication changes without professional guidance
Building Long-Term Resilience
Your goal isn't to eliminate all anxiety or completely manage ADHD symptoms. It's to help your child develop the skills they need to handle life's challenges.
Foster Self-Advocacy Skills
Teach your child to:
Recognize their own warning signs of anxiety or ADHD struggles
Ask for help when they need it
Communicate their needs to teachers and other adults
Use their coping strategies independently
Build on Strengths
Children with ADHD and anxiety often have remarkable strengths:
Creativity and out-of-the-box thinking
Empathy and sensitivity to others' feelings
High energy when channeled appropriately
Attention to detail when interested in something
Focus on and celebrate these strengths while supporting them through challenges.
Normalize the Journey
Help your child understand that:
Many successful people have ADHD, anxiety, or both
Having challenges doesn't define them - they are so much more than their diagnoses
Learning to manage symptoms is a skill that gets easier with practice
It's okay to have hard days - everyone does
Self-Care for Parents
Managing your own stress is crucial when parenting a child with ADHD and anxiety.
Recognize Your Own Triggers
Are you anxious about your child's anxiety?
Do you feel guilty about their struggles?
Are you overwhelmed by all the strategies and interventions?
Build Your Support Network
Connect with other parents who understand the challenges
Take breaks when you can - even 15 minutes helps
Consider therapy for yourself if you're feeling overwhelmed
Practice self-compassion - you're doing your best in a difficult situation
Creating a Family Culture of Understanding
The whole family benefits when you create an environment that normalizes mental health challenges.
Open Communication
Talk openly about ADHD and anxiety in age-appropriate ways
Share your own struggles when appropriate - it helps them feel less alone
Celebrate small victories as a family
Problem-solve together rather than trying to fix everything yourself
Sibling Considerations
Help siblings understand what their brother or sister is going through
Make sure other children get attention and support too
Teach empathy without making siblings feel responsible for managing their siblings' conditions
Your Path Forward
Remember, there is hope. Children with ADHD and anxiety can and do succeed in school, friendships, and life. It takes the right support, understanding, and strategies, but your child has everything they need to thrive.
Start where you are today. Pick one area to focus on first - maybe it's establishing a calming bedtime routine or working with your child's teacher to identify anxiety triggers. You don't have to address everything at once.
Trust yourself as your child's advocate. You know them better than anyone, and your instincts about what they need are valuable. When you combine that parental knowledge with professional guidance and evidence-based strategies, you're giving your child the best possible foundation for success.
Your child's journey with ADHD and anxiety will have ups and downs, and that's completely normal. Celebrate the progress, learn from the setbacks, and remember that every day is a new opportunity to support your remarkable child.
You've got this, one day at a time.
